Photodynamic therapy support device

Abstract

To provide a photodynamic therapy treatment support device that allows a distribution state of a photosensitive substance accumulated in tumor cells to be checked before or after the treatment by a photodynamic therapy.SOLUTION: A photodynamic therapy treatment support device (treatment support device 100) includes a light source (excitation light source 2) and a distribution information output part (image collection part 4). In a photodynamic therapy treatment, the light source (excitation light source 2) executes irradiation of light of a specific wavelength band having energy capable of generating fluorescent light from a photosensitive substance (300) without advancing necrosis of tumor cells (201) onto the photosensitive substance (300) administered in the body of a subject (patient 200). The distribution information output part (image collection part 4) outputs information on the distribution state of the fluorescent light generated from the photosensitive substance (300) on the basis of the fluorescent light generated from the photosensitive substance (300).SELECTED DRAWING: Figure 6

Description

[Technical Field]

[0001] The present invention relates to a photodynamic therapy treatment support device. [Background technology]

[0002] Photodynamic therapy (PDT) has traditionally been used as a treatment for malignant tumors, such as esophageal cancer, lung cancer, and brain tumors. In PDT, a photosensitizer is administered intravenously to the patient, causing a photochemical reaction and accumulating in tumor cells. The photosensitizer accumulates in and around tumor cells, and then the tumor cells are continuously irradiated with light of a specific wavelength band appropriate for the photosensitizer. The photosensitizer then emits fluorescence and undergoes a photochemical reaction, generating reactive oxygen species (singlet oxygen). In PDT, the reactive oxygen species generated by the photochemical reaction of the photosensitizer damages the tumor cells where the photosensitizer has accumulated, as well as the blood vessels surrounding the tumor cells, thereby cutting off the tumor cells' supply of nutrients via blood flow and causing tumor necrosis. Furthermore, when the photosensitizer undergoes a photochemical reaction (i.e., the photochemical reaction has progressed) upon irradiation with light of a specific wavelength band, it ceases to emit fluorescence.

[0003] Furthermore, Patent Document 1 discloses a treatment progress monitor device that displays in real time an index estimating the volume and depth of the treatment area using the fluorescence intensity of the fluorescence emitted from the photosensitive substance during photodynamic therapy (while light in a specific wavelength band corresponding to the photosensitive substance is continuously irradiated). [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Japanese Patent Application Laid-Open No. 2014-221117 Summary of the Invention [Problem to be solved by the invention]

[0005] To enhance the therapeutic effect of photodynamic therapy, it is desirable to confirm the distribution of the photosensitizer (drug) before treatment and to start treatment at a state and location where a sufficient number of the photosensitizer has accumulated in tumor cells in the patient's body. Furthermore, to determine whether additional treatment is necessary after treatment, there is a need to confirm the presence or absence of photosensitizer that has not undergone a photochemical reaction and is not in effect for treatment, based on the distribution of fluorescence emitted by the photosensitizer. Therefore, it is desirable to be able to confirm the distribution of photosensitizers that have accumulated in tumor cells even outside of treatment (before or after treatment). Photodynamic therapy involves administering the photosensitizer to a subject and then continuously irradiating the subject with light in a specific wavelength band to provide the photosensitizer with energy to promote tumor cell necrosis.

[0006] The present invention has been made to solve the above-mentioned problems, and one object of the present invention is to provide a treatment support device that can confirm the distribution state of photosensitive substances that have accumulated in tumor cells before or after photodynamic therapy treatment. [Means for solving the problem]

[0007] A photodynamic therapy treatment support device according to one aspect of the present invention comprises: Talaporfin sodium accumulates in tumor cells, Irradiating light in a specific wavelength range Light Source and a memory unit that stores the light irradiation time and irradiation intensity corresponding to the talaporfin sodium; a control unit that reads out the irradiation time and irradiation intensity stored in the memory unit and irradiates the talaporfin sodium with light from the light source at the read irradiation time and irradiation intensity; a fluorescence detection unit that detects fluorescence emitted by the talaporfin sodium upon excitation by light; Based on fluorescence 、 a distribution information output unit that outputs information about the distribution state of the fluorescent light; The irradiation time and irradiation intensity are those that excite talaporfin sodium but do not kill tumor cells when irradiated with light. . [Effects of the Invention]

[0008] In one aspect of the photodynamic therapy treatment support device of the present invention, as described above, the light source irradiates a photosensitizer administered to the subject's body with light in a specific wavelength band having energy sufficient to cause the photosensitizer to generate fluorescence without promoting necrosis of tumor cells during photodynamic therapy. Furthermore, the distribution information output unit outputs information about the distribution of the fluorescence generated from the photosensitizer based on the fluorescence generated from the photosensitizer. This allows information about the distribution of the fluorescence generated from the photosensitizer to be output before or after treatment without promoting necrosis of tumor cells (without advancing treatment), making it possible to confirm the distribution of the photosensitizer accumulated in tumor cells before or after photodynamic therapy treatment. [Brief explanation of the drawings]

[0009] [Figure 1] FIG. 1 is a diagram for explaining photodynamic therapy. [Figure 2] FIG. 1 shows the fluorescence spectrum of Laserphyrin (registered trademark). [Figure 3] FIG. 1 is a diagram illustrating the mechanism of photosensitizers in photodynamic therapy. [Figure 4] FIG. 2 is a second diagram illustrating the mechanism of photosensitizers in photodynamic therapy. [Figure 5] FIG. 10 is a diagram showing an example of changes in fluorescence intensity during treatment. [Figure 6] 1 is a block diagram showing the overall configuration of a treatment support device according to an embodiment of the present invention. [Figure 7] FIG. 10 is a diagram showing an example of a fluorescence distribution image. [Figure 8] FIG. 2 is a diagram showing an example of a visible light image. [Figure 9] FIG. 10 is a diagram showing an example of a composite image. [Figure 10] FIG. 10 is a diagram showing an example of the tendency of the fluorescence intensity to decrease with increasing cumulative energy amount. [Figure 11]10A and 10B are diagrams showing an example of the irradiation intensity and irradiation time of excitation light irradiated when generating a fluorescence distribution image before or after treatment by the treatment support device of one embodiment of the present invention. [Figure 12] 10A and 10B are diagrams showing another example of the irradiation intensity and irradiation time of the excitation light irradiated when generating a fluorescence distribution image before or after treatment. [Figure 13] FIG. 10 is a block diagram showing the overall configuration of a medical treatment support device according to a first modified example. [Figure 14] FIG. 10 is a block diagram showing the overall configuration of a medical treatment support device according to a second modified example. DETAILED DESCRIPTION OF THE INVENTION

[0010] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, specific embodiments of the present invention will be described with reference to the accompanying drawings.

[0011] (Photodynamic Therapy) First, with reference to Figs. 1 to 5, photodynamic therapy (PDT) using a treatment support device 100 according to one embodiment of the present invention will be described. In photodynamic therapy, as shown in Fig. 1, a drug, a photosensitizer 300, is administered to the body of a patient 200 before treatment. After the photosensitizer 300 (drug) is administered to the patient 200, observation and treatment are carried out using the treatment support device 100 after a predetermined time (4 to 6 hours) has elapsed for the photosensitizer 300 (drug) to accumulate in tumor cells 201. The patient 200 is an example of a "subject" in the claims.

[0012] Photosensitizer 300 is a substance that is excited and emits fluorescence when irradiated with light in a specific wavelength band. Photosensitizer 300 used in this embodiment is talaporfin sodium. Specifically, Laserphyrin (registered trademark) is used as the drug that is photosensitizer 300. Laserphyrin (registered trademark) is excited by light with a wavelength of 664 nm, and emits light with wavelengths of 672 nm to 1800 nm as fluorescence, as shown in FIG. 2. In other words, when Laserphyrin (registered trademark) is used as the drug, light in the specific wavelength band is light in a wavelength band that includes 664 nm.

[0013] Photosensitizer 300 administered to patient 200 travels through the body of patient 200 via the bloodstream, passes through blood vessels 202, and is absorbed and accumulated in cells within the body. Photosensitizer 300 is excreted outside the cells over time, but tumor cells 201 take a longer time from absorption to excretion of photosensitizer 300 than normal cells. Therefore, by utilizing the time difference between absorption and excretion of photosensitizer 300 between tumor cells 201 and normal cells, photosensitizer 300 can be selectively accumulated in tumor cells 201 and around tumor cells 201.

