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CN112089991B - System and method for real-time monitoring and correcting patient-guided positioning and target area displacement - Google Patents

System and method for real-time monitoring and correcting patient-guided positioning and target area displacement
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CN112089991B
CN112089991BCN202011060190.8ACN202011060190ACN112089991BCN 112089991 BCN112089991 BCN 112089991BCN 202011060190 ACN202011060190 ACN 202011060190ACN 112089991 BCN112089991 BCN 112089991B
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patient
treatment
target area
tumor
room
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CN112089991A (en
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陈文军
杨雅清
郑亚军
王少明
孙国珍
袁建东
张旭东
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Institute of Modern Physics of CAS
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Abstract

The invention relates to a system and a method for real-time monitoring and correcting the displacement of a patient-guided positioning and target area, which is characterized by comprising the following steps: 1) a patient guiding positioning and target area displacement real-time monitoring and correcting system is set up in a simulation room and a treatment room of the heavy ion treatment device, and patient tumor target area calibration data under a treatment isocenter coordinate system are obtained in the simulation room; 2) guiding the patient to carry out positioning and carrying out positioning verification according to the acquired patient tumor target area calibration data under the isocenter coordinate system of the treatment room; 3) the displacement of the target area of the tumor of the patient is monitored in real time, and the position of the target area of the tumor of the patient is corrected on line according to the real-time monitoring result of the displacement of the target area of the tumor of the patient and a preset threshold value. The invention can be widely applied to the field of heavy ion treatment.

Description

System and method for real-time monitoring and correcting patient-guided positioning and target area displacement
Technical Field
The invention relates to the technical field of heavy ion radiotherapy, in particular to a system and a method for real-time monitoring and correcting patient guiding positioning and tumor target area displacement in the heavy ion beam radiotherapy process.
Background
Heavy ion radiotherapy is different from traditional photon radiotherapy because the heavy ion beam has unique physical and biological effects, so that the heavy ion beam has more advantages in treating malignant tumors. The Bragg peak of the heavy ion beam can control the beam current to release the maximum dose at the tumor tissue, so that the situation that the normal tissue of a patient receives excessive dose to induce new pathological changes is avoided, and the positioning requirement on the patient in the heavy ion beam radiotherapy process is stricter than that of the conventional radiotherapy. Before heavy ion beam radiotherapy, doctors need to diagnose specific positions of tumors according to images of patients such as CT (computed tomography) and Magnetic Resonance Imaging (MRI), a reasonable radiotherapy plan is formulated according to image data of the patients, and beam parameters, radiotherapy times and the like of radiotherapy of the patients are determined. In order to improve the application efficiency of the heavy ion beam current, when heavy ion radiotherapy is carried out, a patient can firstly carry out the positioning of a tumor target area in a simulation room and mark the tumor target area, and after the patient enters a treatment room, the positioning and positioning verification of the patient is carried out by referring to the marking of the tumor target area of the patient in the simulation room by means of positioning equipment in the treatment room. Therefore, the positioning accuracy of the patient is directly related to the radiotherapy effect of the patient.
The conventional radiotherapy patient positioning technology is mainly characterized in that positioning stitches are drawn on a target area of a tumor on the body surface of a patient in a simulation room by means of imaging equipment such as DR (digital radiography) and positioning laser, and then the patient is positioned by the positioning laser in a treatment room; however, these devices generate radiation dose in the imaging and positioning process, and the positioning trace drawn on the body surface is changed in real time due to the respiration of the patient in the positioning process, so that the alignment accuracy of the positioning laser and the positioning trace is reduced. And the positioning process is relatively complex and tedious, so that the positioning efficiency of the patient is reduced, and the treatment cost of the patient is increased. In addition, the target tumor region is often moved by the involuntary movement of the patient during the treatment after positioning, and especially for the tumor radiotherapy of some patients who are not easy to keep the positioning posture for a long time, the target tumor region of the patient is often moved to cause the radiotherapy effect to be poor. Although there are corrections for patient positioning errors and organ motion in each treatment plan, these corrections are made by taking new images using DR and other equipment after a single radiation treatment, and then comparing the new images with the images in the treatment plan to obtain patient positioning errors.
Researchers have now conducted many studies on the problem of patient positioning during radiotherapy, but there still exist many technical problems, such as:
1. by using a radiographic imaging device in the treatment room to guide the patient in a radiation treatment setup, but the guide image and the verification image of the radiation treatment setup of the patient are acquired by radioactive rays, the patient can receive an additional radiation dose during the positioning process, and further, the side effect of the radiation treatment is larger.
2. The method includes the steps that the patient is guided to be in a position by methods of three-dimensional laser body surface scanning imaging, an infrared mark point combined laser camera is installed above the tumor of the patient and the like, but the position verification systems of the three-dimensional laser scanning, the infrared mark and the like can only detect the relative position deviation of the patient, and the three-dimensional laser scanning system is expensive in price, large in data calculation amount and complex in operation.
3. The method comprises the steps that the patient can be placed and verified by a method of shooting human body images through a plurality of cameras and matching the human body images through standard reference images and real-time video images, but the cameras of the method do not have position reference and coordinate conversion relative to isocenters of a simulation room and a treatment room, the patient can not be guided to be placed through the method of simulating the placement, and absolute position deviation of isocenters of a tumor and the treatment room of the patient can not be visually displayed; and the method does not consider factors such as the change of the breathing of the patient to the human body image in the monitoring of the real-time treatment of the patient. The above methods have disadvantages and advantages, and none of them relate to a method of correction after displacement of the target region of the patient's tumor during treatment.
Disclosure of Invention
Aiming at the problem that the positioning efficiency and positioning precision of a patient are low in heavy ion radiotherapy, the invention aims to provide a system and a method for real-time monitoring and correcting the displacement of a patient guide positioning and tumor target area in heavy ion beam radiotherapy, wherein a high-precision three-dimensional control network of a laser tracker distributed by a dual-camera photogrammetric system and a treatment room is combined to guide the patient to perform positioning before radiotherapy every time, so that the positioning efficiency and positioning precision of the patient are improved; monitoring the position parameters of a tumor target area of a patient in real time in the radiotherapy process, and performing real-time online correction and position compensation according to the position deviation of a treatment isocenter; by means of the calibration data of the patient in the states of expiration and inspiration respectively when the patient is in the initial positioning, the target area in the treatment process of the patient is monitored in real time, and a radiotherapy doctor can correct the position deviation of the tumor target area according to the target area displacement monitoring data, so that the reliability and the safety in the treatment process are improved.
