Patient conveyance carriage and radiation irradiation system

Abstract

To provide a technology that improves at least one of various perspectives in a patient conveyance carriage and a radiation irradiation system.SOLUTION: A patient conveyance carriage (100) includes: a top plate (110) on which a patient is placed; a top plate movement part (120) that is connected to the top plate and moves the top plate; and a conveyance part (130) that conveys the top plate and the top plate movement part. The top plate movement part includes an arm part (122), an adjustment part (121), and a slide part (123). The arm part includes an arm (1221) and a mechanism that operates the arm. The adjustment part is provided between the arm part and the top plate and adjusts a posture of the top plate in a distal end side of the arm. The slide part slides the arm part with respect to the conveyance part.

Description

[Technical field]

[0001] The present invention relates to a patient transport cart and a radiation irradiation system. [Background technology]

[0002] In radiation therapy, before the patient is irradiated with radiation, the patient is placed on a treatment couch and the position of the radiation irradiated from the radiation irradiation unit is aligned with the site to be irradiated with the radiation (this is called patient position setting or positioning processing).

[0003] In particle beam therapy, a type of radiation therapy, particle beams such as proton beams, heavy particle beams, or neutron beams extracted from an accelerator are irradiated to a tumor part (target) such as a lesion or cancer. In these therapies, in order to increase the concentration of the dose of the particle beam on the target while suppressing the effect on normal tissue, the particle beam needs to be irradiated to the target with high accuracy, and high-precision patient positioning is required. On the other hand, if it takes a lot of time to set the patient position in the radiation therapy room, the occupancy time of the radiation therapy room per patient may increase, and the number of patients treated per unit time may decrease. In addition, it may reduce the time available for quality assurance (QA) measurements of radiation to ensure safe therapeutic irradiation, which may increase the burden on medical professionals such as doctors, nurses, and radiologists.

[0004] Patent document 1 proposes a patient transport cart that includes a tabletop (110) on which a patient rests, a tabletop drive unit (120) that moves and / or rotates the tabletop, and a transport unit (130) having a base (131) on which the tabletop drive unit is placed. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Patent No. 6899172 Summary of the Invention [Problem to be solved by the invention]

[0006] In the above-mentioned conventional technology, the patient is positioned on the top plate (110) of the patient transport cart in a positioning room separate from the particle beam therapy room, and then the patient transport cart is moved to the particle beam therapy room, thereby shortening the time each patient occupies the treatment room. However, there is still room for improvement in such patient transport carts from various perspectives, such as miniaturization of the cart, suppression of interference between the arm and other devices, and efficiency of the positioning work.

[0007] The present invention provides a technique for improving at least one of the above-mentioned aspects in a patient transport cart and a radiation irradiation system. [Means for solving the problem]

[0008] The present invention includes the following aspects. [Aspect 1] A patient transport cart, A tabletop on which the patient sits, a top plate moving unit that is connected to the top plate and moves the top plate; a transport unit that transports the top plate and the top plate moving unit; A tabletop movement control unit that controls the tabletop movement unit; A transport control unit that controls the transport unit; Equipped with The tabletop moving unit includes an arm unit, an adjustment unit, and a slide unit. The arm unit has an arm and a mechanism for operating the arm, the adjustment unit is provided between the arm unit and the tabletop and adjusts the attitude of the tabletop at a tip side of the arm; The slide portion slides the arm portion relative to the transport portion. Patient transport trolley. [Aspect 2] The patient transport cart according to aspect 1, When the rotation around the Z axis along the height direction is defined as the rotation in the yaw direction, the rotation around the X axis perpendicular to the Z axis is defined as the rotation in the pitch direction, and the rotation around the Y axis perpendicular to the Z axis and the X axis is defined as the rotation in the roll direction, the adjustment unit is An inclination adjustment mechanism that rotates the tabletop in at least one of a pitch direction and a roll direction to adjust the inclination of the tabletop; an orientation adjustment mechanism for adjusting the orientation of the tabletop by rotating the tabletop in a yaw direction; Including, Patient transport trolley. [Aspect 3] The patient transport cart according to aspect 2, The orientation adjustment mechanism is capable of rotating the tabletop in a yaw direction around two axes along the height direction. Patient transport trolley. [Aspect 4] The patient transport cart according to aspect 1, The mechanism for operating the arm includes: a first rotation mechanism that rotates the arm around an axis extending in a horizontal direction; A second rotation mechanism that rotates the arm in a yaw direction; Including, Patient transport trolley. [Aspect 5] The patient transport cart according to aspect 1, The arm is a robot arm of a parallel link mechanism. Patient transport trolley. [Aspect 6] The patient transport cart according to aspect 1, The arm has an avoidance portion shaped to avoid interference with the transport unit in a posture when a patient gets on or off the tabletop. Patient transport trolley. [Aspect 7] The patient transport cart according to aspect 1, The slide portion is A guide provided on an upper portion of the conveying unit; A movable part that moves along a guide; Including, Patient transport trolley. [Aspect 8] The patient transport cart according to aspect 1, The conveying unit is A base on which the top plate moving part is provided; the base has a space in which the top plate movement control section and the transport control section can be provided, a fixing mechanism provided on the base and engaging with an engaging portion provided in the radiation therapy room to fix the position of the transport unit; Including, Patient transport trolley. [Aspect 9] 9. The patient transport cart according to aspect 8, the fixing mechanism includes a fitting member that fits with the engagement portion and displaces between a storage position stored in the base and a fixed position protruding from the storage position, Patient transport trolley. [Aspect 10] 9. The patient transport cart according to aspect 8, The transport unit includes at least four of the fixing mechanisms. Patient transport trolley. [Aspect 11] 9. The patient transport cart according to aspect 8, the fixing mechanism includes a fitting member that fits with the engagement portion and displaces between a storage position stored in the base and a fixing position protruding from the storage position, The fitting member includes a tapered portion, the engaging portion includes a recess corresponding to the tapered shape of the fitting member, The fitting member and the engaging member are in annular line contact or surface contact. Patient transport trolley. [Aspect 12] 9. The patient transport cart according to aspect 8, The transport unit includes a plurality of wheels attached to the base, The plurality of wheels include: A drive wheel driven by a drive source; A free wheel that follows the drive wheel; Including, Patient transport trolley. [Aspect 13] 13. The patient transport cart according to claim 12, The drive wheels are capable of at least forward and backward movement and turning. Patient transport trolley. [Aspect 14] A radiation irradiation system including a patient transport cart and a radiation irradiation device that irradiates a patient with radiation, The patient transport cart includes: A tabletop on which the patient sits, a top plate moving unit that is connected to the top plate and moves the top plate; a transport unit that transports the top plate and the top plate moving unit; Equipped with The top plate moving unit is an arm unit having an arm and a mechanism for operating the arm; a slide portion that slides the arm portion relative to the transport portion; an adjustment unit provided between the arm unit and the tabletop and configured to adjust the attitude of the tabletop; Including, Radiation exposure system. [Brief description of the drawings]

[0009] [Figure 1] FIG. 1A is a front view showing an outline of a patient transport cart according to one embodiment, and FIGS. [Figure 2-1] 13(a) and 13(b) are diagrams illustrating the movement and rotation of the top plate of a patient transport cart. [Figure 2-2] 13(c) to (e) are diagrams illustrating the movement and rotation of the top plate of the patient transport cart. [Figure 2-3] 13(f) to (h) are diagrams illustrating the movement and rotation of the top plate of the patient transport cart. [Diagram 3] FIG. 4 is a block diagram of a drive control unit of the patient transport cart. [Figure 4] FIG. 4 is a block diagram of a transport control unit of the patient transport cart. [Diagram 5] FIG. 1 is a schematic diagram of a radiation delivery system within a facility. [Figure 6]1(a) and (b) are schematic diagrams of the positioning chamber of the radiation irradiation system. [Figure 7] FIG. 2 is a diagram showing a schematic configuration of a radiation treatment room of the radiation irradiation system. [Figure 8] FIG. 2 is a diagram illustrating the exchange of information between devices. [Figure 9] 1 is a flowchart showing a sequence of steps in radiation therapy using a radiation irradiation system. [Figure 10] 6(a) to 6(c) are explanatory diagrams illustrating the operation of a fixing mechanism of the patient transport cart. [Figure 11] 10(a) and 10(b) are partially enlarged views of FIG. 10(b) and FIG. 10(c). DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0010] [Configuration of patient transport cart 100] <Summary> FIG. 1(a) is a front view showing an outline of a patient transport cart 100 according to an embodiment, and FIG. 1(b) is a plan view thereof, in which the top plate 110 is omitted. FIG. 1(c) is a view showing FIG. 1(b) with the top plate transport unit further omitted. In FIG. 1(a), exterior members such as covers are omitted as appropriate in order to explain the structure of each part of the patient transport cart 100. The patient transport cart 100 is a cart capable of transporting a patient. For example, after the patient position of the patient on the patient transport cart 100 is set in a positioning room described later, the patient is transported to a radiotherapy room in a safe position by the patient transport cart 100. Then, the treatment position is reproduced in the treatment room, and the treatment irradiation is performed. This can shorten the time required for setting the patient position in the treatment room, and the occupancy time of the radiotherapy room per patient can be shortened.