[0014] Photosensitizer 300 is a substance that undergoes a photochemical reaction when continuously irradiated with light of a specific wavelength band (the energy of light of the specific wavelength band accumulates). When photosensitizer 300 changes from an excited state to a ground state, the energy generated by the excitation is transferred to tumor cells 201 and oxygen around tumor cells 201, generating reactive oxygen species 400 (singlet oxygen) (see FIG. 3). The reactive oxygen species 400 generated by the photochemical reaction of photosensitizer 300 damages tumor cells 201 where photosensitizer 300 has accumulated, due to its oxidative power, and also damages blood vessels 202 around tumor cells 201, cutting off the supply of nutrients to tumor cells 201 through blood flow. This causes tumor cells 201 to undergo necrosis (see FIG. 4). In photodynamic therapy, photosensitizer 300 selectively accumulates in tumor cells 201 and around tumor cells 201, and light in a specific wavelength band appropriate for photosensitizer 300 is continuously irradiated to cause a photochemical reaction in photosensitizer 300, which selectively necrotizes tumor cells 201 with reactive oxygen species 400 generated by the photochemical reaction of photosensitizer 300. After undergoing a change due to the photochemical reaction (after the photochemical reaction has progressed), photosensitizer 300 no longer emits fluorescence, and therefore, as shown in Figure 5, the detected fluorescence intensity decreases as the treatment progresses.

[0015] (Configuration of treatment support device) The configuration of the treatment support device 100 according to this embodiment will be described with reference to FIG.

[0016] The treatment support device 100 according to this embodiment is a device that supports treatment in the above-mentioned photodynamic therapy. The treatment support device 100 is an example of a "photodynamic therapy treatment support device" in the claims. The treatment support device 100 according to this embodiment irradiates an affected area 200a of a patient 200 with light (excitation light) in a specific wavelength band that excites a photosensitizer 300, and detects fluorescence emitted from the photosensitizer 300 administered to the patient 200. Then, as will be described later, the treatment support device 100 is configured to generate a fluorescence distribution image 41 (see FIG. 7 ), which is an image representing the distribution state of fluorescence, using the detected fluorescence.

[0017] By using the treatment support device 100 according to this embodiment, a user can confirm how the photosensitizer 300 is distributed and to what extent it has accumulated in the affected area 200a (see FIG. 6 ) inside the body of the patient 200 before continuously irradiating the photosensitizer 300 with light in a specific wavelength band and providing the photosensitizer 300 with energy for necrosing tumor cells 201 (before treatment in photodynamic therapy). Furthermore, the treatment support device 100 allows the user to understand the effect of the treatment (whether the treatment has progressed as expected) from the distribution and accumulation of the photosensitizer 300 in the affected area 200a after treatment in photodynamic therapy.

[0018] In addition to supporting photodynamic therapy treatment, such as displaying the distribution of fluorescence, the treatment support device 100 is also configured to necrotize tumor cells 201 (perform photodynamic therapy treatment) by continuously irradiating them with light of a specific wavelength band corresponding to the photosensitive substance 300.

[0019] As shown in FIG. 6 , the treatment support device 100 includes an endoscope 1, an excitation light source 2, a white light source 3, an image collection unit 4, a PC (Personal Computer) 5, and a storage unit 6. The excitation light source 2 is an example of a "light source" in the claims. The image collection unit 4 is an example of a "distribution information output unit" in the claims, and the PC 5 is an example of an "image synthesis unit" in the claims. The treatment support device 100 also includes a control unit 7, an operation unit 8, and a display unit 9.

[0020] The endoscope 1 of the treatment support device 100 also includes light guides 11 and 12, a fluorescence detection unit 13, and a visible light detection unit 14. The endoscope 1 also includes an objective lens, an air supply / air blowing nozzle, a treatment tool, etc., which are not shown. The endoscope 1 is inserted into the body of the patient 200 by a doctor (user).

[0021] The excitation light source 2 is configured to emit light in a specific wavelength band capable of causing fluorescence from the photosensitizer 300. That is, the excitation light source 2 is configured to emit light in a specific wavelength band that excites the photosensitizer 300. The excitation light source 2 may include a semiconductor laser (LD: Laser Diode) or a light-emitting diode (LED: Light Emitting Diode). The specific wavelength band of the light (excitation light) emitted from the excitation light source 2 to excite the photosensitizer 300 before or after treatment may be the same as or not overlap with the specific wavelength band of the light (therapeutic light) irradiated to the photosensitizer 300 during treatment. The half-width of the spectrum of the excitation light may be different from the half-width of the spectrum of the therapeutic light.

[0022] The light guide 11 of the endoscope 1 is configured to guide and irradiate excitation light from the excitation light source 2. The light guide 11 includes an optical fiber. Light in a specific wavelength band irradiated from the excitation light source 2 is irradiated onto the affected area 200a via the light guide 11, and excites the photosensitive material 300. The light guide 11 may include a laser catheter.

[0023] As described above, the treatment support device 100 can also perform photodynamic therapy treatment by continuously irradiating light of a specific wavelength band emitted from the excitation light source 2 onto the affected area 200a (photosensitive substance 300) of the patient 200 from the endoscope 1.

[0024] The light irradiated onto the photosensitive substance 300 by the endoscope 1 is light in a wavelength band that excites the photosensitive substance 300 (drug) used in the treatment and causes a photochemical reaction, and differs depending on the type of photosensitive substance 300 (drug) used in the treatment. For example, if the above-mentioned Laserphyrin (registered trademark) is used as the photosensitive substance 300 (drug), the light irradiated during, before, and after treatment is light in a wavelength band that includes 664 nm.

[0025] The white light source 3 is a light source that emits visible light and is configured to irradiate white light. The white light source 3 includes a light emitting diode or the like. Furthermore, the light guide 12 of the endoscope 1 is configured to guide the white light (visible light) from the white light source 3. The light guide 12 includes an optical fiber. The white light emitted from the white light source 3 illuminates the affected area 200a of the patient 200, and is irradiated onto the affected area 200a of the patient 200 via the light guide 12 of the endoscope 1 in order to detect visible light reflected from the affected area 200a of the patient 200. Note that the light guide 12 may include a laser catheter.

[0026] The fluorescence detection unit 13 is configured to detect fluorescence emitted by the photosensitive material 300 when irradiated with light in a specific wavelength band. The fluorescence detection unit 13 is an imaging element that detects fluorescence emitted by the photosensitive material 300. The fluorescence detection unit 13 captures an image of the fluorescence emitted by the photosensitive material 300 at a predetermined frame rate such as the frame rate of the NTSC (National Television System Committee) standard. The fluorescence detection unit 13 includes an imaging element such as a CMOS (Complementary Metal Oxide Semiconductor) image sensor or a CCD (Charge Coupled Device) image sensor.

[0027] Furthermore, the fluorescence detection unit 13 is configured not to detect light in a specific wavelength band irradiated by the excitation light source 2 and light having a wavelength shorter than that of the light in the specific wavelength band, but to detect light having a wavelength longer than that of the light in the specific wavelength band irradiated by the excitation light source 2. Specifically, the fluorescence detection unit 13 is configured to selectively detect light having a wavelength longer than that of the light in the specific wavelength band irradiated by the excitation light source 2, due to the wavelength selectivity of the optical filter. For example, when Laserphyrin (registered trademark) is used as the photosensitive material 300, the fluorescence detection unit 13 is configured to selectively detect light having a wavelength longer than that of the light (672 nm) that excites Laserphyrin (registered trademark), due to the wavelength selectivity of the optical filter.