In order to achieve the purpose, the invention adopts the following technical scheme:
in a first aspect of the present invention, a method for real-time monitoring and online correction of patient-guided positioning and tumor target displacement is provided, which comprises the following steps:
1) a patient guiding positioning and target area displacement real-time monitoring and correcting system is set up in a simulation room and a treatment room of the heavy ion treatment device, and patient tumor target area calibration data under a treatment isocenter coordinate system are obtained in the simulation room;
2) guiding the patient to carry out positioning and carrying out positioning verification according to the acquired patient tumor target area calibration data under the isocenter coordinate system of the treatment room;
3) the displacement of the target area of the tumor of the patient is monitored in real time, and the position of the target area of the tumor of the patient is corrected on line according to the real-time monitoring result of the displacement of the target area of the tumor of the patient and a preset threshold value.
Further, in the step 1), a method for acquiring calibration data of a target region of a tumor of a patient in a treatment isocenter coordinate system in a simulation room comprises the following steps:
1.1) respectively establishing a set of double-camera close-range photogrammetry system in a simulation room and a treatment room of the heavy ion treatment device;
1.2) laying a new three-dimensional control net around the treatment beds of the simulation room and the treatment room respectively, wherein the new three-dimensional control net comprises a plurality of three-dimensional control net target points which can be measured by using a laser tracker and a double-camera close-range photogrammetry system;
1.3) unifying a newly-arranged three-dimensional control network and a global control network of the heavy ion treatment device in a global coordinate system by using a laser tracker through a best fitting method, and establishing three-dimensional theoretical coordinates of target points of the newly-arranged three-dimensional control network relative to treatment isocenters of a simulation room and a treatment room;
1.4) sticking specially-made RRT coding mark points or RRT characteristic mark points on a tumor target area on the body surface of a patient, wherein the distribution principle is that the RRT coding mark points or RRT mark points with the number more than 3 uniformly cover the whole tumor target area of the patient;
1.5) in a simulation room, measuring three-dimensional control network target points arranged in a meeting visual field range around a treatment couch by adopting a double-camera close-range photogrammetry system, and carrying out control orientation of the double-camera close-range photogrammetry system in the simulation room so that the origin of a measurement coordinate system of the double-camera close-range photogrammetry system is positioned at a treatment isocenter of the simulation room;
1.6) referring to tumor image data of a patient, and performing simulated positioning on the patient by using a mobile DR device in a simulation room;
1.7) in a simulation room, using a double-camera close-range photogrammetry system to obtain calibration data of a tumor of a patient after simulated positioning relative to a treatment isocenter of the simulation room;
1.8) converting a coordinate system between the simulation room treatment isocenter and the treatment room treatment isocenter, converting the tumor target area calibration data of the patient under the simulation room treatment isocenter coordinate system into patient tumor calibration data under the treatment room treatment isocenter coordinate system, and storing the patient tumor calibration data in a computer control system according to the ID of the patient.
Further, in step 1.1), the method for establishing a set of two-camera close-range photogrammetry system in each of the simulation room and the treatment room of the heavy ion treatment device comprises: the double cameras are arranged at the tops of the treatment beds of the simulation room and the treatment room, and the erection posture and the angle of the double cameras are adjusted, so that the intersection visual field of the double cameras completely covers the whole moving range of the treatment bed.
Further, in the step 1.4), the sticking surfaces of the RRT coding mark points and the RRT characteristic mark points are environment-friendly adhesive glue which does not harm human skin, the sizes of the RRT coding mark points are 30mm x 30mm, and the sizes of the RRT characteristic mark points are 8mm x 8 mm.
Further, in step 1.7), the method for acquiring the tumor target calibration data of the patient by using the dual-camera close-range photogrammetry system comprises: and respectively measuring the characteristic mark point data of the tumor target region when the patient inhales and exhales in the free breathing state after being positioned for multiple times, and taking the average value of the multiple measurements as the tumor calibration data of the patient in the inhaling and exhaling states.
Further, in the step 2), the method for guiding the patient to perform the positioning and performing the positioning verification includes:
2.1) in the treatment room, using a double-camera close-range photogrammetry system to measure three-dimensional control network target points arranged in the intersection visual field range around the treatment couch, and carrying out control orientation of the double-camera close-range photogrammetry system in the treatment room, so that the origin of a measurement coordinate system of the double-camera close-range photogrammetry system is positioned at the treatment isocenter of the treatment room;
2.2) measuring the characteristic mark point data of the patient tumor target area in real time through a double-camera close-range photogrammetry system, converting the characteristic mark point data into the three-dimensional coordinate position deviation of the patient tumor target area relative to the treatment isocenter, and sending the three-dimensional coordinate position deviation to a control system and a display screen, so that a doctor can guide a patient to be positioned according to the actual position of the patient tumor on the display screen and the deviation of the treatment isocenter;
and 2.3) after guiding the patient to finish the positioning, performing positioning verification by using the DR of the treatment room, continuing the next treatment if the verification is passed, and otherwise, returning to the step 2.2) to adjust the positioning of the patient.
Further, in the step 3), the method for monitoring and correcting the target area displacement in real time includes:
3.1) monitoring the displacement information of the tumor target area of the patient in real time by using a double-camera close-range photogrammetry system, and displaying the displacement information on display screens of a treatment room and a control system in real time;
3.2) the control system judges whether the position of the tumor target area of the patient needs to be corrected or not according to the received displacement information of the tumor target area of the patient and a preset threshold, if the displacement of the tumor target area of the patient exceeds the preset threshold, the control system sends an alarm signal and corrects the tumor target area within preset time, if the correction is not completed within the preset time, the control system automatically cuts off the beam, and if the displacement of the tumor target area of the patient does not exceed the preset threshold, the control system returns to the step 3.1) to continuously monitor the displacement information of the tumor target area of the patient; the preset threshold value refers to the allowable moving range of the target region of the tumor of the patient, which is determined according to the size and the position of the tumor of the patient.
Further, in the step 3.2), the method for correcting the tumor target area comprises: a doctor refers to the monitored deviation value of the target area position of the patient relative to the treatment isocenter, and corrects the target area position of the tumor of the patient through remote control of the treatment couch, or a correction program is embedded into a control system of the treatment couch, so that the treatment couch automatically corrects and compensates according to the monitored deviation value of the tumor of the patient relative to the treatment isocenter, and the tumor of the patient can be located at the treatment isocenter in real time.