[0011] In the following description, the axis along the height direction of the patient transport cart 100 is defined as the Z axis, and the axes perpendicular to each other in a plane perpendicular to the Z axis are defined as the X axis and the Y axis. Rotation around the X axis is defined as pitch rotation (rotation in the pitch direction), rotation around the Y axis is defined as roll rotation (rotation in the roll direction), and rotation around the Z axis is defined as yaw rotation (rotation in the yaw direction). In addition, in the following description, when an object is rotated, it is not limited to rotating the object 360 degrees, but also includes rotating (rotating) within a predetermined angle range.

[0012] 1, the axis along the short side direction of the tabletop 110, which is rectangular in plan view, is the X-axis, and the axis along the long side direction of the tabletop 110 is the Y-axis. If the tabletop 110 is elliptical, for example, the short axis may be the X-axis, the long axis may be the Y-axis, and the axis perpendicular to both axes may be the Z-axis.

[0013] The patient transport cart 100 includes a top plate 110 on which a patient is placed, a top plate moving unit 120 that is connected to the top plate 110 and changes the position of the top plate 110, and a transport unit 130 that transports the top plate 110 and the top plate moving unit 120.

[0014] <Tabletop 110> The top plate 110 includes a fixture (not shown) for fixing the patient's body. For example, the fixture may include a device for fixing the patient's head, a device for fixing the patient's limbs, a device for fixing the patient's torso, and / or a cushioning material formed along the shape of the patient's body. The top plate 110 may be configured so that a part of the top plate 110, such as a part corresponding to the patient's head, legs, and / or torso, can be tilted. The top plate 110 may also be provided with a ventilation hole or the like so that the patient can be fixed in a prone position on the top plate 110.

[0015] In this embodiment, the top plate 110 is rectangular (rectangular or square), but is not limited to a rectangular shape in plan view and may be an elliptical shape (including a circle). The top plate 110 is stable (does not bend) even when a patient stands on it, and may have a shape and size that allows the patient to be fixed so as not to move.

[0016] <Tabletop moving section 120> The top board moving section 120 includes an adjustment section 121, an arm section 122, and a slide section 123. Although details will be described later, the top board moving section 120 moves and rotates the top board 110 and the arm 1221 using an inclination adjustment mechanism 1211, a first horizontal rotation mechanism 1213, a second horizontal rotation mechanism 1214, a third horizontal rotation mechanism 1223, a vertical rotation mechanism 1222, and the slide section 123, thereby moving the top board 110 to an arbitrary position.

[0017] (Adjustment section 121) The adjustment unit 121 adjusts the attitude of the tabletop 110 at the tip side of the arm 1221. The adjustment unit 121 is provided between the tabletop 110 and the arm unit 122. Here, the adjustment of the attitude of the tabletop 110 refers to the adjustment of at least one of the inclination of the tabletop 110 with respect to a horizontal plane and the orientation on the horizontal plane.

[0018] The adjustment unit 121 includes an inclination adjustment mechanism 1211 and a direction adjustment mechanism 1212. The inclination adjustment mechanism 1211 adjusts the inclination of the top board 110 by rotating the top board 110 in at least one of the pitch direction and the roll direction.

[0019] The tilt adjustment mechanism 1211 is connected to the top plate 110. In this embodiment, the tilt adjustment mechanism 1211 is configured to tilt the top plate 110 in the pitch rotation direction and the roll rotation direction. The tilt adjustment mechanism 1211 controls the rotation of each axis independently by motor drive so as to enable isocentric rotation (see FIG. 3).

[0020] The tilt adjustment mechanism 1211 has a structure in which the tilt adjustment unit is sandwiched between two connection plates from above and below. The motors and tilt adjustment units for each axis are mounted on the connection plate 1211c connected to the first horizontal rotation mechanism 1213. The connection plate 1211c is provided so as to always maintain a horizontal position relative to the first horizontal rotation mechanism 1213. The connection plate 1211d connected to the top plate 110 follows the tilt when the tilt adjustment unit sets a predetermined tilt. That is, the tilt adjustment unit in which the connection plate 1211d is tilted relative to the connection plate 1211c that maintains a horizontal position may tilt the connection plate 1211d by rotating the connection plate 1211d by a predetermined amount around a predetermined axis extending in the horizontal direction using a known mechanism such as a ball screw.

[0021] In this embodiment, the tilt angle of the tabletop 110 by the tilt adjustment mechanism 1211 is assumed to be within the range used in actual clinical practice. In the case of a radiotherapy device capable of irradiating from multiple directions using a rotating gantry, the rotatable angle of the tabletop is sufficient for patient position setting at ±10 degrees or less. For adjustment of the tilt of the tabletop within this range, the structure can be simplified by adopting a tilt adjustment mechanism rather than a rotary joint structure. On the other hand, when radiation is irradiated from fixed ports in the horizontal, vertical, or 45-degree directions, the tabletop may be tilted significantly up to about ±20 degrees to achieve treatment from a desired irradiation angle. To accommodate such a case, the adjustment unit 121 may adopt a rotary joint structure as the tilt adjustment mechanism 1211.

[0022] The orientation adjustment mechanism 1212 yaw-rotates (horizontally rotates) the top board 110 to adjust the orientation of the top board 110. The orientation adjustment mechanism 1212 includes a first horizontal rotation mechanism 1213 and a second horizontal rotation mechanism 1214.

[0023] The first horizontal rotation mechanism 1213 is connected to the inclination adjustment mechanism 1211 and configured to horizontally rotate the top plate 110. In other words, the first horizontal rotation mechanism 1213 can horizontally rotate the top plate 110 together with the inclination adjustment mechanism 1211. The second horizontal rotation mechanism 1214 is connected to the first horizontal rotation mechanism 1213 and configured to horizontally rotate the top plate 110. In other words, the second horizontal rotation mechanism 1214 can horizontally rotate the top plate 110 together with the inclination adjustment mechanism 1211 and the first horizontal rotation mechanism 1213. That is, in this embodiment, the orientation adjustment mechanism 1212 can adjust the orientation of the top plate 110 using two horizontal rotation mechanisms. For example, the first horizontal rotation mechanism 1213 and the second horizontal rotation mechanism 1214 can be connected by a predetermined connecting member or the like.

[0024] In this embodiment, the adjustment unit 121 has two horizontal rotation mechanisms (first horizontal rotation mechanism 1213 and second horizontal rotation mechanism 1214), so that each joint can be made small while ensuring a sufficient rotation range of the tabletop 110. Note that when it is not necessary to set a large rotation area of ​​the tabletop due to the treatment operation flow of each facility or the layout of medical equipment installed in a radiation therapy room, the first horizontal rotation mechanism 1213 and the second horizontal rotation mechanism 1214 may be substituted with one horizontal rotation mechanism. In that case, the adjustment unit 121 can be made smaller in the vertical direction.

[0025] (Arm part 122) The arm unit 122 moves the top board 110. The arm unit 122 includes an arm 1221, and a vertical rotation mechanism 1222 and a third horizontal rotation mechanism 1223 as mechanisms for operating the arm unit 122.

[0026] The arm 1221 is connected to the second horizontal rotation mechanism 1214 of the adjustment unit 121. The arm 1221 is a robot arm of a parallel link mechanism, and the second horizontal rotation mechanism 1214 connected to the tip of the arm 1221 can be mechanically kept horizontal. That is, the opposing links of the parallel link constituting the arm 1221 are of equal length, and the arm 1221 always rotates while maintaining symmetry. Therefore, even when the arm 1221 rotates by the vertical rotation mechanism 1222 and its height changes, the second horizontal rotation mechanism 1214 connected to the tip of the arm 1221 can be kept horizontal. Note that in this embodiment, the arm 1221 is not an arm in which a plurality of links of a predetermined length are connected in series, such as an arm having an upper arm and a forearm, but is composed of only one link in the series direction. Also, the arm 1221 does not have to be a parallel link.