[0028] In this embodiment, the fluorescence detection unit 13 is configured to detect light in the wavelength band of the fluorescence emitted by the photosensitizer 300, without detecting light in a specific wavelength band irradiated by the excitation light source 2 or light with a wavelength shorter than that of the light in the specific wavelength band. Specifically, the fluorescence detection unit 13 is configured to selectively detect light in a range including the wavelength band of the fluorescence emitted by the photosensitizer 300, using the wavelength selectivity of an optical filter. For example, when Laserphyrin (registered trademark) is used as the photosensitizer 300, the fluorescence detection unit 13 is configured to detect fluorescence based on light in a wavelength band of 672 nm or more and 1800 nm or less, using the wavelength selectivity of the optical filter. Note that, when Laserphyrin (registered trademark) is excited, light in a wavelength band including 664 nm is irradiated, so the fluorescence detection unit 13 is preferably configured to detect fluorescence based on light in a wavelength band of 750 nm or more and 1800 nm or less, excluding the vicinity of 664 nm, using the wavelength selectivity of the optical filter.

[0029] The visible light detection unit 14 is configured to detect visible light, including light emitted from the light guides 11 and 12 of the endoscope 1 and reflected from the affected area 200a of the patient 200. The visible light detection unit 14 is an imaging element that detects visible light (reflected light) reflected from the affected area 200a of the patient 200. The visible light detection unit 14 includes an imaging element such as a CMOS image sensor or a CCD image sensor. The visible light detection unit 14 captures an image of the visible light (reflected light) reflected from the affected area 200a of the patient 200 at a predetermined frame rate, such as the frame rate of the NTSC standard. Furthermore, when Laserphyrin (registered trademark) is used as the photosensitive material 300, the visible light detection unit 14 detects visible light, including light in a specific wavelength band (excitation light and therapeutic light), emitted from the excitation light source 2.

[0030] The image collection unit 4 includes a processor such as a GPU (Graphics Processing Unit), or an FPGA (Field-Programmable Gate Array) configured for image processing.

[0031] The image collecting unit 4 receives as input a signal output by the fluorescence detecting unit 13 based on the detected fluorescence. That is, the image collecting unit 4 is configured to receive as an electrical signal the fluorescence signal detected by the fluorescence detecting unit 13. The image collecting unit 4 also receives as input a signal output by the visible light detecting unit 14 based on the detected visible light. That is, the image collecting unit 4 is configured to receive as an electrical signal the visible light signal detected by the visible light detecting unit 14. The image collecting unit 4 is configured to collect fluorescence signals and visible light signals in chronological order. The image collecting unit 4 is configured to collect or stop collecting fluorescence signals and to collect or stop visible light signals under the control of the control unit 7.

[0032] The image collecting unit 4 is configured to output information on the distribution state of the fluorescence emitted from the photosensitive substance 300, based on the fluorescence emitted from the photosensitive substance 300. In this embodiment, the image collecting unit 4 is configured to generate a fluorescence distribution image 41 (see FIG. 7 ), which is an image representing the distribution state of the fluorescence emitted from the photosensitive substance 300, based on the fluorescence emitted from the photosensitive substance 300. That is, in this embodiment, the image collecting unit 4 is configured to output the fluorescence distribution image 41 as information on the distribution state of the fluorescence emitted from the photosensitive substance 300.

[0033] In this embodiment, the image collecting section 4 is configured to generate a visible light image 42 (see FIG. 8) based on the visible light detected by the visible light detecting section 14.

[0034] The PC 5 is a computer including a CPU (Central Processing Unit), a ROM (Read Only Memory), and a RAM (Random Access Memory).

[0035] The PC 5 is configured to generate a composite image 43 (see FIG. 9 ) by superimposing (overlapping) a fluorescence distribution image 41 (image data of the fluorescence distribution image 41) generated by the image collecting unit 4 and a visible light image 42 (image data of the fluorescence distribution image 41) generated by the image collecting unit 4. That is, the PC 5 is configured to generate a composite image 43 by superimposing a plurality of images generated by the image collecting unit 4. The PC 5 may also include the image collecting unit 4 as a functional configuration (functional block). That is, the PC 5 may be configured to function as the image collecting unit 4 by executing a program.

[0036] Furthermore, PC 5 is configured to analyze the fluorescent light signals and visible light signals (data of fluorescent light distribution image 41 and visible light image 42) collected by image collection unit 4. That is, PC 5 is configured to analyze the fluorescent light signals (fluorescence signal values) detected by fluorescence detection unit 13. PC 5 is configured to analyze the fluorescent light signal values ​​for each time series. PC 5 is also configured to analyze the visible light signal values ​​detected by visible light detection unit 14.

[0037] The storage unit 6 is configured to store image data such as the fluorescence distribution image 41, the visible light image 42, and the composite image 43. The storage unit 6 includes, for example, a storage device such as a nonvolatile memory, a hard disk drive (HDD), or a solid-state drive (SSD). The storage unit 6 may also include a database on a network external to the treatment support device 100. The storage unit 6 is also configured to store (save) the data of the fluorescence signals and the visible light signals collected by the image acquisition unit 4. The storage unit 6 stores (saves) the fluorescence signals and the visible light signals containing therapeutic light collected by the image acquisition unit 4 in chronological order (the data of the fluorescence distribution image 41 and the visible light image 42) along with timestamps such as the image capture dates and times. The storage unit 6 is also configured to store a program executed by the control unit 7 to control the irradiation of light in a specific wavelength band (excitation light and therapeutic light) when generating the fluorescence distribution image 41, as well as data necessary for controlling the irradiation of light in a specific wavelength band (excitation light and therapeutic light).

[0038] The control unit 7 includes a control board (circuit board) on which a CPU, a ROM, a RAM, etc. are mounted. The control unit 7 is configured to control the entire treatment support device 100. The control unit 7 is also connected to be able to communicate with each of the excitation light source 2, the white light source 3, the image collecting unit 4, the PC 5, the storage unit 6, the operation unit 8, and the display unit 9. The PC 5 and the control unit 7 may be configured integrally.

[0039] The control unit 7 is configured to control the irradiation of light of a specific wavelength band (excitation light and therapeutic light) by the excitation light source 2. Specifically, the control unit 7 is configured to control the excitation light source 2 to turn on and off (start and stop irradiation of light of a specific wavelength band). The control unit 7 is also configured to control the excitation light source 2 to control the irradiation time and irradiation intensity of light of a specific wavelength band (excitation light and therapeutic light). The control unit 7 is also configured to allow a doctor (user) to perform controls such as starting and stopping irradiation of light of a specific wavelength band (switching irradiation ON and OFF) through operations performed by the operation unit 8. The control unit 7 is also configured to control the white light source 3 to turn on and off the white light source 3 and to control the irradiation time and irradiation intensity of white light, in the same way as controlling the excitation light source 2.

[0040] The control unit 7 is also configured to control the display unit 9 to display images such as a fluorescence distribution image 41, a visible light image 42, and a composite image 43.

[0041] The operation unit 8 is a user interface for operating the medical treatment support device 100. The operation unit 8 includes, for example, a remote control, a touch panel, a keyboard, or a mouse. A touch panel serving as the operation unit 8 may be provided on the display unit 9. That is, the operation unit 8 and the display unit 9 may be configured integrally. Alternatively, the operation unit 8 may be provided separately for each of the PC 5 and the control unit 7.

[0042] The operation unit 8 is configured to receive operations related to the control of the treatment support device 100. Specifically, the operation unit 8 is configured to receive operations for turning on and off the excitation light source 2 (switching on and off the irradiation of light in a specific wavelength band) and for turning on and off the white light source 3 (switching on and off the irradiation of white light). The operation unit 8 is also configured to receive operations for starting and stopping the detection of fluorescence (collection of fluorescence signals), starting and stopping the detection of visible light (collection of visible light signals), and switching the display method of the image displayed on the display unit 9.

[0043] The operation unit 8 is also configured to receive operations for the PC 5 that analyzes the fluorescent light signals and visible light signals (data of the fluorescent light distribution image 41 and the visible light image 42). The operation unit 8 is also configured to receive operations for setting a region of interest (ROI) for selectively acquiring fluorescent signals.

[0044] The display unit 9 is configured by, for example, a liquid crystal display, an organic EL display, etc. The display unit 9 is connected to the PC 5 and the control unit 7 by, for example, a video interface such as HDMI (registered trademark).

