Planning method of ray beam irradiation plan under endoscope and intraoperative radiotherapy system

Abstract

The invention relates to a planning method for a ray beam irradiation plan under an endoscope and an irradiation system. According to one embodiment, the planning method for the ray beam irradiation plan under the endoscope can comprise the following steps that firstly, multi-dimensional images of an operation area and surrounding tissue are obtained under the endoscope; step 2, determining a to-be-irradiated area based on the multi-dimensional images of the surgical area and the surrounding tissues; and step 3, designing a ray beam scanning irradiation scheme based on the to-be-irradiated area. An endoscopic intraoperative irradiation system may include an illuminator, an imaging assembly, a ray generating assembly, a robotic arm, and a control assembly, the control assembly including a memory and a processor configured to run computer instructions stored on the memory to: control the imaging assembly to image an operative region and surrounding tissue under an endoscope to obtain a plurality of images; determining a to-be-irradiated area based on the plurality of images; planning a ray beam scanning irradiation scheme for the to-be-irradiated area; and controlling the mechanical arm and the ray generation assembly to carry out irradiation treatment. According to the invention, the ray beam scanning irradiation of the to-be-irradiated area under the endoscope can be realized, and the accurate irradiation requirement in the endoscope operation can be met.

Description

Technical Field

[0001] This invention relates to the medical field, and more particularly to a method for planning laparoscopic X-ray beam irradiation schemes. The invention aims to provide a method and system for planning laparoscopic X-ray beam irradiation schemes for intraoperative laparoscopic irradiation. Background Technology

[0002] Laparoscopic surgery has become very common in modern medicine and is widely used in many surgical specialties. Laparoscopic surgical instruments are inserted into the body through small incisions or natural orifices. The surgery is performed after carbon dioxide gas is filled into cavities such as the thoracic, abdominal, and pelvic cavities, significantly increasing the operating space and field of vision, without the need for traditional large incisions. This surgical method typically reduces postoperative pain, speeds up recovery, reduces postoperative complications, and shortens hospital stays.

[0003] Intraoperative radiation therapy (IORT) is radiation therapy administered to the tumor bed or sites prone to recurrence and metastasis after tumor resection during surgery. This technique allows for the removal of vital organs adjacent to the target area from the radiation field during surgery, thereby reducing damage to normal tissues or organs.

[0004] Chinese invention patent ZL201710337491.2, entitled "Method and System for Intraoperative Radiotherapy Scanning Path Planning," discloses a method and system for intraoperative radiotherapy. Its features include an auxiliary scanning component, an imaging component, a radiotherapy component, a robotic arm, and a control component. The auxiliary scanning component acquires multiple images of the area to be scanned, and based on these images, a 3D model of the area is created, the radiotherapy area is determined, and the scanning path of the radiotherapy component is planned to achieve intensity-modulated energy scanning irradiation. However, the auxiliary scanning component needs to be attached above the area to be radiotherapy; its large size makes it suitable for open surgery but difficult to apply in closed body cavities.

[0005] How to achieve intraoperative irradiation with X-ray beams under laparoscopy, meet the needs of intraoperative irradiation in new scenarios, and promote the advantages of intraoperative radiotherapy is a topic worthy of in-depth research. Summary of the Invention

[0006] To address the aforementioned deficiencies in the existing technology, this application provides a method for planning laparoscopic X-ray beam irradiation and an intraoperative radiotherapy system. This system combines the characteristics and advantages of laparoscopic surgery and X-ray beams, enabling the planning and implementation of intraoperative radiotherapy during laparoscopic surgery. This ensures precise treatment of diseased tissues and minimizes damage to surrounding normal tissues.

[0007] According to one aspect of this application, a method for planning a laparoscopic X-ray beam irradiation plan is provided, comprising the following steps: Step 1: acquiring multidimensional images of the surgical area and surrounding tissues under laparoscopy; Step 2: determining the area to be irradiated based on the multidimensional images of the surgical area and surrounding tissues; and Step 3: determining a X-ray beam scanning irradiation scheme based on the area to be irradiated.

[0008] In some embodiments, acquiring multidimensional images of the surgical area and surrounding tissues under laparoscopy in step one may include: controlling an imaging component to image the surgical area and surrounding tissues under laparoscopy to obtain multidimensional images. The imaging component is inserted into the patient's body through a small incision in the laparoscopic surgery. During the acquisition of multidimensional images, the end of the irradiator is pre-positioned near the surgical area, and the acquired multidimensional images include the end of the irradiator. The multidimensional images of the surgical area and surrounding tissues may be, but are not limited to, visible light images, ultrasound images, fluorescence images, and infrared images. These images may be two-dimensional, three-dimensional, and / or four-dimensional.

[0009] In some implementations, step two, which involves determining the irradiation area based on multidimensional images of the surgical area and surrounding tissues, may include: locating the irradiation area and the irradiator using image recognition methods; and determining the shape and size information of the irradiation area based on a predetermined size of the irradiator.

[0010] Alternatively, in step two, the doctor determines the area to be irradiated by visual observation, taking into account the preoperative examination results and the intraoperative surgical situation.