[0027] The vertical rotation mechanism 1222 is connected to the arm 1221 and configured to rotate the arm 1221. The vertical rotation mechanism 1222 is configured to adjust the height of the arm 1221 in a direction perpendicular to the surface on which the patient transport cart 100 is provided. More specifically, the vertical rotation mechanism 1222 is configured to rotate one end of the arm 1221 around an axis extending in the horizontal direction. The rotation angle of the vertical rotation mechanism 1222 can be within a range in which the top plate 110 is raised to a height at which the tumor center position of the patient can be aligned with the isocenter (the geometric center where the charged particle beam reaches) and the top plate 110 is lowered to a height at which the patient can get on and off the top plate 110 without any burden.

[0028] The third horizontal rotation mechanism 1223 is connected to the vertical rotation mechanism 1222 and configured to horizontally rotate the arm 1221. In other words, the third horizontal rotation mechanism 1223 is configured to rotate the arm 1221 around an axis extending in the vertical direction. The third horizontal rotation mechanism 1223 can rotate the arm 1221 on a horizontal plane and rotate the position of the tabletop from 0 degrees to 180 degrees or more.

[0029] Therefore, by using the first horizontal rotation mechanism 1213, the second horizontal rotation mechanism 1214, and the third horizontal rotation mechanism 1223 connected directly or indirectly to both sides of the arm 1221 and the connection plates 1211c, 1211d of the inclination adjustment mechanism 1211, it is possible to keep the tabletop 110 horizontal even when the height changes as the tabletop 110 moves.

[0030] Also, the link of the arm 1221 may be curved. As an example, by curving the link located on the floor side, interference with the base 131 of the transport unit 130 can be avoided. That is, the arm 1221 may have an avoiding portion having a shape such as a curved shape that avoids interference with the transport unit 130 in the boarding and alighting posture when the patient gets on and off the top board 110. As a result, the arm 1221 can be rotated more toward the floor, and the position where the patient gets on and off can be made lower (for example, the height of the top board from the floor surface is 70 cm or less). This allows even elderly people and children to easily get on and off. Note that the avoiding portion is not limited to a curved shape, and may be a bent portion that is bent so as to be convex upward when viewed in the direction of FIG. 1(a), for example.

[0031] (Slide part 123) The slide section 123 slides the arm section 122 relative to the conveying section 130. The slide section 123 is connected to the third horizontal rotation mechanism 1223 of the arm section 122. The slide section 123 includes a guide section 123c provided on the upper part of the conveying section 130 and a movable section 123d that can move linearly along the linear guide of the guide section 123c. In addition to the linear guide, the guide section 123c includes, as an example, a running axis plate that serves as a base, a motor section that is a driving mechanism for linear movement, a reducer that amplifies the output, a timing belt and pulleys that transmit power, a cable bear (registered trademark) that stores the cable of the top board moving section 120 in synchronization with the linear movement, and a belt section that covers the mechanism of the slide section 123. The slide section 123 is fitted into a recess provided in a base 131 of the conveying section 130. A linear guide is installed on the running axis plate, and a support plate is further connected to the linear guide. The support plate is connected to the third horizontal rotation mechanism 1223 and supports the upper part of the top plate moving unit 120 above the third horizontal rotation mechanism 1223. The belt unit encases the running shaft plate and all of the constituent elements mounted on the running shaft plate. The support plate is connected to the linear guide, so that the upper part of the top plate moving unit 120 above the third horizontal rotation mechanism 1223 can be moved linearly, making it possible to change the position of the top plate.

[0032] <Transport unit 130> (overview) The transport unit 130 transports the top plate 110 and the top plate moving unit 120. The transport unit 130 not only houses various devices related to the transport, but also has sufficient space to house the top plate moving unit 120 and its connection unit and devices related to the top plate moving unit 120. For example, the transport unit 130 includes a base 131 on which the top plate moving unit 120 is provided, a plurality of wheels 132 attached to the base 131, a drive control unit 133 and a transport control unit 134 mounted in the base 131, one or more sensors 136 provided, and a fixing mechanism 137 provided on the base 131. The drive control unit 133 and the transport control unit 134 will be described in [Control configuration]. For example, the drive control unit 133 and the transport control unit 134 are accommodated in an accommodation space 131a provided in the base 131. A part of the upper surface of the base 131 may be used as a mounting space for the drive control unit 133 and the transport control unit 134.

[0033] The transport unit 130 constructs, for example, a tape-like guide section on the route, and the patient transport cart 100 moves on the guide section. A marker is incorporated in the guide section. The transport control unit 134 determines where the patient transport cart 100 is located on the route by reading the marker with a sensor or the like. The transport control unit 134 may wirelessly transmit the position of the patient transport cart 100 to an operation management device 260 (see FIG. 8) that manages the operation of the patient transport cart 100. The operation management device 260 can improve the transport efficiency of the patient transport cart 100 as a whole system by determining the position of each patient transport cart 100, particularly when multiple patient transport carts 100 are operating within a facility.

[0034] The patient transport cart 100 is driven by the transport unit 130 to move within the facility by itself using a known autonomous driving technology. The guidance method of the guidance unit may be a magnetic guidance type, an electromagnetic guidance type, an image recognition type such as a two-dimensional code, or a laser guidance type. Alternatively, it may be an autonomous mobile type having a self-position estimation function and a driving control function. The guidance unit may be one that does not easily come off during use but is easy to attach and detach during construction so that the route can be flexibly changed depending on the operation flow of the facility. In addition, the patient transport cart 100 may be a following type that follows or moves in cooperation with a caregiver, or may be capable of switching the driving mode depending on the situation.

[0035] (Wheel 132) In this embodiment, the multiple wheels 132 include driving wheels 1321 (omnidirectional driving wheels) that can move in all directions and free wheels 1322. The driving wheels 1321 can at least move forward and backward and turn. For example, a two-wheel speed difference type may be adopted as the driving wheels 1321. In this case, the driving wheels 1321 can move forward and backward and turn. In addition, the driving wheels 1321 may be a steering type, an independent steering type that can move in all directions, a Mecanum wheel, an omni wheel, or the like. The driving wheels 1321 of the wheels 132 are located in the center part of the base 131 and are installed at least in two places on an axis perpendicular to the traveling axis. On the other hand, the free wheels 1322 are installed at four places on the front, rear, left and right of the base 131. The driving wheels 1321 enable small turning in various directions, and the free wheels 1322 enable stable running. The drive wheels 1321 rotate under the force of a drive source such as a drive motor (not shown) for the drive wheels 1321 under the control of the transport control unit 134, and the patient transport cart 100 travels. The patient transport cart 100 is self-propelled, but may also be moved manually by a caregiver or the like. The drive wheels 1321 are not limited to omnidirectional drive wheels, and may be of a steering type or one that turns by the difference in drive torque or rotation speed between the left and right.

[0036] (Sensor 136) The sensor 136 includes, for example, an obstacle sensor. The sensor 136 is provided at a position (front, rear, four corners, etc.) where an obstacle can be detected when the patient transport cart 100 moves. As an example, the obstacle sensor is a non-contact type that detects surrounding obstacles within a predetermined range (for example, several centimeters to several meters) from the patient transport cart 100, and may be, for example, a two-dimensional or three-dimensional optical sensor, a laser measurement sensor, an acoustic sensor, a magnetic field sensor, an electric field sensor, an induction sensor, a radio wave sensor, or a combination of these. In addition, a contact type sensor may be provided as a sensor for detecting an obstacle. The sensor is provided around a portion that may have the greatest spread in a planar direction (XY plane) such as the base 131 or the top plate 110, and when the patient transport cart 100 comes into contact with an obstacle, the transport control unit decelerates and stops the patient transport cart 100. For example, the sensor is installed so as to surround the periphery of the base 131, and detects contact with a person's feet during transport or contact with a small obstacle on the route, and decelerates and stops the patient transport cart 100.

[0037] The sensor 136 also includes a magnetic induction sensor that detects the marker built into the guiding unit described above. At least two magnetic induction sensors are installed on the floor side of the base 131. Since not only straight paths but also curved paths are assumed, multiple sensors may be installed as necessary. The fixing mechanism 137 is installed so as to protrude from the floor side of the base 131 or to protrude from one or more side surfaces of the front, back, left, and right.

