Medical information processing device, radiotherapy planning device, and radiotherapy assistance device

Abstract

A medical information processing device according to an embodiment comprises an acquisition unit and a display control unit. The acquisition unit acquires, from a storage unit, characteristics of a specific radiotherapy device among a plurality of radiotherapy devices distributed across a plurality of facilities, and information for determining a margin for a target region in radiotherapy for each facility at which the specific radiotherapy device is located. The display control unit, in response to a user's operation, causes a display to display the acquired characteristics of the specific radiotherapy device and at least some of the information for determining the margin.

Description

Medical information processing device, radiation therapy planning device, and radiation therapy support device

[0001] Embodiments disclosed herein and in the drawings relate to a medical information processing device, a radiotherapy planning device, and a radiotherapy support device.

[0002] Facilities that perform radiation therapy require both people and equipment. Personnel include radiation oncologists, radiation technologists who perform radiation therapy, radiation physicists who manage the accuracy of radiation therapy, and nurses who provide support and patient care. Equipment includes radiation therapy devices that emit X-rays and electron beams, radiation therapy planning devices that create radiation therapy plans, and oncology information systems or treatment RIS (Radiology Information System) or similar radiation therapy support devices that manage radiation therapy plans, planning CT images, radiation therapy records, and images obtained during radiation therapy. Furthermore, equipment such as respiratory phase detectors to detect the respiratory phase of patients during treatment, and dosimeters and phantoms used for patient QA (Quality Assurance), including accuracy control of radiation therapy devices and verification of radiation therapy plans, are also necessary. Additionally, radiation therapy devices and radiation therapy planning devices typically have a one-to-one relationship. That is, to create a radiation therapy plan for a specific radiation therapy device, it is necessary to use the radiation therapy planning device that is paired with that device.

[0003] On the other hand, remote radiation therapy planning has been approved in recent years. Remote radiation therapy planning is a method in which a radiation oncologist at facility B (e.g., a university hospital) creates a radiation therapy plan remotely without having to go to facility A (e.g., an affiliated hospital of a university hospital) when there is no radiation oncologist at facility A. However, in Japan, public insurance coverage for remote radiation therapy planning is limited to emergencies (imminent conditions requiring immediate initiation of radiation therapy due to a rapid change in the patient's condition, or situations requiring a temporary change in the radiation therapy plan).

[0004] Here, according to the study by the present inventors, since the birth rate in Japan is decreasing and the population of the elderly in the later stages is increasing, the number of cancer patients, who are mostly elderly, continues to increase, while the number of medical staff in the working generation, including radiation therapy staff, is expected to continue to decrease. Along with this, in the future, when performing remote radiation therapy planning, for example, radiation oncologists at university hospitals or regional cancer centers may set treatment goals for radiation therapy support devices at multiple hospitals, remotely create a radiation therapy plan that matches the treatment goals, and even remotely approve the created radiation therapy plan. In this case, immediately before setting the treatment goals in various radiation therapy support devices, during the creation of the radiation therapy plan in various radiation therapy devices, or even before approving the created radiation therapy plan, the radiation oncologist needs to grasp the prerequisite information such as the characteristics of the radiation therapy devices in each hospital and the information for determining the margin of the target area in radiation therapy at each hospital. In any case, these prerequisite information is related to the treatment techniques available at each hospital, the size of the margin for the target, and so on.

[0005] In contrast, although radiation oncologists grasp the prerequisite information of their own hospitals, it is difficult to accurately grasp the prerequisite information of other hospitals. For example, even if a radiation oncologist has seen the materials provided in advance regarding the prerequisite information of other hospitals, it is easy to get confused with the prerequisite information of multiple facilities and have a vague memory, so there is a possibility that at least a part of the prerequisite information of other hospitals is inaccurately grasped. In addition to these, clinical information for determining the radiation dose to the target area and the dose limit to the risk organs in radiation therapy, or either one or both of the determined irradiation technique, irradiation dose, and dose limit information are required to create a radiation therapy plan.

[0006] Therefore, according to the inventors' research, it is desirable to be able to check at least a part of the characteristics of the radiotherapy device and the information for determining the margin of the target area, depending on the necessary situation, such as when setting treatment goals in various radiotherapy support devices, or when creating a radiotherapy plan in various radiotherapy devices, or before approving the created radiotherapy plan. Furthermore, it is desirable to be able to check either the clinical information for determining the radiation dose to the target area and the dose limit to organs at risk in radiotherapy, or the determined irradiation technique, radiation dose, and dose limit information, or both, depending on the necessary situation.

[0007] Japanese Patent Application Publication No. 2000-242722

[0008] One of the problems that the embodiments disclosed in this specification and drawings aim to solve is to enable confirmation of at least a portion of the characteristics of the radiotherapy device and the information for determining the margin of the target area, as needed, such as during the setting of treatment goals in various radiotherapy support devices, during the creation of radiotherapy plans in various radiotherapy devices, and before the creation of the radiotherapy plan. In addition to these, a radiotherapy plan cannot be created without either clinical information for determining the irradiation dose to the target area and the dose limit to organs at risk in radiotherapy, or the determined irradiation technique, irradiation dose, and dose limit information, or both. However, the problems that the embodiments disclosed in this specification and drawings aim to solve are not limited to the above problems. Problems corresponding to the effects of each configuration shown in the embodiments described later can also be positioned as other problems.

[0009] The medical information processing device according to this embodiment comprises an acquisition unit and a display control unit. The acquisition unit is connected to a storage unit. The storage unit pre-stores the characteristics of a specific radiotherapy device among a plurality of radiotherapy devices distributed across multiple facilities, and information for determining the margin of the target area in radiotherapy at each facility where the specific radiotherapy device is located. The acquisition unit acquires the characteristics of the specific radiotherapy device and the information for determining the margin from the storage unit. The acquisition unit also acquires either clinical information for determining the radiation dose to the target area and the dose limit to organs at risk in radiotherapy, or the determined irradiation technique, radiation dose, and dose limit information, or both. The display control unit displays the acquired characteristics of the specific radiotherapy device, the information for determining the margin, the clinical information for determining the radiation dose to the target area and the dose limit to organs at risk in radiotherapy, or the determined irradiation technique, radiation dose, and dose limit information, or both, on a display according to user operation.

[0010] Figure 1 is a schematic block diagram showing an example of a system comprising an oncology information system and a radiotherapy planning device according to one embodiment. Figure 2 is a block diagram showing an example of the configuration of a radiotherapy planning device or radiotherapy support device according to one embodiment. Figure 3 is a schematic diagram illustrating an example of the features of the radiotherapy device in Figure 2. Figure 4 is a schematic diagram illustrating an example of the skills of the radiotherapy staff in Figure 2. Figure 5 is a schematic diagram illustrating an example of the accuracy of patient QA in Figure 2. Figure 6 is a block diagram showing an example of the configuration of an oncology information system as a radiotherapy support device according to one embodiment. Figure 7 is a sequence diagram illustrating an example of operation in one embodiment. Figure 8 is a schematic block diagram showing an example of a system comprising an oncology information system and a radiotherapy planning device according to a first modification of one embodiment. Figure 9 is a schematic diagram illustrating an example of the radiotherapy device features DB in Figure 8. Figure 10 is a schematic diagram illustrating an example of the treatment staff skills DB in Figure 8. Figure 11 is a schematic diagram illustrating an example of the radiotherapy QA accuracy DB in Figure 8. Figure 12 is a schematic diagram illustrating an example of the beam model DB in Figure 8. Figure 13 is a schematic diagram illustrating an example of the treatment plan format DB in Figure 8. Figure 14 is a schematic diagram illustrating another example of the treatment plan format DB in Figure 8. Figure 15 is a schematic diagram illustrating an example of the radiotherapy device specification DB in Figure 8. Figure 16 is a schematic diagram illustrating another example of the radiotherapy device specification DB in Figure 8. Figure 17 is a schematic block diagram illustrating an example of a system equipped with an oncology information system and a radiotherapy planning device according to a second modification of one embodiment. Figure 18 is a schematic block diagram illustrating an example of a system equipped with an oncology information system and a radiotherapy planning device according to a third modification of one embodiment. Figure 19 is a schematic diagram illustrating an example of the features of the radiotherapy device in Figure 18. Figure 20 is a schematic diagram illustrating an example of information for determining the margin in Figure 18. Figure 21 is a schematic diagram illustrating an example of a table set up by associating steps in a third modification of one embodiment with information corresponding to those steps.Figure 22 is a sequence diagram illustrating an example of operation in a third modified example of one embodiment. Figure 23 is a schematic diagram illustrating an example of operation in step ST4-3 of Figure 22. Embodiment

[0011] Hereinafter, a system comprising a medical information processing device, a radiotherapy support device, or a radiotherapy planning device according to one embodiment will be described with reference to the drawings. The radiotherapy support device is an oncology information system, a treatment RIS (Radiology Information System), or a similar treatment information management system. The latter system may be called by any name such as a remote radiotherapy planning system or a radiotherapy planning system. In the following description, components having substantially the same function and configuration will be denoted by the same reference numerals, and redundant explanations will be provided as appropriate and necessary. The various types of data dealt with in this specification are typically digital data.

[0012] <One Embodiment> Figure 1 is a schematic block diagram showing a system equipped with a radiation therapy planning device and an oncology information system according to one embodiment. This system is deployed across a large-scale cancer center LCC, Hospital AH, ..., Hospital XH, ..., Hospital ZH in a certain region, all of which can communicate with each other via a general network Nw1 such as the Internet. The large-scale cancer center LCC is a core cancer treatment facility in the region. The large-scale cancer center LCC is equipped with an oncology information system 10, radiation therapy planning devices 501-50m, 50A-50Z, and radiation therapy devices 601-60m. Details of the elements of this large-scale cancer center LCC will be described later. The suffixes of the radiation therapy planning devices 501-50m and radiation therapy devices 601-60m indicate the corresponding devices. For example, the radiation therapy planning system 501 and the radiation therapy device 601 correspond to each other by the common suffix "1" in "501" and "601". The radiation therapy planning system 501 has the radiation therapy device 601's unique beam modeling data, treatment plan format data, and radiation therapy device specification data, and cannot create a radiation therapy plan for any radiation therapy device other than the radiation therapy device 601. The beam modeling data is data that represents the relationship between inputs such as a specific beam energy and a specific irradiation intensity, and outputs such as the shape of the X-ray intensity distribution at a specific location. The radiation distribution at any cross-section is calculated using this data.

[0013] On the other hand, Hospitals AH, ..., XH, ..., and ZH are each regionally collaborating radiation therapy facilities. Hospitals AH, ..., XH, ..., and ZH are each equipped with oncology information systems 1A, ..., 1X, ..., 1Z and radiation therapy devices 6A, ..., 6X, ..., 6Z. The capital letters in the reference codes of oncology information systems 1A, ..., 1X, ..., 1Z and radiation therapy devices 6A, ..., 6X, ..., 6Z indicate that they are located in the corresponding hospitals. For example, oncology information system 1A and radiation therapy device 6A are located in Hospital AH, which corresponds to the capital letter "A" in the reference codes "1A" and "6A".

[0014] Here, oncology information systems 1A, ..., 1X, ..., and 1Z store together radiation therapy plans, radiation therapy implementation history, images related to radiation therapy plans, and images generated during radiation therapy at Hospital AH, ..., Hospital XH, ..., and Hospital ZH, respectively. Images related to radiation therapy plans are, for example, CT images of patients taken by radiation therapy planning CT devices (not shown) located at Hospital AH, ..., Hospital XH, ..., and Hospital ZH. When it is difficult to identify the extent of a tumor, medical images taken by MRI devices (not shown) or PET-CT devices (not shown) may be added to these. CT is an abbreviation for computed tomography. MRI is an abbreviation for magnetic resonance imaging. PET is an abbreviation for positron emission tomography. A PET-CT device refers to a device that integrates a PET device and a CT device.

[0015] Furthermore, oncology information systems 1A, ..., 1X, ..., and 1Z manage everything related to radiation therapy, including the radiation therapy schedules at Hospital AH, ..., Hospital XH, ..., and Hospital ZH, respectively. For example, oncology information systems 1A, ..., 1X, ..., and 1Z create information on the radiation therapy equipment used for radiation therapy, the radiation therapy schedule, and the task lists for each stage of radiation therapy, and follow up on each step. Oncology information systems 1A, ..., 1X, ..., and 1Z also register information on determined irradiation techniques, irradiation doses, and dose limit information. Specifically, this includes treatment techniques, the dose administered to each target, margin information for each target, dose constraints for each organ at risk (OAR), and the number of fractions. Clinical information for determining irradiation techniques in radiation therapy, the irradiation dose to the target area, and dose limits for organs at risk may also be registered. Specifically, this includes the organ in which the tumor is located, the location of the tumor within the organ (or CT images + annotations), and the characteristics of the tumor (tissue diagnosis results, genetic abnormality information). Such oncology information systems 1A, ..., 1X, ..., 1Z may be implemented as radiotherapy support devices capable of communicating with each corresponding radiotherapy device 6A, ..., 6X, ..., 6Z. The oncology information systems 1A, ..., 1X, ..., 1Z are examples of radiotherapy support devices that correspond to specific radiotherapy devices among a plurality of radiotherapy devices 6A to 6Z. The oncology information system may also be called OIS. OIS is an abbreviation for Oncology Information System. Alternatively, instead of the oncology information systems 1A, ..., 1X, ..., 1Z, all matters related to radiotherapy may be managed by a treatment RIS (Radiology Information System) or a treatment information management device similar to a treatment RIS.

[0016] Each of the radiotherapy devices 6A to 6Z is managed by its corresponding oncology information system 1A to 1Z, and each performs radiotherapy on patients based on the radiotherapy plan created by the radiotherapy planning devices 50A to 50Z. The capital letters in the reference codes of the radiotherapy planning devices 50A to 50Z indicate that they are radiotherapy planning devices dedicated to the radiotherapy device of the corresponding hospital. For example, radiotherapy planning device 50A is a radiotherapy planning device for radiotherapy device 6A installed in Hospital AH, corresponding to the capital letter "A" in the reference code "50A".

[0017] Specifically, each of the radiation therapy devices 6A to 6Z treats the patient by irradiating them with radiation according to the created radiation therapy plan. Each of the radiation therapy devices 6A to 6Z is installed in the treatment room of each hospital and has a treatment stand and a treatment bed. The treatment bed moves its tabletop so that the patient's treatment area approximately coincides with the iso-center. The iso-center is the point through which the beam passes approximately to its center when the treatment stand is rotated at various angles. The treatment stand supports the irradiation head so that it can rotate around its axis. The irradiation head irradiates with radiation according to the treatment plan. Specifically, the irradiation head forms an irradiation field using an MLC (multi-leaf collimator), and this irradiation field suppresses irradiation of normal tissue. When radiation is irradiated to the treatment area, the treatment area disappears or shrinks. Furthermore, each of the radiation therapy devices 6A to 6Z is a device of many types that correspond to the manufacturer, model, energy, MLC (multi-leaf collimator), and flattening filter insertion / removal.

[0018] The facilities refer to Hospital AH, ..., Hospital XH, ..., and Hospital ZH, where each of the radiation therapy devices 6A to 6Z is located. Accordingly, "Hospital AH, ..., Hospital XH, ..., and Hospital ZH" may be called "facilities" or "external facilities," as long as it does not cause confusion with the Large-Scale Cancer Center LCC. "External facilities" refers to the radiation therapy facilities located outside the Large-Scale Cancer Center LCC: Hospital AH, ..., Hospital XH, ..., and Hospital ZH.

[0019] The manufacturer is indicated by the company that manufactured each of the radiation therapy devices 6A through 6Z.

[0020] The model designation indicates the type of equipment, such as whether each of the 6A-6Z radiotherapy devices is a general-purpose machine (e.g., General-purpose_1) or a specialized machine (e.g., Specialized_1). An example of a general-purpose machine is the general-purpose LINAC. Within the general-purpose LINAC category, there are high-end models (e.g., General-purpose_1) and standard models (e.g., General-purpose_2). An example of a specialized machine is the IMRT / VMAT specialized machine. IMRT is an abbreviation for Intensity-modulated radiation therapy. IMRT refers to the creation of a radiation therapy plan using inverse planning and the subsequent implementation of radiation therapy. In IMRT, a complex dose distribution can be formed by varying the intensity of radiation within the irradiation field by moving the MLC during irradiation. VMAT is an abbreviation for Volumetric Modulated Arc Therapy. VMAT is the irradiation of a beam while rotating the gantry. By moving the MLC during beam irradiation, it is possible to vary the intensity of radiation within the irradiation field, similar to IMRT. As with IMRT, a treatment plan is created using inverse planning, and radiation therapy is then performed.

[0021] Energy [MeV] refers to the energy value of the radiation beam that each radiotherapy device can selectively use. Typically, 6 MeV, 8 MeV, 10 MeV, 15 MeV, 18 MeV, 20 MeV, and 22 MeV are used, and some devices can only use one energy value, while others can use two or more.