[0045] The display unit 9 displays the composite image 43 under the control of the control unit 7. The display unit 9 is also configured to be able to display the fluorescence distribution image 41 and the visible light image 42 in addition to the composite image 43 under the control of the control unit 7. Specifically, the treatment support device 100 can switch between displaying the fluorescence distribution image 41, the visible light image 42, and the composite image 43 on the display unit 9. The treatment support device 100 can simultaneously display any or all of the fluorescence distribution image 41, the visible light image 42, and the composite image 43 side by side on the display unit 9.

[0046] In the treatment support device 100 according to this embodiment, the user can observe the fluorescence distribution 40 (see FIG. 7) in the fluorescence distribution image 41 or the fluorescence distribution 40 (see FIG. 9) in the composite image 43 displayed on the display unit 9 before treatment, and can therefore confirm how the photosensitive substance 300 is distributed and to what extent it has accumulated inside the body of the patient 200 (affected area 200a).

[0047] Furthermore, the medical treatment support device 100 is configured to display the superimposed visible light image 42 and the fluorescent light distribution 40 in a distinguishable manner in the composite image 43, to allow the user to easily confirm the fluorescent light distribution 40 in the composite image 43. Specifically, the display color of the fluorescent light distribution 40 is set to a color that makes it easy to distinguish from the visible light image 42. For example, the fluorescent light distribution 40 may be a fluorescent color such as green, purple, or blue, or a color that is different from the color of the body surface, tissue, and blood of the patient 200. Alternatively, the fluorescent light distribution 40 may be made to blink, for example, to make it easy to distinguish between the visible light image 42 and the fluorescent light distribution 40. In this way, the medical treatment support device 100 uses the PC 5 to create the composite image 43 in which the visible light image 42 and the fluorescent light distribution 40 are distinguishable, and displays the composite image 43 on the display unit 9.

[0048] Furthermore, the PC 5 may set a threshold value in advance for the detected fluorescence intensity or the total value of the detected fluorescence intensities, and when the detected fluorescence intensity or the total value of the detected fluorescence intensities, etc., exceeds the threshold, the PC 5 may perform control to change the display method of the fluorescence distribution 40 or control to display a notification that the intensity has exceeded the threshold. This allows the user to easily identify the area (affected area 200a) where the photosensitive substance 300 has accumulated.

[0049] The treatment support device 100 according to this embodiment can initiate treatment to kill tumor cells 201 by continuously irradiating the affected area 200a, where the photosensitive substance 300 has accumulated, with light in a specific wavelength band from the endoscope 1 inserted into the body of the patient 200. Since the photosensitive substance 300 ceases to emit fluorescence after undergoing a photochemical reaction, the fluorescence distribution 40 changes as the treatment progresses. That is, the user can grasp the distribution of the photosensitive substance 300 in the body of the patient 200 and the progress of the treatment based on the changes in the fluorescence signal during treatment, the changes in the fluorescence distribution 40 in the fluorescence distribution image 41, and the changes in the fluorescence distribution 40 in the composite image 43. After the treatment, the user can grasp the effectiveness of the treatment (whether the treatment progressed as expected) by checking the changes in the fluorescence signal during treatment, the changes in the fluorescence distribution 40 in the fluorescence distribution image 41, and the changes in the fluorescence distribution 40 in the composite image 43, just as they did before the treatment.

[0050] In this embodiment, the light in the specific wavelength band irradiated for treatment (therapeutic light) is configured to also serve as excitation light and be irradiated from the excitation light source 2. The light in the specific wavelength band irradiated for treatment (therapeutic light) may be irradiated from a light source other than the excitation light source 2 or from a device other than the treatment support device 100.

[0051] (Configuration for Excitation Light Irradiation) The excitation light source 2 is configured to irradiate the photosensitizer 300 administered into the body of the patient 200 with light in a specific wavelength band having energy capable of causing the photosensitizer 300 to generate fluorescence without causing necrosis of the tumor cells 201 to progress (treatment to progress) in photodynamic therapy. In this embodiment, before or after photodynamic therapy treatment, the excitation light source 2 irradiates the photosensitizer 300 administered into the body of the patient 200 with light in a specific wavelength band having energy capable of causing the photosensitizer 300 to generate fluorescence without causing necrosis of the tumor cells 201 to progress (treatment to progress).

[0052] The energy that does not cause necrosis of tumor cells 201 to progress can be confirmed in advance by testing, etc. For example, by irradiating tumor cells 201 in which photosensitizer 300 has accumulated with light in a wavelength range that excites photosensitizer 300 and causes a photochemical reaction, and observing the state of tumor cells 201 with a microscope, etc., it is possible to confirm the integrated amount of energy that does not cause necrosis of tumor cells 201 (does not initiate necrosis of tumor cells 201). For example, if the integrated amount of energy applied during treatment is 100 J / cm 2 On the other hand, if the cumulative amount of energy that does not kill the tumor cells 201 is about 1 / 100, the cumulative amount of energy that does not cause the necrosis of the tumor cells 201 to progress is 1 J / cm 2 The integrated amount of energy is calculated based on the irradiation intensity of the light (excitation light) in the specific wavelength band irradiated from the excitation light source 2 and the irradiation time of the light (excitation light) in the specific wavelength band irradiated from the excitation light source 2.

[0053] The control unit 7 is configured to control the irradiation of light (excitation light) in a specific wavelength band by the excitation light source 2 so that the integrated amount of energy imparted to the photosensitizer 300 by light (excitation light) in a specific wavelength band falls within a first integrated energy amount 61 (see FIG. 10 ) when generating a fluorescence distribution image 41 before or after treatment. Note that the first integrated energy amount 61 is the integrated value of the irradiation intensity of the light (excitation light) in a specific wavelength band irradiated onto the photosensitizer 300 and the irradiation time of the light (excitation light) in the specific wavelength band when generating a fluorescence distribution image 41 before or after treatment.

[0054] The first integrated energy amount 61 is set within a range equal to or less than the previously determined integrated energy amount that does not kill the tumor cells 201 (does not start killing the tumor cells 201). For example, if the previously determined integrated energy amount that does not kill the tumor cells 201 is 0.1 J / cm 2 , the first integrated energy amount 61 is 0.1 J / cm 2 It is determined within the following ranges:

[0055] 10 , before or after photodynamic therapy, which necrotizes tumor cells 201 with reactive oxygen species 400 generated by a photochemical reaction, excitation light source 2 irradiates photosensitizer 300 with light of a specific wavelength band so that when image acquisition unit 4 generates fluorescence distribution image 41, first integrated energy amount 61, which is the integrated amount of energy imparted to photosensitizer 300 by light of a specific wavelength band during photodynamic therapy, is smaller (does not reach second integrated energy amount 62). Note that second integrated energy amount 62 is the integral of the irradiation intensity of light of a specific wavelength band (therapeutic light) irradiated to photosensitizer 300 and the irradiation time of light of a specific wavelength band (therapeutic light) during photodynamic therapy, which necrotizes tumor cells 201 with reactive oxygen species 400 generated by a photochemical reaction.

[0056] As described above, the photosensitizer 300 ceases to emit fluorescence after undergoing a photochemical reaction. Therefore, as shown in Fig. 10, as the treatment for killing tumor cells 201 based on irradiating the photosensitizer 300 with light in a specific wavelength band progresses, the fluorescence intensity (fluorescent photosensitizer 300) decreases.

[0057] When generating the fluorescence distribution image 41, the first integrated amount of energy 61 imparted to the photosensitizer 300 by light in the specific wavelength band irradiated by the excitation light source 2 is an integrated amount of energy in a range in which the decrease in fluorescence intensity per unit time (decay of fluorescence intensity) is smaller than during treatment. That is, when generating the fluorescence distribution image 41, the first integrated amount of energy 61 imparted to the photosensitizer 300 by light in the specific wavelength band irradiated by the excitation light source 2 is an integrated amount of energy in a range in which the decrease rate of the fluorescence intensity detected by the fluorescence detection unit 13 in accordance with an increase in the integrated amount of energy imparted to the photosensitizer 300 is smaller than the decrease rate of the fluorescence intensity during treatment detected by the fluorescence detection unit 13 in accordance with an increase in the integrated amount of energy during treatment imparted to the photosensitizer 300 by light in the specific wavelength band, as shown in Fig. 10 .

