Medical information processing device, radiation treatment system, medical information processing method, and program

Abstract

To suppress excessive exposure.SOLUTION: A medical information processing device includes an acquisition unit, a setting unit, an estimation unit, and a comparison unit. The acquisition unit acquires a radiation image to be used for a radiation treatment of a patient. The setting unit sets a plurality of scan conditions when imaging the patient prior to the radiation treatment on the basis of the radiation image. The estimation unit estimates effects of the radiation treatments on the basis of the radiation images captured on the plurality of scan conditions respectively. The comparison unit compares the effects of the plurality of radiation treatments.SELECTED DRAWING: Figure 4

Description

[Technical Field]

[0001] The embodiments disclosed in the present specification and drawings relate to a medical information processing device, a radiation therapy system, a medical information processing method, and a program. [Background technology]

[0002] In radiation therapy, treatment plans are sometimes created based on images taken before treatment of the area around the patient's irradiation area using an MRI device, etc. There is also technology that combines an MRI device with a radiation therapy device, allowing treatment to be performed while continuing to take images with the MRI device during radiation therapy, allowing real-time observation of the tumor area and normal tissue areas, including organs at risk (OAR).

[0003] Furthermore, there is a technology in which an X-ray CT scanner is installed alongside a radiation therapy device instead of an MRI scanner, and images of the tumor and normal tissue are taken with the X-ray CT scanner before treatment with the radiation therapy device is performed. With this technology, there is a problem that if excessive imaging is performed with the X-ray CT scanner, the patient's radiation exposure will increase. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Japanese Patent Publication No. 2020-127723 Summary of the Invention [Problem to be solved by the invention]

[0005] The problem to be solved by the embodiments disclosed in this specification and the drawings is to suppress excessive radiation exposure. However, the problem to be solved by the embodiments disclosed in this specification and the drawings is not limited to the above problem. Problems corresponding to the effects of each configuration shown in the embodiments described below can also be positioned as other problems. [Means for solving the problem]

[0006] A medical image processing device according to an embodiment includes an acquisition unit, a setting unit, an estimation unit, and a comparison unit. The acquisition unit acquires radiographic images to be used in radiotherapy of a patient. The setting unit sets, based on the radiographic images, a plurality of scan conditions for imaging the patient prior to the radiotherapy. The estimation unit estimates the effects of the radiotherapy based on the radiographic images captured under the plurality of scan conditions. The comparison unit compares the effects of the plurality of radiotherapy treatments. [Brief explanation of the drawings]

[0007] [Figure 1] 1 is a diagram showing an example of the configuration of a radiation therapy system 1 according to a first embodiment. [Figure 2] FIG. 1 is a diagram showing an installation environment of a medical imaging apparatus 10. [Figure 3] FIG. 2 is a diagram showing an environment in which a radiotherapy device 20 is installed. [Figure 4] FIG. 1 is a diagram showing an example of the configuration of a medical information processing apparatus 100. [Figure 5] 10A and 10B are diagrams showing examples of a planning image and a pseudo image. [Figure 6] 10A and 10B are diagrams showing planning DVHs and pseudo DVHs corresponding to planning images and pseudo images. [Figure 7] 4 is a flowchart showing an example of processing by the medical information processing apparatus 100. [Figure 8] 4 is a flowchart showing an example of processing by the medical information processing apparatus 100. [Figure 9] FIG. 2 is a diagram showing an example of the configuration of a radiation therapy system 2 according to a second embodiment. [Figure 10] FIG. 2 is a diagram showing the installation environment of a CT room device 30. DETAILED DESCRIPTION OF THE INVENTION

[0008] Hereinafter, a medical information processing apparatus, a radiotherapy system, a medical information processing method, and a program according to embodiments will be described with reference to the drawings.

[0009] (First embodiment) 1 is a diagram showing an example of the configuration of a radiation therapy system 1 according to the first embodiment. The radiation therapy system 1 includes, for example, a medical imaging device 10, a radiation therapy device 20, and a medical information processing device 100. The medical imaging device 10, the radiation therapy device 20, and the medical information processing device 100 are connected to each other via a network so as to be able to communicate with each other.