[0022] MLC stands for Multileaf collimator, which can create a radiation field that directs radiation only to the target by moving multiple corresponding leaves. There are several types of leaves depending on the device, model, and specifications, and the most important of these is the leaf width at the isocenter position. Note that an MLC with a leaf width of 10 mm will have a different number of leaves than an MLC with a leaf width of 5 mm.

[0023] The flattening filter indicates whether it is selectable to have a flattening filter that flattens the radiation intensity distribution of the radiation beam (the distribution in a plane approximately perpendicular to the direction of beam propagation), or whether it is only available with a flattening filter.

[0024] Next, we will explain in detail the elements of a large-scale cancer center (LCC).

[0025] The oncology information system 10 stores together radiation therapy plans created by each of the radiation therapy planning devices 501 to 50m, radiation therapy implementation history, images related to radiation therapy plans, and images generated during radiation therapy. Images related to radiation therapy plans include, for example, CT images of patients taken by a radiation therapy planning CT device (not shown) in the large-scale cancer center LCC. When it is difficult to identify the extent of the tumor, medical images taken by an MRI device (not shown) or a PET-CT device (not shown) may be added to these. The oncology information system 10 also manages all information related to radiation therapy, such as the radiation therapy schedule for executing radiation therapy based on the radiation therapy plan. For example, the oncology information system 10 creates information on the radiation therapy device used for radiation therapy, the radiation therapy schedule, and each task list for radiation therapy, and follows each step. The oncology information system 10 also registers information such as the determined irradiation technique, irradiation dose, and dose limit information. Specifically, this includes treatment techniques, doses administered to each target, margin information for each target, dose constraints for each organ at risk (OAR), and the number of fractions. Alternatively, the oncology information system 10 may register clinical information for determining the radiation dose to the target region and dose limits for organs at risk in radiotherapy. Specifically, this includes the organ in which the tumor is located, the location of the tumor within the organ (or CT images + annotations), and the characteristics of the tumor (tissue diagnosis results, genetic abnormality information).

[0026] The radiotherapy planning devices 501 to 50m are radiotherapy planning devices for radiotherapy devices 601 to 60m within the Large-Scale Cancer Center LCC. The reference numerals at the end of each radiotherapy planning device and radiotherapy device indicate the corresponding radiotherapy planning device and radiotherapy device. Specifically, the last character "1" of radiotherapy planning device "501" corresponds to radiotherapy device "601," and radiotherapy planning device "501" must be used to create a treatment plan for radiotherapy device "601." For example, each of the radiotherapy planning devices 501 to 50m stores beam modeling data, treatment plan format data, and radiotherapy device specification data for the corresponding radiotherapy devices 601 to 60m in a memory that is not shown.

[0027] On the other hand, the radiotherapy planning devices 50A to 50Z for external facilities are radiotherapy planning devices for radiotherapy devices 6A to 6Z located in external facilities, and the reference codes at the end of each radiotherapy planning device and radiotherapy device indicate the corresponding radiotherapy planning device and radiotherapy device, respectively. Specifically, the capital letter "A" in radiotherapy planning device "50A" corresponds to radiotherapy device "6A," and radiotherapy planning device "50A" must be used to create a treatment plan for radiotherapy device "6A." Similarly, each of the radiotherapy planning devices 50A to 50Z stores beam modeling data, treatment plan format data, and radiotherapy device specification data for the corresponding radiotherapy devices 6A to 6Z in a memory that is not shown.

[0028] Each of the radiation therapy planning systems 501 to 50m creates a radiation therapy plan for the corresponding radiation therapy system 601 to 60m based on the contents stored in its memory. Each of the radiation therapy planning systems 501 to 50m can appropriately use two methods when creating a radiation therapy plan: forward planning and inverse planning. In forward planning, the user (radiophysicist or radiation oncologist) determines multiple irradiation angles, doses at each angle, the shape of the MLC (Multileaf Collimator), etc., and the computer (radiation therapy planning system) calculates the dose distribution under those conditions. Forward planning is a method in which the user repeatedly performs this process while making small changes to the conditions until the target dose distribution is finally achieved.

[0029] On the other hand, inverse planning is a method in which, once the user determines multiple irradiation angles, the computer (radiation therapy planning system) automatically changes the conditions (dose intensity for each irradiation angle, MLC shape, dynamic movement of the MLC during irradiation, etc.) and repeatedly calculates how to satisfy the dose conditions, repeating trial and error until the dose conditions are finally satisfied. In future radiation therapy plans, inverse planning will basically be adopted, except in cases where the dose constraints are very complex. Furthermore, each of the radiation therapy planning systems 501 to 50m sends the created radiation therapy plan to the oncology information system 10.

[0030] Each of the radiation therapy devices 601 to 60m is managed by the oncology information system 10, and each device performs radiation therapy on the patient based on the radiation therapy plan created by the corresponding radiation therapy planning device 501 to 50m.

[0031] On the other hand, each of the radiotherapy planning systems 50A to 50Z can create a radiotherapy plan for each of the radiotherapy systems 6A to 6Z based on the beam modeling data, treatment plan format, and specification data of each of the radiotherapy systems 6A to 6Z. Each of the radiotherapy planning systems 50A to 50Z can use the inverse planning method when creating a radiotherapy plan. The radiotherapy planning system may also be called a TPS. TPS is an abbreviation for Treatment Planning System.

[0032] Next, we will describe the configuration of the radiation therapy planning systems 50A to 50Z. Since each of the radiation therapy planning systems 50A to 50Z has the same configuration, we will use radiation therapy planning system 50X as a representative example for explanation.

[0033] As shown in Figure 2, the radiation therapy planning device 50X comprises a processing circuit 51, a storage device 52, a display device 53, an input device 54, and a communication device 55, all of which are interconnected.

[0034] The storage device 52 consists of storage devices such as ROM (Read Only Memory), HDD (Hard Disk Drive), and SSD (Solid State Drive). The storage device 52 stores various programs and various data. As for the various programs, for example, a program for creating a radiation therapy plan, such as fully automatic or semi-automatic treatment planning software, may be used. As for the various data, information about the radiation therapy device 6X, which has a one-to-one relationship with this radiation therapy planning device 50X, such as the characteristics of the radiation therapy device feX, the skills of the radiation therapy staff skX, and the accuracy of patient QA acX are stored in advance. QA is an abbreviation for Quality Assurance. In Figure 1, each of the radiotherapy planning devices 50A, ..., 50X, ..., 50Z, the radiotherapy device features feA, ..., feX, ..., feZ, the skills of the radiotherapy staff skA, ..., skX, ..., skZ, the accuracy of patient QA acA, ..., acX, ..., acZ, and the radiotherapy devices 6A, ..., 6X, ..., 6Z have a one-to-one relationship with each other. For example, in the radiotherapy planning device 50X, the radiotherapy device features feX, the skills of the radiotherapy staff skX, the accuracy of patient QA acX, and the radiotherapy device 6X, the capital letter "X" in the reference numerals "50X", "feX", "skX", "acX", and "6X" represents a one-to-one relationship between them.

[0035] Here, the characteristic feX of the radiotherapy device is information about the characteristics of a specific radiotherapy device 6X among multiple radiotherapy devices 6A to 6Z distributed across multiple facilities from Hospital AH to Hospital ZH. For example, as shown in Figure 3, the characteristic feX of the radiotherapy device may include at least one of the following: information about the specific radiotherapy device 6X and information about the patient's respiratory motion detection device. The information about the specific radiotherapy device 6X may include at least one of the following: manufacturer, model, specifications, and radiotherapy characteristics. The information about the respiratory motion detection device may include at least one of the following: manufacturer, model, specifications, and detection device characteristics. Specifically, for example, the characteristics of a radiotherapy device feX include the type of device (general-purpose C-arm LINAC, O-type gantry IMRT / VMAT dedicated device, robot-type device resembling an industrial robot, MR-LINAC, etc.), device specifications (maximum beam irradiation range, MLC leaf width in the isocenter, MLC configuration (1 layer or 2 layers), table correction axis (3-axis or 6-axis), etc.), and options (whether there is a body surface shape measurement device, type of respiratory phase measurement device, type of fixation device, etc.). The "type of device" and "device specifications" referred to here are included in the "specifications" in the information regarding a specific radiotherapy device 6X. In addition, "options" are included, as appropriate, in the "characteristics" of the detection device or in the "characteristics" in the information regarding a specific radiotherapy device 6X.

[0036] The skill skX of the radiation therapy staff is information regarding the skills of the radiation therapy staff performing radiation therapy using a specific radiation therapy device 6X. In the case of remote radiation therapy planning where there is no full-time radiation oncologist, the radiation therapy staff may include, for example, radiation physicists, radiation technologists, and nurses. Part-time radiation oncologists may also be included as radiation therapy staff. Furthermore, as shown in Figure 4, for example, the skill skX of the radiation therapy staff may include at least one of the following: past treatment performance, a skill score, a recommended margin, and a margin score.

[0037] Past treatment records may include the number of treatments or treatment time statistics. Treatment time statistics may be the average treatment time at Hospital X (time from patient admission to end of treatment) or the average treatment time for each year. Accordingly, in the following explanation, treatment time statistics may be read as average treatment time. Furthermore, past treatment records may be, but are not limited to, a specific period such as six months or one year. The number of treatments (or treatment time statistics) may include at least one of the following: the number of treatments (or treatment time statistics) for each target disease, the number of treatments (or treatment time statistics) for each irradiation method, and the number of treatments (or treatment time statistics) for each respiratory motion countermeasure. Here, of "number of treatments (or treatment time statistics)," the former "number of treatments" corresponds to the case where past treatment records include the number of treatments, and the latter "treatment time statistics" corresponds to the case where past treatment records include treatment time statistics. This is also true in the following explanation.

[0038] For example, the number of treatments (or treatment time statistics) for each target disease can be used as appropriate, such as the number of treatments (or treatment time statistics) for each organ within a specific period.

[0039] For example, the number of treatments (or treatment time statistics) for each irradiation method can be used as appropriate, such as the number of treatments (or treatment time statistics) for each treatment technique within a specific period, or the number of treatments (or treatment time statistics) for each treatment technique for each target organ within a specific period.

[0040] For each respiratory movement management measure, the number of treatments (or treatment time statistics) can be used as appropriate, such as the number of treatments (or treatment time statistics) for each organ (affected by respiratory movement) within a specific period, the number of treatments (or treatment time statistics) for each respiratory movement management measure within a specific period, or the number of treatments (or treatment time statistics) for each respiratory movement management measure for the target organ within a specific period.

[0041] Also, the number of treatments (or treatment time statistics) may include the number of treatments for children. As the number of treatments (or treatment time statistics) for children, for example, the number of treatments (or treatment time statistics) for each organ within a specific period for children can be appropriately used. The number of treatments (or treatment time statistics) may include at least one of the number of treatments (or treatment time statistics) for pediatric patients for each target disease and the number of treatments (or treatment time statistics) for pediatric patients for each irradiation method.

[0042] As the number of treatments (or treatment time statistics) for pediatric patients for each target disease, for example, the number of treatments (or treatment time statistics) for each organ within a specific period for children can be appropriately used.

[0043] As the number of treatments (or treatment time statistics) for pediatric patients for each irradiation method, for example, the number of treatments (or treatment time statistics) for each treatment technique within a specific period for children can be appropriately used.

[0044] The number of treatments (or treatment time statistics) for pediatric patients may include at least one of the number of treatments (or treatment time statistics) under general anesthesia and the number of treatments (or treatment time statistics) under wakefulness.

[0045] As the number of treatments (or treatment time statistics) under general anesthesia, for example, the number of treatments (or treatment time statistics) performed within a specific period under general anesthesia among children, the number of treatments (or treatment time statistics) for each organ performed within a specific period under general anesthesia among children, the number of treatments (or treatment time statistics) for each treatment technique performed within a specific period under general anesthesia among children, etc. can be appropriately used. [[ID=!13]]

[0046] As the number of treatments (or treatment time statistics) under wakefulness, for example, the number of treatments (or treatment time statistics) performed within a specific period without general anesthesia among children, the number of treatments (or treatment time statistics) for each organ performed within a specific period without general anesthesia among children, the number of treatments (or treatment time statistics) for each treatment technique performed within a specific period without general anesthesia among children, etc. can be appropriately used.

[0047] The score representing a skill is an index classified by level according to the skill. For example, the score representing a skill may be determined by ranking the skill levels in advance as 1 to 5 based on the data of past treatment results. The score may be set for each condition such as the target organ, treatment technique, presence or absence of respiratory movement countermeasures, means of respiratory movement countermeasures, whether it is a child, and if it is a child, whether it is general anesthesia or not.

[0048] The recommended margin is a setup margin determined according to the skill. For example, the higher the skill, the smaller the recommended margin value. The recommended margin may also be set for each condition in the same way as the score representing the skill.

[0049] The score representing the margin is an index classified by level according to the recommended margin. For example, the score representing the margin may be determined by ranking the recommended margins in advance as 1 to 5 based on the data of the recommended margins. For example, the smaller the recommended margin, the higher the score representing the margin.

[0050] The accuracy acX of patient QA is information regarding the accuracy of patient QA for verifying the radiotherapy plan used in radiotherapy. For example, as shown in FIG. 5, the accuracy acX of patient QA may include at least one of the information regarding the measuring instrument and phantom used for patient QA, the information regarding the method of patient QA, the information regarding the accuracy expected by the method of patient QA, and the information regarding the characteristics of patient QA.

[0051] As the information regarding the measuring instrument and phantom used for patient QA, a list of QA measuring instruments and phantoms owned, or a list of QA measuring instruments and phantoms to be used for each treatment technique when the method of patient QA changes for each treatment technique, etc. are appropriately available.

[0052] As the information regarding the method of patient QA, specific methods of patient QA, methods of patient QA for each treatment technique, etc. are appropriately available.

[0053] Regarding information on the expected accuracy of patient QA methods, the accuracy level guaranteed (expected) by patient QA, or an accuracy rank pre-assigned to levels from 1 to 5, can be used as appropriate.

[0054] Regarding information on the characteristics of patient QA, information on the characteristics of the relevant patient QA method is available for use as appropriate.

[0055] The memory device 52 is an example of a memory unit.

[0056] The display device 53 consists of display devices such as a liquid crystal display (LCD), a cathode ray tube (CRT) display, and an organic electroluminescent display (OELD). The display device 53 displays various information under the control of the processing circuit 51. The display device 53 is an example of a display.

[0057] The input device 54 consists of input interface devices such as a mouse, keyboard, trackball, switch, button, joystick, touchpad, and touch panel display. The input device 54 receives various input operations from the user and supplies electrical signals corresponding to the received input operations to the processing circuit 51.

[0058] The communication device 55 consists of a communication interface device that performs network communication, such as a NIC (Network Interface Card). The communication device 55 receives data such as treatment plan creation requests and medical images supplied from, for example, the oncology information systems 1A to 1Z of an external facility. The communication device 55 also transmits the created radiation therapy plan to the sender of the treatment plan creation request.

[0059] The processing circuit 51 has a processor consisting of a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), etc. The processing circuit 51 controls the entire radiation therapy planning device 50X by controlling each part of the radiation therapy planning device 50X. In addition, the processing circuit 51 realizes the acquisition function 511, the creation function 512, the communication function 513, and the display control function 514 by executing a program stored in the storage device 52. Some or all of each of the functions 511-514 may be configured by an integrated circuit such as an ASIC (Application Specific Integrated Circuit).

[0060] The acquisition function 511 acquires the characteristics feX of a specific radiotherapy device 6X, the skills skX of the radiotherapy staff, and the accuracy acX of patient QA from the storage device 52. For example, the acquisition function 511 may acquire the characteristics feX, skills skX, and accuracy acX from the storage device 52 based on a request for creation or approval of a radiotherapy plan, or it may acquire the characteristics feX, skills skX, and accuracy acX from the storage device 52 in response to user operations. The acquisition function 511 also acquires beam modeling data, treatment plan format, and specification data of the radiotherapy device 6X, which has a one-to-one relationship with the radiotherapy planning device 50X, from the storage device 52. For example, the acquisition function 511 may acquire the beam modeling data, treatment plan format, and specification data that have been pre-registered in the program. The acquisition function 511 and processing circuit 51 are examples of the acquisition unit.

[0061] The creation function 512 creates a radiotherapy plan to be used for a specific radiotherapy device 6X based on the acquired beam modeling data, treatment plan format, and specification data. The creation function 512 and processing circuit 51 are examples of the creation unit.

[0062] The communication function 513 transmits and receives information with other devices via the communication device 55. The communication function 513 and the processing circuit 51 are an example of a transmitting unit.

[0063] The display control function 514 displays various information on the display device 53. For example, the display control function 514 displays at least a portion of the acquired characteristics feX of a specific radiotherapy device, the skills skX of the radiotherapy staff, and the accuracy acX of patient QA on the display device 53 in accordance with the user's operation. Here, "at least a portion" can be, for example, a portion or combination of the characteristics feX of a specific radiotherapy device, the skills skX of the radiotherapy staff, and the accuracy acX of patient QA, which can be used as appropriate. However, it is not limited to this, and "at least a portion" could be, for example, all of the characteristics feX of a specific radiotherapy device, the skills skX of the radiotherapy staff, and the accuracy acX of patient QA. The display control function 514 and the processing circuit 51 are an example of a display control unit.