In a second aspect of the present invention, a system for real-time monitoring and online correction of patient-guided positioning and tumor target displacement is provided, which comprises: the device comprises a close-range photogrammetry system with two double cameras, a control system and a display screen;
the two double-camera close-range photogrammetry systems are respectively arranged at the top of a simulation room of the heavy ion treatment device and a treatment room treatment couch, and the first double-camera close-range photogrammetry system is used for collecting the position of a tumor target area of a patient on the treatment couch and the positions of three-dimensional control mesh points arranged around the treatment couch;
the control system is arranged in the control hall and used for calibrating a patient tumor target area according to the position of the patient tumor target area and the position data of the three-dimensional control network point, which are acquired by the first double-camera close-range photogrammetry system and the laser tracker in the simulation room, converting the patient tumor target area into patient tumor target area calibration data in the treatment room, guiding the patient to be positioned according to the patient tumor target area calibration data and the real-time tumor target area position of the patient, which is acquired by the second double-camera close-range photogrammetry system, in the ion radiotherapy process, and correcting when the displacement of the tumor target area exceeds a preset threshold value;
the display screens are respectively arranged in the treatment room and the control hall and are used for displaying the position of the target area of the tumor of the patient acquired by the second double-camera close-range photogrammetry system in real time and guiding a doctor to carry out on-line correction of position deviation in the process of ion radiotherapy.
Due to the adoption of the technical scheme, the invention has the following advantages: (1) in the process of guiding the patient to be positioned, the absolute position of the treatment isocenter is provided, and the positioning accuracy of the patient is improved; (2) in the guiding and positioning process, the positioning precision of the patient is improved by referring to the calibration data of the characteristic mark points of the tumor target area of the patient in the inspiration and expiration states respectively; (3) in the whole radiotherapy treatment course of the patient, the patient can be positioned every time, and a radiotherapy doctor can position according to calibration data of the characteristic points of the body surface of the patient monitored by the photogrammetric system, so that the operation is visual and simple, and the positioning efficiency of the patient is improved. (4) The position deviation of the tumor relative to the treatment isocenter is monitored by a method of arranging the characteristic mark points on the target area of the tumor, the monitoring data acquisition amount is small, the data operation speed is high, the monitoring displacement deviation amount can be visually displayed on a screen in real time, and real-time monitoring is achieved. (5) In the treatment process, a radiotherapy doctor can perform online correction according to the tumor position deviation on the display screen, so that the treatment precision of a patient is improved; (6) the reasonable threshold value of the position deviation of the tumor target area and the time range of normal tissues near the tumor of the patient, which can be borne under the set dose rate, are arranged in the control system, so that the treatment safety of the patient is improved, the beam current can be prevented from being frequently cut off by the system under the unnecessary condition, and the utilization efficiency of the beam current is improved.
Drawings
FIG. 1 is a block diagram of a system for real-time monitoring and correction of patient-guided positioning and target displacement in accordance with the present invention;
FIG. 2 is a flow chart of a method for real-time monitoring and correcting patient-guided positioning and target displacement according to the present invention;
FIGS. 3a and 3b are screenshots of display interfaces for real-time monitoring of the displacement of a tumor target region of a phantom (patient) in a validation experiment performed at a HIRFL deep treatment terminal according to the present invention; fig. 3a is a three-dimensional graph of real-time monitoring of position deviation of a phantom (patient) tumor target area relative to a deep treatment terminal treatment isocenter in an experiment; FIG. 3b is a three-dimensional coordinate data display of real-time monitoring of positional deviation of a phantom (patient) tumor target area relative to a deep treatment terminal treatment isocenter in an experiment;
fig. 4a and 4b are screenshots of monitoring and displaying interfaces for online correction of position deviation of target area of phantom (patient) in a verification experiment performed by a hirl deep treatment terminal, wherein fig. 4a is a three-dimensional graph for online correction of position deviation of target area of phantom (patient) in the experiment; FIG. 4b is a three-dimensional coordinate data display of on-line correction of the position deviation of the target area of the phantom (patient) in the experiment;
FIG. 5 is a three-dimensional coordinate difference diagram of the tumor target area of the phantom (patient) after on-line monitoring and correction and the laser tracker monitoring in the verification experiment performed by the HIRFL deep treatment terminal;
the respective symbols in the figure are as follows: 1. a dual-camera close-range photogrammetry camera; 2. a control system; 3. a display screen; 4. characteristic mark points of the tumor target area; 5. three-dimensional control mesh points; 6. a therapeutic bed.
Detailed Description
The following detailed description describes embodiments of the invention, examples of which are illustrated in the accompanying drawings, which are meant to be exemplary and intended to be illustrative of the invention, and not to be construed as limiting the invention.
The first embodiment is as follows:
as shown in fig. 1, the system for real-time monitoring and correcting patient-guided positioning and target displacement provided in this embodiment includes: the device comprises two double-camera close-range photogrammetry systems 1, a control system 2 and a display screen 3, wherein the two double-camera close-range photogrammetry systems 1 are respectively arranged at the top of a treatment couch in a simulation room and a treatment room of the heavy ion treatment device, and the first double-camera close-range photogrammetry system 1 is used for collecting the position of a tumor target area of a patient on the treatment couch 6 and the positions of three-dimensional control network points arranged around the treatment couch; the control system is arranged in the control hall and used for calibrating a patient tumor target area according to the position data of the three-dimensional control network points acquired by the first double-camera close-range photogrammetry system 1 and the laser tracker in the simulation room and converting the data into patient tumor target area calibration data in the treatment room, then guiding the patient to be positioned according to the patient tumor target area calibration data and the real-time tumor target area position of the patient acquired by the second double-camera close-range photogrammetry system in the ion radiotherapy process, and correcting when the displacement of the tumor target area exceeds a preset threshold value; the display screens 3 are respectively arranged in the treatment room and the control hall and are used for displaying the position of the target area of the tumor of the patient acquired by the second double-camera close-range photogrammetry system in real time and guiding a doctor to carry out on-line correction of position deviation in the process of ion radiotherapy.