[0011] In some implementations, the automatic determination of the irradiation area using image recognition methods can be, but is not limited to, any of the following: traditional methods, such as threshold segmentation, region growing, and edge detection; machine learning-based methods, such as support vector machines and random forests; deep learning-based convolutional neural network methods, such as architectures like U-Net, 3D U-Net, and nnU-Net; and combining intraoperative image registration with augmented reality technology to achieve real-time intraoperative target area identification and navigation, and further optimize the segmentation results by combining anatomical knowledge and clinical rules.

[0012] In some implementations, step three, which involves determining the irradiation scheme based on the area to be irradiated, may include: determining the number and location of scanning points based on the shape and depth of the area to be irradiated, combined with the dosimetric characteristics of the radiation beam treatment depth and the size of the irradiator, and planning the irradiation parameters for each scanning point, as well as determining the irradiation path and irradiation method.

[0013] In some embodiments, the irradiation parameters include beam energy, irradiation time, dose rate, etc., with each scanning point set with a single energy or multiple energy, each energy corresponding to a corresponding irradiation time and dose rate, and / or, the irradiation path is a zigzag or spiral shape formed along each scanning point, and / or, the irradiation method is to use a single energy to irradiate along the irradiation path, traversing each set energy to complete multiple scanning paths, or to traverse each set energy at each scanning point to complete one scanning path.

[0014] In some implementations, the number and location of scan points can be determined manually, and the irradiation parameters for each scan point can be calculated manually. Alternatively and preferably, the number and location of scan points can be determined automatically based on an automated algorithm, the irradiation parameters for each scan point can be automatically planned, and the irradiation path and method can be determined. For example, the automatic planning refers to using an optimization algorithm to plan the shortest irradiation path to irradiate all scan points.

[0015] According to another aspect of the present invention, a planning device for intraoperative irradiation planning under laparoscopy is provided, comprising: an imaging control module for controlling an imaging component to image a surgical area and surrounding tissues under laparoscopy to obtain multiple images of the area to be irradiated; an irradiation area determination module for determining the area to be irradiated based on the multiple images; and an irradiation scheme planning module for determining a scheme for X-ray beam scanning irradiation based on the area to be irradiated.

[0016] In some implementations, the illumination area determination module may include: a modeling module for establishing an illumination area model based on multiple images; and a determination module for determining the illumination area in the model.

[0017] In some implementations, the determining module may include: an image recognition unit configured to identify the region to be illuminated in the model; and an illumination region selection unit configured to receive a user's selection of the region to be illuminated in the model.

[0018] In some implementations, the irradiation scheme planning module may include an irradiation path planning module for planning the path through which the ray generating component scans and irradiates the area to be irradiated.

[0019] According to another aspect of the present invention, a laparoscopic intraoperative irradiation system is provided, comprising an irradiator, an imaging assembly, a radiation generating assembly, a robotic arm, and a control assembly. The control assembly includes a memory and a processor, the processor being configured to execute computer instructions stored in the memory to: control the imaging assembly to image the surgical area and surrounding tissue under laparoscopy to obtain multidimensional images; determine the area to be irradiated based on the multidimensional images; plan a radiation beam scanning irradiation scheme for the area to be irradiated; and control the robotic arm and the radiation generating assembly to perform irradiation according to the scanning irradiation scheme.

[0020] In some embodiments, the imaging components (at least imaging functional components, such as optical components) are inserted into the patient's body through a small incision in laparoscopic surgery, for example, adjacent to the surgical area / area to be scanned.

[0021] In some implementations, the processor is configured to execute computer instructions stored in the memory to determine the area to be irradiated in such a way as to: determine a model of the area to be irradiated based on the multiple images; and determine the area to be irradiated based on the model.

[0022] In some implementations, the processor is configured to run computer instructions stored in the memory to plan a beam scanning irradiation scheme in such a way as to plan the movement paths of the irradiator and the beam generating components for the area to be irradiated.

[0023] In some embodiments, the irradiator is mounted at the end of a robotic arm or connected to the ray-generating assembly.

[0024] In some embodiments, the processor is configured to execute computer instructions stored in the memory to perform irradiation in the following manner: (i) adjusting the pose of the irradiator according to the irradiation plan so that it is aligned with the scanning point, then adjusting the alignment of the ray generating component with the irradiator so that its axis is aligned with the axis of the irradiator, and the distance between the source point of the ray generating component and the scanning point (source-to-surface distance) is consistent with the set parameters, and the ray generating component emits a beam for irradiation; or, (ii) mounting the irradiator on the ray generating component so that their axes are aligned and the source-to-surface distance meets the set parameter requirements, adjusting the pose parameters of the ray generating component according to the irradiation plan, and synchronously driving the irradiator to align with the scanning point, and the ray generating component emits a beam for irradiation.

[0025] In some embodiments, the position of the irradiator during irradiation can be obtained by connecting the scanning point and the incision through which the irradiator enters the patient's body.

[0026] In some implementations, the adjustment of the illuminator's position can be achieved using methods such as automatic adjustment by a robotic arm.