[0038] (Fixing mechanism 137) The fixing mechanism 137 is a mechanism for fixing the position of the transport unit 130 by engaging with receiving parts 225, 235 (see Figs. 6 and 7), which are an example of an engaging part provided on the floor of the radiation therapy room and the positioning room, and fixing the patient transport cart 100 so as not to move relative to the floor. The fixing mechanism 137 includes an engaging member 137c that engages with the receiving parts 225, 235, an engaging member 137c, and a drive motor 137a described later.

[0039] The fitting member 137c is provided on the lower part of the base 131. The number of fitting members 137c can be set as appropriate, but for example, four fitting members are provided. The fitting member 137c is provided so as to be movable forward and backward from the base 131 relative to the floor surface by the drive motor 137a. As a specific mechanism for moving the fitting member 137c forward and backward, known techniques such as a rack and pinion mechanism and a ball screw mechanism can be appropriately used.

[0040] Figures 10(a) to 10(c) are diagrams illustrating the operation of the fixing mechanism 137. Figure 11(a) is a partially enlarged view of the dashed line portion of Figure 10(b), and Figure 11(b) is a partially enlarged view of the dashed line portion of Figure 10(c).

[0041] When the engaging member 137c is not engaged with the receiving parts 225 and 235 (unlocked state), it is stored in the base 131 so as not to get in the way when the patient transport cart 100 moves (storage position, FIG. 10(a)). When the engaging member 137c is engaged with the receiving parts 225 and 235, the driving motor 137a causes the engaging member 137c to protrude downward from the base 131. For example, when the patient transport cart 100 reaches the end of the guide part indicating the fixed position or the marker part designated as the fixed position, the engaging member 137c protrudes from the base 131 toward the receiving parts 225 and 235 on the floor (FIG. 10(b)). Then, the engaging member 137c engages with the receiving parts 225 and 235, and the position of the patient transport cart 100 is fixed (fixed position, FIG. 10(c)).

[0042] As an example, the fitting member 137c of the fixing mechanism 137 has a tapered shape (a truncated cone shape), and the receiving portions 225 and 235 are recesses having a shape corresponding to the tapered shape of the fitting member 137c. As a result, even if the patient transport cart 100 stops at a position slightly shifted from the target position and the fitting member 137c is protruded downward based on the instruction of the fixing mechanism control portion 134c, the fitting member 137c is guided along the tapered shape of the recesses of the receiving portions 225 and 235 (FIG. 11(a)), and the position is uniquely determined (FIG. 11(b)). Note that the shape of the fitting member 137c may be a hemispherical shape or the like in addition to the tapered shape. Also, it is sufficient that the receiving portions 225 and 235 have a shape corresponding to the shape of the fitting member 137c. That is, when the fitting member 137c comes into contact with the receiving portions 225, 235 at a position slightly deviated from the target position, the fitting member 137c may be guided along the receiving portions 225, 235. Alternatively, the fitting member 137c and the receiving portions 225, 235 may have a relationship in which their relative positions are uniquely determined by annular line contact or surface contact along the circumferential direction when fitted together.

[0043] In addition, the fitting member 137c may protrude laterally instead of or in addition to protruding downward. In this case, the receiving portions 225, 235 may be provided on the side surfaces of the walls of the positioning room and the radiation therapy room or other structures.

[0044] Although it is possible to adjust the position of the patient transport cart 100 using a displacement sensor or the like, it may be difficult to ensure positioning accuracy. On the other hand, in this embodiment, positioning is performed using a simple fitting member 137c, so that it is possible to ensure positioning accuracy while simplifying the configuration of the patient transport cart 100. In addition, no large-scale equipment is required on the floor surface, and the receiving parts 225, 235 can be easily installed in the positioning room and the radiation therapy room.

[0045] <Other configurations of the patient transport cart 100> Each drive motor provided on the patient transport cart 100 receives power from a battery (not shown) installed on the base 131, for example, to drive each mechanism to be controlled. The battery loaded on the patient transport cart 100 may be charged through an auto connector (not shown) provided on the base 131. Basically, the top board moving unit 120 and the transport unit 130 do not operate simultaneously, so the power supply destination can be switched and used, and a common battery may be used to receive power for the top board moving unit 120 and the transport unit 130. The battery may be stored in the storage space 131a. By storing it at the end in the longitudinal direction, it can be easily removed and replaced.

[0046] In the patient transport cart 100, the top board moving part 120 and the transport part 130 may be manufactured separately and connected by a fastening part. For example, as shown in Fig. 1(b) and Fig. 1(c), fastening parts 1231 are provided on both ends of the traveling axis plate that do not overlap with the belt part in the longitudinal direction, and fastening parts 1311 are provided on the base 131, and the two are fastened by bolts or the like. This allows the two to be easily assembled, and performance tests and maintenance can be performed separately. In addition, the storage space 131a and the space between the spaces can be used to receive power and perform signal wiring for the top board moving part 120 and the transport part 130.

[0047] [Posture of patient transport cart 100] 1, the tabletop 110, the inclination adjustment mechanism 1211, the first horizontal rotation mechanism 1213, the second horizontal rotation mechanism 1214, the third horizontal rotation mechanism 1223, the vertical rotation mechanism 1222, the arm 1221, and the slide section 123 are configured to be stored in a folded state so as to overlap in the height direction (approximately the Z axis). This state is called the home position state of the patient transport cart 100. In other words, when the patient transport cart 100 is in the home position state, the tabletop 110 and the arm 1221 are folded in the height direction (approximately the Z axis).

[0048] 1(b), in the home position state, the table top 110 and the table top moving part 120 are arranged to be within the widths of the transport part 130 in the X and Y directions in a plan view. Therefore, when the patient transport cart 100 is in the home position state, the spread of the table top 110 and the table top moving part 120 in the planar direction (XY plane) can be suppressed. The patient transport cart 100 moves within a facility such as a hospital with a patient placed on the table top 110 while remaining in this home position state.

[0049] 2(a) to 2(h) are diagrams showing examples of postures that can be taken by the patient transport cart 100. The top board moving unit 120 can move and rotate the top board 110 during radiation therapy, and move the patient to any posture.

[0050] 2(a) and 2(b) show the patient boarding and disembarking positions. At this time, the patient boards and disembarks safely in a wide space on the opposite side of the irradiation device. The top plate 110 is held horizontally by the inclination adjustment mechanism 1211. Furthermore, the arm 1221 is rotated by the third horizontal rotation mechanism 1223 and / or the slide part 123, the top plate 110 is made approximately parallel to the base 131 by the first horizontal rotation mechanism 1213 and / or the second horizontal rotation mechanism 1214, and the top plate 110 is lowered by the vertical rotation mechanism 1222, so that the patient can disembark from the top plate 110. At this time, the drive start posture may be from the home position. On the other hand, if the treatment is immediately after the end of the treatment, the treatment posture, that is, the top plate 110 is in a posture in which it is rotated or moved from the home position, so the top plate 110 may be driven and controlled to gradually move to a horizontal posture by the inclination adjustment mechanism 1211 before reaching the disembarking position.

[0051] 2(c) to (e) are examples of treatment postures. FIG. 2(c) is the 0 degree posture, and FIG. 2(e) is the 180 degree posture. FIG. 2(d) shows the deployment posture during the movement from the 0 degree posture to the 180 degree posture. For example, in prostate cancer treatment, irradiation is divided and performed from the left and right directions of the patient in order to suppress the amount of radiation exposure to normal tissues such as the femoral head. In this case, when two-port irradiation (irradiation from the 0 degree and 180 degree directions) is performed continuously in one day of treatment, it is necessary to quickly rotate the top plate 110 by 180 degrees to maintain the posture when the patient position was set. The arm 1221 is rotated by the third horizontal rotation mechanism 1223 and the slide part 123, and the top plate 110 passes through a position perpendicular to the base 131 by the first horizontal rotation mechanism 1213 and / or the second horizontal rotation mechanism 1214 (FIG. 2(d)), and the top plate 110 is placed at the position of FIG. 2(e) which is a left-right inversion of FIG. 2(c). At this time, since the tabletop 110 is rotated from the treatment position by 0 degrees or 180 degrees to a position inverted from left to right, the tabletop 110 may be rotated while maintaining its position. Also, depending on the position of the tabletop 110, there is a possibility that it may interfere with the arm 1221, so the tilt adjustment mechanism 1211 may be returned to the horizontal position before rotating, and the position may be reproduced until the tabletop 110 reaches the inverted position or when the tabletop 110 reaches the inverted position.