Example two:
as shown in fig. 2, the present invention provides a real-time monitoring and correcting method for patient-guided positioning and target displacement, which specifically comprises the following steps:
1) preparation before radiotherapy: a patient guiding positioning and target area displacement real-time monitoring and correcting system is set up in a simulation room and a treatment room, and patient tumor target area calibration data under a treatment isocenter coordinate system is obtained in the simulation room;
2) guiding and verifying the position: according to the acquired patient tumor target area calibration data under the treatment isocenter coordinate system, guiding the patient to carry out positioning and carrying out positioning verification in the whole treatment process;
3) monitoring and correcting displacement of the target area in real time: in the whole treatment process, the displacement of the target area of the tumor of the patient is monitored in real time, and the position of the target area of the tumor of the patient is corrected according to the real-time monitoring result of the displacement of the target area of the tumor of the patient and a preset threshold value.
In the step 1), the method for preparing before radiotherapy comprises the following steps:
1.1) respectively establishing a set of double-camera close-range photogrammetry system in a simulation room and a treatment room of the heavy ion treatment device.
1.2) arranging a new three-dimensional control net around the treatment beds of the simulation room and the treatment room respectively, wherein the three-dimensional control net comprises a plurality of three-dimensional control net target points which can be measured by using a laser tracker and a double-camera close-range photogrammetry system.
1.3) unifying the newly-arranged three-dimensional control net and the global control net of the heavy ion treatment device in a global coordinate system by a best fitting method by using a laser tracker, and establishing three-dimensional theoretical coordinates of target points of the newly-arranged three-dimensional control net relative to treatment isocenters of a simulation room and a treatment room.
1.4) sticking special small-size (30mm x 30mm) RRT coding mark points or special RRT characteristic mark points (the sticking surface is environment-friendly adhesive which is harmless to the skin of a human body) on the target tumor area on the body surface of the patient, wherein the arrangement principle is that the small-size RRT coding mark points or the RRT mark points with the number more than 3 uniformly cover the target tumor area of the patient.
1.5) in the simulation chamber, a double-camera close-range photogrammetry system is adopted to measure three-dimensional control net target points arranged in the intersection visual field range around the treatment couch, and the control orientation of the double-camera close-range photogrammetry system in the simulation chamber is carried out, so that the origin of a measurement coordinate system of the double-camera close-range photogrammetry system is positioned at the treatment isocenter of the simulation chamber.
1.6) referring to the tumor image data of CT/MRI and the like of the patient, the patient is simulated and positioned in a simulation room by using a mobile DR device.
1.7) in the simulation room, a double-camera close-range photogrammetry system is used for acquiring calibration data of a tumor target area after the patient is simulated to be positioned relative to a treatment isocenter of the simulation room.
1.8) using measurement software to convert a coordinate system between the simulation room treatment isocenter and the treatment room treatment isocenter, converting the tumor target calibration data of the patient in the simulation room isocenter coordinate system into the patient tumor target calibration data in the treatment room isocenter coordinate system, and storing the patient tumor target calibration data in a control system according to the ID of the patient.
In the step 1.1), the method for respectively establishing a set of two-camera close-range photogrammetry system in the simulation room and the treatment room of the heavy ion treatment device comprises the following steps: the dual cameras are mounted on top of the treatment couch in the simulation room and the treatment room so that the convergent vision field of the dual cameras can completely cover the full range of motion of the treatment couch.
In the step 1.7), the method for acquiring the tumor calibration data of the patient by using the dual-camera close-range photogrammetry system in the simulation room comprises the following steps: the target feature point data of the tumor target area during inspiration and expiration in the free breathing state after the patient is positioned are measured for multiple times, for example, the target feature point data can be measured 20 times respectively during inspiration and expiration in the free breathing state after the patient is positioned, and the average value of the 20 measurements is taken as the tumor calibration data of the patient in the inspiration and expiration states.
In the step 2), the method for guiding the patient to perform positioning and positioning verification comprises the following steps:
2.1) in the treatment room, using the double-camera close-range photogrammetry system to measure three-dimensional control net target points arranged in the intersection visual field range around the treatment couch, and carrying out control orientation of the double-camera close-range photogrammetry system in the treatment room, so that the origin of the measurement coordinate system of the double-camera close-range photogrammetry system is positioned at the treatment isocenter of the treatment room.
2.2) in the whole radiotherapy treatment course of the patient, when the patient is guided to be positioned in the treatment room each time, the characteristic mark point calibration data of the tumor target area of the patient is measured in real time by the double-camera close-range photogrammetry system and is sent to thecontrol system 2 and thedisplay screen 3, so that a doctor can guide the patient to be positioned according to the actual position of the tumor of the patient on thedisplay screen 3 and the deviation of the treatment isocenter of the treatment room.
And 2.3) after guiding the patient to finish the positioning, performing positioning verification by using the DR of the treatment room, starting treatment if the verification is passed, and otherwise, adjusting the positioning of the patient.
In the step 3), the method for monitoring and correcting the displacement of the target area in real time comprises the following steps:
3.1) in the treatment process, the double-camera close-range photogrammetry system is used for monitoring the displacement information of the tumor target area of the patient in real time and displaying the displacement information on the display screens of the treatment room and the control system in real time.
3.2) the control system judges whether the position of the tumor target area of the patient needs to be corrected according to the received displacement information of the tumor target area of the patient and a preset threshold value, if so, the step 3.3) is carried out, otherwise, the step 3.1) is returned to continuously monitor the displacement information of the tumor target area of the patient. The preset threshold value refers to the allowable moving range of the target region of the tumor of the patient, which is determined according to the size and the position of the tumor of the patient.
3.3) in the treatment process, if patient's tumour target area displacement surpassed the threshold value, then control system can send the chimes of doom and suggestion doctor and patient, the doctor can refer to the deviation value of patient's target area position relative to treatment isocenter that monitors, carry out patient's tumour target area position through remote control treatment bed and correct, perhaps imbed the rectification procedure in the control system of treatment bed, make the treatment bed according to the deviation value of patient's target area relative to treatment isocenter that monitors automatically correct the compensation, make patient's tumour target area can be in treatment isocenter position in real time. If the displacement of the tumor target area of the patient exceeds the set threshold value and the position deviation of the tumor target area of the patient is not corrected in time within the time range which can be borne by the set dose rate of the normal tissue of the patient, the control system automatically cuts off the beam current, and the condition that the normal tissue of the patient receives excessive dose to induce new pathological changes is avoided.