[0027] In some embodiments, when adjusting the alignment of the ray generating component and the irradiator in Method 1, an automatic alignment method can be adopted. The pose relationship between the ray generating component and the irradiator is obtained through a pose detection module. The pose detection module can be integrally set on the ray generating component or the irradiator, or it can be separately set on the ray generating component and the irradiator.

[0028] In some implementations, the pose detection module may be, but is not limited to, an optical surface pose detection module, a stereo camera pose detection module, and / or a gyroscope pose detection module.

[0029] According to another aspect of the present invention, a computer-readable storage medium is provided having computer program instructions stored thereon, which, when executed by a processor, cause the processor to perform the methods as described above.

[0030] In some embodiments, the computer program instructions, when executed by the processor, also cause the processor to perform the following steps: control the robotic arm to move the irradiation assembly (applier) and the ray generating assembly along a planned scanning path to irradiate the area to be irradiated.

[0031] The beneficial effects of this invention are: under laparoscopic conditions, multidimensional images acquired through imaging components such as visible light and fluorescence can locate the position and size of the area to be irradiated, which can be applied to intraoperative radiotherapy planning under laparoscopy. Guided by the imaging components, the irradiator is placed above the area to be irradiated under laparoscopic conditions, establishing the positional relationship between the robotic arm carrying the irradiator and the area to be irradiated. Under the condition of a small incision in laparoscopic surgery, the robotic arm carrying the irradiator, through coordinate system transformation, allows the irradiator to rotate and move up and down at the small incision to achieve intraoperative irradiation of the radiation beam within the area to be irradiated, effectively protecting normal tissue while ensuring the prescribed dose to the target area, thus meeting the requirements of precise IORT radiotherapy. This application combines the advantages of radiation beams and laparoscopic surgery, further promoting the clinical advantages of intraoperative radiotherapy.

[0032] Other features and advantages of this application will be set forth in the description which follows, and will be apparent in part from the description, or may be learned by practicing the application. The objectives and other advantages of this application may be realized and obtained by means of the structures particularly pointed out in the description, claims and drawings. Attached Figure Description

[0033] The accompanying drawings are provided to further understand this application and form part of the specification. They are used together with the embodiments of this application to explain this application and do not constitute a limitation thereof.

[0034] Figure 1A schematic diagram of an intraoperative radiotherapy system based on beam irradiation planning under endoscopy according to an embodiment is shown.

[0035] Figure 2 A schematic diagram of an intraoperative radiotherapy system based on beam irradiation planning under endoscopy according to another embodiment is shown.

[0036] Figure 3 A flowchart illustrating the method for planning X-ray beam irradiation under endoscopy is shown.

[0037] Figure 4 A schematic diagram of the helical scanning irradiation path planning method under laparoscope is shown.

[0038] Figure 5 A block diagram of the control device for an intraoperative radiotherapy system under laparoscopic surgery is shown. Detailed Implementation

[0039] To make the technical means, creative features, achieved objectives and effects of the present invention readily understandable, the technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the accompanying drawings. In the drawings, the same reference numerals are assigned to components that have substantially the same or similar structure and function, and repeated descriptions of them will be omitted.

[0040] Figure 1-2 This illustrates an intraoperative radiotherapy system based on beam irradiation planning under endoscopy according to an embodiment of this application. First, refer to... Figure 1 Please provide an explanation. For example... Figure 1 The intraoperative radiotherapy system includes an imaging component 200, an irradiator 300, a robotic arm 400, and a radiation generating component 500. It is understood that the radiotherapy system may also include a control component or module, the functions of which will be described later.

[0041] The imaging component 200 can be used to acquire images of the surgical area and surrounding tissues. Laparoscopic surgery is generally performed by making several small incisions on the surface of the patient's body, such as in the chest cavity, abdominal cavity, or pelvic cavity. The imaging component 200 can be positioned near the area to be irradiated through the formed small incisions 101 to acquire images. The imaging component 200 can be various commonly used imaging components in hospitals, such as visible light, ultrasound, infrared, and fluorescence imaging devices, all of which are configured for laparoscopic surgery. Preferably, the imaging component is a visible light device, which is the most common and convenient to configure and operate.

[0042] The irradiator 300 is positioned above the irradiated area via another small incision 102, which guides the rays emitted by the radiation-generating assembly 500 in a specific shape to the patient's irradiated area 103. Figure 1In this embodiment, the irradiator 300 is fixed to the robotic arm 400 or a bedside fixation device (not shown) using a flexible connection. The irradiator can be selected in different shapes and sizes depending on the different radiotherapy applications. For example, the irradiator can be cylindrical or square, or have a balloon-shaped end. This size information can be stored in a memory, and the control component can use the size information of the irradiator to determine the position, size, and other information of the area to be irradiated 103.

[0043] In one embodiment, such as Figure 1 As shown, the imaging component 200 and the irradiator 300 are set at a certain angle. When the imaging component 200 acquires an image of the area to be irradiated, the end of the irradiator 300 is pre-positioned near the surgical area, so that the acquired image includes the end of the irradiator. This is beneficial for determining the area to be irradiated from the acquired image and thus determining the corresponding X-ray beam scanning irradiation scheme.