[0058] 10 shows the tendency of the decrease in the fluorescence intensity linearly, but the decrease in the fluorescence intensity is not limited to a linear decrease and may decrease while repeatedly increasing and decreasing. Furthermore, the fluorescence intensity at the first integrated energy amount 61 is not limited to being constant and may increase and decrease.

[0059] Furthermore, the magnitude of the first integrated energy amount 61 is equal to or greater than the magnitude capable of exciting the photosensitizer 300 to generate fluorescence, but is less than the magnitude at which reactive oxygen species 400 generated by the photochemical reaction of the photosensitizer 300 causes necrosis of the tumor cells 201. That is, the magnitude of the first integrated energy amount 61 is such that the fluorescence detection unit 13 can detect the fluorescence emitted by the photosensitizer 300, and the photosensitizer 300 does not generate reactive oxygen species 400, or generates only a small amount of reactive oxygen species 400. Therefore, necrosis of the tumor cells 201 due to the reactive oxygen species 400 does not occur, and even if necrosis (death) of the tumor cells 201 occurs, it is very small.

[0060] Furthermore, the control unit 7 is configured to control the irradiation of light in a specific wavelength band by the excitation light source 2 so that light in a specific wavelength band is irradiated at a predetermined pulse width based on the first integrated energy amount 61 when generating a fluorescence distribution image 41 before or after treatment. The control unit 7 controls the irradiation of excitation light by the excitation light source 2 so that light in a specific wavelength band (excitation light) is irradiated by a predetermined pulse width each time the user performs an irradiation operation. Furthermore, the fluorescence detection unit 13 is configured to detect fluorescence in synchronization with the predetermined pulses irradiated by the excitation light. Therefore, the minimum value of the predetermined pulse width is changed based on the value of the imaging processing speed in the fluorescence detection unit 13.

[0061] The irradiation intensity of the light of the specific wavelength band irradiated when generating the fluorescence distribution image 41 before or after treatment is equal to or greater than the irradiation intensity of the light irradiated during treatment. Specifically, the irradiation intensity of the light of the specific wavelength (therapeutic light) irradiated during treatment is 150 mW / cm or more. 2 In this case, the irradiation intensity of the light (excitation light) of a specific wavelength irradiated when generating the fluorescence distribution image 41 before or after treatment is 150 mW / cm 2 For example, the treatment support device 100 may be configured such that the irradiation intensity of the light of a specific wavelength irradiated during treatment is 150 mW / cm 2 11, the irradiation intensity of the excitation light irradiated when generating the fluorescence distribution image 41 before or after the treatment is 150 mW / cm 2 Furthermore, the treatment support device 100 can be configured, by changing the settings by the user, to set the irradiation intensity of the excitation light irradiated when generating the fluorescence distribution image 41 to be greater than the irradiation intensity of the light irradiated during treatment.

[0062] In addition, the control unit 7 is configured to change the settings of the irradiation time and irradiation intensity of the excitation light source 2 so that the irradiation intensity of the light (excitation light) of a specific wavelength band irradiated by the excitation light source 2 is maximized based on the first accumulated energy amount 61 and the number of imaging times set (input) by the user.

[0063] That is, as the number of imaging times increases, the control settings for the irradiation of light (excitation light) in a specific wavelength band by the excitation light source 2 are changed so as to shorten the irradiation time t per pulse (see FIG. 11). Then, when the irradiation time t per pulse (pulse width) reaches the speed of the imaging process in the fluorescence detection unit 13, the control settings for the irradiation of light (excitation light) in a specific wavelength band by the excitation light source 2 are changed so as to reduce the irradiation intensity.

[0064] Furthermore, the control unit 7 can also set the irradiation intensity, irradiation time, and number of irradiations by user operation within a range not exceeding the first accumulated energy amount 61. That is, the treatment support device 100 is configured so that the settings of the irradiation intensity, irradiation time, and number of irradiations of the excitation light can be switched between settings by user operation (manual setting) and settings by the control unit 7 (automatic setting).

[0065] Furthermore, in this embodiment, the control unit 7 is configured to perform control to limit the irradiation intensity, irradiation time, and number of irradiations of light in a specific wavelength band from the excitation light source 2 based on the first integrated energy amount 61. Specifically, in order to prevent the treatment from progressing during observation of the fluorescence distribution before or after treatment (while the fluorescence distribution image 41 is being generated before or after treatment), the control unit 7 is configured to automatically limit (stop) the irradiation of light in a specific wavelength band (excitation light) from the excitation light source 2 if the integrated energy amount of the excitation light irradiated during observation of the fluorescence distribution before or after treatment is likely to exceed the integrated energy amount (upper observation amount) determined based on the first integrated energy amount 61. Note that the integrated energy amount (upper observation amount) determined based on the first integrated energy amount 61 may be the same as the first integrated energy amount 61, or may be smaller than the first integrated energy amount 61 as long as it is an integrated amount of energy capable of exciting the photosensitizer 300.

[0066] Specifically, when the control unit 7 irradiates excitation light at a predetermined pulse width each time the user operates, if the upper limit of the number of irradiations that can be performed at a predetermined accumulated amount of energy (upper observation limit amount) based on the first accumulated energy amount 61 is reached, the control unit 7 is configured to perform control to limit the irradiation of excitation light so that excitation light is not irradiated even if the user operates.

[0067] In addition, when the excitation light is continuously irradiated, if the irradiation time of the excitation light is long and the accumulated amount of energy given to the photosensitive material 300 by the excitation light is likely to exceed the accumulated amount of energy (upper observation limit amount) determined based on the first accumulated energy amount 61, the control unit 7 is configured to stop the irradiation of the excitation light (turn off the excitation light source 2) and perform control to limit the irradiation of the excitation light.

[0068] In addition, the control unit 7 is configured to perform control to limit the irradiation intensity of the excitation light (reduce the irradiation intensity of the excitation light) when the irradiation intensity of the excitation light is high and the accumulated amount of energy given to the photosensitive material 300 by irradiation with the excitation light exceeds a predetermined accumulated amount of energy (upper observation limit amount) based on the first accumulated energy amount 61.

[0069] The restriction on irradiation of excitation light by the control unit 7 may be made reversible by a user operation, as necessary. Furthermore, the control of irradiation of excitation light by the control unit 7 as described above is configured to be performed not only on the excitation light source 2 but also on the excitation light source 2 via the control unit 7 etc.

[0070] (Effects of this embodiment) In this embodiment, the following effects can be obtained.

[0071] In this embodiment, in photodynamic therapy, an excitation light source 2 (light source) irradiates a photosensitizer 300 administered into the body of a patient 200 (subject) with light in a specific wavelength band having energy sufficient to cause the photosensitizer 300 to generate fluorescence without promoting necrosis of tumor cells 201. Furthermore, based on the fluorescence generated from the photosensitizer 300, information on the distribution state of the fluorescence generated from the photosensitizer 300 (fluorescence distribution image 41) is output by an image collecting unit 4 (distribution information output unit). As a result, information on the distribution state of the fluorescence generated from the photosensitizer 300 (fluorescence distribution image 41) is output without promoting necrosis of the tumor cells 201 before or after treatment, so that the distribution state of the photosensitizer 300 accumulated in the tumor cells 201 can be confirmed before or after treatment by photodynamic therapy.

[0072] Furthermore, the treatment support device 100 according to the above embodiment has the following configuration, thereby providing the following additional effects.

[0073] Furthermore, in the treatment support device 100 of this embodiment, the fluorescence detection unit 13 is configured to detect light having a longer wavelength than the light of the specific wavelength band irradiated by the excitation light source 2, without detecting light of the specific wavelength band irradiated by the excitation light source 2 (light source) and light having a shorter wavelength than the light of the specific wavelength band. As a result, during detection by the fluorescence detection unit 13, the light of the specific wavelength band irradiated by the excitation light source 2 and light having a shorter wavelength than the light of the specific wavelength band are excluded, so that the fluorescence caused by the photosensitizer 300 can be detected with high accuracy. As a result, the distribution state of the photosensitizer 300 accumulated in the tumor cells 201 can be confirmed with high accuracy.