[0010] The radiation therapy system 1 is used for treatment by irradiating therapeutic radiation (hereinafter referred to as radiation) to an affected area (tumor site) of a patient who is the target of radiation therapy. The radiation therapy system 1 performs radiation therapy in two stages: a planning stage and a treatment stage. In the planning stage, an area including the affected area of ​​the patient is imaged (scanned) by the medical imaging device 10, and a radiation therapy plan (hereinafter referred to as treatment plan) is created in the medical information processing device 100 based on the image thus captured.

[0011] The treatment plan includes, for example, the dose (dose volume), irradiation area, and irradiation direction of radiation to be irradiated to the patient. In the treatment phase, radiation is irradiated based on the created treatment plan. In the treatment phase, before radiation is irradiated, the patient (affected area) is positioned relative to the radiation therapy device 20. The positioning is performed based on, for example, information obtained by detecting the surface shape of the patient and the position of the affected area using the measurement results of a surface shape measurement device and a reference image. The reference image is, for example, a CT image captured of the patient in the treatment phase. The imaging area of ​​the reference image is set, for example, in the planning phase. The CT image may be captured by the medical imaging device 10 that captured the patient in the planning phase, or the reference image may be captured by an imaging device of the medical imaging device 10.

[0012] The medical imaging device 10 captures an image of a region including a tumor site of a patient to be radiotherapy treated, and generates a radiological medical image (hereinafter referred to as a planning image) to be used for treatment planning. The planning image may be a two-dimensional image composed of pixels arranged two-dimensionally, or a three-dimensional image composed of voxels arranged three-dimensionally. The planning image may be a 360-degree captured image or a scout captured image. The medical imaging device 10 may be any modality device capable of generating a planning image.

[0013] Examples of modality devices include an X-ray computed tomography (CT) device (hereinafter referred to as an X-ray CT device), a cone beam CT device, and a nuclear medicine diagnostic device (PET: positron emission tomography, SPECT: single photon emission computed tomography). In the following description, the medical imaging device 10 is assumed to be an X-ray CT device. The medical imaging device 10 captures an X-ray CT image. The medical imaging device 10 transmits the captured X-ray CT image to the medical information processing device 100 as a planning image.

[0014] 2 is a diagram showing the installation environment of the medical imaging device 10. The medical imaging device 10 is installed, for example, in a planning CT room. The medical imaging device 10 has an imaging gantry 11 and an imaging bed 12. The medical imaging device 10 has a console installed in an operation room adjacent to the planning CT room.

[0015] The imaging gantry 11 has an opening 13 through which a patient is inserted. An X-ray tube, an X-ray detector, and a support mechanism for supporting these rotatably around a rotation axis Z1 are mounted inside the imaging gantry 11. The imaging bed 12 includes an imaging top plate 14 on which the patient rests, and a base 15 for movably supporting the imaging top plate 14. The imaging top plate 14 has a flat shape.

[0016] During imaging, the imaging gantry 11 rotates the X-ray tube and the X-ray detector at high speed, irradiating X-rays with the X-ray tube and detecting X-rays with the X-ray detector, thereby collecting raw data indicating the attenuation of X-rays by the patient with the X-ray detector. The raw data is transmitted to a console. The console reconstructs two-dimensional or three-dimensional CT image data based on the raw data. The console may generate, as CT image data, image data indicating the spatial distribution of CT values ​​according to the X-ray attenuation coefficient, or may calculate the X-ray attenuation coefficient from the CT value and use the X-ray attenuation coefficient Alternatively, image data showing the spatial distribution of the CT image data may be generated. The CT image data is transmitted to the medical information processing apparatus 100 or an external device such as a picture archiving and communication system (PACS).