[0044] The imaging component 200 can be electrically connected to the control component. For example, multiple images acquired can be stored in a memory, and the control component can determine the area to be irradiated and formulate a beam scanning irradiation plan based on these images.

[0045] The robotic arm 400, for example, is an electrically, pneumatically, or hydraulically driven robotic arm. During the irradiation planning phase, it can hold the irradiator 300 in place to facilitate the imaging assembly 200's imaging operation. (Refer to...) Figure 1 The distal end 403 of the robotic arm 400 and the irradiator 300 303 can have matching engagement features, such as corresponding protrusions and recesses, so that the mounting position of the irradiator 300 on the robotic arm 400 is fixed, thereby allowing the robotic arm to precisely control the pose of the irradiator. During the scanning irradiation phase, the robotic arm 400 can achieve multiple degrees of freedom of movement through manual or program control, thereby enabling the irradiator 300 mounted at its distal end to be aligned with the treatment site and perform scanning irradiation according to a determined X-ray beam irradiation scheme.

[0046] In one embodiment, the robotic arm 400 may be equipped with a position feedback device 401 to complete the pose detection of the robotic arm. When acquiring images, the position feedback device 401 records the pose of the robotic arm, i.e., the position of the illuminator. During the subsequent automatic illumination process, when the robotic arm moves, the position feedback device 401 can track the position of the illuminator in real time.

[0047] The radiation generating assembly 500 may include a beam module for generating radiotherapy radiation beams, which may be electron beams and / or X-rays, etc., and the beam energy can be adjusted to meet different radiation requirements. Figure 1In one embodiment, the X-ray generating component 500 can be dynamically aligned (e.g., axial alignment) with the irradiator 300 on the robotic arm under the control of the control component via a soft connection. That is, when the robotic arm executes the scanning path, the X-ray generating component 500 also moves accordingly, thereby ensuring that the emitted X-ray beam is guided to the irradiated area 103 by the irradiator in a manner parallel to the axis of the irradiator.

[0048] Figure 2 This invention illustrates an intraoperative radiotherapy system based on beam irradiation planning under endoscopy according to another embodiment of this application, and... Figure 1 Similarly, the intraoperative radiotherapy system includes an imaging unit 200, an irradiator 300, a robotic arm 400, and a radiation generating unit 500, and... Figure 1 The difference lies in the fact that the irradiator 300 is connected to the radiation generating assembly 500 using a hard connection, with their axes aligned. That is, during the scanning irradiation phase, the radiation generating assembly 500 directly carries the irradiator 300 to execute the irradiation scheme determined in the planning phase, such as beam scanning along a determined scanning path.

[0049] Figure 3 A flowchart illustrating a method for planning X-ray beam irradiation under endoscopy is shown. It can be understood that this method can, for example, be used in... Figure 1-2 The intraoperative radiotherapy system shown will be used for the procedure, and will be referred to below. Figure 1-2 This application describes a method for planning laparoscopic beam irradiation according to some embodiments of an intraoperative radiotherapy system.

[0050] First, in step S10, the imaging component 200 (such as...) is used. Figure 1 and Figure 2 As shown, the imaging component 200 is positioned near the area to be irradiated (via a small incision 101) to acquire images of the surgical area and surrounding tissues. The imaging component 200 can be, for example, various imaging components found in hospitals, such as visible light, ultrasound, infrared, and fluorescence imaging devices. The acquired multidimensional images can be two-dimensional, three-dimensional, and / or four-dimensional. These imaging components are commonly used in laparoscopic surgery, with visible light devices being the most common. The following description uses a visible light device as an example; however, it should be understood that, under the teachings of this invention, the process of imaging using other components will be readily apparent to those skilled in the art.

[0051] like Figure 1 and Figure 2 As shown, the visible light imaging component 200 can be positioned by the operator to image the surgical area and surrounding tissues. At this time, the irradiator 300 is inserted into the patient through the small incision 102 and, guided by the visible light imaging component 200, is positioned above the area to be irradiated, and is fixed to the robotic arm 400 or bedside fixation device using a flexible connection. Figure 1 Alternatively, it can be connected to the ray generator assembly 500 using a hard connection. Figure 2 Therefore, the image acquired by the visible light imaging component 200 contains the illuminator.

[0052] Next, in step S20, the area to be irradiated can be determined based on the multidimensional images of the surgical area and surrounding tissues.

[0053] In one embodiment, a manual process can be employed. For example, the physician, combining preoperative examination results and intraoperative surgical observation, visually determines the area to be irradiated. Based on this, in the subsequent irradiation phase, the position of the applicator 300 is manually adjusted to align it with a specific scanning point. If a hard-connection method is used, beam irradiation can be performed directly after alignment; if a soft-connection method is used, the alignment of the radiation generating component with the applicator is adjusted, i.e., the pose of the radiation generating component is adjusted so that its axis is aligned with the axis of the irradiation component, and the distance between the source point of the radiation generating component and the scanning point (source-to-surface distance) matches the set parameters. The radiation generating component then emits a beam for irradiation. This process is suitable for simple cases where the area to be irradiated is small and far from surrounding tissues.