[0052] 2(f)-(g) show an example of a treatment posture, which is a case of non-coplanar irradiation. Non-coplanar irradiation is an irradiation method in which a treatment beam is irradiated not only from a cross section perpendicular to the patient's body axis direction but also from a non-coplanar plane, thereby reducing the dose to normal tissue and important organs adjacent to a tumor. This is mainly performed for head and neck cancer, which has a complex bone structure. When the patient transport cart is fixed to the treatment position, the arm 1221 is rotated by the third horizontal rotation mechanism 1223 and / or the slide unit 123, and the top plate 110 is positioned at a desired angle by the first horizontal rotation mechanism 1213 and / or the second horizontal rotation mechanism 1214. As an example, when irradiating from the top of the head, the top plate 110 is positioned at 90 degrees with respect to the base 131 as shown in FIG. 2(f). In addition, when performing multiple-port irradiation on the same day, if irradiation is to be performed next from 45 degrees as shown in FIG. 2(g), the top plate 110 is rotated around the isocenter (center of irradiation) (isocentric rotation). The rotation start angle is arbitrary. At this time, the arm 1221 and the tabletop 110 do not overlap each other, but are angled so that the position of the tabletop can be adjusted.

[0053] FIG. 2(h) shows an example of using a diagnostic device. The diagnostic device may be, for example, a self-propelled CT, PET, or MRI. The diagnostic device may be installed not only in a dedicated diagnostic room, but also in a radiotherapy room. When the patient transport cart is fixed parallel to the bore (opening) surface of the diagnostic device, the top plate 110 is positioned vertically to the base 131 by the first horizontal rotation mechanism 1213 and / or the second horizontal rotation mechanism 1214. At this time, the arm 1221 is superimposed on the base 131. The diagnostic device self-propels and passes the top plate 110 into the bore to perform imaging. Note that, although each driving mechanism of the top plate moving unit 120 has been described to achieve the postures shown in FIG. 2(a) to FIG. 2(h), these driving mechanisms may be operated in combination.

[0054] [Control configuration] <Control configuration of drive control unit 133> 3 is an example of a functional block diagram of the drive control unit 133. The drive control unit 133 is, for example, a control circuit including one or more processors such as a CPU (Central Processing Unit) and a memory. Each functional unit of the drive control unit 133 may be realized by the processor operating according to a program (software) readably stored in the memory. The program may be stored in a storage unit in the drive control unit 133, for example.

[0055] The drive control unit 133 may be configured to include hardware such as an integrated circuit typified by a field programmable gate array (FPGA) or an application specific integrated circuit (ASIC) instead of or in addition to a processor and a memory. The drive control unit 133 may be realized by a single control circuit, or may be realized by a plurality of control circuits to which each functional unit of the drive control unit 133 is assigned.

[0056] The transmitting / receiving unit 133a transmits and receives information to and from a predetermined device, such as a positioning room management device 240 and a treatment room management device 250, which will be described later, and the operation management device 260, which has been described above (see FIG. 8).

[0057] The pitch rotation / tilt adjustment mechanism control unit 1331b of the tilt adjustment mechanism control unit 133b controls the drive motor 12111a of the tilt adjustment mechanism 1211 based on the instruction received by the transmission / reception unit 133a to control the pitch rotation of the tabletop 110. The amount of rotation of the pitch rotation is calculated by the position detector 12111b and output to the pitch rotation / tilt adjustment mechanism control unit 1331b. The roll rotation / tilt adjustment mechanism control unit 1332b of the tilt adjustment mechanism control unit 133b controls the drive motor 12112a of the tilt adjustment mechanism 1211 based on the instruction received by the transmission / reception unit 133a to control the roll rotation of the tabletop 110. The amount of rotation of the roll rotation is calculated by the position detector 12112b and output to the roll rotation / tilt adjustment mechanism control unit 1332b. The position detector may be a resolver or an encoder. The tilt adjustment mechanism control unit 133b transmits information on the amount of tilt to a predetermined device via the transmission / reception unit 133a. A predetermined device grasps the amount of tilt of the tilt adjustment mechanism 1211 based on the information.

[0058] The first horizontal rotation mechanism control unit 133c controls the drive motor 1213a of the first horizontal rotation mechanism 1213 based on the instruction received by the transmitting and receiving unit 133a. The second horizontal rotation mechanism control unit 133d controls the drive motor 1214a of the second horizontal rotation mechanism 1214 based on the instruction received by the transmitting and receiving unit 133a. The third horizontal rotation mechanism control unit 133e controls the drive motor 1223a of the third horizontal rotation mechanism 1223 based on the instruction received by the transmitting and receiving unit 133a. This causes the top board 110 to be horizontally rotated (yaw rotation) by the first horizontal rotation mechanism 1213 and the second horizontal rotation mechanism 1214, or the arm 1221 to be horizontally rotated (yaw rotation) by the third horizontal rotation mechanism 1223.

[0059] The amount of rotation (amount of yaw rotation) is calculated by each position detector 1213b, 1214b, 1223b and output to each horizontal rotation mechanism control unit 133c, 133d, 133e. Each horizontal rotation mechanism control unit 133c, 133d, 133e transmits information on the amount of rotation to a predetermined device via the transmitting / receiving unit 133a. The predetermined device determines the amount of rotation of the first horizontal rotation mechanism 1213, the second horizontal rotation mechanism 1214, and the third horizontal rotation mechanism 1223 based on the information.

[0060] Based on the instruction received by the transmitting / receiving unit 133a, the vertical rotation mechanism control unit 133f controls the drive motor 1222a of the vertical rotation mechanism 1222 to control the rotation of the arm 1221. The amount of rotation is calculated by the position detector 1222b and output to the vertical rotation mechanism control unit 133f. The vertical rotation mechanism control unit 133f transmits information on the amount of rotation to a predetermined device via the transmitting / receiving unit 133a. The predetermined device grasps the amount of rotation of the vertical rotation mechanism 1222 based on the information.

[0061] The linear drive mechanism control unit 133g controls the drive motor 123a of the slide unit 123 based on the instruction received by the transmission / reception unit 133a to control the linear movement amount of the arm 1221. The movement amount is calculated by the position detector 123b and output to the linear drive mechanism control unit 133g. The linear drive mechanism control unit 133g transmits information on the movement amount to a predetermined device via the transmission / reception unit 133a. The predetermined device grasps the movement amount of the slide unit 123 based on the information. A control unit 133h may be present between the transmission / reception unit 133a and the control units of each axis. The control unit 133h is responsible for overall control such as trajectory calculation of the top board drive unit for moving the top board 110 to a desired position.

[0062] <Control configuration of the transport control unit 134> 4 is a functional block diagram of the transport control unit 134. The transport control unit 134 is, for example, a control circuit equipped with one or more processors such as a CPU (Central Processing Unit) and a memory. Each functional unit of the drive control unit 133 may be realized by the processor operating according to a program (software) readably stored in the memory. The program may be stored in a storage unit in the transport control unit 134, for example.

[0063] The transport control unit 134 may be configured to include hardware such as an integrated circuit typified by an FPGA (Field Programmable Gate Array) or an ASIC (Application Specific Integrated Circuit) instead of or in addition to a processor and memory. The transport control unit 134 may be realized by a single control circuit, or may be realized by a plurality of control circuits to which each functional unit of the transport control unit 134 is assigned.

[0064] The transmitting / receiving unit 134a transmits and receives information to and from a predetermined device. Examples of the predetermined device include a positioning room management device 240 and a treatment room management device 250, which will be described later, and the operation management device 260, which has been described above (see FIG. 8). In addition, the drive control unit 133 and the transport control unit 134 may be able to communicate with each other via the transmitting / receiving unit 133a and the transmitting / receiving unit 134a.