Example three:
in the method for monitoring and correcting the patient guide positioning and target area displacement in real time provided by the embodiment, experimental verification for monitoring and correcting the patient guide positioning and the tumor target area position in real time and on line is performed on a deep treatment terminal of a HIRFL (Lanzhou heavy ion research device), and the invention is further described in detail by adopting a rubber phantom simulating a tumor patient. Specifically, the method comprises the following steps:
(1) erecting a double camera in a treatment room of the HIRFL deep treatment terminal, establishing a double camera close-range photogrammetry system, adjusting the erection posture and the angle of the double camera, and ensuring that the intersection visual field of the double camera can cover the whole moving range of the treatment couch; in order to verify the precision of guiding positioning, real-time monitoring and online correction of a double-camera close-range photogrammetric system, a laser tracker measuring target seat is adhered to the corner of a treatment couch and serves as a coordinate position monitoring point, and a laser tracker is erected near the treatment couch.
(2) The rubber phantom simulating a tumor patient is placed on a treatment bed of a deep treatment terminal, and the special RRT characteristic mark points are pasted on the tumor target area on the surface of the phantom (patient) to ensure that the characteristic mark points are uniformly distributed around the tumor target area to form a covering state for the tumor of the patient.
(3) Three-dimensional control network points which can be measured by a laser tracker and a double-camera close-range photogrammetry system are distributed around the treatment bed, the laser tracker is used for connecting the distributed new three-dimensional control network points with the overall control network points of the deep treatment terminal, and three-dimensional theoretical coordinates of the three-dimensional control network points relative to the treatment isocenter of the treatment room are established.
(4) The laser tracker is positioned at the treatment isocenter of a treatment room, the three-dimensional control network points distributed around the treatment couch are measured by using the measuring target balls of the 1.5-inch laser tracker, and the three-dimensional coordinates of the three-dimensional control network points newly distributed around the treatment couch relative to the treatment isocenter are established in a best fitting mode. The method comprises the steps of placing 1.5-inch steel target balls special for photogrammetry upwards on three-dimensional control net target seats newly distributed on the periphery of a treatment bed, measuring three-dimensional control network points on the periphery of the treatment bed by using a double-camera close-range photogrammetry system, and positioning the double-camera close-range photogrammetry system at a treatment isocenter of a deep treatment terminal by controlling orientation according to target data of the three-dimensional control network points measured by a laser tracker.
(5) The tumor target area (simulated tumor) of the phantom is placed to the position of the treatment isocenter by means of positioning laser of a deep treatment terminal, and the positioning of a simulation room of a patient is simulated.
(6) And measuring characteristic mark points of the tumor target area on the surface of the phantom by using a double-camera close-range photogrammetry system, and simulating the calibration of the tumor target area of the patient after the patient is positioned in a simulation room.
(7) The patient body model is randomly moved for a certain distance along the horizontal direction, the vertical direction and the longitudinal direction respectively through the displacement of the treatment bed in each axial direction through manual operation. The positional deviation of the patient relative to the isocenter treatment point prior to setup in the treatment room is simulated.
(8) Under the monitoring mode of the double-camera close-range photogrammetry system, the characteristic mark points of the patient tumor target area are measured in real time, the calibration data of the tumor target area is referred, the position deviation of the patient tumor target area relative to the treatment isocenter in each direction is calculated through the 6-degree-of-freedom parameter calculation of the position coordinates of the plurality of characteristic mark points, and all the deviation directions are visually displayed on a computer screen. According to the deviation of each direction displayed on the computer screen relative to the position of the treatment isocenter, the treatment bed is controlled to gradually move the phantom (patient) to the position of the treatment isocenter in the treatment room, and the process of guiding the patient to swing is simulated.
(9) After the patient is guided to be positioned by using the double-camera close-range photogrammetry system, a laser tracker is used for measuring a reference target seat (coordinate position monitoring point) on the treatment couch, the positioning of the patient is verified by comparing the deviation values of the initial calibration coordinate and the measurement position coordinate before the movement of the treatment couch, and the precision of guiding the patient to be positioned by using the double-camera close-range photogrammetry system is verified.
(10) After the positioning verification, a group of characteristic mark points attached to a target area on the body surface of a phantom (patient) is measured again by using a double-camera close-range photogrammetry system, the three-dimensional coordinates of each mark point are recorded in a control system, and calibration data of the tumor target area relative to a treatment isocenter point after the patient is positioned in a simulation room are simulated.
(11) After the simulation treatment starts, the characteristic mark points attached to the target area on the body surface of the patient are measured in real time through the double-camera close-range photogrammetry system, matching and resolving of image points and object points are carried out through matched software of the double-camera close-range photogrammetry system, the real-time offset of the tumor of the patient relative to the treatment isocenter is resolved by combining the displacement of tumor calibration data of the patient relative to the characteristic mark points through matched developed fitting software, and the offset values in all directions are visually displayed on a control computer screen in real time.
(12) The treatment bed is moved artificially and randomly, and the unconscious movement of the patient in the treatment process is simulated. The position deviation of the target area of the tumor displayed on a control computer screen is remotely controlled by the real-time monitoring system of the double cameras to move towards the reverse direction of the position deviation, so that the displacement deviation of the target area is corrected on line. After on-line correction, a laser tracker is used for measuring a coordinate position monitoring point on the treatment couch, and the accuracy of on-line monitoring and correction of the double cameras is verified by comparing the deviation value of the initial calibration coordinate before the movement of the treatment couch with the corrected coordinate.
3 a-3 b and 4 a-4 b, are screenshots of displays for guiding patient positioning and on-line monitoring and correction in an embodiment; fig. 5 shows the deviation of the coordinate values displayed by the dual-camera close-range photogrammetric system and the (coordinate position monitoring points) reset coordinate values measured by the laser tracker in each direction after the displacement of the phantom (patient) is monitored and corrected in real time by continuously repeating the above experimental verification for 15 times under the guidance of the dual-camera close-range photogrammetric system; the maximum deviation of the reset coordinates of the double-camera close-range photogrammetry system and the laser tracker is not more than 0.15mm, the standard deviation is about 0.07mm, and the precision can meet the requirement of the positioning precision of the patient in the radiotherapy process. Through multiple times of patient positioning simulation experiments, the method for guiding the positioning of the patient and monitoring and correcting the position of the target area of the tumor in real time can meet the requirements of practical application.
The above embodiments are only used for illustrating the present invention, and the structure, connection mode and the like of each component can be changed, and all equivalent changes and improvements made on the basis of the technical scheme of the present invention should not be excluded from the protection scope of the present invention.