[0074] Furthermore, in the treatment support device 100 of this embodiment, the fluorescence detection unit 13 is configured to detect light in the wavelength band of fluorescence emitted by talaporfin sodium, which is the photosensitizer 300, without detecting light in a specific wavelength band irradiated by the excitation light source 2 (light source) or light with a wavelength shorter than that of the light in the specific wavelength band. This allows the fluorescence detection unit 13 to detect light in the wavelength band of fluorescence emitted by the photosensitizer 300 (talaporfin sodium) while excluding light in the specific wavelength band irradiated by the excitation light source 2 and light with a wavelength shorter than that of the light in the specific wavelength band, thereby enabling more accurate detection of fluorescence caused by the photosensitizer 300 (talaporfin sodium). As a result, the distribution state of the photosensitizer 300 accumulated in the tumor cells 201 can be confirmed more accurately.

[0075] Furthermore, in the treatment support device 100 of this embodiment, before or after photodynamic therapy treatment, which necrotizes tumor cells 201 with reactive oxygen species 400 generated by a photochemical reaction, the excitation light source 2 (light source) irradiates light of a specific wavelength band so that when the image acquisition unit 4 (distribution information output unit) generates a fluorescence distribution image 41, a first integrated energy amount 61, which is the integrated amount of energy imparted to the photosensitizer 300 by light of the specific wavelength band, is smaller than a second integrated energy amount 62, which is the integrated amount of energy imparted to the photosensitizer 300 by light of the specific wavelength band during treatment by photodynamic therapy. As a result, when generating a fluorescence distribution image 41 before or after treatment, the integrated amount of energy imparted to the photosensitizer 300 by light of the specific wavelength band (first integrated energy amount 61) does not reach the integrated amount of energy imparted to the photosensitizer 300 by light of the specific wavelength band during treatment (second integrated energy amount 62). As a result, before treatment, when generating the fluorescence distribution image 41, it is possible to prevent treatment from being started unintentionally, and after treatment, when generating the fluorescence distribution image 41, it is possible to prevent treatment from being restarted unintentionally.

[0076] Furthermore, in the treatment support device 100 of this embodiment, the magnitude of the first integrated energy amount 61 is equal to or greater than the magnitude that can excite the photosensitizer 300 to generate fluorescence, but is smaller than the magnitude that causes the reactive oxygen 400 generated by the photochemical reaction of the photosensitizer 300 to cause necrosis of the tumor cells 201. This makes it possible to detect the fluorescence generated from the photosensitizer 300 while suppressing the progression of necrosis of the tumor cells 201.

[0077] Furthermore, in the treatment support device 100 of this embodiment, when generating the fluorescence distribution image 41, the first integrated amount of energy 61 imparted to the photosensitizer 300 by light of a specific wavelength band irradiated by the excitation light source 2 (light source) is an integrated amount of energy within a range such that the rate of decrease in fluorescence intensity detected by the fluorescence detection unit 13 as the integrated amount of energy imparted to the photosensitizer 300 increases is smaller than the rate of decrease in fluorescence intensity during treatment detected by the fluorescence detection unit 13 as the integrated amount of energy imparted to the photosensitizer 300 by light of the specific wavelength band increases. As a result, when generating the fluorescence distribution image 41, the rate of decrease in fluorescence intensity as the integrated amount of energy increases is smaller than the rate of decrease in fluorescence intensity during treatment as the integrated amount of energy increases. As a result, it is possible to confirm the distribution 40 of fluorescence generated from the photosensitizer 300 as the treatment progresses and before the fluorescence intensity decreases.

[0078] Furthermore, in the treatment support device 100 of this embodiment, the first integrated energy amount 61 is the integral of the irradiation intensity of light in a specific wavelength band irradiated onto the photosensitizer 300 and the irradiation time of light in the specific wavelength band when generating a fluorescence distribution image 41 before or after treatment. Furthermore, the second integrated energy amount 62 is the integral of the irradiation intensity of light in a specific wavelength band irradiated onto the photosensitizer 300 and the irradiation time of light in the specific wavelength band when generating a fluorescence distribution image 41 before or after treatment. The control unit 7 is configured to control the irradiation of light in the specific wavelength band by the excitation light source 2 (light source) so that the integrated amount of energy imparted to the photosensitizer 300 by light in the specific wavelength band falls within the first integrated energy amount 61 when generating a fluorescence distribution image 41 before or after treatment. As a result, because the first accumulated energy amount 61 is based on the integral of the irradiation intensity and the irradiation time, when generating a fluorescence distribution image 41 before or after treatment, the accumulated amount of energy imparted to the photosensitizer 300 by light in a specific wavelength band (excitation light) can be easily controlled based on the irradiation intensity and the irradiation time so as to fall within the range of the first accumulated energy amount 61. As a result, when generating a fluorescence distribution image 41 before or after treatment by photodynamic therapy, the control unit 7 can more easily control the irradiation of light in a specific wavelength band (excitation light) so that the first accumulated energy amount 61 does not exceed the second accumulated energy amount 62.

[0079] Furthermore, in the treatment support device 100 of this embodiment, the control unit 7 is configured to perform control to limit the irradiation intensity, irradiation time, and number of irradiations of light in a specific wavelength band emitted by the excitation light source 2 (light source), based on the first accumulated energy amount 61. This makes it possible to prevent the accumulated amount of energy imparted to the photosensitizer 300 by light in a specific wavelength band (excitation light) from exceeding the first accumulated energy amount 61 due to an increase in the irradiation intensity, irradiation time, and number of irradiations of the light in a specific wavelength band (excitation light) when generating a fluorescence distribution image 41 before or after treatment by photodynamic therapy.

[0080] Furthermore, in the treatment support device 100 of this embodiment, the control unit 7 is configured to control the irradiation of light in a specific wavelength band by the excitation light source 2 (light source) so that light in a specific wavelength band is irradiated with a predetermined pulse width based on the first integrated energy amount 61 when generating a fluorescence distribution image 41 before or after treatment. As a result, light in a specific wavelength band (excitation light) is irradiated with a pulse width based on the first integrated energy amount 61, so that the irradiation time of light in a specific wavelength band (excitation light) irradiated by the excitation light source 2 when generating a fluorescence distribution image 41 before or after treatment can be shortened. As a result, the irradiation intensity of the excitation light can be increased within a range that does not exceed the first integrated energy amount 61.

[0081] Furthermore, in the treatment support device 100 of this embodiment, the irradiation intensity of the light in the specific wavelength band irradiated when generating the fluorescence distribution image 41 before or after treatment is equal to or greater than the irradiation intensity of the light irradiated during treatment. As a result, when generating the fluorescence distribution image 41 before or after photodynamic therapy treatment, the light in the specific wavelength band (excitation light) is irradiated at an irradiation intensity equal to or greater than the irradiation intensity of the light irradiated during treatment, making it possible to confirm the distribution state of the photosensitizer 300 up to a depth position equal to or greater than the depth position reached by the light irradiated during treatment (therapeutic light).

[0082] Moreover, in the treatment support device 100 of this embodiment, the image collection unit 4 (distribution information output unit) is configured to generate a visible light image 42 based on the visible light detected by the visible light detection unit 14. Furthermore, the PC 5 is configured to generate a composite image 43 by superimposing the fluorescence distribution image 41 and the visible light image 42. Furthermore, the control unit 7 is configured to perform control to display the composite image 43 on the display unit 9. As a result, the composite image 43 by superimposing the fluorescence distribution image 41 and the visible light image 42 is displayed on the display unit 9, making it possible to easily compare the fluorescence distribution 40 (fluorescence distribution image 41) with the visible light image 42.

[0083] [Variations] The embodiments disclosed herein should be considered to be illustrative and not restrictive in all respects. The scope of the present invention is defined by the claims rather than the above description of the embodiments, and further includes all modifications (variations) within the meaning and scope of the claims.

[0084] For example, in the above embodiment, the treatment support device 100 (photodynamic therapy treatment support device) is provided with the display unit 9 for displaying the composite image 43, but the present invention is not limited to this. In the present invention, the photodynamic therapy treatment support device may be configured not to include a display unit, but to output and display the composite image, etc., on an external monitor or the like.