[0017] 3 is a diagram showing the installation environment of the radiation therapy device 20. The radiation therapy device 20 is installed in, for example, a treatment room. The radiation therapy device 20 treats a patient by irradiating the patient with radiation in accordance with a treatment plan created by the medical information processing device 100. The radiation therapy device 20 includes a treatment gantry 21 and a treatment bed 22. The radiation therapy device 20 also includes a console installed in an operation room adjacent to the treatment room.

[0018] The treatment gantry 21 includes a gantry main body 23 and an irradiation head unit 24. The gantry main body 23 is installed, for example, on a wall surface of a treatment room. The gantry main body 23 supports the irradiation head unit 24 so that the irradiation head unit 24 is rotatable around a rotation axis Z2. The irradiation head unit 24 forms an irradiation range of radiation using, for example, a multi-leaf collimator. The irradiation head unit 24 is an example of a radiation irradiation device.

[0019] The treatment couch 22 includes a treatment top 25 on which a patient rests, and a base 26 that movably supports the treatment top 25. The treatment top 25 has a planar shape, similar to the imaging top 14. The treatment top 25 is movable forward and backward relative to the treatment gantry 21. The treatment couch 22 moves the treatment top 25 so that the treatment site (tumor site) of the patient substantially coincides with the isocenter. After moving the treatment top 25, the radiation therapy device 20 irradiates the tumor site with radiation using the irradiation head unit 24.

[0020] The medical information processing device 100 creates a treatment plan using medical images generated by the medical imaging device 10. The medical information processing device 100 provides the created treatment plan to the radiation therapy device 20. The medical information processing device 100 may store the created treatment plan in a storage device (such as a server) on a network. In this case, the radiation therapy device 20 receives the treatment plan created by the medical information processing device 100 from the storage device.

[0021] 4 is a diagram showing an example of the configuration of the medical information processing device 100. The medical information processing device 100 includes, for example, a communication interface 110, an input interface 120, a display 130, a processing circuit 140, and a memory 150. The communication interface 110 communicates with external devices such as the medical imaging device 10 and the radiation therapy device 20 via a network NW such as a LAN (Local Area Network). The communication interface 110 includes, for example, a communication interface such as a NIC (Network Interface Card).

[0022] The input interface 120 accepts various input operations from a user such as a doctor, converts the accepted input operations into electrical signals, and outputs the electrical signals to the processing circuitry 140. For example, when an input operation is performed by a user, the input interface 120 generates information corresponding to the input operation. The input interface 120 outputs the generated information corresponding to the input operation to the processing circuitry 140.

[0023] The input interface 120 includes, for example, a mouse, a keyboard, a trackball, a switch, a button, a joystick, a touch panel, etc. The input interface 120 may be, for example, a user interface that accepts audio input from a microphone, etc. The input interface 120 may also have a display function as the display 130, such as a touch panel, for example.

[0024] In this specification, the input interface is not limited to an interface having physical operation parts such as a mouse, keyboard, etc. For example, an example of an input interface also includes an electrical signal processing circuit that receives an electrical signal corresponding to an input operation from an external input device provided separately from the device and outputs this electrical signal to a control circuit.

[0025] The display 130 is a display unit that displays various types of information. For example, the display 130 displays images generated by the processing circuit 140, a GUI (Graphical User Interface) for receiving various input operations from the user, etc. For example, the display 130 is an LCD (Liquid Crystal Display), a CRT (Cathode Ray Tube) display, an organic EL (Electro Luminescence) display, etc.

[0026] The processing circuitry 140 includes, for example, an acquisition function 141, a creation function 142, a setting function 143, an estimation function 144, a comparison function 145, a determination function 146, and a judgment function 147. The processing circuitry 140 realizes these functions by, for example, a hardware processor (computer) executing a program stored in a memory (storage circuitry) 150.

[0027] The hardware processor refers to a circuit such as a central processing unit (CPU), a graphics processing unit (GPU), an application specific integrated circuit (ASIC), a programmable logic device (e.g., a simple programmable logic device (SPLD) or a complex programmable logic device (CPLD)), or a field programmable gate array (FPGA).