Claims (8)

Translated fromChinese
1.一种患者引导摆位及肿瘤靶区位移实时监测和在线矫正的方法,其特征在于包括以下步骤:1. a method for patient-guided placement and real-time monitoring of tumor target displacement and online correction, is characterized in that comprising the following steps:1)在重离子治疗装置的模拟室和治疗室搭建患者引导摆位及靶区位移实时监测和矫正系统,并在模拟室获取治疗等中心坐标系下的患者肿瘤靶区标定数据;1) Build a real-time monitoring and correction system for patient-guided positioning and target displacement in the simulation room and treatment room of the heavy ion therapy device, and obtain the calibration data of the patient's tumor target area in the treatment isocenter coordinate system in the simulation room;所述步骤1)中,在模拟室获取治疗等中心坐标系下的患者肿瘤靶区标定数据的方法,包括以下步骤:In the step 1), the method for obtaining the calibration data of the patient's tumor target area under the treatment isocenter coordinate system in the simulation room includes the following steps:1.1)分别在重离子治疗装置的模拟室和治疗室各建立一套双相机近景摄影测量系统;1.1) Establish a dual-camera close-range photogrammetry system in the simulation room and the treatment room of the heavy ion therapy device respectively;1.2)分别在模拟室和治疗室的治疗床周围布设新的三维控制网,所述新的三维控制网包括多个使用激光跟踪仪和双相机近景摄影测量系统都能测量的三维控制网靶标点;1.2) A new 3D control net is arranged around the treatment couch in the simulation room and the treatment room, respectively, and the new 3D control net includes a plurality of 3D control net target points that can be measured using a laser tracker and a dual-camera close-range photogrammetry system. ;1.3)利用激光跟踪仪将新布设的三维控制网和重离子治疗装置的全局控制网通过最佳拟合的方法统一在全局坐标系,并创建新布设的三维控制网靶标点相对于模拟室和治疗室治疗等中心点的三维理论坐标;1.3) Use the laser tracker to unify the newly laid 3D control net and the global control net of the heavy ion therapy device in the global coordinate system by the best fitting method, and create the target points of the newly laid 3D control net relative to the simulation room and The three-dimensional theoretical coordinates of the isocenter of the treatment room;1.4)在患者体表的肿瘤靶区粘贴特制RRT编码标志点或者RRT特征标志点,布设原则为使得RRT编码标志点或者数量大于3个以上的RRT标志点均匀覆盖患者整个肿瘤靶区;1.4) Paste special RRT coding markers or RRT characteristic markers on the tumor target area on the patient's body surface, and the principle of layout is to make the RRT coding markers or more than 3 RRT markers evenly cover the entire tumor target area of the patient;1.5)在模拟室内,采用双相机近景摄影测量系统测量布设在治疗床周围交会视野范围内的三维控制网靶标点,进行模拟室双相机近景摄影测量系统的控制定向,使得双相机近景摄影测量系统的测量坐标系原点定位于模拟室的治疗等中心点;1.5) In the simulation room, a dual-camera close-range photogrammetry system is used to measure the three-dimensional control network target points arranged in the intersecting field of view around the treatment table, and the control orientation of the dual-camera close-range photogrammetry system in the simulation room is carried out, so that the dual-camera close-range photogrammetry system The origin of the measurement coordinate system is located at the treatment isocenter of the simulation room;1.6)参考患者的肿瘤影像资料,在模拟室内使用移动DR设备对患者进行模拟摆位;1.6) Referring to the patient's tumor image data, use the mobile DR equipment to simulate the patient placement in the simulation room;1.7)在模拟室内,使用双相机近景摄影测量系统获取患者模拟摆位后的肿瘤相对于模拟室治疗等中心点的标定数据;1.7) In the simulation room, use the dual-camera close-up photogrammetry system to obtain the calibration data of the tumor after the patient's simulated placement relative to the treatment isocenter in the simulation room;1.8)进行模拟室治疗等中心点和治疗室治疗等中心点之间的坐标系转换,将模拟室治疗等中心坐标系下患者的肿瘤靶区标定数据转换为治疗室治疗等中心坐标系下的患者肿瘤标定数据,并根据患者的ID存储于电脑控制系统;1.8) Carry out the coordinate system transformation between the isocenter point of the simulation room treatment and the isocenter point of the treatment room, and convert the calibration data of the tumor target area of the patient under the isocenter coordinate system of the simulation room treatment to the isocenter coordinate system of the treatment room treatment. The calibration data of the patient's tumor is stored in the computer control system according to the patient's ID;2)根据获取的治疗室等中心坐标系下的患者肿瘤靶区标定数据,引导患者进行摆位并进行摆位验证;2) According to the obtained calibration data of the patient's tumor target area under the isocenter coordinate system of the treatment room, guide the patient to place and verify the placement;3)对患者肿瘤靶区位移进行实时监测,并根据患者肿瘤靶区位移实时监测结果以及预设阈值,对患者肿瘤靶区位置进行在线矫正。3) Real-time monitoring of the displacement of the patient's tumor target area, and online correction of the position of the patient's tumor target area according to the real-time monitoring results of the patient's tumor target area displacement and a preset threshold.2.如权利要求1所述的一种患者引导摆位及肿瘤靶区位移实时监测和在线矫正的方法,其特征在于:所述步骤1.1)中,分别在重离子治疗装置的模拟室和治疗室各建立一套双相机近景摄影测量系统的方法为:将双相机安装于模拟室和治疗室的治疗床顶部,调节双相机的架设姿态和角度,使得双相机的交汇视野完全覆盖治疗床的全部移动范围。2. The method for real-time monitoring and online correction of patient-guided placement and tumor target displacement as claimed in claim 1, characterized in that: in the step 1.1), in the simulation room of the heavy ion therapy device and the treatment The method of establishing a set of two-camera close-up photogrammetry system in each room is as follows: install the two-camera on the top of the treatment couch in the simulation room and the treatment room, and adjust the erection posture and angle of the dual-camera so that the intersecting field of view of the dual-camera completely covers the treatment couch. Full range of movement.3.如权利要求1所述的一种患者引导摆位及肿瘤靶区位移实时监测和在线矫正的方法,其特征在于:所述步骤1.4)中,所述RRT编码标志点和RRT特征标志点的粘贴面均为对人体皮肤无伤害的环保型粘连胶,且所述RRT编码标志点的大小为30mmⅹ30mm,RRT特征标志点的大小为8mmⅹ8mm。3. the method for real-time monitoring and online correction of a kind of patient guide placement and tumor target displacement as claimed in claim 1, is characterized in that: in described step 1.4), described RRT coding mark point and RRT characteristic mark point The sticking surfaces are all environmentally friendly adhesives that are harmless to human skin, and the size of the RRT coding mark point is 30mmⅹ30mm, and the size of the RRT characteristic mark point is 8mmⅹ8mm.4.