[0064] These storage devices 52, display devices 53, input devices 54, communication devices 55, and the acquisition function 511, communication function 513, and display control function 514 of the processing circuit 51 constitute the medical information processing device 80. Accordingly, the descriptions of the storage devices 52, display devices 53, input devices 54, communication devices 55, and the acquisition function 511, communication function 513, and display control function 514 of the processing circuit 51 are descriptions of the radiotherapy planning device 50X and the medical information processing device 80, respectively. The medical information processing device 80 is not limited to being provided by any radiotherapy planning device 50X, but may also be provided by any oncology information system 1X. Note that any radiotherapy planning device 50X is an example of a radiotherapy planning device equipped with a medical information processing device.

[0065] Next, we will describe the configuration of oncology information systems 1A to 1Z. Since each of the oncology information systems 1A to 1Z has the same configuration, we will use oncology information system 1X as a representative example for explanation.

[0066] As shown in Figure 6, the oncology information system 1X, like the radiotherapy planning device 50X, comprises interconnected processing circuits 1, storage devices 2, display devices 3, input devices 4, and communication devices 5.

[0067] The storage device 2 consists of storage devices such as ROM (Read Only Memory), HDD (Hard Disk Drive), and SSD (Solid State Drive). The storage device 2 stores various programs and various data. As for the various programs, for example, a program for managing treatment information management, such as treatment information management software, may be used. As for the various data, information related to the radiotherapy device 6X, which has a one-to-one relationship with this oncology information system 1X, such as the characteristics of the radiotherapy device feX, the skills of the radiotherapy staff skX, and the accuracy of patient QA acX are stored in advance. Note that the characteristics of the radiotherapy device feX, the skills of the radiotherapy staff skX, and the accuracy of patient QA acX are the same information as those for the radiotherapy planning device 50X, so their explanation is omitted here.

[0068] Memory device 2 is an example of a memory unit.

[0069] The display device 3 consists of display devices such as a liquid crystal display (LCD), a cathode ray tube (CRT) display, and an organic electroluminescent display (OELD). The display device 3 displays various information under the control of the processing circuit 1. The display device 3 is an example of a display.

[0070] Input device 4 consists of input interface devices such as a mouse, keyboard, trackball, switch, button, joystick, touchpad, and touch panel display. Input device 4 receives various input operations from the user and supplies electrical signals corresponding to the received input operations to processing circuit 1.

[0071] The communication device 5 consists of a communication interface device that performs network communication, such as a NIC (Network Interface Card). The communication device 5 receives various medical images necessary for creating a radiation therapy plan, such as those captured by a CT scanner for radiation therapy planning (not shown). Also, for example, the communication device 5 transmits a request for the creation of a radiation therapy plan, along with various medical images necessary for creating the radiation therapy plan, to the radiation therapy planning device 50X.

[0072] The processing circuit 1 has a processor consisting of a CPU (Central Processing Unit), a GPU (Graphics Processing Unit), etc. The processing circuit 1 controls the entire oncology information system 1X by controlling each part of the oncology information system 1X. Furthermore, the processing circuit 1 realizes acquisition function 11, creation function 12, communication function 13, and display control function 14 by executing a program stored in the storage device 2. Note that some or all of each of the functions 11-14 may be configured by an integrated circuit such as an ASIC (Application Specific Integrated Circuit).

[0073] The creation function 12 creates a radiotherapy task using a specific radiotherapy device 6X based on the diagnosis of a radiation oncologist. Furthermore, it creates a request for the radiotherapy planning device 50X to create a radiotherapy plan. The creation function 12 and processing circuit 1 are examples of the creation unit.

[0074] The acquisition function 11 acquires the determined irradiation technique, irradiation dose, and dose limit information for the created radiotherapy task. Irradiation dose and dose limit information includes information such as the treatment technique, the dose administered to each target, margin information for each target, dose constraints for each organ at risk (OAR), and the number of fractions. Alternatively, the acquisition function 11 may acquire clinical information to determine the irradiation dose to the target region and the dose limit to organs at risk in radiotherapy. Specifically, this includes the organ in which the tumor is located, the location of the tumor within the organ (or CT images + annotations), and the characteristics of the tumor (tissue diagnosis results, genetic abnormality information). The acquisition function 11 also acquires the characteristics feX of a specific radiotherapy device 6X, the skills skX of the radiotherapy staff, and the accuracy acX of patient QA from the storage device 2. For example, the acquisition function 11 may acquire the characteristics feX, skills skX, and accuracy acX from the storage device 2 based on the creation of the radiotherapy task. For example, the acquisition function 11 may acquire the feature feX, the skill skX, and the accuracy acX from the storage device 2 in response to user operations.

[0075] The communication function 13 transmits and receives information with other devices via the communication device 5. Specifically, this includes the radiation therapy plan created by the radiation therapy planning device 50X, the radiation dose distribution inside the phantom for patient QA, records of treatment performed by the radiation therapy device 6X, and images taken during treatment. The communication function 13 and processing circuit 1 are examples of a transmission unit.

[0076] The display control function 14 displays various information on the display device 3. For example, the display control function 14 displays at least a portion of the acquired characteristics feX of a specific radiotherapy device, the skills skX of the radiotherapy staff, and the accuracy acX of patient QA on the display device 3 according to the user's operation. Here, "at least a portion" can be, for example, a portion or combination of the characteristics feX of a specific radiotherapy device, the skills skX of the radiotherapy staff, and the accuracy acX of patient QA, which can be used as appropriate. However, it is not limited to this, and "at least a portion" could be, for example, all of the characteristics feX of a specific radiotherapy device, the skills skX of the radiotherapy staff, and the accuracy acX of patient QA. The display control function 14 and the processing circuit 1 are an example of a display control unit.

[0077] These storage device 2, display device 3, input device 4, communication device 5, and the acquisition function 11, communication function 13, and display control function 14 of the processing circuit 1 constitute a medical information processing device 81. Accordingly, the descriptions of the storage device 2, display device 3, input device 4, communication device 5, and the acquisition function 11, communication function 13, and display control function 14 of the processing circuit 1 are descriptions of the oncology information system 1X and the medical information processing device 81, respectively. The medical information processing device 81 is not limited to being included in any oncology information system 1X, but may also be included in any radiotherapy planning device 50X. Note that the oncology information system 1X is an example of a radiotherapy support device equipped with a medical information processing device.

[0078] Next, the operation of the radiotherapy planning system configured as described above will be explained using the sequence diagram in Figure 7. The following explanation will use the example of creating a radiotherapy plan for radiotherapy at X Hospital XH using the Large-Scale Cancer Center LCC.

[0079] (Step ST1) The first step in radiotherapy is registration in the oncology information system 1X (radiation therapy support device). At Hospital XH, once a patient's radiotherapy is decided, a radiotherapy task is created using a terminal (not shown), and the necessary data is registered in the oncology information system 1X. Since Hospital XH does not have a full-time radiation oncologist, a part-time radiation oncologist may register the data, or a radiation oncologist from the large-scale cancer center LCC may register the data in the oncology information system 1X at Hospital XH using a remote monitor or the like.

[0080] The oncology information system 1X creates information on the radiation therapy equipment used for radiation therapy, a radiation therapy schedule, and a list of each radiation therapy task, and follows each step. Furthermore, the processing circuit 1 of the oncology information system 1X acquires the characteristics of the radiation therapy equipment feX, the skills of the radiation therapy staff skX, and the accuracy of patient QA acX from the storage device 2 based on the creation of the radiation therapy task. This allows the processing circuit 1 to display at least a portion of the acquired characteristics of the specific radiation therapy equipment feX, the skills of the radiation therapy staff skX, and the accuracy of patient QA acX on the display device 3 in response to user input in each of the following steps. The oncology information system 1X also registers determined irradiation techniques, irradiation doses, and dose limit information. Specifically, treatment techniques, administered doses for each target, margin information for each target, dose constraints for each risk organ (OAR), and the number of fractions are registered in the oncology information system 1X. The oncology information system 1X may register clinical information for determining the radiation dose to the target area and dose limits for organs at risk during radiotherapy. Specifically, the organ in which the tumor is located, the location of the tumor within the organ (or CT images + annotations), and the characteristics of the tumor (tissue diagnosis results, genetic abnormality information) are registered in the oncology information system 1X. At this time, margin information and other factors are determined by referring to at least some of the characteristics of the specific radiotherapy device acquired (feX), the skills of the radiotherapy staff (skX), and the accuracy of patient QA (acX).

[0081] (Step ST2) The second step in radiation therapy is CT imaging for radiation therapy planning. In the CT room for radiation therapy planning at Hospital XH, the radiation therapy staff prepares patient immobilization devices. Patient immobilization devices are devices that support the patient to prevent movement during radiation therapy. These include devices that cover and fix the patient from above, and devices of a specific shape on which the patient lies to fix the patient's body shape when lying on the treatment table. Once the patient immobilization devices are prepared, the radiation therapy staff set them up in the same way as during radiation therapy and take planning CT images of the patient using the CT scanner for radiation therapy planning. Once the planning CT images are created, they are transferred to the oncology information system 1X.

[0082] (Step ST3) The third step in radiotherapy is the creation of a radiotherapy plan. There is a one-to-one relationship between the radiotherapy devices 601-60m and the radiotherapy planning devices 501-50m within the Large Cancer Center LCC. Similarly, there is a one-to-one relationship between the 26 radiotherapy planning devices 50A-50Z within the Large Cancer Center LCC and the 26 radiotherapy devices 6A-6Z located outside the Large Cancer Center LCC. The following description will use the case of creating a radiotherapy plan using the radiotherapy planning device 50X as an example. The oncology information system 1X transmits a request for radiotherapy plan creation and planning CT images to the corresponding radiotherapy planning device 50X. At this time, the request for radiotherapy plan creation may include either clinical information for determining the radiation dose to the target area and the dose limit to organs at risk in radiotherapy, or the determined irradiation technique, radiation dose, and dose limit information, or both.

[0083] Furthermore, the radiation therapy plan request includes personal information such as the patient's name, and the CT images may allow for facial recognition depending on the area, thus containing information that requires protection of personal information. Therefore, even when using the general network Nw1, it is necessary to establish a secure environment, such as by using a VPN (virtual private network). In addition, the radiation therapy plan request includes information about a specific radiation therapy device 6X.

[0084] Furthermore, in some cases, it is difficult to distinguish between tumors and normal tissue using only the transmitted planning CT images. In such cases, Hospital XH may acquire medical images of the patient (MRI images, PET-CT images) in addition to the planning CT images and transmit them to the radiation therapy planning system 50X. This is because these medical images are aligned with the planning CT images, and the tumor boundaries that can be identified in these medical images are used to draw the tumor boundaries on the planning CT images.

[0085] (Step ST4) When the radiotherapy planning device 50X receives a request for radiotherapy planning and a CT image for planning, it reserves space for the patient's radiotherapy in a database (not shown) and registers the information necessary for creating the radiotherapy plan that is included in the request for radiotherapy planning. The processing circuit 51 of the radiotherapy planning device 50X also acquires the characteristics of the radiotherapy device feX, the skills of the radiotherapy staff skX, and the accuracy of the patient QA acX from the storage device 52 based on the request for radiotherapy planning. As a result, in each of the following steps, the processing circuit 51 can display at least a portion of the acquired characteristics of the specific radiotherapy device feX, the skills of the radiotherapy staff skX, and the accuracy of the patient QA acX on the display device 53 in response to user operation.

[0086] Radiation therapy planning consists of two steps: contouring and treatment plan creation. Contouring is a term used in the field of radiation therapy, and is generally called segmentation. Contouring refers to the contouring process performed by radiation oncologists. Specifically, contouring involves creating contours of areas identified as tumors with the naked eye and areas of organs at risk, based on planning CT images or other medical images (MRI images, PET-CT images, etc.). These contours can be drawn manually by radiation oncologists or automatically based on CT value information, organ shape, etc. In recent years, AI-based automatic contouring functions have developed, and it has become possible to create contours to a certain extent automatically, especially for organs at risk. In the future, it may be possible to similarly create tumor contours automatically using AI-based software. If this happens, the burden of contouring on radiation oncologists will be greatly reduced, and it is expected that radiation oncologists will be able to check the results of automatic contouring and create contours manually only when necessary. Alternatively, radiation oncologists can expect to be able to create contours semi-automatically by roughly specifying a certain range and then automatically extracting contours from within that range. Once the area identified as a tumor macroscopically is determined, the planning target volume (PTV) is determined by considering the area of ​​potential malignant tumor to be treated and all uncertainties.

[0087] To elaborate, contouring identifies the gross tumor volume (GTV) and determines the clinical target volume (CTV), considering the possibility that the tumor has already infiltrated at the cellular level. Next, the internal target volume (ITV), which takes into account migration within the body (such as to organs or bones), is determined. Finally, a setup margin (SM) is added to the CTV to determine the planned target volume (PTV) in order to ensure that the dose is reliably delivered to the CTV. A relatively small value for this setup margin (SM) is recommended if the skill level of the radiation therapy staff at Hospital XH is high, and a relatively large value is recommended if their skill level is low. At this time, the processing circuit 51 displays at least a portion of the acquired characteristics of the radiation therapy device feX, the skill level of the radiation therapy staff skX, and the accuracy of patient QA acX on the display device 53, according to the operation of the radiation oncologist. This allows radiation oncologists to confirm at least some of the characteristics of the radiation therapy device feX, the skills of the radiation therapy staff skX, and the accuracy of patient QA acX while creating a radiation therapy plan for radiation therapy device 6A at hospital XH, another hospital.

[0088] For example, the processing circuit 51 of the radiation therapy planning device 50X displays the recommended margins included in the acquired radiation therapy staff skill skX on the display device 53, in response to the radiation oncologist's operation. Subsequently, the processing circuit 51 determines the planned target volume (PTV) using the recommended margins, in response to the radiation oncologist's operation. This completes the contouring process.

[0089] (Step ST5) After contouring, the creation of a treatment plan begins. Inverse planning is employed for creating the treatment plan. In inverse planning, when a radiation oncologist specifies multiple irradiation angles, the radiation therapy planning device 50X automatically and repeatedly calculates, changing the conditions (dose intensity, MLC shape, etc.) to satisfy the dose conditions from each of the specified irradiation angles, and repeats trial and error until the dose conditions are finally satisfied. The range of condition search during inverse planning corresponds to the specification data of the radiation therapy device 6X. For this reason, the processing circuit 51 acquires the specification data that has been registered in advance in the program in the storage device 52. Based on the acquired specification data, the processing circuit 51 determines the range of condition changes. Also in inverse planning, the processing circuit 51 of the radiation therapy planning device 50X acquires beam modeling data that has been registered in advance in the program in the storage device 52. Based on the acquired beam modeling data, the processing circuit 51 calculates the dose distribution inside the subject. In inverse planning, a more complex dose distribution can be created by dynamically changing the MLC shape during beam irradiation from a single direction.

[0090] In step ST5, the example given was that the radiation oncologist initially specifies multiple irradiation angles, but this is not the only example. For example, the processing circuit 51 may automatically identify the irradiation angles by referring to irradiation angles in similar cases by running fully automated treatment planning software. Alternatively, the radiation oncologist may only determine the number of beam irradiation directions, and the processing circuit 51 may determine the irradiation direction so that the dose to the organs at risk is minimized.

[0091] (Step ST6) The processing circuit 51 obtains the treatment plan format that has been previously registered in the program in the storage device 52. Then, based on the results of inverse planning, the processing circuit 51 creates a radiation therapy plan by writing the data for performing radiation therapy to the treatment plan format. When the creation of the radiation therapy plan is completed in this way, the radiation therapy plan is completed. Upon completion of the radiation therapy plan, the status of the radiation therapy plan in the task list becomes completed, and the process moves to the next step. At this time, the processing circuit 51 may generate an approval request for the radiation therapy plan.

[0092] (Step ST7) The next step is the approval of the radiation therapy plan. In this step, the radiation therapy planning device 50X displays the radiation therapy plan created based on the request for approval of the radiation therapy plan on the display device 53. A highly skilled radiation oncologist then checks the created radiation therapy plan (contouring, dose distribution, DVH (Dose Volume Histogram), etc.) and confirms that it matches the treatment objectives. After confirmation, if it matches the treatment objectives, the radiation oncologist approves the created radiation therapy plan. If it does not match, the radiation therapy plan is rejected and the radiation therapy planning device 50X is instructed to recreate it. At this time, the radiation oncologist inputs guidelines for improving the treatment objectives into the radiation therapy planning device 50X. At this time, the highly skilled radiation oncologist may also check the characteristics of the radiation therapy device feX, the skills of the radiation therapy staff skX, the accuracy of patient QA acX, etc., as needed. For example, the processing circuit 51 may acquire features feX, skills skX, accuracy acX, etc. from the storage device 52 based on the request for approval of the radiation therapy plan, and may display the acquired content on the display device 53 as appropriate in accordance with the operation of the radiation oncologist.