[0028] Instead of storing the program in the memory 150, the program may be directly embedded in the circuit of the hardware processor. In this case, the hardware processor realizes its functions by reading and executing the program embedded in the circuit. The program may be stored in the memory 150 in advance, or may be stored in a non-transitory storage medium such as a DVD or CD-ROM, and installed into the memory 150 from the non-transitory storage medium by inserting the non-transitory storage medium into a drive device (not shown) of the medical information processing device 100.

[0029] The hardware processor is not limited to being configured as a single circuit, but may be configured as a single hardware processor by combining multiple independent circuits to realize each function, or multiple components may be integrated into a single hardware processor to realize each function.

[0030] The memory 150 is realized by, for example, a semiconductor memory element such as RAM or flash memory, a hard disk, or an optical disk. These non-transitory storage media may also be realized by other storage devices connected via a communication network, such as a network-attached storage (NAS) or an external storage server device. The memory 150 may also include other non-transitory storage media, such as a read-only memory (ROM) or a register.

[0031] The acquisition function 141 acquires radiation images to be used in radiation therapy of a patient. The acquisition function 141 acquires, for example, planning images captured and transmitted by the medical imaging device 10. The acquisition function 141 may acquire, as planning images, X-ray CT images transmitted by the medical imaging device 10 and stored in a PACS or the like. The acquisition function 141 is an example of an acquisition unit.

[0032] The creation function 142 acquires reference information representing the lethal dose of the tumor site and the tolerable dose of radiation to be irradiated to normal tissue sites. Based on the acquired reference information, the creation function 142 creates a treatment plan including an irradiation plan for radiation to be irradiated to the tumor site and normal tissue sites.

[0033] The creation function 142 creates a dose volume distribution (DVH: Dose Volume Histogram, hereinafter referred to as planned DVH) of the imaging range in the planning image when radiation is irradiated to the tumor site and normal tissue site according to the created irradiation plan. The creation function 142 creates a DVH for each of multiple imaging ranges set to different ranges by the setting function 143. The creation function 142 is an example of a creation unit.

[0034] The setting function 143 sets a plurality of scan conditions for imaging a patient before radiation therapy based on the radiation image. For example, the setting function 143 sets a plurality of imaging ranges as a plurality of scan conditions for imaging a reference image based on the planning image acquired by the acquisition function 141. For example, when setting the plurality of imaging ranges, the setting function 143 gradually narrows the imaging range in the craniocaudal direction of the patient. The setting function 143 is an example of a setting unit.

[0035] The estimation function 144 estimates the effect of radiation therapy based on radiation images captured under multiple scan conditions. The estimation function 144 generates multiple images (hereinafter referred to as pseudo images) that are estimated to be planning images captured under the imaging range set by the setting function 143, for example, a predetermined number of images. The predetermined number may be any number.

[0036] The estimation function 144 processes the planned image according to the imaging range set by the setting function 143, for example, and when the imaging range becomes narrower, it processes the planned image to be smaller accordingly to generate a pseudo image. The estimation function 144 narrows the imaging range in the craniocaudal direction of the patient, for example. The estimation function 144 creates DVHs (hereinafter referred to as pseudo DVHs) for each of the multiple pseudo images.

[0037] FIG. 5 shows an example of a planning image and a pseudo image. The left diagram of FIG. 5 shows a planning image GA11, and the right diagram shows a pseudo image GA21. The planning image GA11 is an image that uses an X-ray image captured by the medical imaging device 10 as is. The pseudo image GA21 is an image that has been reduced in size by deleting the head side and tail side of the planning image GA11. The estimation function 144 generates a new pseudo image by gradually deleting parts of the head side and tail side of the planning image GA11 or the pseudo image GA21.

[0038] 6 shows the planned DVH and pseudo DVH corresponding to the planned image and pseudo image. For example, the planned DVH is generated based on the planned image GA11, and the first pseudo DVH is generated based on the first pseudo image GA21. Furthermore, since the second pseudo image GA22 does not include the organs at risk, no DVH is generated.