如权利要求1所述的一种患者引导摆位及肿瘤靶区位移实时监测和在线矫正的方法,其特征在于:所述步骤1.7)中,使用双相机近景摄影测量系统获取患者的肿瘤靶区标定数据的方法为:分别多次测量患者摆位后在自由呼吸状态下吸气和呼气时的肿瘤靶区特征标志点数据,取多次测量的平均值作为吸气和呼气状态下患者的肿瘤标定数据。4. The method for real-time monitoring and online correction of patient-guided placement and tumor target displacement as claimed in claim 1, characterized in that: in the step 1.7), a dual-camera close-range photogrammetry system is used to obtain the tumor of the patient The method of target area calibration data is as follows: after the patient is placed in the free breathing state, the characteristic landmark point data of the tumor target area during inhalation and exhalation are measured for multiple times, and the average value of the multiple measurements is taken as the inspiratory and expiratory states. The tumor calibration data of the patients below.5.如权利要求1所述的一种患者引导摆位及肿瘤靶区位移实时监测和在线矫正的方法,其特征在于:所述步骤2)中,引导患者进行摆位并进行摆位验证的方法为:5. The method for real-time monitoring and online correction of patient-guided placement and tumor target displacement as claimed in claim 1, characterized in that: in the step 2), the patient is guided to perform placement and to perform placement verification. The method is:2.1)在治疗室内,使用双相机近景摄影测量系统测量布设在治疗床周围交会视野范围内的三维控制网靶标点,进行治疗室双相机近景摄影测量系统的控制定向,使得双相机近景摄影测量系统的测量坐标系原点定位于治疗室的治疗等中心点;2.1) In the treatment room, use the dual-camera close-range photogrammetry system to measure the three-dimensional control network target points arranged in the intersecting field of view around the treatment table, and carry out the control orientation of the dual-camera close-range photogrammetry system in the treatment room, so that the dual-camera close-range photogrammetry system The origin of the measurement coordinate system is located at the treatment isocenter of the treatment room;2.2)通过双相机近景摄影测量系统实时测量患者肿瘤靶区的特征标志点数据,并转换为患者肿瘤靶区相对于治疗等中心点的三维坐标位置偏差发送到控制系统和显示屏幕上,以便于医师根据显示屏幕上的患者肿瘤的实际位置和治疗等中心点的偏差引导患者进行摆位;2.2) Real-time measurement of the characteristic landmark data of the patient's tumor target area by the dual-camera close-range photogrammetry system, and convert the data into the three-dimensional coordinate position deviation of the patient's tumor target area relative to the treatment isocenter and send it to the control system and the display screen, so as to facilitate The doctor guides the patient to position according to the actual position of the patient's tumor on the display screen and the deviation of the center point of the treatment;2.3)引导患者完成摆位后,使用治疗室的DR进行摆位验证,验证通过则继续进行下一步治疗,否则,返回步骤2.2)对患者摆位进行调整。2.3) After guiding the patient to complete the placement, use the DR in the treatment room to verify the placement. If the verification is passed, proceed to the next treatment. Otherwise, go back to step 2.2) to adjust the patient placement.6.如权利要求1所述的一种患者引导摆位及肿瘤靶区位移实时监测和在线矫正的方法,其特征在于:所述步骤3)中,进行靶区位移实时监测和矫正的方法为:6. the method for real-time monitoring and on-line correction of a kind of patient guide placement and tumor target displacement as claimed in claim 1, is characterized in that: in described step 3), the method for carrying out target displacement real-time monitoring and correction is: :3.1)使用双相机近景摄影测量系统实时监测患者肿瘤靶区的位移信息,并实时显示在治疗室和控制系统的显示屏幕上;3.1) Use the dual-camera close-range photogrammetry system to monitor the displacement information of the patient's tumor target area in real time, and display it on the display screen of the treatment room and the control system in real time;3.2)控制系统根据接收到的患者肿瘤靶区的位移信息以及预设阈值,判断是否需要对患者肿瘤靶区位置进行矫正,如果患者肿瘤靶区的位移超过预设阈值,则控制系统发出报警信号,并在预设时间内对肿瘤靶区进行矫正,如果预设时间内没有完成矫正则控制系统自动切断束流,如果患者肿瘤靶区的位移没有超过预设阈值,则返回步骤3.1)持续对患者肿瘤靶区的位移信息进行监测;其中,预设阈值是指根据患者肿瘤的大小和位置确定的患者肿瘤靶区允许移动范围。3.2) The control system judges whether it is necessary to correct the position of the patient's tumor target area according to the received displacement information of the patient's tumor target area and the preset threshold. If the displacement of the patient's tumor target area exceeds the preset threshold, the control system will issue an alarm signal , and correct the tumor target area within the preset time. If the correction is not completed within the preset time, the control system will automatically cut off the beam current. If the displacement of the patient's tumor target area does not exceed the preset threshold, return to step 3.1) and continue to correct The displacement information of the patient's tumor target area is monitored; wherein, the preset threshold refers to the allowable movement range of the patient's tumor target area determined according to the size and position of the patient's tumor.7.如权利要求6所述的一种患者引导摆位及肿瘤靶区位移实时监测和在线矫正的方法,其特征在于:所述步骤3.2)中,对肿瘤靶区进行矫正的方法包括:医师参考监测到的患者靶区位置相对于治疗等中心点的偏差值,通过远程操控治疗床进行患者肿瘤靶区位置矫正,或者在治疗床的控制系统内嵌入矫正程序,使得治疗床根据监测到的患者肿瘤相对于治疗等中心点的偏差值自动进行矫正补偿,使得患者肿瘤能实时处于治疗等中心点位置。7. The method for real-time monitoring and online correction of patient-guided placement and displacement of tumor target area as claimed in claim 6, characterized in that: in the step 3.2), the method for correcting the tumor target area comprises: a physician With reference to the deviation of the monitored patient target position relative to the treatment isocenter, the patient's tumor target position can be corrected by remotely controlling the treatment couch, or a correction program can be embedded in the control system of the treatment couch, so that the treatment couch can adjust the position according to the monitored treatment couch. The deviation value of the patient's tumor relative to the treatment isocenter is automatically corrected and compensated, so that the patient's tumor can be positioned at the treatment isocenter in real time.8.