[0065] Based on an instruction received from a predetermined device, the wheel control unit 134b controls the drive motor 132a of the drive wheel 1321 included in the wheel 132 to control the rotation and direction of the drive wheel 1321. The transport control unit 134 controls the drive wheel 1321, so that the patient transport cart 100 moves independently within the facility. The amount of rotation (speed, travel distance, etc.) of the drive wheel 1321 is calculated by the position detector 132b and output to the wheel control unit 134b. The position detector may also be a resolver or an encoder. The wheel control unit 134b transmits information on the amount of rotation to a predetermined device via the transmission / reception unit 134a. In addition, when the sensor 136 of the transport unit 130 detects an obstacle, it transmits a detection signal to the transport control unit 134. In response to this, the transport control unit 134 decelerates and stops the patient transport cart 100. Alternatively, when the transport control unit 134 knows the position of the patient transport cart 100 from the marker of the guidance unit, the transport control unit 134 may instruct the wheel control unit 134b to perform appropriate driving control using the self-position estimation function. In other words, the transport control unit 134 may instruct the wheel control unit 134b to perform appropriate driving control without communicating with a predetermined device such as the traffic management device 260. In this case, closed control of the driving of the patient transport cart 100 within the patient transport cart 100 becomes possible.

[0066] The fixing mechanism control unit 134c controls the drive motor 137a based on an instruction received from a specific device to transition the state of the fixing mechanism 137 between a locked state and an unlocked state. Here, the locked state refers to a state in which the fitting member 137c of the fixing mechanism 137 protrudes from the base 131 and engages with the receiving part. The unlocked state refers to a state in which the fitting member 137c of the fixing mechanism 137 is released from the receiving part and stored in the base 131. Alternatively, when the transport control unit 134 knows the position of the patient transport cart 100 based on the marker of the guidance unit, it may determine that the patient transport cart 100 has reached the fixed position by the self-position estimation function and instruct the fixing mechanism control unit 134c to control the state transition of the fixing mechanism. That is, the transport control unit 134 may instruct the fixing mechanism control unit 134c to control the state transition of the fixing mechanism without communicating with a specific device.

[0067] [Summary of the patient transport cart 100] As described above, according to this embodiment, the patient transport cart 100 can be made smaller in size. Specifically, the patient transport cart 100 has the slide section 123 that slides the arm section 122 relative to the transport section 130. This allows the patient transport cart 100 to be made smaller in size than when the same degree of freedom is ensured without providing the slide section 123. In other words, when an attempt is made to ensure the same degree of freedom without providing the slide section 123, for example, it is necessary to further add a link in series to the arm 1221. In this embodiment, the patient transport cart 100 can be made smaller in size than in such a case.

[0068] Furthermore, in this embodiment, the arm 1221 is not an arm in which a plurality of links of a predetermined length are connected in series, such as an arm having an upper arm and a forearm, but is composed of only one link in the series direction. Therefore, the patient transport cart 100 can be made smaller in size in the vertical direction compared to an arm having an upper arm and a forearm, for example. In detail, the patient transport cart 100 of this embodiment can be made smaller in size in the vertical direction compared to an arm or the like in which the upper arm and the forearm need to be folded and stacked in the vertical direction in the home position state.

[0069] In this embodiment, the top board 110 is moved by the slide unit 123 and the arm unit 122. Therefore, the length of the arm can be made shorter and the range of passage of the arm narrower than an arm in which, for example, multiple links of a predetermined length are connected in series without providing the slide unit 123. Therefore, interference between the top board moving unit 120 and other devices can be suppressed.

[0070] In this embodiment, the arm 1221 may have an avoiding portion 1221a having a shape such as a curved shape that avoids interference with the transport unit 130 in the mounting and dismounting posture when the patient gets on and off the top board 110. As a result, the arm 1221 can be rotated toward the floor to a greater extent, and the position where the patient gets on and off can be made lower (for example, the height of the top board from the floor surface is 70 cm or less). This allows even the elderly and children to easily get on and off.

[0071] In this embodiment, the fitting member 137c of the fixing mechanism 137 has a tapered shape, and the receiving portions 225 and 235 are recesses having a shape corresponding to the tapered shape of the fitting member 137c. As a result, the fitting member 137c is guided along the tapered shape of the recesses of the receiving portions 225 and 235, and the position of the fitting member 137c is uniquely determined with respect to the receiving portions 225 and 235. Therefore, the positioning accuracy of the patient transport cart 100 can be ensured with a simple shape.

[0072] In addition, since the positioning accuracy of the patient transport cart 100 can be ensured, by providing similar receiving portions 225, 235 in the positioning room and the radiation therapy room, positioning in the radiation therapy room can be effectively performed using the positioning data obtained in the positioning room.

[0073] [Radiation Irradiation System] <Summary> A description will now be given of a radiation irradiation system 200 using the above-described patient transport cart 100. The radiation irradiation system 200 includes one or more patient transport carts 100, a radiation irradiation device 210, patient positioning devices 220 and 230, a positioning room management device 240, a treatment room management device 250, and a traffic management device 260.

[0074] Fig. 5 shows an example of a radiation irradiation system 200 installed in a facility (e.g., a hospital) where radiation therapy is performed. The facility where radiation therapy is performed includes at least one or more radiation therapy rooms in which a radiation irradiation device 210 that irradiates radiation to a patient is placed, and one or more positioning rooms in which a positioning process is performed to match the position of the affected part of the patient with the irradiation position (isocenter IC) of the radiation irradiation device 210. In the example of Fig. 5, a particle beam therapy facility is assumed.

[0075] <Positioning Room> 6(a) and 6(b) are diagrams showing the configuration of the positioning room. The positioning room is provided with a patient positioning device 220 and a receiving portion 225 that engages with the fixing mechanism 137 of the patient transport cart 100. For example, the patient transport cart 100 carrying the patient is transported through the facility to the positioning room, and after the fixing mechanism 137 is fitted and fixed to the receiving portion 225 provided in the positioning room, it is used as it is as a measurement table for positioning. There is no need to move the patient from the transport cart to the measurement table for positioning, and the burden on the patient is reduced. In addition, there is no need to provide a fixed measurement table in the positioning room, and the space required for the positioning room can be reduced.

[0076] The patient positioning device 220 includes a plurality of X-ray tubes 221a, 221b and a plurality of detectors 222a, 222b for detecting X-rays, such as a CCD area image sensor, a CMOS area image sensor, or a flat panel detector. The patient positioning device 220 is, for example, an X-ray imaging device or an X-ray CT device. An MRI device may be used as the patient positioning device 220. In this case, a magnetic field generating device (such as an electromagnet) is used instead of the X-ray tube 221, and a magnetic field detecting device (such as an RF receiving coil) is used as the detector 222.

[0077] 6(a) and 6(b), two pairs of X-ray tubes 221a, 221b and corresponding detectors 222a, 222b are illustrated, but there may be one pair, or three or more pairs. The greater the number, the higher the accuracy, but the more complicated the processing, so for example, two to four pairs are preferable.

[0078] In the positioning room, the positioning of the affected area relative to the position of the radiation irradiation position (isocenter IC) is performed using the patient position setting device 220 (FIG. 6(a)). The isocenter coordinate data (XYZ coordinates), X-ray image data, and positioning data of the tabletop moving unit 120 are sent to the positioning room management device 240, and are sent from the positioning room management device 240 to the treatment room management device 250 via the network 270. Here, the positioning data may be positioning data of the inclination adjustment mechanism 1211, the first horizontal rotation mechanism 1213, the second horizontal rotation mechanism 1214, the third horizontal rotation mechanism 1223, the vertical rotation mechanism 1222, the arm 1221, and the slide unit 123. In other words, it may be various data for reproducing the posture of the tabletop 110 and the tabletop moving unit 120 in the radiation treatment room, which is obtained during positioning. After the positioning of the radiation irradiation position is completed in the positioning room, the patient transport cart 100 returns to the home position with the patient on the tabletop 110 (FIG. 6(b)). The patient then moves from the positioning room to the radiation treatment room along the installed guidance section.

[0079] <Radiation treatment room> The radiation therapy room is surrounded by thick concrete or other shielding to prevent unnecessary leakage of radiation to the outside (Figure 5). The entrance to the radiation therapy room has a maze structure with many twists and turns, and measures are taken to prevent radiation leakage.

[0080] FIG. 7 is a diagram showing a schematic configuration of a radiation therapy room. The radiation therapy room is equipped with a radiation irradiation device 210 (particularly, an irradiation unit 213), a patient position setting device 230 for positioning the radiation irradiation position, and a receiving part 235 for engaging with the fixing mechanism 137 of the patient transport cart 100. The patient transport cart 100 carrying the patient is transported through the facility to the radiation therapy room, and after the engaging member 137c of the fixing mechanism 137 is engaged with the receiving part 235 provided in the radiation therapy room and fixed, it is used as a table for radiation therapy as it is. There is no need to move the patient from the transport cart to a table for treatment of the patient, and the burden on the patient is reduced. In addition, there is no need to provide a fixed treatment table in the radiation therapy room, and the space in the radiation therapy room can be reduced.