[0039] The estimation function 144 estimates the effect of radiation therapy for each of the created pseudo DVHs. For example, the estimation function 144 estimates the dose volume of radiation irradiated to a tumor site as the effect of radiation therapy. The estimation function 144 may estimate the effect of treatment including the dose volume of radiation irradiated to normal tissue sites, particularly risk organs. The estimation function 144 may obtain a dose constraint result and use the dose constraint result as the effect of radiation therapy. The estimation function 144 is an example of an estimation unit.

[0040] The comparison function 145 compares the effects of multiple radiation therapies with each other. For example, the comparison function 145 compares the dose volume of radiation irradiated to a tumor site, a normal tissue site, and particularly to an organ at risk, as the effect for each imaging range estimated by the estimation function 144. The comparison function 145 is an example of a comparison unit.

[0041] Based on the comparison result of the effects of radiation therapy, the determination function 146 determines the immediately preceding scan conditions when the patient is scanned by the medical imaging device 10 during the treatment stage. Based on, for example, the comparison result by the comparison function 145, the determination function 146 determines the imaging range of the reference image used for positioning the patient relative to the radiation therapy device 20. The determination function 146 stores in the memory 150 the imaging range of the determined reference image and a planned DVH created based on the planning image of this imaging range.

[0042] The determination function 147 compares the planned DVH with a DVH (hereinafter referred to as the reference DVH) created based on a reference image whose imaging range has been determined by the determination function 146. The determination function determines whether or not to revise the treatment plan created by the creation function 142 based on the result of comparing the planned DVH with the reference DVH. For example, the determination function 147 determines that the treatment plan should be revised when it is determined that the planned DVH and the reference DVH do not match. The planned DVH is an example of a first effect of radiation therapy, and the reference DVH is an example of a second effect of radiation therapy, and the determination function 147 is an example of a determination unit.

[0043] When the imaging range is gradually narrowed, the radiation dose volume calculated as DVH gradually decreases. Therefore, the determination function 146 may determine, for example, the smallest imaging range in which the dose volume of the tumor site does not fall below a threshold. On the other hand, if the imaging range does not include the risk organ, it becomes impossible to calculate the dose volume for the risk organ and even the DVH. Therefore, the determination function 146 determines the imaging range by excluding the imaging range that does not include the risk organ from the comparison target in the comparison function 145. The determination function 146 is an example of a determination unit.

[0044] In the treatment stage, the creation function 142 creates a reference DVH based on a reference image whose imaging range has been determined by the determination function 146. The comparison function 145 compares the reference DVH created by the creation function 142 with the planned DVH identified by the determination function 146 in the planning stage. Based on the result of the comparison between the reference DVH and the planned DVH by the comparison function 145, the determination function 146 determines whether to revise the treatment plan.

[0045] Next, the processing of the medical information processing device 100 will be described. Below, the processing of the medical information processing device 100 in each of the planning stage and the treatment stage will be described. Figs. 7 and 8 are flowcharts showing an example of the processing of the medical information processing device 100. First, the processing of the medical information processing device 100 in the planning stage will be described. Fig. 7 shows the processing of the medical information processing device 100 in the planning stage.

[0046] The planning stage processing is performed, for example, before radiation therapy, for example, several days before or on the day of radiation therapy. In the planning stage, the medical information processing device 100 first acquires a planning image transmitted by the medical imaging device 10 (step S101). Next, the acquisition function 141 performs image processing on the planning image to extract the contours of the tumor site and the risk organs (step S103), and identifies the tumor site, normal tissue site, and risk organs.

[0047] Next, the creation function 142 creates a DVH based on the planning image acquired by the acquisition function 141 (step S105), and creates a treatment plan based on the created DVH (step S107). Next, the setting function 143 adjusts the imaging range so as to narrow it in the craniocaudal direction of the patient (step S109) and sets it anew.

[0048] Next, the estimation function 144 creates a pseudo image by narrowing the planned image to the imaging range set by the setting function 143 (step S111). Next, the determination function 146 determines whether or not the pseudo image includes the risk organ (step S113). If it is determined that the risk organ is not included in the pseudo image, the determination function 146 proceeds to step S119.