[0054] In another embodiment, more preferably than a manual process, the irradiation area can be determined based on an automated process. For example, image recognition methods can be used to locate the irradiation area and the irradiator, and the shape and size information (area size, depth, etc.) of the irradiation area can be determined based on the predetermined size of the irradiator. Based on the acquired images of the surgical area and surrounding tissues, traditional methods, such as threshold segmentation, region growing, and edge detection, are suitable for cases with simple structures and clear boundaries; machine learning methods, such as support vector machines and random forests, can classify tissues by extracting image features, improving segmentation accuracy; deep learning-based convolutional neural network methods, such as U-Net, 3D U-Net, and nnU-Net architectures, can achieve high-precision target area segmentation in complex anatomical structures, suitable for multimodal image fusion, and using multimodal images can more accurately determine the irradiation area 103. In some embodiments, intraoperative image registration and augmented reality technology can be combined to achieve real-time intraoperative target area recognition and navigation, and the segmentation results can be further optimized by combining anatomical knowledge and clinical rules. Through these means, the irradiation area can be automatically located or determined. The size of the illuminator located on the image is known, and it can provide true information about the image size for calibration in image reconstruction.

[0055] For automated processes, in some implementations, the control component can first build a model of the area to be irradiated based on acquired images, and then use image recognition technology to identify tumor regions in the model and designate them as the irradiated areas. In some approaches, based on image recognition, the user can use a labeling tool, based on experience, to select specific regions in the model as the final irradiated areas, thereby improving the accuracy of determining the irradiated areas.

[0056] Then, in step S30, a beam scanning irradiation scheme is determined based on the area to be irradiated.

[0057] This step can be done manually or automatically. In the manual method, the doctor can manually determine the number and location of the scanning points and manually calculate the irradiation parameters for each scanning point.

[0058] This application preferably employs an automated approach. For example, an automated algorithm can automatically determine the number and location of scanning points based on the shape and depth of the area to be irradiated, combined with the dosimetric characteristics of the radiation beam treatment depth and the size of the applicator, and plan the irradiation parameters for each scanning point, determining the irradiation path and method. It should be noted that during laparoscopic irradiation, because the applicator 300 is inserted into the patient's body through a small incision 102, the applicator's radiation field is limited, while the area to be treated is large, exceeding the radiation field range. Large-field irradiation needs to be achieved through radiation field superposition. Scanning irradiation can achieve superposition more quickly; therefore, the irradiation method planned in this embodiment is scanning irradiation. It is understood that in step S30, only information about the area to be irradiated can be used to determine the number and location of scanning points or plan the irradiation path. Therefore, the results are not necessarily used in the actual irradiation process, but only provide a simulation assessment (non-treatment) to better evaluate the dose to surrounding normal tissues and vital organs, maximizing patient safety and quality of life.

[0059] For example, the planned irradiation parameters may include beam energy, irradiation time, dose rate, etc., for each scan point. Each scan point may be set with a single energy or multiple energy sources, and each energy source corresponds to a specific irradiation time and dose rate. After planning the dwell time and irradiation intensity of the irradiator at each scan point, the scanning path can be determined. The irradiation scanning path can be planned using optimization methods to find the shortest possible path to save irradiation time. For example, the scanning path may be a spiral or zigzag shape formed along each scan point. The scanning irradiation method may involve using a single energy source along the scanning path, traversing each set energy source to complete multiple scan paths, or traversing each set energy source at each scan point to complete one scan path. (Refer to...) Figure 1-2 104 is the defined scanning path, and 301 and 302 are two schematic positions in the irradiation path of the irradiator 300 performing endoscopic X-ray beam scanning.

[0060] Note that when planning and implementing the irradiation scanning path, it is necessary to consider that during laparoscopic irradiation, the surgical incision is a small incision, such as 101 and 102, which does not have enough space to achieve translation. Therefore, during scanning irradiation, the small surgical incision is used as the rotation center, and the coordinates of each point on the scanning path are changed one by one. The scanning path is achieved by rotation and lifting. The motion control of the irradiator will be described later.

[0061] During this process, the movement of the irradiator within the patient's body should be minimized to reduce the risks introduced by movement. Furthermore, the treatment time should be kept as short as possible. Therefore, a suitable scanning strategy needs to be developed. In one embodiment, a helical scanning method can be selected. Figure 4 The specific strategy for planning the helical scanning irradiation path under laparoscopy is shown.

[0062] Reference Figure 4 The (irregular) area enclosed by the closed curve shown in S230-0 is the irradiated area; S230-1 is the center of the irradiated area; S230-2, S230-3, and S230-4 are the scanning points requiring different scanning energies, whose energy is determined by the tumor depth and whose location is determined by the size of the scanning applicator; S230-5 is a series of circles centered on S230-1, passing through the scanning points; S230-6 and S230-7 are the coronal and sagittal views of the scanning path, respectively. The endoscopic scanning path can be a spiral scan starting from the outermost circle towards the center, or a scan from the center outwards. All irradiation is completed in a single spiral scan, eliminating the need for energy-by-energy scanning. This planned scanning method offers several advantages: firstly, the accelerator energy adjustment time is close to 20ms, which is very short and avoids wasting time due to frequent energy switching; secondly, it minimizes the number of applicator movements and the path length.