[0081] In the radiation therapy room, the positioning process of the affected area relative to the radiation irradiation position is performed again based on the positioning data received from the positioning room management device 240. The patient positioning device 230 installed in the radiation therapy room may include multiple X-ray tubes 231a, 231b and multiple detectors 232a, 232b that detect X-rays. Although the configuration may be different from that of the patient positioning device 220 installed in the positioning room, by having the same configuration, alignment between the radiation therapy room and the positioning room is facilitated.

[0082] <Patient positioning device 220, 230> The patient positioning device 220 in the positioning room may be partially provided in the positioning room and the remaining part may be provided outside the positioning room. Similarly, the patient positioning device 230 in the radiation treatment room may be partially provided in the radiation treatment room and the remaining part may be provided outside the radiation treatment room. Therefore, if a part of the patient positioning devices 220, 230 is provided in the positioning room or the radiation treatment room, they are called "patient positioning devices provided in the positioning room" and "patient positioning devices provided in the radiation treatment room."

[0083] The patient positioning device 220 includes various communication interfaces, a program and a processor (or ASIC, etc.) for various controls, a memory for calculating the amount of displacement during positioning processing and for reading acquired images, etc. The patient positioning device 220 includes an X-ray imaging control unit (not shown) as a functional unit of the patient positioning device 220 that is realized by operating a processor according to a program (software) readably stored in the memory.

[0084] The X-ray imaging control unit controls the X-ray tube 221 and the detector 222 in response to an instruction from the positioning room management device 240 or at a predetermined cycle, generates an X-ray image of the affected area of ​​the patient, and outputs it to the patient position setting unit. The patient position setting unit compares the input X-ray image with a reference X-ray image of the affected area of ​​the patient that is stored in advance, calculates the amount of error (position error) between the two, and outputs the information to the positioning room management device 240.

[0085] <Positioning room management device 240> The positioning room management device 240 calculates the amount of movement and / or rotation of the top 110 and top moving unit 120 of the patient transport cart 100 so as to reduce (or eliminate) the position error, and sends this information to the drive control unit 133 of the patient transport cart 100. In response to this, the drive control unit 133 moves the top moving unit 120 to adjust the position of the top 110. The positioning room management device 240 also receives information on the actual amount of movement and / or rotation from the patient transport cart 100.

[0086] The positioning room management device 240 sends various information to the treatment room management device 250 via the network 270. The various information includes information on the amount of movement and / or the amount of rotation received by the positioning room management device 240 from the transport control unit 134.

[0087] The patient position setting device 230 and the treatment room management device 250 in the radiation therapy room can have the same configurations as the patient position setting device 220 and the positioning room management device 240 in the positioning room, respectively, but a description thereof will be omitted.

[0088] <Operation management device 260> 8 is a diagram explaining the exchange of information between the operation management device 260, the patient transport cart 100, the positioning room management device 240, and the treatment room management device 250. The operation management device 260 is a computer that manages the position of the patient transport cart 100. The operation management device 260 communicates with the transport control unit 134 of the patient transport cart 100, and grasps the position of the patient transport cart 100 from information read from the markers of the guidance unit.

[0089] To improve the efficiency of radiation therapy, it is necessary to shorten the time each patient occupies a treatment room and to have the next patient enter the radiation therapy room immediately after the completion of radiation therapy for one patient. There may be multiple patient transport carts operating in the radiation therapy room or facilities outside the radiation therapy room, and a management device that grasps the position of each patient transport cart is required to operate multiple patient transport carts. In consideration of this situation, the operation management device 260 may grasp the positions of multiple patient transport carts 100 within the facility.

[0090] <Control switching of the patient transport cart 100> Next, switching of control of the patient transport cart 100 when entering the positioning room and the radiation therapy room will be described.

[0091] When the patient transport cart 100 enters the positioning room and the engagement between the fixing mechanism 137 and the receiving portion 225 is completed (locked state), a signal indicating that the locked state has been achieved is transmitted from the transmitting / receiving unit 134a to the positioning room management device 240. In response to this, the positioning room management device 240 sends an instruction to the transport control unit 134 to put the transport control unit 134 into a standby state (standby state) in order to prevent the patient transport cart 100 from moving unexpectedly. In addition, the positioning room management device 240 sends an instruction to the drive control unit 133 to return the drive control unit 133 from the standby state. Note that the instruction may be sent from the transport control unit 134 to the drive control unit 133.

[0092] After the drive control unit 133 completes the positioning of the top board 110 by controlling the top board moving unit 120, the positioning room management device 240 sends a positioning completion signal to the drive control unit 133. In response to this, the drive control unit 133 returns the top board 110 to the home position state. After returning to the home position state, the drive control unit 133 transmits a signal indicating that the top board 110 has returned to the home position state to the positioning room management device 240. In response to this, the positioning room management device 240 transmits an instruction to the transport control unit 134 to return from the standby state. Upon receiving an instruction from the positioning room management device 240, the transport control unit 134 returns from the standby state. Meanwhile, the drive control unit 133 receives an instruction from the positioning room management device 240 or the transport control unit 134 and enters the standby state. Then, the transport control unit 134 sets the fixing mechanism 137 to an unlocked state and transmits a signal indicating that the fixing mechanism 137 has been unlocked to the positioning room management device 240. In response to this, the positioning room management device 240 sends an instruction (including a route specification) to the transport control device 134 to permit the movement of the patient transport cart 100. In response to this, the transport control device 134 moves the patient transport cart 100, leaves the positioning room, and moves to the radiotherapy room. The transport control device 134 may transmit a signal indicating that the lock has been released to the operation management device 260. Then, the transport control device 134 may receive an instruction (including a route specification) to permit the movement of the patient transport cart 100 from the operation management device 260.

[0093] Similarly, when the patient transport cart 100 enters the radiotherapy room and the engagement between the fixing mechanism 137 and the receiving part 235 is completed, a signal indicating that the locked state has been achieved is transmitted to the treatment room management device 250. In response to this, the treatment room management device 250 sends an instruction to put the transport control unit 134 into a standby state and an instruction to restore the drive control unit 133 from the standby state in order to prevent the patient transport cart 100 from moving unexpectedly.

[0094] After the radiation therapy is completed, the treatment room management device 250 sends a return signal to the drive control device 133 to return the top board moving unit 120 to the home position. In response to this, the drive control device 133 returns the top board 110 to the home position state. After returning to the home position state, the drive control device 133 sends a signal indicating that the top board 110 has returned to the home position state to the treatment room management device 250. In response to this, the treatment room management device 250 sends an instruction to the transport control device 134, and upon receiving the instruction from the treatment room management device 250, the transport control device 134 recovers from the standby state and the drive control device 133 goes into the standby state. Then, the transport control device 134 puts the fixing mechanism 137 into an unlocked state and sends a signal indicating that the lock has been released to the treatment room management device 250. In response to this, the treatment room management device 250 sends an instruction (including a route designation) to the transport control device 134 to permit the patient transport cart 100 to move. In response to this, the transport control device 134 moves the patient transport cart 100 and leaves the radiation therapy room.

[0095] <Processing example> 9 is a flowchart for explaining a series of steps in radiation therapy in the radiation irradiation system 200. Note that the order of steps in this flowchart is not limited to the above and may be appropriately adjusted as necessary.

[0096] When the patient transport cart 100 is ready to move to the positioning room, the drive control unit 133 goes into a standby state, and the transport control unit 134 moves the patient transport cart 100 to the designated positioning room along the guide unit of the designated route (step S1). At this time, a caregiver or the like may appropriately specify the destination to the transport control unit 134 from an input unit (not shown) of the patient transport cart 100.