[0093] Once the radiation therapy plan is approved, the status of "Radiation Therapy Plan Approval" in the task list will change to "Completed," and you will proceed to the next step.

[0094] (Step ST8) The next step is the calculation of the dose distribution for patient QA. In this step, the radiation therapy planning system 50X calculates the radiation dose distribution at a specific location when a treatment plan is implemented using a specific phantom. For example, it assumes that a treatment plan is implemented using a phantom in which a large number of semiconductor detectors are configured in a three-dimensional space inside a cylindrical structure, and calculates the radiation dose distribution under those conditions. This step may be performed manually by medical staff other than radiation oncologists (radiophysicists, radiologic technologists, etc.), or it may be performed automatically by a program if the phantom and verification method are predetermined. Once the calculation of the dose distribution for patient QA is complete, the status of the calculation of the dose distribution for patient QA in the task list will be completed, and the system will proceed to the next step.

[0095] (Step ST9) The next step is to transfer the data created by the radiation therapy planning device 50X to the oncology information system 1X. The radiation therapy planning device 50X transfers the created radiation therapy plan, radiation dose distribution, and calculated patient QA dose distribution to the oncology information system 1X in X Hospital XH. The command for the transfer may be manually entered into the radiation therapy planning device 50X by the medical staff who manually created the patient QA dose distribution. Alternatively, it may be automatically started as a background process starting from the completion status of the patient QA dose distribution calculation.

[0096] (Step ST10) Once all the necessary data is available in the oncology information system 1X within Hospital XH, the next step is patient QA. The radiotherapy device 6X within Hospital XH uses a specific phantom to measure the radiation dose distribution at a specific location based on the transferred treatment plan. The measured dose distribution data for patient QA is transferred to a computer terminal (not shown) for patient QA analysis. The computer terminal compares the calculated dose distribution for patient QA with the measured dose distribution for patient QA, and if there is no error exceeding an acceptable range between the two, it is judged as passing. If it passes, patient QA is completed. If it fails, a warning message is displayed on at least one of the devices, for example, the radiotherapy device 6X or the oncology information system 1X. When a warning message is displayed, a radiation oncologist or radiation physicist checks whether to execute the radiotherapy plan, and if they determine there is no problem, patient QA is completed as in the case of passing. If there is a problem, countermeasures are taken if necessary (and the plan may be replanned), and verification (patient QA) is performed again. Step ST10 is completed when the patient QA status is finalized. This completes the preparation for radiation therapy.

[0097] (Radiation Therapy) On the first day of radiation therapy at Hospital XH, radiation therapy is usually performed by two radiologic technologists (hereinafter referred to as staff). While one staff member prepares for the treatment, the other staff member escorts the patient to the treatment room. Treatment preparation involves transferring data necessary for radiation therapy, such as treatment plan data and planning CT images from the oncology information system 1X, to the radiation therapy device 6X, and preparing the patient restraint devices to be used during radiation therapy. The patient restraint devices have barcodes attached to them, for example, and the restraint device information transferred to the radiation therapy device 6X is referenced (scanned with a barcode reader) to prevent mix-ups of patient restraint devices. There are two types of patient restraint devices: those that cover the patient from above and those that are placed under the patient. The restraint devices that are placed under the patient are set in their designated positions on the treatment table at this stage.

[0098] When a patient enters the radiation therapy room, their name is confirmed to prevent any misidentification. After confirming the patient's name, they are placed on the treatment table. At this time, the table only lowers to a certain height, so two or one staff member will support the patient as needed. Once the patient is on the table, the staff will attach a restraint device that covers the patient from above.

[0099] After confirming that all patient restraints are properly set for the patient placed on the treatment table, the table is moved to position the patient in the treatment area. Next, the position is adjusted so that the marker drawn on the patient's body surface (center position of the planning CT image) coincides with the laser marker. Then, the displacement vector between the center of the planning CT image and the center of the target is calculated, and the treatment table is moved according to the displacement vector. Assuming that the patient is in the exact same position as during the CT scan and that the tumor inside the patient is in the exact same position, it is assumed that the tumor is located at the position indicated by the laser marker after the table has been moved. Therefore, the position is marked again with markers at three locations on the body surface indicated by the laser marker: on the sides of the patient's body (left and right) and in front of the patient. From the second treatment onward, the position is adjusted so that these markers coincide with the laser marker.

[0100] Next, the gantry angle of the 6X radiotherapy device is set to the first radiation irradiation angle (the starting angle of rotational irradiation in the case of VMAT), and two-directional X-ray imaging (with the angle changed by rotation) or rotational X-ray imaging is performed to identify the discrepancy between the position indicated by the laser marker (isocenter) and the position of the tumor in the body.

[0101] Two-directional X-ray imaging creates two DRR images from the planning CT image, each appearing as if it were centered on the target. These two DRR images are then compared with the X-ray images taken from the two directions to identify positional displacement, primarily based on the misalignment of bone structure. DRR stands for Digitally Reconstructed Radiographs. The two-directional imaging method is fundamentally based on the assumption that the positional relationship between the bone near the tumor and the tumor itself does not shift.

[0102] On the other hand, rotational radiography using X-rays involves cone-beam CT reconstruction (CBCT reconstruction) to create CBCT images. While there are errors in the CT values ​​of these CBCT images compared to the planning CT images, they accurately reproduce the shape of organs. Therefore, rotational radiography compares the organ positions in the planning CT images with those in the CBCT images to identify any discrepancies. The rotational radiography method is fundamentally based on the premise that the position of the tumor within the organ containing the tumor does not shift.

[0103] By identifying the misalignment using two-directional or rotational imaging, the bed is shifted or rotated by the amount of the misalignment vector to correct it, and the target center and isocenter are adjusted to coincide.

[0104] When the target center and the isocenter coincide, the radiotherapy device 6X begins irradiating with a radiation beam from the first irradiation angle. If the target is affected by respiratory movements, methods such as irradiating with the radiation beam only when the breath is held, or measuring respiratory movements with a detector and irradiating only when the respiration is within a specific phase range, are employed.

[0105] Once the radiation beam irradiation from the first irradiation angle is complete, the gantry angle of the radiation therapy device 6X is set to the second radiation irradiation angle (the starting angle of rotational irradiation in the case of VMAT), and radiation beam irradiation at the second irradiation angle is performed.

[0106] Similarly, radiation beam irradiation is performed at the third, fourth, ... irradiation angles, and once radiation beam irradiation has been performed at all irradiation angles required in the radiation therapy plan, the first day of treatment is complete.

[0107] Similarly, on the second day, third day, and so on, treatment is typically administered five times a week on weekdays for six weeks, completing a series of 30 sessions. This number of sessions may vary depending on other treatments used in combination or the dose of each individual radiation dose. For example, in cases of combination therapy with chemotherapy (anti-cancer drug treatment), if side effects from both the chemotherapy and radiation therapy appear in the same area, radiation therapy may be reduced from the usual five times a week to three times a week (Monday, Wednesday, Friday). Alternatively, while the usual dose to the target is 2 Gy, there are cases where 8 Gy is administered at once, completing the treatment in one week (five sessions) (for example, in the case of low-risk prostate cancer).

[0108] During treatment, the radiation oncologist will regularly examine the patient to check the effectiveness of the radiation therapy and the extent of any side effects. They may also examine the patient irregularly if the patient complains of pain or other issues.

[0109] Once the series of radiation therapies is completed, the first step is to check the effectiveness of the treatment on the tumor using a CT or MRI scanner. If a certain level of therapeutic effect is confirmed, then regular follow-up (examinations, diagnostic image collection, etc.) is performed thereafter.

[0110] As described above, according to one embodiment, the storage device 2,52 pre-stores information regarding the characteristics feX of a specific radiotherapy device 6X among a plurality of radiotherapy devices 6A to 6Z distributed across multiple facilities, the skills skX of the radiotherapy staff performing radiotherapy with the specific radiotherapy device 6X, and the accuracy acX of patient QA verifying the radiotherapy plan used for radiotherapy with the radiotherapy device 6X. The processing circuit 1,51 is connected to the storage device 2,52 and retrieves information regarding the characteristics feX of a specific radiotherapy device, the skills skX of the radiotherapy staff, and the accuracy acX of patient QA from the storage device 2,52 based on the creation of a radiotherapy task, a request for the creation of a radiotherapy plan, a request for approval of a radiotherapy plan, contouring processing, radiotherapy plan creation processing by inverse planning, or radiotherapy plan approval processing. The processing circuit 1,51 displays at least a portion of the acquired information regarding the characteristics of a specific radiotherapy device feX, the skills of the radiotherapy staff skX, and the accuracy of patient QA acX on the display device 3,53 in accordance with the operation of the radiation oncologist. Therefore, when setting treatment goals for a radiotherapy task, or during the creation of a radiotherapy plan for various radiotherapy devices 6A to 6Z, or before approving a radiotherapy plan, it is possible to confirm at least a portion of the characteristics of the radiotherapy device, the level of the radiotherapy staff, and the accuracy of patient QA.

[0111] Furthermore, according to one embodiment, the characteristic feX of a specific radiotherapy device may include at least one of the following: information relating to the specific radiotherapy device 6X and information relating to the patient's respiratory motion detection device. In this case, at least one of the following can be confirmed: information relating to the specific radiotherapy device 6X and information relating to the patient's respiratory motion detection device.

[0112] Furthermore, according to one embodiment, information regarding a specific radiotherapy device may include at least one of the following: manufacturer, model, specifications, and characteristics of the radiotherapy. In this case, the manufacturer, model, specifications, and characteristics of the radiotherapy device 6X can be appropriately confirmed.

[0113] Furthermore, according to one embodiment, information regarding the respiratory motion detection device may include at least one of the following: manufacturer, model, specifications, and characteristics of the detection device. In this case, the manufacturer, model, specifications, and characteristics of the respiratory motion detection device can be appropriately confirmed.

[0114] Furthermore, according to one embodiment, the skill skX of the radiation therapy staff may include at least one of past treatment performance, a skill score, a recommended margin, and a margin score. In this case, the radiation therapy staff's past treatment performance, skill score, recommended margin, and margin score can be checked as appropriate.

[0115] Furthermore, according to one embodiment, past treatment records may include the number of treatments or the average treatment time. In this case, the number of treatments or the average treatment time can be appropriately confirmed as past treatment records of the radiation therapy staff.

[0116] Furthermore, according to one embodiment, if past treatment records include the number of treatments, the number of treatments may include at least one of the following: the number of treatments for each target disease, the number of treatments for each irradiation method, and the number of treatments for each respiratory motion countermeasure. In this case, the number of treatments for each target disease, the number of treatments for each irradiation method, and the number of treatments for each respiratory motion countermeasure can be appropriately confirmed as the number of treatments for the radiation therapy staff. Also, if past treatment records include the average treatment time, the average treatment time may include at least one of the following: the average treatment time for each target disease, the average treatment time for each irradiation method, and the average treatment time for each respiratory motion countermeasure. In this case, the average treatment time for each target disease, the average treatment time for each irradiation method, and the average treatment time for each respiratory motion countermeasure can be appropriately confirmed as the average treatment time for the radiation therapy staff.

[0117] Furthermore, according to one embodiment, if past treatment records include the number of treatments, the number of treatments may include at least one of the number of treatments for pediatric patients for each target disease and the number of treatments for pediatric patients for each irradiation method. In this case, the number of treatments for radiation therapy staff can be appropriately confirmed as the number of treatments for pediatric patients for each target disease and the number of treatments for pediatric patients for each irradiation method. Also, if past treatment records include average treatment time, the average treatment time may include at least one of the average treatment time for pediatric patients for each target disease and the average treatment time for pediatric patients for each irradiation method. In this case, the average treatment time for radiation therapy staff can be appropriately confirmed as the average treatment time for pediatric patients for each target disease and the average treatment time for pediatric patients for each irradiation method.

[0118] Furthermore, according to one embodiment, if past treatment records include the number of treatment cases, the number of pediatric patients included in said number of treatment cases may include at least one of the number of treatment cases under general anesthesia and the number of treatment cases under awake. In this case, the number of treatment cases under general anesthesia and the number of treatment cases under awake can be appropriately confirmed as the number of treatment cases for pediatric patients. Also, if past treatment records include average treatment time, the average treatment time included in said average treatment time may include at least one of the average treatment time under general anesthesia and the average treatment time under awake. In this case, the average treatment time under general anesthesia and the average treatment time under awake can be appropriately confirmed as the average treatment time for pediatric patients.

[0119] Furthermore, according to one embodiment, the score representing a skill may be an index divided into levels according to that skill. In this case, the index divided into levels according to the skill can be appropriately checked as the score representing the skill.

[0120] Furthermore, according to one embodiment, the recommended margin may be a setup margin determined according to the skill. In this case, the setup margin determined according to the skill can be checked as appropriate as the recommended margin.

[0121] Furthermore, according to one embodiment, the score representing the margin may be an index divided into levels according to the recommended margin. In this case, the index divided into levels according to the recommended margin can be appropriately checked as the score representing the margin.

[0122] Furthermore, according to one embodiment, the information regarding the accuracy of patient QA may include at least one of the following: information regarding measuring instruments and phantoms used in patient QA, information regarding the patient QA method, information regarding the accuracy expected by the patient QA method, and information regarding the characteristics of patient QA. In this case, the information regarding measuring instruments and phantoms used in patient QA, the information regarding the patient QA method, the information regarding the accuracy expected by the patient QA method, and the information regarding the characteristics of patient QA can be checked as appropriate.

[0123] Furthermore, according to one embodiment, the oncology information system 1X or the radiation therapy planning device 50X, which serves as a radiation therapy support device, is equipped with a storage device 2 or 52. This allows information regarding the characteristics of a specific radiation therapy device feX, the skills of the radiation therapy staff skX, and the accuracy of patient QA acX to be obtained from the storage device 2 in the oncology information system 1X or from the storage device 52 in the radiation therapy planning device 50X.

[0124] Next, I will provide some supplementary information regarding the background of the embodiment described above.

[0125] The first reason is that the relationship between input and output (dose) differs significantly among multiple radiation therapy devices from different manufacturers, models, and specifications. Furthermore, even among multiple radiation therapy devices of the same model and specifications, there may be slight differences in the output relative to the input, and slight differences in the distribution of the radiation beam. For this reason, a radiation therapy planning system that is paired with a specific radiation therapy device stores beam modeling data for that specific radiation therapy device. Beam modeling data represents the relationship between inputs such as a specific beam energy and irradiation intensity, and outputs such as the shape of the X-ray intensity distribution at a specific location.

[0126] The second reason is that even if multiple radiotherapy devices from different manufacturers or models have nearly identical configurations, the treatment plan formats recognized as radiotherapy plans will differ. Furthermore, even with two radiotherapy devices of the same model, if one has an iso-center MLC (multi-leaf collimator) with a leaf width of 10 mm and the other has an optional high-performance MLC with an iso-center and a leaf width of 5 mm, the number of leaves covering the same irradiation area will differ. The number of leaves in the former will be half the number of leaves in the latter. Therefore, a radiotherapy planning device that is paired with a specific radiotherapy device stores a treatment plan format that that specific radiotherapy device can recognize. The radiotherapy planning device also outputs the radiotherapy plan in that treatment plan format.

[0127] Typically, within a single hospital, a radiation therapy device and a radiation therapy planning system operate in a one-to-one relationship. In this normal operation, the radiation therapy planning system possesses beam modeling data, radiation therapy device specifications, and a radiation therapy planning format specific to that device. By using this data, the radiation therapy planning system can create a radiation therapy plan that is executable with that specific device and maintains accuracy.

[0128] In recent years, remote radiotherapy planning has been approved. Remote radiotherapy planning is a method in which a radiation oncologist at another facility (facility B) creates a radiotherapy plan remotely without having to travel to facility A, when there is no radiation oncologist available at facility A. However, in Japan, public insurance coverage for remote radiotherapy planning is limited to emergencies (imminent conditions requiring immediate initiation of radiotherapy due to a rapid change in the patient's condition, or situations requiring a temporary change in the radiotherapy plan). For this reason, remote radiotherapy planning is often adopted when facility B is a university hospital and facility A is an affiliated hospital of the university. Remote radiotherapy planning is operated in a manner that does not deviate from the general operating environment, and the radiotherapy planning system is mainly operated using either (i) or (ii).

[0129] (i) The radiation therapy planning system at the affiliated hospital is remotely connected from the university hospital, and the radiation therapy plan is created using the radiation therapy planning system at the affiliated hospital.

[0130] (ii) A second radiotherapy planning system is prepared at the university hospital, which is identical in model, software, beam modeling data, and radiotherapy planning format to the first radiotherapy planning system at the affiliated hospital. The second radiotherapy planning system at the university hospital creates radiotherapy plans independently of the first radiotherapy planning system at the affiliated hospital. In this case, the first and second radiotherapy planning systems will create the same radiotherapy plan if the input conditions are the same. Furthermore, if the same radiotherapy plan is used, the same radiotherapy will be performed in each system.