一种适用于如权利要求1~7任一项所述方法的患者引导摆位及肿瘤靶区位移实时监测和在线矫正系统,其特征在于,包括:两双相机近景摄影测量系统、控制系统、显示屏幕;8. A patient-guided positioning and real-time monitoring and online correction system for patient-guided placement and tumor target displacement according to the method according to any one of claims 1 to 7, characterized in that, comprising: a two-camera close-range photogrammetry system, a control system, display screen;两所述双相机近景摄影测量系统分别设置在重离子治疗装置的模拟室和治疗室内治疗床的顶部,且第一双相机近景摄影测量系统用于对所述治疗床上患者的肿瘤靶区位置以及布设在所述治疗床周围的三维控制网点的位置进行采集;The two dual-camera close-range photogrammetry systems are respectively arranged on the top of the treatment couch in the simulation room of the heavy ion therapy device and in the treatment room, and the first dual-camera close-up photogrammetry system is used to measure the position of the tumor target area of the patient on the treatment couch and collecting the positions of the three-dimensional control network points arranged around the treatment couch;所述控制系统设置在控制大厅内,用于根据模拟室内第一双相机近景摄影测量系统和激光跟踪仪采集到的患者肿瘤靶区位置、三维控制网点位置数据对患者肿瘤靶区进行标定并转换为治疗室内患者肿瘤靶区标定数据,并在离子放疗过程中根据该患者肿瘤靶区标定数据以及第二双相机近景摄影测量系统采集到的患者实时肿瘤靶区位置引导患者进行摆位,并在肿瘤靶区位移超出预设阈值时进行矫正;其中,获取治疗室内患者肿瘤靶区标定数据时:分别在重离子治疗装置的模拟室和治疗室各建立一套双相机近景摄影测量系统;分别在模拟室和治疗室的治疗床周围布设新的三维控制网,所述新的三维控制网包括多个使用激光跟踪仪和双相机近景摄影测量系统都能测量的三维控制网靶标点;利用激光跟踪仪将新布设的三维控制网和重离子治疗装置的全局控制网通过最佳拟合的方法统一在全局坐标系,并创建新布设的三维控制网靶标点相对于模拟室和治疗室治疗等中心点的三维理论坐标;在患者体表的肿瘤靶区粘贴特制RRT编码标志点或者RRT特征标志点,布设原则为使得RRT编码标志点或者数量大于3个以上的RRT标志点均匀覆盖患者整个肿瘤靶区;在模拟室内,采用双相机近景摄影测量系统测量布设在治疗床周围交会视野范围内的三维控制网靶标点,进行模拟室双相机近景摄影测量系统的控制定向,使得双相机近景摄影测量系统的测量坐标系原点定位于模拟室的治疗等中心点;参考患者的肿瘤影像资料,在模拟室内使用移动DR设备对患者进行模拟摆位;在模拟室内,使用双相机近景摄影测量系统获取患者模拟摆位后的肿瘤相对于模拟室治疗等中心点的标定数据;进行模拟室治疗等中心点和治疗室治疗等中心点之间的坐标系转换,将模拟室治疗等中心坐标系下患者的肿瘤靶区标定数据转换为治疗室治疗等中心坐标系下的患者肿瘤标定数据,并根据患者的ID存储于电脑控制系统;The control system is arranged in the control hall, and is used for calibrating and converting the tumor target area of the patient according to the position of the tumor target area of the patient and the position data of the three-dimensional control network point collected by the first dual-camera close-range photogrammetry system and the laser tracker in the simulation room. To calibrate the data of the patient's tumor target area in the treatment room, and guide the patient to set up the patient's tumor target area according to the patient's tumor target area calibration data and the patient's real-time tumor target area position collected by the second dual-camera close-range photogrammetry system during the ion radiotherapy process. Correction is performed when the displacement of the tumor target area exceeds the preset threshold; among them, when obtaining the calibration data of the tumor target area of the patient in the treatment room: a set of two-camera close-range photogrammetry systems are established in the simulation room and the treatment room of the heavy ion therapy device respectively; A new 3D control net is placed around the treatment table in the simulation and treatment rooms, the new 3D control net includes multiple 3D control net target points that can be measured using a laser tracker and a dual-camera close-range photogrammetry system; using laser tracking The instrument unifies the newly arranged 3D control network and the global control network of the heavy ion therapy device in the global coordinate system by the best fitting method, and creates the newly arranged 3D control network target points relative to the simulation room and treatment room treatment center. The three-dimensional theoretical coordinates of the point; paste special RRT-coded markers or RRT characteristic markers on the tumor target area on the patient's body surface, and the principle of layout is to make the RRT-coded markers or more than 3 RRT markers evenly cover the entire tumor target of the patient In the simulation room, the two-camera close-range photogrammetry system is used to measure the three-dimensional control network target points arranged in the intersecting field of view around the treatment table, and the control orientation of the two-camera close-range photogrammetry system in the simulation room is carried out, so that the double-camera close-range photogrammetry system The origin of the measurement coordinate system is located at the treatment isocenter of the simulation room; referring to the patient's tumor image data, use the mobile DR equipment to simulate the patient placement in the simulation room; in the simulation room, use the dual-camera close-range photogrammetry system to obtain the patient simulation The calibration data of the tumor after placement relative to the isocenter point of the simulated room treatment; the coordinate system transformation between the isocenter point of the simulated room therapy and the isocenter point of the treatment room is performed to convert the tumor of the patient under the isocenter coordinate system of the simulated room therapy The calibration data of the target area is converted into the calibration data of the patient's tumor in the isocentric coordinate system of the treatment room, and stored in the computer control system according to the patient's ID;所述显示屏幕分别设置在治疗室和控制大厅内,用于在离子放疗过程中对第二双相机近景摄影测量系统采集到的患者肿瘤靶区位置进行实时显示和指导医师进行位置偏差的在线矫正。The display screens are respectively arranged in the treatment room and the control hall, and are used for real-time display of the position of the tumor target area of the patient collected by the second dual-camera close-range photogrammetry system during the ion radiotherapy process and to guide the physician to perform online correction of the position deviation. .
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