[0049] If the determination function 146 determines that the pseudo image includes the organ at risk, the estimation function 144 creates a pseudo DVH based on the created pseudo image (step S115). Subsequently, the estimation function 144 determines whether a predetermined number of pseudo images and pseudo DVHs have been created (step S117).

[0050] If the estimation function 144 determines that the predetermined number of pseudo images and pseudo DVHs have not been created, the setting function 143 returns the process to step S109, further narrows the imaging range (step S109), and creates pseudo images (step S111). If the estimation function 144 determines that the predetermined number of pseudo images and pseudo DVHs have been created, the comparison function 145 compares the DVH created by the creation function 142 in step S105 with each of the multiple pseudo DVHs created by the estimation function 144 in step S115 (step S119). When comparing the DVH and the pseudo DVH, the comparison function 145 compares, for example, the amount of reduction in the dose volume of the tumor site in the pseudo DVH from the dose volume of the tumor site in the DVH.

[0051] Next, the determination function 146 determines the imaging range of the reference image based on the result of the dose volume comparison by the comparison function 145 (step S121). For example, the determination function 146 determines the imaging range of the pseudo image with the narrowest imaging range among the pseudo images in which the reduction amount of the dose volume of the tumor site is equal to or less than the threshold value as the imaging range of the reference image.

[0052] Next, the determination function 146 specifies the planned DVH based on the determined imaging range. The determination function 146 stores the specified planned DVH together with the imaging range of the reference image in the memory 150 (step S123). In this way, the medical information processing apparatus 100 ends the processing shown in FIG.

[0053] Next, the processing of the medical information processing device 100 in the treatment stage will be described. Fig. 8 shows the processing of the medical information processing device 100 in the treatment stage. The processing in the treatment stage is executed, for example, immediately before radiation therapy, for example, on the day of treatment. In the treatment stage, the medical information processing device 100 first reads out the imaging range of the reference image stored in the memory 150 using the acquisition function 141 and transmits it to the medical imaging device 10 (step S201).

[0054] The medical imaging device 10 captures a reference image of the imaging range transmitted by the medical information processing device 100 and transmits it to the medical information processing device 100. The medical information processing device 100 acquires the transmitted reference image using the acquisition function 141 (step S203). Subsequently, the creation function 142 creates a reference DVH based on the reference image acquired by the acquisition function 141 (step S205).

[0055] Next, the comparison function 145 reads out the planned DVH created in the planning stage and stored in the memory 150, compares the planned DVH with the reference DVH, and determines whether the planned DVH and the reference DVH match (step S207). The comparison function 145 determines that the planned DVH and the reference DVH match, for example, when all of the differences between the planned DVH and the reference DVH for the tumor site, normal tissue site, and organ at risk are equal to or less than a predetermined value. The comparison function 145 may determine whether the planned DVH and the reference DVH match in other ways. The comparison function 145 may determine that the planned DVH and the reference DVH match, for example, when some of the differences between the tumor site, normal tissue site, and organ at risk are equal to or less than a predetermined value.

[0056] If the comparison function 145 determines that the planned DVH and the reference DVH do not match, the decision function 146 decides to revise the treatment plan (step S209). Thereafter, the creation function 142 revises the treatment plan and executes re-planning. After revising the treatment plan, the creation function 142 creates a reference image based on the planned image again, and returns the process to step S207, where the comparison function 145 compares the planned DVH and the reference DVH.

[0057] If the comparison function 145 determines that the planned DVH and the reference DVH match, the creation function 142 maintains the treatment plan (step S211). Then, the creation function 142 transmits the treatment plan to the radiation therapy device 20 to execute the treatment plan (step S213). In this way, the medical information processing device 100 ends the processing shown in FIG. 8.

[0058] The medical information processing apparatus 100 of the first embodiment sets a plurality of imaging ranges in a planning image, estimates and compares DVHs based on the planning images set in each imaging range, and uses the DVHs for positioning or determines whether replanning is necessary. Since the DVHs are estimated and compared, the number of imaging times of the patient by the medical imaging apparatus 10 can be reduced. Therefore, excessive radiation exposure can be suppressed.