[0131] Statistical data shows that Japan's birth rate is declining year by year, and it is an aging society where the elderly population significantly exceeds the working-age population. This trend is expected to continue. As a result, the number of cancer patients, who are predominantly elderly, will continue to increase, while the number of working-age medical staff (e.g., doctors, nurses, radiologists, etc.) will continue to decrease. Therefore, there are concerns that in the near future, the proportion of cancer patients who cannot receive treatment will increase year by year due to a shortage of medical staff.

[0132] Currently, the main cancer treatments include surgery (often referred to as the "three major cancer therapies"), chemotherapy (anticancer drugs, molecular targeted drugs, and immune checkpoint inhibitors), and radiation therapy. While surgery is currently the first-line treatment for cancer, there are concerns that the number of elderly cancer patients, who are at high risk during surgery, will not be sufficient to perform surgery due to a decrease in medical staff (surgeons, nurses, anesthesiologists, etc.). Therefore, it is expected that the application of surgery will decrease in the future. Conversely, as the number of cancer patients increases and the number of surgical procedures decreases, it is expected that the application of chemotherapy and radiation therapy will increase.

[0133] There are several irradiation methods in radiation therapy, but among them, IMRT (Intensity-Modulated Radiation Therapy) and VMAT (Variable Frequency Assisted Radiation) are attracting attention as cutting-edge treatments. The application of these two technologies, IMRT and VMAT, has been increasing in recent years and is expected to become the mainstream of radiation therapy in the future. IMRT is a radiation therapy method that allows for free adjustment of dose and irradiation field (the area irradiated) using an advanced treatment planning system and a treatment machine capable of high-precision irradiation. In contrast, VMAT is an application of IMRT, which shortens treatment time by rotating the gantry while modulating the irradiation beam. Implementing IMRT and VMAT requires a system that includes an advanced radiation therapy planning system and radiation oncologists with the skills to verify and approve advanced radiation therapy plans. Therefore, in order to safely implement IMRT and VMAT under public insurance, hospitals are required to establish a sufficient system. A sufficient system here includes having at least two full-time radiation oncologists who are exclusively responsible for radiation therapy. However, an increasing number of facilities are currently unable to secure even one full-time radiation oncologist, and a further decrease in the number of medical staff is anticipated. Therefore, it is extremely difficult to have two or more full-time radiation oncologists, and in some rural areas, even securing part-time radiation oncologists is not easy.

[0134] On the other hand, according to the remote radiotherapy plan, if a radiation oncologist cannot be secured at a specific facility, the creation of the radiotherapy plan can be requested from a radiation oncologist at another facility. However, the implementation of the remote radiotherapy plan is limited to emergencies (imminent situations where radiotherapy must be started immediately due to a sudden change in the patient's condition, or situations where the radiotherapy plan needs to be changed on an ad-hoc basis). However, considering the declining birth rate in Japan, in the future, in order to provide the latest treatments such as IMRT and VMAT to more cancer patients than currently, it will be necessary to be able to perform remote radiotherapy "routinely" and "without a full-time physician."

[0135] When implementing remote radiotherapy planning, as mentioned above, the radiotherapy device and the radiotherapy planning device may be operated in a one-to-one ratio, or they may be operated in a one-to-two (twin) ratio.

[0136] In many cases, university hospitals and affiliated hospitals have radiation therapy equipment from the same manufacturer, similar models, and with similar specifications. Therefore, the radiation therapy planning equipment in each university hospital and affiliated hospital can be used with almost identical operation.

[0137] In response to this, from the perspective of implementing remote radiation therapy planning "routinely" and "without full-time physicians" in the future, it will be necessary for one radiation oncologist to create radiation therapy plans for multiple hospitals. For example, it is conceivable that one radiation oncologist at a university hospital would remotely create radiation therapy plans for multiple hospitals that are not affiliated with the university hospital. In this case, one radiation oncologist would need to create radiation therapy plans for each of the different radiation therapy devices by operating a radiation therapy planning system that has a one-to-one relationship with the respective radiation therapy device. Furthermore, this one radiation oncologist would need to understand prerequisite information such as the characteristics of the radiation therapy devices, the skill level of the radiation therapy staff, and the accuracy of patient QA that verifies the radiation therapy plans while creating radiation therapy plans for various devices. However, as mentioned above, while radiation oncologists understand the prerequisite information for their own hospital, it is difficult for them to accurately understand the prerequisite information for other hospitals.

[0138] Therefore, it is desirable to be able to confirm at least some of the following during the creation of radiation therapy plans for various radiation therapy devices: the characteristics of the radiation therapy device, the skill level of the radiation therapy staff, and the accuracy of patient QA.

[0139] The above is the background to one embodiment.

[0140] One embodiment is designed with the above background in mind, and is configured to allow confirmation of the characteristics of the radiation therapy equipment at each facility, the level (experience) of the radiation therapy staff, and the accuracy of patient QA verifying the radiation therapy plan, while creating radiation therapy plans for multiple different facilities. Therefore, it becomes easier to determine, for example, the treatment techniques to be used and the size of the margins relative to the target, while creating the radiation therapy plan.

[0141] <Various Modifications> One embodiment may be modified as shown in the following variations. Each variation may be combined with one another.

[0142] <First Modification> In one embodiment, the Large-Scale Cancer Center LCC is equipped with radiation therapy planning devices 50A to 50Z, each in a one-to-one relationship with each of the radiation therapy devices 6A to 6Z of another hospital, but is not limited to this. For example, as shown in Figure 8, the Large-Scale Cancer Center LCC is equipped with radiation therapy planning devices 50n to 50z, a radiation therapy device features DB 71, a treatment staff skills DB 72, a radiation therapy QA accuracy DB 73, a beam model DB 74, a treatment plan format DB 75, and a radiation therapy device specifications DB 76 instead of these radiation therapy planning devices 50A to 50Z. In addition, the Large-Scale Cancer Center LCC is equipped with an oncology information system 10, radiation therapy planning devices 501 to 50m, and radiation therapy devices 601 to 60m, as described above. Furthermore, as shown in Figures 9 to 11, the radiation therapy device features DB 71, the treatment staff skills DB 72, and the radiation therapy QA accuracy DB 73 store information regarding the features of the radiation therapy device, the skills of the radiation therapy staff, and the accuracy acX of patient QA, instead of the storage device 52 in Figure 2. Note that the radiation therapy device features DB 71, the treatment staff skills DB 72, and the radiation therapy QA accuracy DB 73 are just other examples of the storage units.

[0143] Here, unlike the radiation therapy planning devices 50A to 50Z in Figure 1, each of the radiation therapy planning devices 50n to 50z does not have a one-to-one relationship with each of the radiation therapy planning devices 6A to 6Z. Since each of the radiation therapy planning devices 50n to 50z has the same configuration as the others, we will use radiation therapy planning device 50s as a representative example for explanation.

[0144] The radiotherapy planning device 50s has a processing circuit 51, a storage device 52, a display device 53, an input device 54, and a communication device 55, similar to the configuration shown in Figure 2. However, unlike the configuration shown in Figure 2, the storage device 52 of the radiotherapy planning device 50s does not store information regarding the characteristics of the radiotherapy device, the skills of the radiotherapy staff, and the accuracy of patient QA. Accordingly, the acquisition function 511 of the processing circuit 51 acquires information regarding the characteristics of the radiotherapy device, the skills of the radiotherapy staff, and the accuracy of patient QA from DBs 71 to 73. The acquisition function 511 also acquires beam modeling data, treatment plan format, and specification data from DBs 74 to 76. For example, the acquisition function 511 acquires beam modeling data from beam model DB 74 based on the radiotherapy device ID of radiotherapy device 6X. Also, for example, the acquisition function 511 acquires the treatment plan format from treatment plan format DB 75 based on the radiotherapy device ID or type of radiotherapy device 6X. For example, the acquisition function 511 acquires specification data from the radiation therapy device specification DB 76 based on the radiation therapy device ID or type of the radiation therapy device 6X.

[0145] As shown in Figure 9, the radiation therapy device feature DB 71 stores a radiation therapy device ID that identifies each of the radiation therapy devices 6A to 6Z, and information related to the radiation therapy device. The radiation therapy device feature DB 71 also stores a detection device ID that identifies each of the respiratory motion detection devices, and information related to the respiratory motion detection device. The information related to the respiratory motion detection device is the same information included in the aforementioned radiation therapy device features feA, ..., feX, ..., feZ. Note that the radiation therapy device feature DB 71 may also store information related to the radiation therapy device and information related to the respiratory motion detection device. For example, the radiation therapy device feature DB 71 may store a radiation therapy device ID, information related to the radiation therapy device, and information related to the respiratory motion detection device.

[0146] As shown in Figure 10, the treatment staff skill DB72 stores the ID of each radiation therapy device 6A to 6Z in association with past treatment results, a score representing skill, a recommended margin, and a score representing the margin. Past treatment results, a score representing skill, a recommended margin, and a score representing the margin are the same information that was included in the radiation therapy staff skills skA, ..., skX, ..., skZ mentioned above.

[0147] As shown in Figure 11, the radiation therapy QA accuracy DB73 stores the radiation therapy device ID for each of the radiation therapy devices 6A to 6Z, information about the measuring instruments and phantoms used for patient QA, information about the patient QA method, information about the accuracy expected from the patient QA method, and information about the characteristics of patient QA, in association with each other. The information about the measuring instruments and phantoms used for patient QA, information about the patient QA method, information about the accuracy expected from the patient QA method, and information about the characteristics of patient QA are the same information that was included in the aforementioned patient QA accuracy acA, ..., acX, ..., acZ.

[0148] The beam model DB 74 is a database that stores beam modeling data for performing beam modeling on each of the radiotherapy devices 6A to 6Z located at external facilities. For example, as shown in Figure 12, the beam model DB 74 stores the associated ID of each radiotherapy device 6A to 6Z with the beam modeling data for each radiotherapy device 6A to 6Z. Details of the beam modeling data are as described above. The beam model DB 74 is used for each of the multiple radiotherapy planning devices 50n to 50z used for remote radiotherapy planning, among the radiotherapy planning devices 501 to 50z. The number of radiotherapy planning devices 50n to 50z can be any number of devices less than the 26 radiotherapy devices 6A to 6Z, as appropriate.

[0149] The treatment plan format DB 75 is a database (DB) that stores data for treatment plan formats corresponding to each type of radiotherapy device 6A to 6Z. For example, as shown in Figure 13, the treatment plan format DB 75 stores data for treatment plan formats in association with each type of radiotherapy device 6A to 6Z (e.g., combination of manufacturer, model, energy, MLC, and flattening filter). However, the treatment plan format DB 75 may also be configured to store data for treatment plan formats in association with each radiotherapy device ID of radiotherapy devices 6A to 6Z, as shown in Figure 14. Details of the treatment plan format data are as described above. The treatment plan format DB 75 is used for each of the multiple radiotherapy planning devices 50n to 50z for remote radiotherapy planning.

[0150] The radiation therapy device specification DB 76 is a database (DB) that stores specification data corresponding to each type of radiation therapy device 6A to 6Z. For example, as shown in Figure 15, the radiation therapy device specification DB 76 stores each type of radiation therapy device 6A to 6Z (e.g., combination of manufacturer, model, energy, MLC, flattening filter) in association with the specification data for each radiation therapy device 6A to 6Z. However, the radiation therapy device specification DB 76 may also be configured to store each radiation therapy device ID of radiation therapy devices 6A to 6Z in association with the specification data corresponding to each type of radiation therapy device 6A to 6Z, as shown in Figure 16. Details of the specification data for radiation therapy devices 6A to 6Z are as described above. The radiation therapy device specification DB 76 is used in each of the multiple radiation therapy planning devices 50n to 50z for remote radiation therapy planning. The data stored in the radiation therapy device characteristics DB71 is in a format that makes it easy for humans (radiation oncologists) to understand the characteristics of radiation therapy performed with each radiation therapy device 6A to 6Z. On the other hand, the data stored in the radiation therapy device specifications DB76 is used to sequentially change irradiation conditions during inverse planning in radiation therapy planning. Therefore, although these two sets of data may seem similar in content, they are completely different.

[0151] The other components are the same as in one embodiment.

[0152] With the above configuration, DB71 to DB73 pre-store information regarding the characteristics feA, ..., feX, ..., feZ of a specific radiotherapy device among multiple radiotherapy devices 6A to 6Z distributed across multiple facilities, the skills skA, ..., skX, ..., skZ of the radiotherapy staff performing radiotherapy with the specific radiotherapy device 6A, ..., 6X, ..., 6Z, and the accuracy acA, ..., acX, ..., acZ of the patient QA used to verify the radiotherapy plan. The processing circuit 51 is connected to DB71 to DB73 and, based on a request to create a radiotherapy plan, obtains information regarding the characteristics feX of a specific radiotherapy device, the skills skX of the radiotherapy staff, and the accuracy acX of the patient QA from DB71 to DB73. The processing circuit 51 displays at least a portion of the acquired information regarding the characteristics of a specific radiotherapy device feX, the skills of the radiotherapy staff skX, and the accuracy of patient QA acX on the display device 53 according to the operation of the radiation oncologist. Therefore, according to the first modification, in addition to the effects of the first embodiment, instead of the radiotherapy planning devices 50A to 50Z which have a one-to-one relationship with the radiotherapy devices 6A to 6Z of other hospitals, it is possible to remotely create a radiotherapy plan for any radiotherapy device 6X of any other hospital using any radiotherapy planning device 50s from among the radiotherapy planning devices 50n to 50z for other hospitals. Furthermore, according to the first modification, in addition to the effects of the first embodiment, even when it is desired to create radiotherapy plans for different radiotherapy devices 6A and 6Z in sequence, it is possible to efficiently create them using one available radiotherapy planning device 50s. In one embodiment, when it is desired to sequentially create radiation therapy plans for two different radiation therapy devices 6A and 6Z, the radiation therapy planning devices 50A and 50Z, which have a one-to-one relationship with each of the radiation therapy devices 6A and 6Z, are used sequentially. This may result in seat changes and a decrease in efficiency.

[0153] Regarding the radiotherapy support device, similar to the radiotherapy planning device 50s, it may obtain necessary information from each DB via the network based on the radiotherapy ID, or, as in one embodiment, it may obtain necessary information from the storage device 2 inside the oncology information system 1X, which is the radiotherapy support device.

[0154] Furthermore, according to the first modification, the radiation therapy planning devices 50n to 50z can create a radiation therapy plan for any radiation therapy device 6X among the radiation therapy devices 6A to 6Z at each of the hospitals from AH to ZH. To this end, beam model DB 74, treatment plan format DB 75, and radiation therapy device specification DB 76 are further connected to the radiation therapy planning devices 50n to 50z. Each of the radiation therapy planning devices 50n to 50z can read beam modeling data, radiation therapy plan format, and radiation therapy device specification for any radiation therapy device 6X from DB 74 to 76, and each radiation therapy planning device 50n to 50z can perform processing as if it were a dedicated radiation therapy planning device for the radiation therapy device 6X.

[0155] <Second Modification> In the first modification, the hospital is equipped with radiation therapy planning devices 501-50m for its own radiation therapy devices 601-60m and radiation therapy planning devices 50n-50z for radiation therapy devices 6A-6Z located in other hospitals, but it is not limited to this. For example, as shown in Figure 17, the large-scale cancer center LCC is equipped with radiation therapy planning devices 501-50z for both its own hospital and other hospitals, instead of radiation therapy planning devices 501-50m for its own hospital and radiation therapy planning devices 50n-50z for other hospitals. That is, each of the radiation therapy planning devices 501-50z in the second modification is capable of creating radiation therapy plans not only for radiation therapy devices 6A-6Z located in other hospitals, but also for radiation therapy devices 601-60z located in its own hospital.

[0156] Accordingly, the beam model DB74, treatment planning format DB75, and radiotherapy equipment specification DB76 have been expanded to include the memory contents for the radiotherapy equipment 601-60m located within the hospital, in addition to the configuration described above.

[0157] For example, the beam model DB74 stores the IDs of each radiation therapy device 601-60m and 6A-6Z in association with the beam modeling data for each radiation therapy device 601-60m and 6A-6Z.

[0158] For example, the treatment plan format DB75 stores data in association with each type of radiotherapy device 601-60m and 6A-6Z. Alternatively, the treatment plan format DB75 may store data in association with each radiotherapy device ID of 601-60m and 6A-6Z and the corresponding treatment plan format data for each type of radiotherapy device 601-60m and 6A-6Z.

[0159] For example, the radiation therapy equipment specification DB76 stores the respective types of radiation therapy equipment 601-60m and 6A-6Z in association with the respective specification data for each of the radiation therapy equipment 601-60m and 6A-6Z. Alternatively, the radiation therapy equipment specification DB76 may store the respective radiation therapy equipment IDs for each of the radiation therapy equipment 601-60m and 6A-6Z in association with the specification data corresponding to each of the respective types of radiation therapy equipment 601-60m and 6A-6Z.

[0160] Furthermore, the radiation therapy plan creation request transmitted from the oncology information system 1A to 1Z to the radiation therapy planning devices 501 to 50z includes a flag that identifies whether it is a remote treatment plan creation or a radiation therapy plan creation for the hospital. The radiation therapy plan creation request also includes a radiation therapy device ID that identifies the radiation therapy device 6X on which the radiation therapy plan will be used.