[0063] Taking a spiral scan from the outermost ring towards the center as an example, during this process, the distance from the incision to the tumor surface gradually shortens as one scan point moves to the next scan point along the spiral scan path (assuming the incision through which the irradiator is inserted is located above the area to be irradiated). After scanning the center point of the innermost ring, the irradiator is at its shortest length within the patient's body, located directly below the incision, and can be directly removed from the incision. When moving from one scan point to the next, the irradiator needs to be raised to the appropriate height for the next scan point, and then rotated to the target position. Once at the scan point, the beam energy is selected, and irradiation is performed.

[0064] In another embodiment, a zigzag scanning method can be implemented, that is, scanning from the left to the right of the first row, then from the right to the left of the second row, and so on, row by row. Regarding energy selection, all energies can be scanned together, or energy-by-energy scanning can be performed.

[0065] The planning scheme determined in step S30 will be implemented by the robotic arm directly or indirectly manipulating the illuminator, referring to... Figure 1 The applicator can be mounted on the end effector of the robotic arm 400. This can be done manually by an operator or by the robotic arm 400 actively grasping the applicator 300 located at a predetermined position. As described above, the end effector 403 of the robotic arm 400 and the applicator 300 can have matching engagement features, such as corresponding protrusions and recesses. Figure 2 The irradiator can be installed on the radiation generating assembly 500 by means of fastening such as snap-fit ​​or threaded connection. It is fixedly installed on the robotic arm 400, so the installation position of the irradiator 300 relative to the robotic arm 400 is also fixed. This is the basis for the robotic arm to accurately control the position of the irradiator.

[0066] In step S10, the irradiator 300 is inserted into the patient's body through the small incision 102 via the robotic arm 400 and positioned above the area to be irradiated, thus acquiring an image containing the position information of the irradiator 300. This position can be used as the initial position of the robotic arm, i.e., the origin of the coordinate system. The relative positional relationship between the area to be irradiated 103 and the robotic arm 400 carrying the irradiator 300 can be established through the irradiator assembly, which facilitates the subsequent movement of the robotic arm. For example, under the condition of a small incision in laparoscopic surgery, the robotic arm carrying the irradiator can rotate and move the irradiator at the small incision through coordinate system transformation to achieve intraoperative beam scanning and irradiation of the area to be irradiated, effectively protecting normal tissue while ensuring the prescribed dose to the target area, thus meeting the requirements of IORT precise radiotherapy.

[0067] The pose of the irradiator 300 during irradiation can be obtained by connecting the scanning point and the incision 102 through which the irradiator enters the patient's body. A position feedback device 401 is provided on the robotic arm 400 to detect its pose. Available long-distance position feedback methods include optical surface detection, stereoscopic camera pose detection, and gyroscope pose detection. Taking an optical surface detection device as an example, during image acquisition, the optical surface position feedback device 401 records the robotic arm pose, i.e., the irradiator position. During subsequent automatic irradiation, the position of the irradiator can be tracked in real time as the robotic arm moves.

[0068] During the irradiation phase, the control unit can control the robotic arm and the radiation generating unit to perform irradiation according to the planned scanning irradiation scheme. For example, for a determined area to be irradiated, the radiation generating unit 500 can be connected to the irradiator 300 via a soft or hard connection, and the robotic arm executes the determined scanning path. This allows for the irradiation of irregular irradiation areas 103, forming a conformal dose distribution and effectively protecting the tumor or normal tissue behind the tumor bed. (Refer to...) Figure 1-2In the soft-connection mode, the radiation generating component 500 is dynamically aligned with the irradiator 300 on the robotic arm; that is, when the robotic arm executes the scanning path, the radiation generating component 500 also moves accordingly. In the hard-connection mode, the radiation generating component 500 is connected to the irradiator 300; that is, the radiation generating component 500 directly carries the irradiator 300 to execute the scanning path. This allows for the irradiation of irregular irradiation areas 103, forming a conformal dose distribution and effectively protecting the tumor or normal tissue behind the tumor bed. This procedure is suitable for complex cases with large irradiation areas and close proximity to surrounding tissues. This invention combines the characteristics and advantages of laparoscopic surgery and radiation beam irradiation, achieving precise treatment of diseased tissues while minimizing damage to surrounding normal tissues.

[0069] In some examples, irradiation can be performed in multiple ways. In the first method, the irradiator's pose can be adjusted according to the irradiation plan to align it with a specific scanning point. Then, the beam generating component is aligned with the irradiator, meaning its pose is adjusted so that its axis is aligned with the irradiator's axis, and the distance between the source point and the scanning point (source-to-surface distance) matches the set parameters. This achieves the dose distribution and treatment accuracy required by the irradiation plan, and the beam is emitted from the beam generating component. In the second method, the irradiator can be mounted on the beam generating component, aligning their axes, and ensuring the source-to-surface distance meets the set parameters. The pose parameters of the beam generating component are adjusted according to the irradiation plan, simultaneously aligning the irradiator with a specific scanning point, and the beam is emitted from the beam generating component.