[0059] (Second embodiment) Next, a second embodiment will be described. Fig. 9 is a diagram showing an example of the configuration of a radiation therapy system 2 according to the second embodiment. The radiation therapy system 2 includes, for example, a CT room apparatus 30 and a medical information processing device 100. The CT room apparatus 30 includes a medical imaging device 40, a radiation irradiation device 50, and a bed 60, and the medical imaging device 40 and the radiation irradiation device 50 are installed in the same room. The medical imaging device 40, the radiation irradiation device 50, and the medical information processing device 100 are connected to each other via a network so as to be able to communicate with each other.

[0060] 10 is a diagram showing an installation environment of the CT room-side device 30. The medical imaging device 40 in the CT room-side device 30 includes an imaging gantry 41. The imaging gantry 41 has an opening 42 through which a patient is inserted. Inside the imaging gantry 41, an X-ray tube, an X-ray detector, and a support mechanism for rotatably supporting these are mounted, similar to those in the first embodiment.

[0061] The radiation irradiation device 50 includes a treatment gantry 51 and an irradiation head unit 52. As in the first embodiment, the treatment gantry 51 is installed, for example, on the wall of a treatment room, and the treatment gantry 51 rotatably supports the irradiation head unit 52. The irradiation head unit 52 forms an irradiation range of radiation using, for example, a multi-leaf collimator.

[0062] The bed 60 includes a top plate 61 on which a patient rests, and a base 62 that movably supports the top plate 61. The top plate 61 has a flat shape. The medical imaging device 40 is disposed on one side of the longitudinal direction of the top plate 61 (in the craniocaudal direction of the patient), and the radiation irradiation device 50 is disposed on the other side. The top plate 61 is movable toward and away from the medical imaging device 40 and the radiation irradiation device 50, and is rotatable around a vertical axis approximately at the center of the longitudinal direction.

[0063] The bed 60 moves the top plate 61 in the forward and backward directions and around the vertical axis. For example, when imaging a patient, the bed 60 rotates the top plate 61 around the vertical axis so that the patient's head or feet face the medical imaging device 40, moves the top plate 61 toward the imaging gantry 41, and moves the top plate 61 and the patient toward and away from the opening 42. When irradiating the patient with radiation during the treatment phase, the bed 60 moves the top plate 61 so that the treatment site (tumor site) of the patient approximately coincides with the isocenter. After moving the top plate 61, the radiation irradiation device 50 irradiates the tumor site with radiation using the irradiation head unit 52.

[0064] By using the CT in-room device 30, for example, adaptive radiotherapy (ART) can be smoothly performed. In radiotherapy, there are cases where the initial treatment plan may result in an insufficient dose to the target and an increase in the dose to surrounding normal organs due to tumor shrinkage and patient weight gain / loss that occur during the radiotherapy treatment period. In such cases, adaptive radiotherapy is a type of radiotherapy in which a new treatment plan is re-planned based on radiological medical images acquired during the treatment period (hereinafter referred to as in-treatment images) and radiation rays are irradiated.

[0065] By using the medical information processing device 100 in the second embodiment, when adaptive radiation therapy is performed using the CT room device 30, it is possible to set multiple imaging ranges in the in-treatment image, estimate DVHs for each, and compare the estimated DVHs to re-plan the treatment plan, thereby preventing excessive exposure of the patient when adaptive radiation therapy is performed.

[0066] According to at least one of the embodiments described above, the medical information processing device can suppress excessive exposure by having an acquisition unit that acquires radiation images to be used in radiation therapy of a patient, a setting unit that sets, based on the radiation images, multiple scan conditions for imaging the patient before the radiation therapy, an estimation unit that estimates the effects of the radiation therapy based on the radiation images captured under the multiple scan conditions, and a comparison unit that compares the effects of the multiple radiation therapies.