[0161] Accordingly, the display control function 514 of the processing circuit 51 displays at least a portion of the information regarding the characteristics feX of a specific radiotherapy device 6X, the skills skX of radiotherapy staff, and the accuracy acX of patient QA obtained from the radiotherapy device characteristics DB 71, the treatment staff skills DB 72, and the radiotherapy QA accuracy DB 73 on the display device 53 when the radiotherapy is remote radiotherapy. However, when the radiotherapy is not remote radiotherapy, the information regarding the characteristics feX, the skills skX, and the accuracy acX is not displayed on the display device 53.

[0162] Here, whether or not the radiation therapy is remote radiation therapy can be identified, for example, by the state of the flag. For example, if the radiation therapy is remote radiation therapy, the flag is in the ON state, which identifies the creation of a remote treatment plan, and if the radiation therapy is not remote radiation therapy, the flag is in the OFF state, which identifies the creation of a radiation therapy plan at the hospital. However, this is not limited to this, and the ON and OFF states of the flag may be reversed.

[0163] Alternatively, whether or not the radiation therapy is remote radiation therapy can be identified from the radiation therapy device ID included in the radiation therapy plan creation request, without using a flag. For example, if the radiation therapy is remote radiation therapy, it can be identified by the radiation therapy device ID indicating one of the radiation therapy devices 6A to 6Z at another hospital. If the radiation therapy is not remote radiation therapy, it can be identified by the radiation therapy device ID indicating one of the radiation therapy devices 601 to 60m at the hospital itself.

[0164] In either the flag or the radiotherapy device ID, the display control function 514 can identify whether or not the radiotherapy is remote radiotherapy based on the request for radiotherapy plan creation.

[0165] The other components are the same as in the first modification.

[0166] With the above configuration, for example, the radiotherapy planning device 501 reads a radiotherapy device ID or flag based on a radiotherapy plan creation request transferred from each facility's oncology information system 1A to 1Z. If the flag is ON (i.e., remote treatment plan creation), the processing circuit 51 of the radiotherapy planning device 501 reads information from the radiotherapy device features DB 71, treatment staff skills DB 72, and radiotherapy QA accuracy DB 73 based on the radiotherapy device ID, according to the operation of the radiation oncologist, and displays it on the display device 53. On the other hand, if the flag is OFF (i.e., in-house treatment plan creation instead of remote treatment plan creation), the processing circuit 51 of the radiotherapy planning device 501 does not display the information read from the radiotherapy device features DB 71, treatment staff skills DB 72, and radiotherapy QA accuracy DB 73 on the display device 53.

[0167] Therefore, according to the second modification, in addition to the effects of the first embodiment, instead of the radiation therapy planning devices 50A to 50Z which have a one-to-one relationship with radiation therapy devices 6A to 6Z in other hospitals, it is possible to remotely create a radiation therapy plan for any radiation therapy device 6X in any other hospital using any radiation therapy planning device 501 from among the radiation therapy planning devices 501 to 50z for use in the own hospital and for use in other hospitals. Furthermore, according to the second modification, similar to the first modification, even when it is desired to create radiation therapy plans for different radiation therapy devices 6A and 6Z in sequence, it is possible to efficiently create them using one available radiation therapy planning device 501.

[0168] <Third Modification> In one embodiment, each of the radiation therapy planning devices 50A to 50Z (and oncology information systems 1A to 1Z) stores and displays information regarding the characteristics of the radiation therapy device, the skills of the radiation therapy staff, and the accuracy of patient QA, but is not limited to this. For example, as shown in Figure 18, each of the radiation therapy planning devices 50A to 50Z (and oncology information systems 1A to 1Z) may store and display the characteristics of the radiation therapy device feA to feZ and information mgA to mgZ for determining the margin. Hereinafter, each of the radiation therapy planning devices 50A to 50Z will be described using the radiation therapy planning device 50X as a representative example, as described above. The storage device 52, display device 53, input device 54, communication device 55, acquisition function 511 of the processing circuit 51, communication function 513, and display control function 514 of the radiation therapy planning device 50X described below constitute the medical information processing device 80, as described above. Similarly, the descriptions of the storage device 52, display device 53, input device 54, communication device 55, and the acquisition function 511, communication function 513, and display control function 514 of the processing circuit 51 are descriptions of the radiotherapy planning device 50X and the medical information processing device 80, respectively. The medical information processing device 80 is not limited to being provided by any radiotherapy planning device 50X, but may also be provided by any oncology information system 1X. That is, the descriptions of the processing circuit 51, storage device 52, display device 53, input device 54, and communication device 55 of the medical information processing device 80 provided by the radiotherapy planning device 50X are also applicable to the processing circuit 1, storage device 2, display device 3, input device 4, and communication device 5 of the medical information processing device 81 provided by each of the oncology information systems 1A to 1Z. Note that any radiotherapy planning device 50X is an example of a radiotherapy planning device equipped with a medical information processing device. Also, the oncology information system 1X is an example of a radiotherapy support device equipped with a medical information processing device.

[0169] The radiotherapy planning device 50X has a processing circuit 51, a storage device 52, a display device 53, an input device 54, and a communication device 55, similar to the configuration shown in Figure 2. However, the storage device 52 of the radiotherapy planning device 50X pre-stores information that includes the information shown in Figure 2, namely the characteristics of the radiotherapy device feX and information mgX for determining the margin. The storage device 52 is an example of a storage unit.

[0170] Here, the radiotherapy device feature feX is information about the features of a specific radiotherapy device 6X among multiple radiotherapy devices 6A to 6Z distributed across multiple facilities from Hospital AH to Hospital ZH. For example, as shown in Figure 19, the radiotherapy device feature feX may include at least one of the following: information about the specific radiotherapy device 6X, information about a patient's respiratory motion detection device, information about a body surface motion detection device that detects movement on the patient's body surface, and information about a target motion detection device that detects movement in a target area.

[0171] Information regarding a specific radiotherapy device 6X is the same as described above and may include at least one of the following: manufacturer, model, specifications, and characteristics of the radiotherapy.

[0172] Information regarding the respiratory motion detection device is the same as described above and may include at least one of the following: manufacturer, model, specifications, and characteristics of the detection device.

[0173] Information regarding a body surface movement detection device may include at least one of the following: the manufacturer, the model, the specifications, and the characteristics of the body surface movement detection device.

[0174] Information regarding a target motion detection device may include at least one of the following: the manufacturer, the model, the specifications, and the characteristics of the target motion detection device.

[0175] On the other hand, the information used to determine the margin is information regarding the margin of the target area in radiotherapy at each facility where a specific radiotherapy device 6X is installed. For example, as shown in Figure 20, the information used to determine the margin may include at least one of the following: patient posture management, respiratory motion management, organ movement management, systematic error, and random error.

[0176] Patient posture management may include at least one of the following: information on immobilization devices, information on posture management methods, and estimated treatment time. As a posture management method, for example, a method using a body surface motion detection device may be used as appropriate. The estimated treatment time is the treatment time estimated according to the "type of device" included in the characteristics feX of the radiotherapy device 6X. As the estimated treatment time increases, the patient's posture tends to change.

[0177] Respiratory motion management may include at least one of the respiratory management options available at the facility performing the radiation therapy, and the skills associated with each respiratory management option at that facility. The respiratory management options may be displayed according to the estimated motion volume calculated by analyzing the patient's 4D-CT data. The skills associated with each respiratory management option are the skills of the radiation therapy staff performing the radiation therapy, and may include at least one of the following: past treatment performance, a skill score, a recommended margin, and a margin score. Past treatment performance is the same information as described above, and may include the number of treatments or the average treatment time. The skill score is the same information as described above, and is an index categorized into levels according to skill. The recommended margin is the same information as described above, and is a setup margin determined according to skill. The margin score is the same information as described above, and is an index categorized into levels according to the recommended margin.

[0178] Organ movement management may include organ movement management options available at facilities performing radiation therapy. These options may include, for example, 4D-CT, MRI, and empirical data, which can be used as appropriate.

[0179] Systematic error may include at least one of the following: mechanical errors of the device, accuracy of patient motion correction, and information regarding the accuracy of patient QA. Mechanical errors of the device may be mechanical errors specific to the radiotherapy device installed in the facility where radiotherapy is performed. Accuracy of patient motion correction is the accuracy of correction under image guidance, or the accuracy due to the direction of movement of the patient bed. Examples of patient bed movement directions include six-axis correction of the patient bed and three-axis correction of the patient bed. Information regarding the accuracy of patient QA is the same information as described above, and may include at least one of the following: information regarding measuring instruments and phantoms used in patient QA, information regarding the patient QA method, information regarding the accuracy expected from the patient QA method, and information regarding the characteristics of patient QA.

[0180] Random error may include at least one of the following: errors related to reproducibility after image-guided correction, and information regarding the skills of the radiation therapy staff performing the radiation therapy.

[0181] Furthermore, the storage device 52 may also store either or both of the determined irradiation technique, irradiation dose, and dose limit information, and clinical information for determining the irradiation dose to the target area and the dose limit to organs at risk in radiotherapy. The irradiation dose and dose limit information may include the irradiation dose to the target area, the dose limit to organs at risk, and the number of fractions of radiotherapy. The clinical information may include the organ in which the tumor is located, the location of the tumor within that organ, and the characteristics of the tumor (tissue diagnosis results, genetic abnormality information, etc.). In addition, the organ in which the tumor is located and the location of the tumor within that organ can be substituted with a CT image taken of the organ and the location of the tumor (annotation) shown on the CT image. Furthermore, the storage device 52 stores clinical information for determining the irradiation dose to the target area and the dose limit to organs at risk in radiotherapy for each facility where a specific radiotherapy device 6A to 6Z, among multiple radiotherapy devices distributed across multiple facilities, is located.

[0182] The acquisition function 511 of the processing circuit 51 acquires the characteristics feX of a specific radiotherapy device and information mgX for determining margins from the storage device 52. For example, the acquisition function 511 may acquire the characteristics feX and information mgX from the storage device 52 based on a request for creation or approval of a radiotherapy plan, or it may acquire the characteristics feX and information mgX from the storage device 52 in response to user operation. Similarly, the acquisition function 511 may further acquire information regarding treatment targets and information regarding tumors to be treated from the storage device 52. Alternatively, the acquisition function 511 may acquire from the storage device 52 either clinical information for determining the irradiation dose to the target area and dose limits to organs at risk in radiotherapy, or the determined irradiation technique, irradiation dose, and dose limit information, or both, without acquiring the characteristics feX of a specific radiotherapy device and information mgX for determining margins. Furthermore, the acquisition function 511 acquires beam modeling data, treatment plan format, and specification data of the radiotherapy device 6X from the storage device 52, as described above. The acquisition function 511 and processing circuit 51 are examples of an acquisition unit.

[0183] The display control function 514 causes various information to be displayed on the display device 53. For example, the display control function 514 causes at least a portion of the acquired characteristics feX of a specific radiotherapy device and information mgX for determining the margin to be displayed on the display device 53 in response to user operation. Here, "at least a portion" may be, for example, a portion or combination of the characteristics feX of a specific radiotherapy device and information mgX for determining the margin, which can be used as appropriate. However, it is not limited to this, and "at least a portion" may be, for example, all of the characteristics feX of a specific radiotherapy device and information mgX for determining the margin.

[0184] Furthermore, the display control function 514 may display information on the display device 53 that corresponds to the step, from among the characteristics feX of a specific radiotherapy device 6X and the information mgX for determining the margin, for each step in the radiotherapy planning of radiotherapy. For example, the display control function 514 may display the information mgX for determining the margin on the display device 53 in accordance with the contouring step in the radiotherapy planning, in which the boundaries of the target area and the organs at risk are drawn, or the margin determination step after the contouring step in which the margin is determined. Also, for example, the display control function 514 may display at least one of the acquired information regarding the treatment target and the information regarding the tumor to be treated on the display device 53 in accordance with the technique determination step in the radiotherapy planning, in which the treatment technique is determined and the treatment beam is defined. Also, for example, the display control function 514 may display both the characteristics feX of a specific radiotherapy device and the information mgX for determining the margin on the display device 53 in accordance with the approval step in the radiotherapy planning, in which the created radiotherapy plan is verified and approved. The display control function 514 may, as shown in Figure 21, display information corresponding to each step on the display device 53 based on a table that associates the steps of the radiotherapy plan with the information corresponding to each step. The table is an example, and the steps may be divided or combined as appropriate. Similarly, the information corresponding to each step may be divided or combined as appropriate. In Figure 21, the steps of the radiotherapy plan are exemplified as contouring step, margin determination step, technique determination step, plan creation step, and approval step. The information corresponding to each step is exemplified as feX, a characteristic of a specific radiotherapy device, mgX, information for determining the margin, information regarding the treatment objective, and information regarding the tumor to be treated.

[0185] Furthermore, the display control function 514 displays at least a portion of the acquired characteristics feX of a specific radiotherapy device and information mgX for determining the margin on the display device 53 when the radiotherapy is remote radiotherapy, whereas when the radiotherapy is not remote radiotherapy, it is not necessary to display the characteristics feX and information mgX for determining the margin on the display device 53.

[0186] Furthermore, the display control function 514 may, regardless of whether or not information mgX for determining the characteristics feX and margins of a specific radiotherapy device is acquired, display clinical information for determining the radiation dose to the target area and the dose limit to organs at risk in radiotherapy, or either one or both of the determined irradiation technique, radiation dose, and dose limit information, on the display device 53 in response to user operation. The display control function 514 and the processing circuit 51 are examples of display control units. The display device 53 is an example of a display.

[0187] The other components are the same as in one embodiment.

[0188] Next, the operation of the radiotherapy planning system configured as described above will be explained using the sequence diagram in Figure 22 and the schematic diagram in Figure 23. In the following explanation, the technique determination step in step ST4-3 may be executed in a different order from the contouring step in step ST4-1 and the margin determination step in ST4-2. For example, the contouring step and the margin determination step may be executed in order after the technique determination step. Alternatively, the technique determination step may be executed in parallel with at least one of the contouring step and the margin determination step.

[0189] (Step ST1) The oncology information system 1X creates information on the radiotherapy device used for radiotherapy, a radiotherapy schedule, and a list of each radiotherapy task, and follows each step. The processing circuit 1 of the oncology information system 1X also acquires the characteristics feX of the radiotherapy device and information mgX for determining the margin from the storage device 2 based on the creation of the radiotherapy task. As a result, in each of the following steps, the processing circuit 1 can display at least a portion of the acquired characteristics feX of the specific radiotherapy device and information mgX for determining the margin on the display device 3 in response to user operation. The oncology information system 1X also registers clinical information for determining the radiation dose to the target area and the dose limit to organs at risk in radiotherapy, or either one or both of the determined irradiation technique, radiation dose, and dose limit information. Specifically, the former includes the organ in which the tumor resides, the location of the tumor within the organ (or CT images + annotations), and the characteristics of the tumor (tissue diagnosis results, genetic abnormality information), while the latter includes treatment techniques, the dose administered to each target, margin information for each target, dose constraints for each risk organ (OAR), and the number of fractions, all of which are registered in the oncology information system 1X. The latter information is determined from the former information. At this time, margin information, etc., is determined by referring to at least a part of the characteristics feX of the specific radiotherapy device acquired and the information mgX for determining the margins.

[0190] (Steps ST2 to ST3) Steps ST2 to ST3 are performed in the same manner as described above.

[0191] (Step ST4-1) When the radiotherapy planning device 50X receives a request for radiotherapy planning and a CT image for planning, it reserves space for the patient's radiotherapy in a database (not shown) and registers the information necessary for creating the radiotherapy plan included in the request for radiotherapy planning. The information necessary for creating the radiotherapy plan includes either clinical information for determining the radiation dose to the target area and the dose limit to organs at risk in radiotherapy, or the determined irradiation technique, radiation dose, and dose limit information, or both. The processing circuit 51 of the radiotherapy planning device 50X also acquires the characteristics of the radiotherapy device feX and information mgX for determining the margin from the storage device 52 based on the request for radiotherapy planning. As a result, in each of the following steps, the processing circuit 51 can display the acquired characteristics of the specific radiotherapy device feX and information mgX for determining the margin on the display device 53 according to the user's operation. However, the processing circuit 51 may also display information on the display device 53 according to each step of the radiotherapy planning, as shown in Figure 21.

[0192] In step ST4-1, the processing circuit 51 performs contouring based on the planning CT image to depict the boundary between the target region including the tumor and the organs at risk (OAR). The target region is the clinical target volume (CTV) region, which includes the gross tumor volume (GTV) mentioned above. During this contouring step, the processing circuit 51 displays information mgX for determining the margin of the target region on the display device 53. The information for determining the margin may include at least one of the following: patient posture management, respiratory motion management, organ movement management, systematic error, and random error, or it may be in a form that integrates all of them.