[0097] When the transport control unit 134 reaches the guide unit indicating the fixed position in the positioning room, it locks the fixing mechanism 137 and sends a signal indicating that the lock has been completed to the positioning room management device 240 (step S2). In response to this, the positioning room management device 240 sends an instruction to the transport control unit 134 to enter a standby state and an instruction to the drive control unit 133 to return from the standby state (step S3). The patient who entered the positioning room gets on the patient transport cart 100 and moves to a predetermined position. After that, in order to suppress the deviation between the patient and the treatment table, the patient is fixed to the top plate 110 by a fixing device so as not to move. When the patient gets on the top plate 110, the drive control unit 133 moves the top plate moving unit 120 to move the top plate 110 closer to the floor surface to make it easier for the patient to get on (FIG. 2(a)). The top plate 110 with the patient on it moves to a predetermined initial position based on the data (positioning data) at the time of the treatment plan or the data at the previous treatment. To save time, the patient fixing work may be performed outside the positioning room. The drive control unit 133 moves the tabletop 110 and the tabletop moving unit 120 to position the radiation irradiation position (step S4). Data obtained by the positioning is sent from the positioning room management device 240 to the treatment room management device 250 via the network 270. In the positioning, for example, a laser pointer or the like installed in the positioning room is used to roughly position the position where the radiation is irradiated and the part to be irradiated from above the patient's skin. After that, an X-ray image, CT image, or MRI image of the patient is taken, and the position and inclination of the tabletop on which the patient stands are adjusted while viewing the image, to determine the position to irradiate the radiation particle beam with high precision (for example, to the unit of 0.1 mm).

[0098] When the positioning is completed, the positioning room management device 240 sends a return signal to the drive control device 133 to return the top board moving unit 120 to the home position, and in response to this, the drive control device 133 returns the top board 110 to the home position state. After that, the drive control device 133 sends a signal indicating that it has returned to the home position state to the positioning room management device 240, and the positioning room management device 240 sends an instruction to restore the transport control unit 134 from the standby state and an instruction to put the drive control unit 133 into the standby state. In response to this, the drive control unit 133 goes into the standby state, and the transport control unit 134 recovers from the standby state (step S5). The transport control unit 134 puts the fixing mechanism 137 into the unlocked state (step S6).

[0099] The transport control unit 134 transmits a signal indicating that the lock has been released to the positioning room management device 240, and the positioning room management device 240, upon receiving the signal, transmits an instruction to permit the patient transport cart 100 to be moved. In response to this, the transport control unit 134 moves the patient transport cart 100 to the radiation treatment room along the guidance section of the route designated by the operation management device 260 (step S7).

[0100] When the patient reaches the guide unit indicating the fixed position in the radiation therapy room, the transport control unit 134 locks the fixing mechanism 137 and sends a signal indicating that the locking state has been reached to the treatment room management device 250 (step S8). In response to this, the treatment room management device 250 sends an instruction to put the transport control unit 134 into a standby state and an instruction to restore the drive control unit 133 from the standby state. In response to this, the transport control unit 134 goes into a standby state, the drive control unit 133 restores from the standby state, and becomes able to control the top board 110 and the top board moving unit 120 (step S9). The drive control unit 133 receives information on the radiation irradiation position determined in the positioning room (including the posture information of the top board 110 and the top board moving unit 120) from the treatment room management device 250, and reproduces the patient position based on the information (step S10). Thereafter, if necessary, a further positioning process (step S11) may be performed by the patient position setting device 230 in the radiation therapy room.

[0101] When the positioning is completed, the operation management device 260 operates the radiation irradiating device 210, and radiation therapy begins (step S12).

[0102] When the radiation therapy is completed, the treatment room management device 250 sends a signal indicating that the patient positioning is completed to the drive control device 133, and the drive control device 133 receives the signal and returns the tabletop 110 to the home position state. The treatment room management device 250 sends an instruction to the transport control device 134 to recover from the standby state and an instruction to the drive control device 133 to put the transport control device 133 into the standby state. In response to this, the drive control device 133 goes into the standby state, and the transport control device 134 recovers from the standby state (step S13). Then, the transport control device 134 puts the fixing mechanism 137 into the unlocked state (step S14). The transport control device 134 sends a signal indicating that the unlocked state has been reached to the treatment room management device 250, and the treatment room management device 250 receives the signal and sends an instruction to the transport control device 134 to permit the patient transport cart 100 to be moved. In response to this, the transport control device 134 moves the patient transport cart 100 to leave the radiation therapy room and move along the guidance section to a preparation room or the like (step S15).

[0103] The dimensions, materials, shapes, relative positions of components, and the like described in the above embodiments are arbitrary, and a person skilled in the art will understand that they will be changed depending on the structure of the device to which the present invention is applied or various conditions. Furthermore, the present invention is not limited to the above embodiments specifically described. [Explanation of symbols]

[0104] 100: patient transport cart, 110: tabletop, 120: tabletop moving unit, 121: adjustment unit, 122: arm unit, 1221: arm, 1222: vertical rotation mechanism, 1223: third horizontal rotation mechanism, 123: slide unit, 130: moving unit, 200: radiation irradiation system

Claims

1. A patient transport cart, A tabletop on which the patient sits, a top plate moving unit that is connected to the top plate and moves the top plate; a transport unit that transports the top plate and the top plate moving unit; A tabletop movement control unit that controls the tabletop movement unit; A transport control unit that controls the transport unit; Equipped with The tabletop moving unit includes an arm unit, an adjustment unit, and a slide unit. The arm unit has an arm and a mechanism for operating the arm, the adjustment unit is provided between the arm unit and the tabletop and adjusts the attitude of the tabletop at a tip side of the arm; The slide portion slides the arm portion relative to the transport portion. Patient transport trolley.

2. 2. The patient transport cart according to claim 1, When a rotation around the Z axis along the height direction is defined as a rotation in the yaw direction, a rotation around the X axis perpendicular to the Z axis is defined as a rotation in the pitch direction, and a rotation around the Y axis perpendicular to the Z axis and the X axis is defined as a rotation in the roll direction, the adjustment unit: An inclination adjustment mechanism that rotates the tabletop in at least one of a pitch direction and a roll direction to adjust the inclination of the tabletop; an orientation adjustment mechanism for adjusting the orientation of the tabletop by rotating the tabletop in a yaw direction; Including, Patient transport trolley.

3. 3. The patient transport cart according to claim 2, The orientation adjustment mechanism is capable of rotating the tabletop in a yaw direction around two axes along a height direction. Patient transport trolley.

4. 2. The patient transport cart according to claim 1, The mechanism for operating the arm includes: a first rotation mechanism that rotates the arm around an axis extending in a horizontal direction; A second rotation mechanism that rotates the arm in a yaw direction; Including, Patient transport trolley.

5. 2. The patient transport cart according to claim 1, The arm is a robot arm of a parallel link mechanism. Patient transport trolley.

6. 2. The patient transport cart according to claim 1, The slide portion is A guide provided on an upper portion of the conveying unit; A movable part that moves along a guide; Including, Patient transport trolley.

7. 2. The patient transport cart according to claim 1, The conveying unit is A base on which the top plate moving part is provided; the base has a space in which the top plate movement control section and the transport control section can be provided, a fixing mechanism provided on the base and engaging with an engaging portion provided in the radiation therapy room to fix the position of the transport unit; Including, Patient transport trolley.

8. The patient transport cart according to claim 7, the fixing mechanism includes a fitting member that fits with the engagement portion and displaces between a storage position stored in the base and a fixed position protruding from the storage position, Patient transport trolley.

9. The patient transport cart according to claim 7, The transport unit includes at least four of the fixing mechanisms. Patient transport trolley.

10. The patient transport cart according to claim 7, the fixing mechanism includes a fitting member that fits with the engagement portion and displaces between a storage position stored in the base and a fixing position protruding from the storage position, The fitting member includes a tapered portion, the engaging portion includes a recess corresponding to the tapered shape of the fitting member, The fitting member and the engaging member are in annular line contact or surface contact. Patient transport trolley.

11. The patient transport cart according to claim 7, The transport unit includes a plurality of wheels attached to the base, The plurality of wheels include: A drive wheel driven by a drive source; A free wheel that follows the drive wheel; Including, Patient transport trolley.

12. 12. The patient transport cart according to claim 11, The drive wheels are capable of at least forward and backward movement and turning. Patient transport trolley.

13. A radiation irradiation system including a patient transport cart and a radiation irradiation device that irradiates a patient with radiation, The patient transport cart includes: A tabletop on which the patient sits, a top plate moving unit that is connected to the top plate and moves the top plate; a transport unit that transports the top plate and the top plate moving unit; Equipped with The top plate moving unit is an arm unit having an arm and a mechanism for operating the arm; a slide portion that slides the arm portion relative to the transport portion; an adjustment unit provided between the arm unit and the tabletop and configured to adjust the attitude of the tabletop; Including, Radiation exposure system.

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