[0067] Although several embodiments have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, substitutions, and modifications can be made without departing from the spirit of the invention. These embodiments and their modifications are included within the scope and spirit of the invention, as well as within the scope of the invention and its equivalents as defined in the claims. [Explanation of symbols]

[0068] 1,2 Radiation therapy system 10,40 Medical imaging device 11,41 Imaging stand 12 Imaging couch 13,42 aperture 14. Top plate for imaging 15 Foundation 20 Radiation therapy equipment 21,51 Treatment stand 22 Treatment Bed 23 Stand body 24,52 Irradiation head 25 Treatment tabletop 26 Foundation 30 CT room equipment 50 Radiation irradiation equipment 60 berths 61 Top plate 62 Foundation 100 Medical information processing device 110 Communication Interface 120 input interface 130 Display 140 Processing Circuit 141 Acquisition Function 142 Creation Function 143 Setting Function 144 Estimation Function 145 Comparison Function 146 Decision Function 147 Judgment Function 150 memory GA11 Plan Image GA21 1st pseudo image GA21 pseudo image GA22 Second pseudo image NW Network Z1, Z2 rotation axis

Claims

1. an acquisition unit for acquiring a radiation image to be used in radiation therapy of a patient; a setting unit that sets a plurality of scan conditions for imaging the patient before the radiation therapy based on the radiation image; an estimation unit that estimates the effect of the radiation therapy based on the radiation images captured under each of the plurality of scan conditions; a comparison unit that compares the effects of the plurality of radiation therapies; A medical information processing device comprising:

2. the scan conditions include an imaging range of the radiation image; The medical information processing device according to claim 1 .

3. The imaging range includes a craniocaudal range of the patient. The medical information processing device according to claim 2 .

4. The effect includes a dose of radiation irradiated to the patient in the radiation therapy. The medical information processing device according to claim 1 .

5. the estimation unit estimates the effect based on at least one of a dose volume distribution or a dose constraint result; The medical information processing device according to claim 1 .

6. the estimation unit excludes the effect when the risk organ is outside the imaging range from a comparison target. The medical information processing device according to claim 2 .

7. The radiation image includes at least one of a 360-degree captured image or a scout captured image. The medical information processing device according to claim 1 .

8. a determination unit that determines immediately preceding scan conditions for scanning the patient in the treatment stage based on a result of the comparison; The medical information processing device according to claim 1 .

9. the immediately preceding scan conditions include an imaging range of a reference image for imaging the patient in a treatment stage, the reference image being used for positioning the patient with respect to a radiation irradiation device that irradiates the patient with therapeutic radiation in the treatment stage. The medical information processing device according to claim 8 .

10. a creation unit that creates a treatment plan for radiation therapy in a planning stage prior to the treatment stage; and a determination unit that determines whether to revise the treatment plan based on a result of comparing, in the planning stage, a first effect of the radiation therapy estimated based on the radiation images captured under the immediately preceding scan conditions with a second effect of the radiation therapy estimated based on the radiation images captured under the immediately preceding scan conditions in the treatment stage. The medical information processing device according to claim 8 .

11. The medical information processing device according to claim 10; a radiation therapy apparatus including a radiation irradiation device that irradiates a patient with therapeutic radiation based on the treatment plan created by the medical information processing apparatus; a medical imaging device that captures the radiation image during the treatment stage; Radiation therapy system.

12. the radiation irradiation device and the medical imaging device are installed in the same room; The radiation therapy system of claim 11.

13. The computer Obtaining radiological images to be used in the patient's radiation therapy; setting a plurality of scan conditions for imaging the patient before the radiation therapy based on the radiation image; Estimating the effect of the radiation therapy based on the radiation images captured under each of the plurality of scan conditions; comparing the effects of the multiple radiation treatments; Medical information processing method.

14. On the computer, Obtaining radiological images to be used in the patient's radiation therapy; setting a plurality of scan conditions for imaging the patient before the radiation therapy based on the radiation image; Estimating the effect of the radiation therapy based on the radiation images captured under each of the plurality of scan conditions; and comparing the effects of the plurality of radiation treatments. program.

Images