[0193] Respiratory motion management may include at least one of the respiratory management options available at the facility performing the radiotherapy, and the skills required for each respiratory management option at that facility. Respiratory management options may include, for example, free breathing, suppression (abdominal compression), DIBH (Deep Inspiration Breath Hold), triggered irradiation, and tracking irradiation, as appropriate. Triggered irradiation is performed in synchronization with a specific respiratory phase detected by a respiratory synchronization sensor or position sensor. Tracked irradiation involves recognizing the target from real-time X-ray motion images, real-time CBCT images, real-time MRI images, etc., and performing tracking irradiation with the radiotherapy device. Respiratory management options may be displayed according to the estimated motion amount (Δ) calculated by analyzing the patient's 4D-CT data (or X-ray fluoroscopy images). For example, if 5 mm < Δ, the respiratory management option "free breathing" may be displayed. Alternatively, for example, if 5 mm ≤ Δ < 10 mm, the respiratory management option "suppression" may be displayed. Also, for example, if 10 mm ≤ Δ, the respiratory management options "DIBH" and "triggered irradiation (or tracking irradiation)" may be displayed.

[0194] Organ movement management may include organ movement management options available at facilities performing radiation therapy. These options may include, for example, 4D-CT, MRI, and empirical values, which can be used as appropriate. The organ movement management option "4D-CT" (or "MRI") is an option for managing the movement of internal organs using 4D-CT data (or MRI data), and is used when the facility has a 4D-CT (or MRI) and the organ movement is significant. The organ movement management option "empirical values" is an option for managing the movement of internal organs using values ​​estimated from experience, and is used when the organ movement is small, regardless of whether the facility has a 4D-CT (or MRI).

[0195] Systematic error may include at least one of the following: mechanical errors of the device, accuracy of patient movement correction, and information regarding the accuracy of patient QA. Mechanical errors of the device may be specific to the radiotherapy device installed in the facility where radiotherapy is performed. Alternatively, mechanical errors of the device may be common to all radiotherapy devices 6A to 6Z, in accordance with standard guidelines. Accuracy of patient movement correction is the accuracy of correction under image guidance or the accuracy due to the direction of movement of the treatment table. Examples of treatment table movement directions include 6-axis correction and 3-axis correction. 6-axis correction of the treatment table provides higher accuracy in correcting patient movement compared to 3-axis correction. To add to this, before radiotherapy, the position of organs in the planning CT image is compared with the position of organs in the CBCT image (taken before treatment), and any discrepancies are identified. Based on these discrepancies, the treatment table is adjusted so that the target center in the CBCT image coincides with the isocenter. There are two types of treatment table adjustments, called 6-axis correction and 3-axis correction. Three-axis correction is adjustment by translation only along the X, Y, and Z axes. Six-axis correction is adjustment by translation along the X, Y, and Z axes and rotational movement around the X, Y, and Z axes. As mentioned above, six-axis correction provides higher correction accuracy. Six-axis correction and three-axis correction correspond to the correction axes of the treatment table shown in the "Device Specifications" included in the features feX of the radiotherapy device 6X. Information regarding the accuracy of patient QA is the same as above and may include at least one of the following: information regarding the measuring instruments and phantoms used in patient QA, information regarding the patient QA method, information regarding the accuracy expected from the patient QA method, and information regarding the characteristics of patient QA.

[0196] Random error may include at least one of the following: errors related to reproducibility when image-guided correction is performed, and information related to the skills of the radiation therapy staff performing the radiation therapy. Errors related to reproducibility are inevitable errors that occur when the same action is performed repeatedly. Information related to skills is an experience-dependent error, which tends to fall within a smaller error range the more past treatment experience (experience) a person has.

[0197] Furthermore, the processing circuit 51 displays on the display device 53 either the irradiation technique in radiotherapy, the irradiation dose to the target area and the dose limit to organs at risk, or the determined irradiation technique, irradiation dose, and dose limit information, or both. The determined irradiation technique, irradiation dose, and dose limit information may include the target dose to the target area, the dose limit to organs at risk, and the number of fractions for radiotherapy. Information regarding the tumor to be treated may include the organ in which the tumor is located, the location of the tumor within that organ, and the characteristics of the tumor (tissue diagnosis results, genetic abnormality information, etc.). In addition, the organ in which the tumor is located and the location of the tumor within that organ can be substituted with a CT image of the organ and the location of the tumor (annotation) shown on the CT image.

[0198] This allows radiation oncologists to, during the contouring step of the radiation therapy plan for radiotherapy device 6A at hospital XH, another hospital, to check either or both of the following: information mgX for determining margins, clinical information for determining irradiation techniques in radiation therapy, irradiation dose to the target area and dose limits to organs at risk, and the determined irradiation techniques, irradiation doses, and dose limit information.

[0199] (Step ST4-2) In step ST4-2, the processing circuit 51 determines the internal margin (IM) and the setup margin (SM) according to the operation of the radiation oncologist. The processing circuit 51 also determines the internal target volume (ITV) by adding the internal margin (IM) to the clinical target volume (CTV) whose boundaries have been drawn. The processing circuit 51 also determines the planned target volume (PTV) by adding the setup margin (SM) to the determined internal target volume (ITV). During this margin determination step, the processing circuit 51 displays on the display device 53 information such as "presence or absence of motion detection device" and "information on respiratory motion management" included in the characteristics feX of the specific radiotherapy device, as well as information mgX for determining the margins.

[0200] This allows radiation oncologists to confirm the presence or absence of a motion detection device, the options for respiratory motion management and the specific implementation methods for each management method, and the information mgX for determining the margins during the margin determination step of the radiation therapy plan for radiotherapy device 6A at X Hospital XH, another hospital.

[0201] (Step ST4-3) In step ST4-3, the processing circuit 51 determines the treatment technique and defines the treatment beam based on the determined planned target volume (PTV) and the defined boundaries of organs at risk (OAR), in accordance with the radiation oncologist's actions. The treatment technique includes an irradiation technique to achieve the irradiation dose to the target within the planned target volume (PTV) and dose limiting to the organs at risk (OAR).

[0202] During this technique determination step, the processing circuit 51 displays at least one of the following on the display device 53: clinical information for determining the irradiation technique in radiotherapy, the irradiation dose to the target area, and the dose limit to organs at risk; and the determined irradiation technique, irradiation dose, and dose limit information. The processing circuit 51 also displays the characteristics feX of a specific radiotherapy device on the display device 53.

[0203] The characteristics of the radiotherapy device feX may include at least one of the following: information about a specific radiotherapy device 6X, information about a patient's respiratory motion detection device, information about a body surface motion detection device that detects movement on the patient's body surface, and information about a target motion detection device that detects movement in a target area.

[0204] Information regarding a specific radiotherapy device 6X may include at least one of the following: manufacturer, model, specifications, and characteristics of the radiotherapy. Specifically, for example, the characteristics of radiotherapy device 6X feX may include the type of device (general-purpose LINAC, IMRT / VMAT dedicated device (CT-LINAC), robot-type device (CyberKnife), MR-LINAC, etc.), device specifications (maximum beam irradiation range, MLC leaf width, MLC configuration (1 layer or 2 layers), table correction axis (3 axes or 6 axes), etc.), and options (e.g., presence or absence of a body surface motion detection device, presence or absence of a target motion detection device, etc.). Of the types of devices, general-purpose LINAC and CyberKnife are capable of both 360-degree irradiation from a plane perpendicular to the body axis (coplanar irradiation) and three-dimensional irradiation from a direction other than a plane perpendicular to the body axis (non-coplanar irradiation). In contrast, CT-LINAC and MR-LINAC, being O-type gantry devices, are capable of coplanar irradiation but not non-coplanar irradiation. Here, the necessity of non-coplanar irradiation depends on the location of the tumor, from the perspective of avoiding irradiation to organs at risk. For example, non-coplanar irradiation is necessary when the tumor is located in the brain (excluding whole-brain irradiation) or lungs. Also, non-coplanar irradiation is usually unnecessary when the tumor is located in the breast, prostate, rectum, uterus, or brain (whole-brain irradiation). Furthermore, non-coplanar irradiation may be necessary when the tumor is located in the head and neck or gastrointestinal cancer (hepatobiliary and pancreatic). Furthermore, since the organs at risk for contouring differ depending on whether non-coplanar irradiation is required, it is desirable that the "type of device" indicating whether non-coplanar irradiation is mechanically possible, along with the "location of the tumor" indicating whether it is clinically necessary, be displayed in the step of determining the treatment technique, including the irradiation technique ((3D-CRT) / IMRT / VMAT / SBRT / SRT). 3D-CRT is an abbreviation for Three Dimensional Conformal Radiation Therapy. SBRT is an abbreviation for Stereotactic Body Radiotherapy. SRT is an abbreviation for Stereotactic Radiotherapy.

[0205] Information regarding a respiratory motion detection device may include at least one of the following: manufacturer, model, specifications, and characteristics of the detection device.

[0206] Information regarding a body surface movement detection device may include at least one of the following: the manufacturer, the model, the specifications, and the characteristics of the body surface movement detection device.

[0207] Information regarding a target motion detection device may include at least one of the following: the manufacturer, the model, the specifications, and the characteristics of the target motion detection device.

[0208] This allows radiation oncologists to, during the technique determination step of radiotherapy planning for radiotherapy device 6A at hospital XH, another hospital, to check either the characteristics feX of a specific radiotherapy device, the clinical information for determining the irradiation technique, the radiation dose to the target area, and the dose limit to organs at risk, or the determined irradiation technique, radiation dose, and dose limit information, or both.

[0209] Furthermore, the processing circuit 51 may, as shown in Figure 23, determine evaluation indicators according to the irradiation technique, irradiation direction, and respiratory motion management, and display these evaluation indicators on the display device 53. Examples of evaluation indicators that can be used as appropriate include indicators related to estimated treatment time, indicators related to each margin and patient movement management, and indicators related to dose evaluation to PTV and OAR. Specifically, for example, a table is prepared in advance that associates the range of the parameters to be evaluated (e.g., estimated treatment time) with the values ​​of the evaluation indicators. The processing circuit 51 can determine the parameters to be evaluated according to the irradiation technique, irradiation direction, and respiratory motion management, and read the values ​​of the evaluation indicators from the table according to those parameters. The same applies to other parameters (each margin and patient movement management, dose evaluation to PTV and OAR). In this case, the radiation oncologist can refer to the evaluation indicators corresponding to the irradiation technique, irradiation direction, and respiratory motion management when determining the treatment technique.

[0210] (Step ST6a) After steps ST4-1 to ST4-3, the creation of a treatment plan is initiated. Inverse planning is employed for the creation of the treatment plan. In inverse planning, when a radiation oncologist specifies multiple irradiation angles (irradiation directions), the radiation therapy planning device 50X automatically and repeatedly calculates, changing the conditions (dose intensity, MLC shape, etc.) to satisfy the dose conditions from each of the specified irradiation angles, and repeats trial and error until the dose conditions are finally satisfied. The range of condition search during inverse planning corresponds to the specification data of the radiation therapy device 6X. For this reason, the processing circuit 51 acquires the specification data that has been registered in advance in the program in the storage device 52. Based on the acquired specification data, the processing circuit 51 determines the range of condition changes. Also in inverse planning, the processing circuit 51 of the radiation therapy planning device 50X acquires beam modeling data that has been registered in advance in the program in the storage device 52. Based on the acquired beam modeling data, the processing circuit 51 calculates the dose distribution inside the subject.

[0211] Furthermore, as described above, step ST6a is not limited to cases where the radiation oncologist specifies multiple irradiation angles; the processing circuit 51 may automatically identify the irradiation angle by referring to irradiation angles in similar cases. Alternatively, the radiation oncologist may determine only the number of beam irradiation directions, and the processing circuit 51 may determine the irradiation direction so that the dose to the organs at risk is minimized.

[0212] Furthermore, the processing circuit 51 obtains a treatment plan format that has been previously registered in the program in the storage device 52. Then, based on the results of inverse planning, the processing circuit 51 creates a radiation therapy plan by writing the data for executing radiation therapy into the treatment plan format. When the creation of the radiation therapy plan is completed in this way, the radiation therapy plan is completed. Upon completion of the radiation therapy plan, the status of the radiation therapy plan in the task list becomes completed, and the system proceeds to the next step. At this time, the processing circuit 51 may generate an approval request for the radiation therapy plan.

[0213] (Step ST7a) The next step is the verification and approval of the radiation therapy plan. In this approval step, the radiation therapy planning device 50X displays the radiation therapy plan created based on the request for approval of the radiation therapy plan on the display device 53.

[0214] This allows highly skilled radiation oncologists to check the created radiation therapy plan (contouring, dose distribution, DVH (Dose Volume Histogram), etc.) and confirm that it matches the determined irradiation technique, irradiation dose, and dose limit information. After confirmation, if it matches the determined irradiation technique, irradiation dose, and dose limit information, the radiation oncologist approves the created radiation therapy plan. If it does not match, the radiation therapy plan is rejected and instructed to be recreated by the radiation therapy planning system 50X. At this time, the radiation oncologist inputs guidelines into the radiation therapy planning system 50X to improve the determined irradiation technique, irradiation dose, and dose limit information. At this time, highly skilled radiation oncologists may also check the characteristics of the radiation therapy equipment feX, the skills of the radiation therapy staff skX, and the accuracy of patient QA acX as needed. Alternatively, the processing circuit 51 displays the characteristics feX of a specific radiotherapy device, information mgX for determining margins, information regarding the treatment objective, and information regarding the tumor to be treated on the display device 53, based on the request for approval of the radiotherapy plan. In both step ST1 and step ST7a, the characteristics feX of the radiotherapy device are checked. However, even when checking the same information, the information actually checked differs. Specifically, step ST1 requires an overview of what irradiation techniques are possible, what respiratory motion management is possible, etc., while step ST7a requires detailed specifications such as the beam energy options, maximum beam irradiation range, MLC leaf width in the isocenter, MLC configuration (1 layer or 2 layers), table correction axis (3 axes or 6 axes), and options (whether there is a body surface shape measuring device, type of respiratory phase measuring device, type of fixation device, etc.). Therefore, even when using the same source, it is appropriate to display the information necessary for that situation in each step.

[0215] Once the radiation therapy plan is approved, the status of "Radiation Therapy Plan Approval" in the task list changes to "Completed." Then, as described above, the patient QA dose distribution calculation is performed. Once the patient QA dose distribution calculation is complete, the status of "Patient QA Dose Distribution Calculation" in the task list changes to "Completed," and the process proceeds to the next step.

[0216] (Step ST9 and beyond) As described above, the processing from step ST9 onwards is executed.

[0217] As described above, according to the third modification, the memory device 2,52 pre-stores the characteristics feX of a specific radiotherapy device 6X among multiple radiotherapy devices 6A to 6Z distributed across multiple facilities, and information mgX for determining the margin of the target area in radiotherapy for each facility where the specific radiotherapy device 6X is located. The processing circuit 1,51 is connected to the memory device 2,52 and acquires the characteristics feX of the specific radiotherapy device and the information mgX for determining the margin from the memory device 2,52 based on the creation of a radiotherapy task, a request for the creation of a radiotherapy plan, a request for approval of a radiotherapy plan, contouring processing, radiotherapy plan creation processing by inverse planning, or radiotherapy plan approval processing. The processing circuit 1,51 displays at least a portion of the acquired characteristics feX of the specific radiotherapy device and the information mgX for determining the margin on the display device 3,53 according to the operation of the radiation oncologist. Therefore, when registering irradiation technique, irradiation dose, and dose limit information in a radiotherapy task, or when creating a radiotherapy plan for various radiotherapy devices 6A to 6Z, or before approval of a radiotherapy plan, it is possible to check at least a portion of the information mgX used to determine the characteristics and margins of the radiotherapy device, as needed.

[0218] Furthermore, according to the third modification, the processing circuit 1,51 may display information corresponding to each step in the radiotherapy planning process on the display device 3,53, which includes the characteristics of a specific radiotherapy device feX and information mgX for determining the margin. In this case, by displaying the information corresponding to each step on the display device 3,53, the effort required to read and display the information corresponding to each step from the storage device 2,52 can be reduced.

[0219] Furthermore, according to the third modification, the processing circuit 1,51 may display information mgX for determining margins on the display device 3,53 in accordance with the contouring step, which depicts the boundaries of the target region and organs at risk, or the margin determination step, which determines the margins after the contouring step, among the steps in the radiotherapy planning. In this case, the effort required to read and display the information mgX for determining margins from the storage device 2,52 during the contouring step or the margin determination step can be reduced.

[0220] Furthermore, according to the third modification, the memory devices 2, 52 may further store either or both of the following: the irradiation technique in radiotherapy, the irradiation dose to the target area and the dose limit to organs at risk, or the determined irradiation technique, irradiation dose, and dose limit information. The processing circuit 1, 51 may further acquire either or both of the following from the memory devices 2, 52: the irradiation technique in radiotherapy, the irradiation dose to the target area and the dose limit to organs at risk, or the determined irradiation technique, irradiation dose, and dose limit information. Depending on the technique determination step in the radiotherapy planning, which involves determining the treatment technique and defining the treatment beam, the processing circuit 1, 51 may display at least one of the following on the display device 3, 53: the irradiation technique in radiotherapy, the irradiation dose to the target area and the dose limit to organs at risk, or the determined irradiation technique, irradiation dose, and dose limit information. In this case, it is possible to confirm at least one of the following: irradiation technique in radiotherapy, clinical information for determining the irradiation dose to the target area and dose limits to organs at risk, or the determined irradiation technique, irradiation dose, and dose limit information, and the effort required to read and display the information from the storage devices 2 and 52 can be reduced.