[0085] Furthermore, in the above embodiment, an example was shown in which the irradiation intensity of the excitation light irradiated when generating the fluorescence distribution image 41 before or after treatment is equal to or greater than the irradiation intensity of the light irradiated during treatment, and the excitation light source 2 is controlled to irradiate light of a specific wavelength band at a predetermined pulse width, but the present invention is not limited to this. In the present invention, the irradiation intensity of the excitation light irradiated when generating the fluorescence distribution image before or after treatment may be set to be smaller than the irradiation intensity of the light irradiated during treatment, and the excitation light may be irradiated continuously. For example, if the irradiation intensity of the light of a specific wavelength irradiated during treatment is 150 mW / cm 2 12, the irradiation intensity of the excitation light irradiated when generating the fluorescence distribution image before or after treatment was set to 50 mW / cm 2 may be set to , and configured to irradiate the excitation light continuously.

[0086] In the above embodiment, the endoscope 1 inserted into the patient 200 irradiates the patient 200 with light (excitation light and therapeutic light) in a specific wavelength band and detects fluorescence emitted by the photosensitizer 300. However, the present invention is not limited to this. In the present invention, a treatment support device 500 according to a first modification shown in FIG. 13 may be configured such that an irradiation and observation unit 501 disposed outside the patient 200 irradiates the patient 200 with light (excitation light and therapeutic light) in a specific wavelength band from outside the patient 200, and detects fluorescence emitted by the photosensitizer 300 outside the patient 200. A photodynamic therapy treatment support device may include both the endoscope 1 according to the above embodiment and the irradiation and observation unit 501 according to the first modification. The photodynamic therapy treatment support device may also be configured such that the endoscope 1 and the irradiation and observation unit 501 are detachable and can be replaced depending on the treatment.

[0087] In the above embodiment, the endoscope 1 inserted into the patient 200 irradiates light in a specific wavelength band (excitation light and therapeutic light) and detects fluorescence emitted by the photosensitizer 300. However, the present invention is not limited to this. In the present invention, a section for irradiating light in a specific wavelength band (excitation light and therapeutic light) and a section for detecting fluorescence emitted by the photosensitizer 300 may be provided separately. For example, a treatment support device 600 according to a second modification shown in FIG. 14 may include an irradiation unit 601 including a light guide 11 that guides light in a specific wavelength band emitted by the excitation light source 2 and a light guide 12 that guides white light emitted by the white light source 3, and an observation unit 602 that includes a fluorescence detection unit 13 and a visible light detection unit 14.

[0088] Furthermore, in the above embodiment, an example was shown in which the fluorescence detection unit 13 is configured to detect light of a specific wavelength band irradiated by the excitation light source 2 (light source) without detecting light of a specific wavelength band or light of a shorter wavelength than the light of the specific wavelength band, but the present invention is not limited to this. In the present invention, the fluorescence detection unit may be configured to detect light of a shorter wavelength than the light of the specific wavelength band and light of a longer wavelength than the light of the specific wavelength band irradiated by the light source without detecting light of the specific wavelength band irradiated by the light source.

[0089] In the above embodiment, the photosensitizer 300 is talaporfin sodium, but the present invention is not limited to this. In the present invention, the photosensitizer does not have to be talaporfin sodium. For example, it may be a chlorin-based drug having a chlorin skeleton.

[0090] Furthermore, in the above embodiment, the controller 7 controls the irradiation of light of a specific wavelength band by the excitation light source 2 (light source) so that the integrated amount of energy imparted to the photosensitizer 300 by light of a specific wavelength band falls within the first integrated energy amount 61 when generating the fluorescence distribution image 41 before or after treatment. However, the present invention is not limited to this. In the present invention, the controller may be configured to control the irradiation of light of a specific wavelength band (excitation light) by displaying a message on the display unit or by sound, etc., when the integrated amount of energy imparted to the photosensitizer by light of a specific wavelength band reaches a preset threshold. The user may then control (stop irradiation of) the irradiation of light of a specific wavelength band (excitation light) based on the notification.

[0091] In the above embodiment, the treatment support device 100 (photodynamic therapy treatment support device) is configured to be able to perform treatment in addition to treatment support, but the present invention is not limited to this. In the present invention, the photodynamic therapy treatment support device may be configured to only support treatment by photoimmunotherapy (only generate a fluorescence distribution image or only output information on the fluorescence distribution state).

[0092] Furthermore, in the above embodiment, an example was shown in which the image collection unit 4 (distribution information output unit) is configured to generate a fluorescence distribution image 41, which is an image representing the distribution state of fluorescence emitted from the photosensitive substance 300, based on the fluorescence emitted from the photosensitive substance 300, but the present invention is not limited to this. In the present invention, the distribution information output unit may be configured to output the value of the detected fluorescence signal (fluorescence signal intensity) as a numerical value, or may be configured to output the average value of the detected fluorescence signal value (fluorescence signal intensity).

[0093] In the above embodiment, the treatment support device 100 (photodynamic therapy treatment support device) is provided with the fluorescence detection unit 13 and the visible light detection unit 14 separately, but the present invention is not limited to this. In the present invention, the photodynamic therapy treatment support device may be configured to detect, by a common detection unit (image pickup element), fluorescence emitted by a photosensitive substance in response to irradiation with light in a specific wavelength band, and visible light.

[0094] [Aspect] It will be appreciated by those skilled in the art that the exemplary embodiments described above are examples of the following aspects.

[0095] (Item 1) In photodynamic therapy, which causes tumor cells to necrotize by reactive oxygen generated by a photochemical reaction caused by irradiating a photosensitive substance with light of a specific wavelength band, a light source irradiates the photosensitive substance administered to the body of a subject with light of the specific wavelength band, the light having energy capable of causing fluorescence from the photosensitive substance without causing necrosis of the tumor cells to progress; a distribution information output unit that outputs information about a distribution state of the fluorescence emitted from the photosensitive substance based on the fluorescence emitted from the photosensitive substance.

[0096] (Item 2) a fluorescence detection unit that detects fluorescence emitted by the photosensitizer when irradiated with light in the specific wavelength range, 2. The photodynamic therapy treatment support device according to item 1, wherein the fluorescence detection unit is configured to detect light having a longer wavelength than the light of the specific wavelength band irradiated by the light source, without detecting light of the specific wavelength band irradiated by the light source and light having a shorter wavelength than the light of the specific wavelength band.

[0097] (Item 3) Item 3. The photodynamic therapy treatment support device according to item 2, wherein the fluorescence detection unit is configured to detect light in the wavelength band of fluorescence emitted by the photosensitive substance without detecting light in the specific wavelength band irradiated by the light source and light having a wavelength shorter than that of light in the specific wavelength band.

[0098] (Item 4) Item 4. A photodynamic therapy treatment support device according to item 3, wherein the photosensitizer is talaporfin sodium.

[0099] (Item 5) the distribution information output unit is configured to generate, based on the fluorescence emitted from the photosensitizer, a fluorescence distribution image which is an image representing a distribution state of the fluorescence emitted from the photosensitizer; 5. The photodynamic therapy treatment support device according to any one of items 2 to 4, wherein, when generating the fluorescence distribution image before or after photodynamic therapy treatment that necrotizes the tumor cells by the active oxygen generated based on a photochemical reaction, the light source irradiates the light of the specific wavelength band so that a first integrated energy amount, which is an integrated amount of energy imparted to the photosensitive material by the light of the specific wavelength band, is smaller than a second integrated energy amount, which is an integrated amount of energy imparted to the photosensitive material by the light of the specific wavelength band during the photodynamic therapy treatment.

[0100] (Item 6) 6. The photodynamic therapy treatment support device according to item 5, wherein the magnitude of the first integrated energy amount is equal to or greater than the magnitude that can excite the photosensitive substance to generate fluorescence, and is less than the magnitude that can cause necrosis of the tumor cells with the reactive oxygen generated by a photochemical reaction of the photosensitive substance.

[0101] (Item 7) 7. The photodynamic therapy treatment support device according to item 5 or 6, wherein when generating the fluorescence distribution image, the first integrated amount of energy imparted to the photosensitive substance by light of the specific wavelength band irradiated by the light source is an integrated amount of energy in a range such that a decrease rate of fluorescence intensity detected by the fluorescence detection unit with an increase in the integrated amount of energy imparted to the photosensitive substance is smaller than a decrease rate of fluorescence intensity during the treatment detected by the fluorescence detection unit with an increase in the integrated amount of energy during the treatment imparted to the photosensitive substance by light of the specific wavelength band.