[0070] In some examples, the pose of the irradiator during irradiation can be obtained by connecting the scanning point and the incision through which the irradiator enters the patient's body. As mentioned above, the pose detection module can be, but is not limited to, an optical surface pose detection module, a stereo camera pose detection module, and / or a gyroscope pose detection module.

[0071] In some examples, the adjustment of the emitter's pose can be done manually or automatically by a robotic arm.

[0072] In some examples, when adjusting the alignment of the ray generating component and the irradiator in Method 1, manual or automatic alignment can be used. The pose relationship between the ray generating component and the irradiator is obtained through a pose detection module. The pose detection module can be integrally set on the ray generating component or the irradiator, or it can be separately set on the ray generating component and the irradiator.

[0073] Figure 5A block diagram is shown of a control or planning device 600 that can be used in the aforementioned intraoperative radiotherapy system to perform the aforementioned operations or realize the aforementioned functions. It should be understood that the control device 600 can be integrated into the aforementioned intraoperative radiotherapy system as a software module, which can be stored in memory, and its included computer instructions can be executed by, for example, a processor to perform the aforementioned operations. Alternatively, the control device 600 (including its various modules and units) can also be implemented by specialized hardware (e.g., ASIC) or firmware. All implementations of the control device 600, including software, hardware, and firmware, should be understood to fall within the protection scope of this invention.

[0074] like Figure 5 As shown, the control device 600 may include an imaging control module 610, an irradiation area determination module 620, an irradiation scheme planning module 630, and an irradiation scheme execution module 640.

[0075] The imaging control module 610 can be used to control the imaging assembly to image the surgical area and surrounding tissues under laparoscopy, so as to obtain multiple images of the area to be irradiated. For example, when both the imaging assembly and the irradiator have been inserted into the patient's body through a small incision, the imaging control module 610 can control the imaging assembly to perform imaging, so that the acquired images simultaneously include images of the surgical area and surrounding tissues as well as images of the irradiator (end).

[0076] The illumination area determination module 620 can determine the area to be illuminated based on the multiple images. For example, the illumination area determination module may include: a modeling module for establishing a model of the area to be illuminated based on the acquired multiple images; and a determination module for determining the area to be illuminated in the model. In some embodiments, the determination module may include: an image recognition unit configured to identify the area to be illuminated in the model; and an illumination area selection unit configured to receive a user's selection of the area to be illuminated in the model.

[0077] The irradiation scheme planning module 630 can determine a scheme for scanning irradiation of the X-ray beam based on the area to be irradiated. For example, it may include an irradiation path planning module for planning the path for the X-ray generating component to scan and irradiate the area to be irradiated.

[0078] The irradiation execution module 640 is used to control the robotic arm to move the radiation generating component along the planned irradiation path to perform irradiation. Specifically, the radiotherapy execution module 640 may include a robotic arm control unit and / or a radiotherapy component control unit. The robotic arm control unit can be used to control the robotic arm to move the irradiator along the planned radiotherapy path to perform rotational and vertical movements to achieve the scanning path. In the case of a soft connection, the radiotherapy component control unit can control the radiation generating component to also move synchronously, thereby controlling the beam to irradiate the predetermined area through the irradiator.

[0079] The functions or operations of the various modules or units in the control device 600 have been briefly described above. It should be understood that these functions or operations have been referenced above. Figure 1-4 Further detailed descriptions were provided, and therefore can be combined with information about Figure 1-4 The description is provided to understand further details of the function or operation of the various modules or units in the control device 600.

[0080] In addition to the methods described above, embodiments of this application can also be computer program products, comprising computer program instructions that, when executed by a processor, cause the processor to perform the irradiation plan planning method of the various embodiments of this application described above, and to perform various operations, steps, and functions according to the planned irradiation method. The computer program product can be written in any combination of one or more programming languages ​​to execute program code for performing the operations of the embodiments of this application. The programming languages ​​include object-oriented programming languages ​​such as Java and C++, as well as conventional procedural programming languages ​​such as C or similar programming languages. The program code can be executed entirely on a user computing device, partially on a user device, as a standalone software package, partially on a user computing device and partially on a remote computing device, or entirely on a remote computing device or server.

[0081] Furthermore, embodiments of this application may also be computer-readable storage media storing computer program instructions thereon. When executed by a processor, these computer program instructions cause the processor to perform the irradiation plan planning method described above according to various embodiments of this application, and to perform various operations, steps, and functions according to the planned irradiation method. The computer-readable storage medium may be any combination of one or more readable media. A readable medium may be a readable signal medium or a readable storage medium. A readable storage medium may include, for example, an electrical, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any combination thereof. More specific examples of readable storage media (a non-exhaustive list) include: an electrical connection having one or more wires, a portable disk, a hard disk, random access memory (RAM), read-only memory (ROM), erasable programmable read-only memory (EPROM or flash memory), optical fiber, portable compact disk read-only memory (CD-ROM), optical storage device, magnetic storage device, or any suitable combination thereof.

[0082] Numerous specific details are set forth in this specification. However, it should be understood that embodiments of the invention may be practiced without these specific details. In some embodiments, well-known methods, structures, and techniques have not been shown in detail so as not to confuse the reader with an understanding of the principles of this specification.