[0221] Furthermore, according to the third modification, the determined irradiation technique, irradiation dose, and dose limit information may include the irradiation technique, the dose administered to the target area, the dose limit for organs at risk, and the number of fractions for radiotherapy. In this case, the target dose to the target area, the dose limit for organs at risk, and the number of fractions for radiotherapy can be checked as appropriate while the determined irradiation technique, irradiation dose, and dose limit information is displayed.

[0222] Furthermore, according to the third modification, the clinical information used to determine the irradiation technique in radiotherapy, the irradiation dose to the target area, and the dose limit to organs at risk may include the organ in which the tumor is located, the location of the tumor within the organ, and the characteristics of the tumor. In this case, the organ in which the tumor is located, the location of the tumor within the organ, and the characteristics of the tumor can be checked as appropriate while displaying information about the tumor to be treated.

[0223] Furthermore, according to the third modification, the organ in which the tumor is located and the location of the tumor within that organ can be substituted with a CT image of the organ and the location of the tumor shown on the CT image. This allows the organ in which the tumor is located and the location of the tumor within that organ to be confirmed by a CT image of the organ and the location of the tumor shown on the CT image while displaying information about the tumor to be treated.

[0224] Furthermore, according to the third modification, the processing circuit 1,51 may display both the characteristics of a specific radiotherapy device, feX, and the information mgX for determining the margin on the display device 3,53, in accordance with the approval step in the radiotherapy planning process, which involves verifying and approving the created radiotherapy plan. In this case, the effort required to read and display both the characteristics of a specific radiotherapy device, feX, and the information mgX for determining the margin from the storage device 2,52 during the approval step can be reduced.

[0225] Furthermore, according to the third modification, the characteristic feX of a specific radiotherapy device may include at least one of the following: information about the specific radiotherapy device, information about a patient's respiratory motion detection device, information about a body surface motion detection device that detects movement on the patient's body surface, and information about a target motion detection device that detects movement in a target area. In this case, at least one of the following can be viewed while the characteristic feX of the specific radiotherapy device is displayed: information about the specific radiotherapy device, information about a patient's respiratory motion detection device, information about a body surface motion detection device, and information about a target motion detection device.

[0226] Furthermore, according to the third modification, the information regarding the body surface movement detection device may include at least one of the following: the manufacturer, the model, the specifications, and the characteristics of the body surface movement detection device. In this case, at least one of the manufacturer, model, specifications, and characteristics of the body surface movement detection device can be confirmed while the information regarding the body surface movement detection device is displayed.

[0227] Furthermore, according to the third modification, the information regarding the target motion detection device may include at least one of the following: the manufacturer, the model, the specifications, and the characteristics of the target motion detection device. In this case, at least one of the manufacturer, model, specifications, and characteristics of the target motion detection device can be confirmed while the target motion detection device is being displayed.

[0228] Furthermore, according to the third modification, the information mgX for determining the margin may include at least one of the following: patient posture management, respiratory motion management, organ movement management, systematic error, and random error. In this case, at least one of the following can be checked while the information mgX for determining the margin is displayed: patient posture management, respiratory motion management, organ movement management, systematic error, and random error.

[0229] Furthermore, according to the third modification, patient posture management may include at least one of the following: information about the immobilization device, information about the posture management method, and estimated treatment time. In this case, at least one of the following can be confirmed during the display of patient posture management in the information mgX for determining the margin: information about the immobilization device, information about the posture management method, and estimated treatment time.

[0230] Furthermore, according to the third modification, respiratory motion management may include at least one of the respiratory motion management options available at the facility performing radiation therapy and the skills associated with each respiratory motion management option at that facility. In this case, at least one of the respiratory motion management options and the skills associated with each respiratory motion management option can be confirmed while displaying respiratory motion management in the information mgX for determining the margin.

[0231] Furthermore, according to the third modification, the respiratory management options may be displayed according to the estimated motion volume calculated by analyzing the patient's 4D-CT data. In this case, the respiratory management options corresponding to the patient's estimated motion volume can be viewed while the respiratory management options are displayed in mgX, the information used to determine the margin.

[0232] Furthermore, according to the third modification, the skills for each respiratory management option are the skills of the radiation therapy staff performing the radiation therapy, and may include at least one of the following: past treatment performance, a score representing the skill, a recommended margin, and a score representing the margin. In this case, when displaying the skills for each respiratory management option in information mgX, it is possible to confirm at least one of the following as the skills of the radiation therapy staff for each respiratory management option: past treatment performance, a score representing the skill, a recommended margin, and a score representing the margin.

[0233] Furthermore, according to the third modification, organ movement management may include organ movement management options available at the facility performing the radiotherapy. In this case, the organ movement management options can be viewed while the organ movement management information mgX for determining the margin is displayed.

[0234] Furthermore, according to the third modification, the systematic error may include at least one of the following: mechanical errors of the device, accuracy of patient movement correction, and information regarding the accuracy of patient QA. In this case, at least one of the following can be confirmed during the display of the systematic error in the information mgX for determining the margin: mechanical errors of the device, accuracy of patient movement correction, and information regarding the accuracy of patient QA.

[0235] Furthermore, according to the third modification, the mechanical error of the device may be a mechanical error specific to the radiotherapy device installed in the facility where radiotherapy is performed. In this case, the mechanical error specific to the radiotherapy device can be identified while displaying the systematic error in the information mgX for determining the margin.

[0236] Furthermore, according to the third modification, the accuracy of patient movement correction may be the accuracy under image guidance or the accuracy due to the direction of movement of the bed. In this case, while the patient movement correction accuracy is displayed in the information mgX for determining the margin, the accuracy under image guidance or the accuracy due to the direction of movement of the bed can be confirmed.

[0237] Furthermore, according to the third modification, the random error may include at least one of the following: an error related to reproducibility when image-guided correction is performed, and information regarding the skills of the radiation therapy staff performing the radiation therapy. In this case, at least one of the following can be identified during the display of the random error in the information mgX for determining the margin: an error related to reproducibility and information regarding the skills of the radiation therapy staff.

[0238] Furthermore, according to the third modification, the processing circuit 51 displays at least a portion of the acquired characteristics feX of the specific radiotherapy device and the information mgX for determining the margin on the display device 53 when the radiotherapy is remote radiotherapy, while not displaying the characteristics feX and the information mgX for determining the margin on the display device 53 when the radiotherapy is not remote radiotherapy. As a result, the radiotherapy planning device 50X can create a radiotherapy plan for both remote radiotherapy and non-remote radiotherapy.

[0239] Furthermore, according to the third modification, the memory devices 2,52 store either clinical information for determining the irradiation technique, the irradiation dose to the target area and the dose limit to organs at risk, or the determined irradiation technique, irradiation dose, and dose limit information, or both, for each facility where a specific radiotherapy device 6X is located among multiple radiotherapy devices 6A to 6Z distributed across multiple facilities. The processing circuit 1,51 is connected to the memory device 2,52 and retrieves either clinical information for determining the irradiation technique, the irradiation dose to the target area and the dose limit to organs at risk, or the determined irradiation technique, irradiation dose, and dose limit information, or both, from the memory device 2,52 based on the creation of a radiotherapy task, a request for the creation of a radiotherapy plan, or a request for approval of a radiotherapy plan. The processing circuits 1 and 51 display either clinical information for determining the irradiation technique, the irradiation dose to the target area, and the dose limit to organs at risk, or the determined irradiation technique, irradiation dose, and dose limit information, or both, on the display device 3 and 53 according to the operation of the radiation oncologist. Therefore, when setting treatment goals for a radiotherapy task, during the creation of a radiotherapy plan in various radiotherapy devices 6A to 6Z, or before the approval of a radiotherapy plan, it is possible to check either clinical information for determining the irradiation technique, the irradiation dose to the target area, and the dose limit to organs at risk, or the determined irradiation technique, irradiation dose, and dose limit information, or both, as needed.

[0240] Furthermore, according to the third modification, the oncology information system 1X or the radiation therapy planning device 50X, as a radiation therapy support device, is equipped with a storage device 2 or 52. This allows information for determining the characteristics and margins of a specific radiation therapy device to be obtained from the storage device 2 in the oncology information system 1X or from the storage device 52 in the radiation therapy planning device 50X. In addition, clinical information for determining irradiation technique, irradiation dose to the target area and dose limit to organs at risk, or either one or both of the determined irradiation technique, irradiation dose, and dose limit information can be obtained from the storage device 2 in the oncology information system 1X or from the storage device 52 in the radiation therapy planning device 50X.

[0241] According to the at least one embodiment and its modifications described above, at least a portion of the characteristics of the radiotherapy device and the information for determining the margin of the target area can be confirmed as needed, such as when creating a radiotherapy plan for various radiotherapy devices. Alternatively, one or both of the following can be confirmed: irradiation technique, clinical information for determining the irradiation dose to the target area and dose limits to organs at risk, or the determined irradiation technique, irradiation dose, and dose limit information.

[0242] In the above description, the term "processor" refers to circuits such as CPUs, GPUs, or Application Specific Integrated Circuits (ASICs), programmable logic devices (e.g., Simple Programmable Logic Devices (SPLDs), Complex Programmable Logic Devices (CPLDs), and Field Programmable Gate Arrays (FPGAs)). When the processor is a CPU, for example, it implements its functions by reading and executing programs stored in memory. On the other hand, when the processor is an ASIC, for example, instead of the program being stored in memory, the functions are directly incorporated as logic circuits within the processor's circuitry. In this embodiment, each processor is not limited to being configured as a single circuit; multiple independent circuits may be combined to form a single processor and implement its functions. Furthermore, the multiple components shown in Figures 2 to 6 may be integrated into a single processor to implement its functions.

[0243] While several embodiments of the present invention have been described, these embodiments are presented as examples only and are not intended to limit the scope of the invention. These embodiments can be carried out in a variety of other forms, and various omissions, substitutions, and modifications can be made without departing from the spirit of the invention. These embodiments and their variations are included in the scope and spirit of the invention, as well as in the claims and their equivalents.

Claims

It is connected to a storage unit that pre-stores the characteristics of a specific radiotherapy device among multiple radiotherapy devices distributed across multiple facilities, and information for determining the margin of the target area in radiotherapy at each facility where the specific radiotherapy device is located, and an acquisition unit that acquires the characteristics of the specific radiotherapy device and the information for determining the margin from the storage unit, A display control unit that displays at least a portion of the acquired characteristics of the specific radiotherapy device and the information for determining the margin on a display in response to user operation. A medical information processing device equipped with [a specific feature]. 　 The display control unit, at each step in the radiotherapy planning of the radiotherapy, displays on the display the information corresponding to that step, from among the characteristics of the specific radiotherapy device and the information for determining the margin. The medical information processing device according to claim 1. 　 The display control unit displays information for determining the margin on the display in accordance with the contouring step in the radiotherapy planning step, which involves drawing the boundaries between the target region and the organs at risk, or the margin determination step after the contouring step, which involves determining the margin. The medical information processing device according to claim 2. 　 The memory unit further stores information regarding the treatment goal and information regarding the tumor to be treated. The acquisition unit further acquires information relating to the treatment goal and information relating to the tumor to be treated from the storage unit. The display control unit, in accordance with the technique determination step in the radiotherapy planning step which involves determining the treatment technique and defining the treatment beam, causes at least one of the acquired information regarding the treatment target and the information regarding the tumor to be treated to be displayed on the display. The medical information processing device according to claim 2. 　 The information relating to the treatment objective includes the irradiation technique, the dose administered to the target region, the dose limit for organs at risk, and the number of fractions of radiotherapy. The medical information processing device according to claim 4. 　 The information relating to the tumor to be treated includes the organ in which the tumor is located, the location of the tumor within that organ, and the characteristics of the tumor. The medical information processing device according to claim 4. 　 The organ in which the tumor is located and the location of the tumor within that organ can be substituted by a CT image of the organ and the location of the tumor shown on the CT image. The medical information processing device according to claim 6. 　 The display control unit, in accordance with the approval step in the radiation therapy plan, which involves verifying and approving the created radiation therapy plan, displays both the characteristics of the specific radiation therapy device and the information for determining the margin on the display. The medical information processing device according to claim 2. 　 The features of the particular radiotherapy device include at least one of the following: information relating to the particular radiotherapy device, information relating to a patient's respiratory motion detection device, information relating to a body surface motion detection device that detects movement of the patient's body surface, and information relating to a target motion detection device that detects movement of the target region. The medical information processing device according to claim 1. 　 The information relating to the specific radiotherapy device includes at least one of the manufacturer, model, specifications, and characteristics of the radiotherapy, The medical information processing device according to claim 9. 　 The information relating to the respiratory motion detection device includes at least one of the manufacturer, model, specifications, and characteristics of the detection device. The medical information processing device according to claim 9. 　 The information relating to the body surface movement detection device includes at least one of the manufacturer, model, specifications, and characteristics of the body surface movement detection device. The medical information processing device according to claim 9. 　 The information relating to the target motion detection device includes at least one of the manufacturer, model, specifications, and characteristics of the target motion detection device. The medical information processing device according to claim 9. 　 The information for determining the margin includes at least one of the following: patient posture management, respiratory motion management, organ movement management, systematic error, and random error. The medical information processing device according to claim 1. 　 The postural management of the aforementioned patient includes at least one of the following: information regarding the immobilization device, information regarding the postural management method, and estimated treatment time. The medical information processing device according to claim 14. 　 The aforementioned respiratory motion management includes at least one of the respiratory management options available at the facility where radiation therapy is performed, and the skills required for each respiratory management option at that facility. The medical information processing device according to claim 14. 　 The aforementioned respiratory management options are displayed according to the estimated motion volume calculated by analyzing the patient's 4D-CT data. The medical information processing device according to claim 16. 　 The skills for each respiratory management option are the skills of the radiation therapy staff performing the radiation therapy, and include at least one of the following: past treatment performance, a score representing the skills, a recommended margin, and a score representing the margin. The medical information processing device according to claim 16. 　 The aforementioned past treatment results include the number of treatments or the average treatment time. The medical information processing device according to claim 18. 　 The score representing the aforementioned skill is an index that categorizes skills into levels. The medical information processing device according to claim 18. 　 The aforementioned recommended margin is a setup margin determined according to the aforementioned skills. The medical information processing device according to claim 18. 　 The medical information processing device according to claim 18, wherein the score representing the margin is an index categorized into levels according to the recommended margin. 　 The aforementioned organ movement management includes organ movement management options available at facilities performing radiation therapy. The medical information processing device according to claim 14. 　 The aforementioned systematic error includes at least one of the following: mechanical errors of the device, accuracy of patient movement correction, and information regarding the accuracy of patient QA. The medical information processing device according to claim 14. 　 The mechanical error of the aforementioned device is a mechanical error specific to the radiation therapy device installed in the facility where the radiation therapy is performed. The medical information processing device according to claim 24. 　 The accuracy of the correction of the patient's movement is either the accuracy of correction under image guidance or the accuracy due to the direction of movement of the bed. The medical information processing device according to claim 24. 　 The information relating to the accuracy of the patient QA includes at least one of the following: information relating to the measuring instrument and phantom used in the patient QA; information relating to the method of the patient QA; information relating to the accuracy expected by the method of the patient QA; and information relating to the characteristics of the patient QA. The medical information processing device according to claim 24. 　 The aforementioned random error includes at least one of the following: an error relating to reproducibility when image-guided correction is performed, and information relating to the skills of the radiation therapy staff performing the radiation therapy. The medical information processing device according to claim 14. 　 The display control unit, when the radiotherapy is remote radiotherapy, displays at least a portion of the acquired characteristics of the specific radiotherapy device and the information for determining the margin on the display, while when the radiotherapy is not remote radiotherapy, it does not display the characteristics and the information for determining the margin on the display. The medical information processing device according to claim 1. 　 A storage unit is connected to a storage unit that stores either or both of the following information for radiation therapy at each facility where a specific radiation therapy device is located among multiple radiation therapy devices distributed across multiple facilities: the irradiation technique, the irradiation dose to the target area, and the dose limit to organs at risk; and an acquisition unit that acquires the irradiation technique, the irradiation dose to the target area, and the dose limit to organs at risk, or the determined irradiation technique, irradiation dose, and dose limit information from the storage unit. A display control unit that displays the acquired irradiation technique, the clinical information for determining the irradiation dose to the target region and the dose limit to organs at risk, or either one or both of the determined irradiation technique, irradiation dose, and dose limit information on a display in response to user operation. A medical information processing device equipped with [a specific feature]. 　 A medical information processing device according to any one of claims 1 to 30, comprising the storage unit. 　 A radiotherapy support device or radiotherapy planning device comprising the medical information processing device described in claim 31.

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