[0102] (Item 8) a control unit that controls the irradiation of light in the specific wavelength band by the light source, the first integrated energy amount is an integral value of the irradiation intensity of the light in the specific wavelength band irradiated onto the photosensitizer and the irradiation time of the light in the specific wavelength band when generating the fluorescence distribution image before or after the treatment, the second integrated energy amount is an integral value of the irradiation intensity of the light in the specific wavelength band irradiated to the photosensitizer during the treatment and the irradiation time of the light in the specific wavelength band, 8. The photodynamic therapy treatment support device according to any one of items 5 to 7, wherein the control unit is configured to control the irradiation of the light source with the light of the specific wavelength band so that an integrated amount of energy imparted to the photosensitive material by the light of the specific wavelength band falls within the first integrated energy amount when generating the fluorescence distribution image before or after the treatment.

[0103] (Item 9) Item 9. The photodynamic therapy treatment support device according to item 8, wherein the control unit is configured to perform control to limit the irradiation intensity, irradiation time, and number of irradiations of the light of the specific wavelength band from the light source based on the first accumulated energy amount.

[0104] (Item 10) Item 10. The photodynamic therapy treatment support device according to item 8 or 9, wherein the control unit is configured to control the irradiation of light in the specific wavelength band by the light source so that light in the specific wavelength band is irradiated with a predetermined pulse width based on the first integrated energy amount when generating the fluorescence distribution image before or after the treatment.

[0105] (Item 11) Item 11. The photodynamic therapy treatment support device according to item 10, wherein the irradiation intensity of the light in the specific wavelength band irradiated when generating the fluorescence distribution image before or after the treatment is equal to or greater than the irradiation intensity of the light irradiated during the treatment.

[0106] (Item 12) a visible light detection unit that detects visible light; an image synthesis unit that generates a synthetic image by superimposing the multiple images generated by the distribution information output unit; a display unit for displaying the composite image; the distribution information output unit is configured to generate a visible light image based on the visible light detected by the visible light detection unit; the image synthesis unit is configured to generate the synthesis image by superimposing the fluorescence distribution image and the visible light image, 12. The photodynamic therapy treatment support device according to any one of items 8 to 11, wherein the control unit is configured to perform control to display at least the composite image on the display unit. [Explanation of symbols]

[0107] 2. Excitation light source (light source) 4. Image collection unit (distribution information output unit) 5 PC (Image synthesis unit) 7 Control Unit 9 Display section 13 Fluorescence detection unit 14 Visible light detector 41 Fluorescence distribution image 42 visible light images 43 Composite Images 61 First cumulative energy amount 62 Second cumulative energy amount 100, 500, 600 Treatment support device (photodynamic therapy treatment support device) 200 patients (subjects) 201 Tumor cells 300 Photosensitive substances 400 Active oxygen

Claims

1. A method for treating tumors, comprising: a light source that irradiates talaporfin sodium accumulated in tumor cells with light of a specific wavelength band; a memory unit that stores the irradiation time and irradiation intensity of the light corresponding to the talaporfin sodium; a control unit that reads out the irradiation time and the irradiation intensity stored in the memory unit and causes the light source to irradiate the talaporfin sodium with the light at the read irradiation time and irradiation intensity; a fluorescence detection unit that detects fluorescence emitted from the talaporfin sodium upon excitation by the light; a distribution information output unit that outputs information about a distribution state of the fluorescence based on the fluorescence detected by the fluorescence detection unit, A photodynamic therapy treatment support device, wherein the irradiation time and the irradiation intensity are irradiation time and irradiation intensity that excite the talaporfin sodium but do not kill tumor cells when the light is irradiated to the talaporfin sodium at the irradiation time and irradiation intensity.

2. A photodynamic therapy treatment support device as described in claim 1, wherein the fluorescence detection unit is configured to detect light having a longer wavelength than the light of the specific wavelength band irradiated by the light source, without detecting light of the specific wavelength band irradiated by the light source and light having a shorter wavelength than the light of the specific wavelength band.

3. 3. The photodynamic therapy treatment support device of claim 2, wherein the fluorescence detection unit is configured to detect light in the wavelength band of the fluorescence emitted by the talaporfin sodium, without detecting light in the specific wavelength band irradiated by the light source and light having a wavelength shorter than that of light in the specific wavelength band.

4. the distribution information output unit is configured to generate a fluorescence distribution image that represents a distribution state of the fluorescence generated from the talaporfin sodium based on the fluorescence detected by the fluorescence detection unit, The photodynamic therapy treatment support device of claim 2 or 3, wherein, when generating the fluorescence distribution image before or after photodynamic therapy treatment, which necrotizes the tumor cells by active oxygen generated based on a photochemical reaction caused by irradiating the talaporfin sodium with light in the specific wavelength band, the light source irradiates the specific wavelength band light so that a first integrated energy amount, which is the integrated amount of energy imparted to the talaporfin sodium by light in the specific wavelength band, is smaller than a second integrated energy amount, which is the integrated amount of energy imparted to the talaporfin sodium by light in the specific wavelength band during the photodynamic therapy treatment.

5. 5. The photodynamic therapy treatment support device of claim 4, wherein the magnitude of the first accumulated energy amount is equal to or greater than the magnitude capable of exciting the talaporfin sodium to generate fluorescence, and is less than the magnitude at which the reactive oxygen generated by the photochemical reaction of the talaporfin sodium causes necrosis of the tumor cells.

6. 6. The photodynamic therapy treatment support device of claim 4 or 5, wherein when generating the fluorescence distribution image, the first integrated amount of energy imparted to the talaporfin sodium by light in the specific wavelength band irradiated by the light source is an integrated amount of energy in a range in which the rate of decrease in fluorescence intensity detected by the fluorescence detection unit as the integrated amount of energy imparted to the talaporfin sodium increases is smaller than the rate of decrease in fluorescence intensity during treatment detected by the fluorescence detection unit as the integrated amount of energy during treatment imparted to the talaporfin sodium by light in the specific wavelength band increases.

7. The first accumulated energy amount is an integral value of the irradiation intensity of the light of the specific wavelength band irradiated to the talaporfin sodium and the irradiation time of the light of the specific wavelength band when generating the fluorescence distribution image before or after the treatment, the second integrated energy amount is an integral value of the irradiation intensity of the light in the specific wavelength band irradiated to the talaporfin sodium during the treatment and the irradiation time of the light in the specific wavelength band, The photodynamic therapy treatment support device of any one of claims 4 to 6, wherein the control unit is configured to control the irradiation of light in the specific wavelength band by the light source so that the accumulated amount of energy imparted to the talaporfin sodium by light in the specific wavelength band falls within the first accumulated energy amount when generating the fluorescence distribution image before or after the treatment.

8. 8. The photodynamic therapy treatment support device of claim 7, wherein the control unit is configured to perform control to limit the irradiation intensity, irradiation time, and number of irradiations of the light of the specific wavelength band from the light source based on the first accumulated energy amount.

9. 9. The photodynamic therapy treatment support device according to claim 7, wherein the control unit is configured to control the irradiation of the light source with the light of the specific wavelength band so that the light source irradiates the light of the specific wavelength band with a predetermined pulse width based on the first integrated energy amount when generating the fluorescence distribution image before or after the treatment.

10. 10. The photodynamic therapy treatment support device according to claim 9, wherein the irradiation intensity of the light in the specific wavelength band irradiated when generating the fluorescence distribution image before or after the treatment is equal to or greater than the irradiation intensity of the light irradiated during the treatment.

11. a visible light detection unit that detects visible light; an image synthesis unit that generates a synthetic image by superimposing the multiple images generated by the distribution information output unit; a display unit for displaying the composite image; the distribution information output unit is configured to generate a visible light image based on the visible light detected by the visible light detection unit; the image synthesis unit is configured to generate the synthesis image by superimposing the fluorescence distribution image and the visible light image, 11. The photodynamic therapy treatment support device according to claim 7, wherein the control unit is configured to perform control to display at least the composite image on the display unit.

Images