[0083] Those skilled in the art will understand that modules in the apparatus of each embodiment can be adaptively modified and placed in one or more apparatuses different from that embodiment. Except where features or processes are mutually exclusive, any combination can be used to combine all steps of any method or all modules of any apparatus disclosed herein. Unless expressly stated otherwise, each feature disclosed herein can be replaced by an alternative feature serving the same, equivalent, or similar purpose.

[0084] It should be noted that the above embodiments are illustrative of the invention and not restrictive, and various alternative embodiments can be devised by those skilled in the art without departing from the scope of the appended claims. In the claims, the ordering of features does not imply any particular order of features, and in particular, the order of steps in a method claim does not imply that these steps must be performed in that order. Rather, these steps can be performed in any suitable order. Any reference marks enclosed in parentheses in the claims should not be construed as limiting the claims. The terms “comprising” or “including” do not exclude the presence of modules or steps not listed in the claims. The terms “a” or “an” preceding a module or step do not exclude the presence of a plurality of such modules or steps. The use of the terms “first,” “second,” and “third,” etc., does not indicate any order and can be interpreted as names.

Claims

1. A method for planning a laparoscopic X-ray beam irradiation program, comprising the following steps: Acquire multidimensional images of the surgical area and surrounding tissues under laparoscopy; The area to be irradiated is determined based on multidimensional images of the surgical area and surrounding tissues; and The X-ray beam scanning irradiation scheme is determined based on the area to be irradiated.

2. The method as described in claim 1, wherein, Multidimensional images of the surgical area and surrounding tissues obtained under laparoscopy include: The imaging component is controlled to image the surgical area and surrounding tissues under laparoscopy to obtain multidimensional images. The imaging component is inserted into the patient's body through a small incision in laparoscopic surgery. When acquiring multidimensional images, the end of the applicator is pre-positioned near the surgical area, and the acquired multidimensional images include the end of the applicator.

3. The method as described in claim 1, wherein, The determination of the irradiation area based on the multidimensional images of the surgical area and surrounding tissues includes: Image recognition methods are used to locate the area to be irradiated and the irradiator; and Based on the predetermined size of the irradiator, the shape and size information of the area to be irradiated are determined.

4. The method of claim 1, wherein, Determining the irradiation scheme based on the area to be irradiated includes: Based on the shape and depth of the area to be irradiated, combined with the dosimetric characteristics of the radiation beam treatment depth and the size of the irradiator, the number and location of scanning points are determined, and the irradiation parameters for each scanning point are planned, and the irradiation path and irradiation method are determined.

5. The method of claim 4, wherein, The irradiation parameters include beam energy, irradiation time, and dose rate. Each scan point is set with a single energy or multiple energy sources, and each energy corresponds to a specific irradiation time and dose rate, and / or... The illumination path is a zigzag or spiral shape formed along each scanning point, and / or, The irradiation method involves using a single energy source to irradiate along the irradiation path, traversing each set energy source to complete multiple scan paths, or traversing each set energy source at each scan point to complete one scan path.

6. A planning device for intraoperative irradiation planning under laparoscopy, comprising: An imaging control module is used to control the imaging components to image the surgical area and surrounding tissues under the endoscope, so as to obtain multiple images of the area to be irradiated. An illumination area determination module is used to determine the area to be illuminated based on the multiple images; and The irradiation scheme planning module is used to determine the irradiation scheme of the X-ray beam scanning based on the area to be irradiated.

7. A laparoscopic intraoperative irradiation system, comprising an irradiator, an imaging assembly, a radiation generating assembly, a robotic arm, and a control assembly, wherein the control assembly includes a memory and a processor, the processor being configured to execute computer instructions stored in the memory to: The imaging components are controlled to image the surgical area and surrounding tissues under laparoscopy to obtain multidimensional images; Based on the multidimensional image, the area to be illuminated is determined; Planning a beam scanning irradiation scheme for the area to be irradiated; and The robotic arm and the radiation generating assembly are controlled to perform irradiation according to the scanning irradiation scheme.

8. The system of claim 7, wherein, The irradiator is mounted at the end of the robotic arm or connected to the ray-generating assembly.

9. The system of claim 7, wherein, The processor is configured to execute computer instructions stored in the memory to perform irradiation in the following manner: Adjust the position and orientation of the irradiator according to the irradiation plan to align it with the scanning point. Then, adjust the alignment of the ray generating component with the irradiator so that its axis is aligned with the axis of the irradiator, and the distance between the source point of the ray generating component and the scanning point is consistent with the set parameters. The ray generating component then emits a beam for irradiation. or, Install the irradiator on the radiation generating assembly, align the axes of the two, and ensure that the distance between the source point and the scanning point of the radiation generating assembly meets the set parameter requirements. Adjust the position and orientation parameters of the radiation generating assembly according to the irradiation plan, and simultaneously drive the irradiator to align with the scanning point. The radiation generating assembly then emits a beam for irradiation.

10. A computer-readable storage medium having stored thereon computer program instructions, which, when executed by a processor, cause the processor to perform the method as described in any one of claims 1-5.

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