WO2011058730A1

WO2011058730A1 - Signal generator for respiratory gating, tomography device, radiation simulator, and radiation therapy device

Info

Publication number: WO2011058730A1
Application number: PCT/JP2010/006556
Authority: WO
Inventors: 昭男武藤; 恵一中川; 敬田村; 康彦白井
Original assignee: 株式会社ホンダ・ハドロニクス; 国立大学法人東京大学
Priority date: 2009-11-10
Filing date: 2010-11-09
Publication date: 2011-05-19
Also published as: JP2013017491A

Abstract

Provided is a signal generator for respiratory gating which forces a patient to take short, quick breaths, and which is capable of detecting body movement caused by the precise breathing. The signal generator for respiratory gating (10) comprises: a trunk stabilizer (11) for stabilizing the trunk of a patient (K); a diaphragm compression device (12) for compressing the diaphragm by pressing the lower hypochondrium of the patient; a body movement detection sensor (14) which is in contact with the patient (K), and detects body movement caused by breathing as a change in pressure; and a controller (16) which receives output from the body movement detection sensor (14), and generates a signal for respiratory gating synchronized to the breathing. The body movement detection sensor (14) comprises: a pressure-receiving vessel (21) in contact with the patient (K); a thin-film sensor element (31); and a sensor receptacle (29) for housing the thin-film sensor element (31). The pressure-receiving vessel (21) and the sensor receptacle (29) are linked by means of a linking tube (25) and air is sealed therewithin.

Description

Respiratory synchronization signal generation apparatus, tomography apparatus, radiation simulation apparatus, and radiotherapy apparatus

The present invention relates to a respiratory synchronization signal generation device that outputs a signal synchronized with body movement due to respiration to a CT scan device, a PET device, a radiotherapy simulation device, or a radiotherapy device, and further synchronizes with respiration. The present invention relates to a tomography apparatus that performs tomography and a radiotherapy apparatus that performs radiation therapy in synchronization with respiration.

A so-called tomography device is well known as a medical device that can take a tomographic image of a human body cut at an arbitrary part. A CT scan device that takes an image by exposing X-rays, and a patient is given a radioactive tracer. A PET apparatus that detects and captures gamma rays emitted from a radioactive tracer is known. In addition, medical equipment in which a predetermined device is added to a tomographic apparatus is also known, and so-called radiation therapy simulation apparatuses, radiation therapy apparatuses, and the like are known. The radiotherapy simulation apparatus is an apparatus that can take a tomographic image of a patient and perform a radiotherapy simulation based on the acquired tomographic image, thereby making a treatment plan. The radiotherapy apparatus is an apparatus that irradiates an affected area with radiation by an operator operating the apparatus based on a radiotherapy plan.

As is well known in the art, the CT scanning apparatus is composed of a gantry having an opening with a predetermined inner diameter penetrating the center, a bed on which a patient lies, and a computer for processing data. Inside the gantry, an X-ray source that emits X-rays and a detector array composed of a large number of sensors that detect X-rays transmitted through the human body are arranged at positions facing each other across the opening. The radiation source and the detector array can be rotated in the circumferential direction around the opening. A patient who is supine on the bed is inserted into the opening together with the bed. When a tomographic image is obtained with such a CT scanning apparatus, a patient who is lying on the bed by driving the bed is inserted into the opening of the gantry, and a predetermined region to be imaged is placed in the X-ray exposure field. So that Then, while rotating the X-ray source and the detector array, X-rays are emitted from different directions, and the X-ray transmitted through the human body is detected by the detector array. When the data detected in this way is processed in an integrated manner by a computer, one tomographic image is obtained.

In the tomography apparatus, the bed is driven to move the region to be imaged little by little, and a plurality of tomographic images are captured. If it does so, the site | part of imaging | photography object can be imaged in three dimensions. By the way, when taking a tomographic image, the patient is careful not to move on the bed, but the patient moves due to a breathing movement or a slight movement of the body, that is, a body movement. If the patient moves due to body movement, a shift occurs between a plurality of tomographic images to be photographed, so that a three-dimensional tomographic image cannot be obtained clearly. If it does so, a tumor cannot be overlooked in a diagnosis, or the position of a tumor cannot be pinpointed correctly. In addition, it is impossible to appropriately design a treatment plan in the radiotherapy simulation apparatus, and in the radiotherapy apparatus, a healthy tissue other than a tumor may be accidentally irradiated with radiation to be damaged.

Well-known vacuum pillows that can substantially fix the upper body of the patient, and diaphragm compression devices that compress the patient's abdomen and restrict the abdominal breathing through the diaphragm to allow chest breathing with small body movements are well known. If these are used when performing radiotherapy, body movement can be suppressed to some extent. A vacuum pillow is a body fixing device having a futon shape in which a predetermined amount of a filler made of fine granular polystyrene is put in a predetermined bag made of a resin material having flexibility and airtightness. The body frame is provided in a body frame formed so as to have a U-shaped cross section. When the patient is lying on the vacuum pillow and the air in the bag is sucked, the vacuum pillow adheres to the shape of the back and sides of the patient and solidifies, and the trunk, that is, the upper body, is opened with the chest open. It can be substantially fixed. The diaphragm compression device is provided at a bridge-shaped support base that is installed above the abdomen so as to straddle the abdomen of a supine patient, a drive shaft that is supported by the support base and can be driven in the vertical direction, and a distal end of the drive shaft. It consists of a compression plate. Therefore, when a predetermined part of the patient's abdomen, specifically the lower part of the season, is compressed with the compression plate of the diaphragm compression device, the diaphragm is compressed and diaphragm breathing, that is, abdominal breathing cannot be performed. You will have a small chest breath. When the movement of the diaphragm is suppressed, the movement of the internal organs is suppressed to some extent. Therefore, when the vacuum pillow and the diaphragm compression tool are used in combination, it is relatively difficult to be affected by body movement in tomography and radiotherapy. However, although the body movement can be suppressed to some extent, the body movement due to chest-type breathing cannot be suppressed, so that an error occurs in tomography and radiotherapy.

Also known is a tomographic method of obtaining a clear tomographic image by controlling the tomographic apparatus in synchronism with the movement of the breath and the heartbeat to remove the influence of the body motion. A tomography apparatus capable of performing such a method is configured to receive a signal for controlling the tomography apparatus from the outside, and detects a body movement of a human body to generate a synchronization signal. When is connected, tomography can be performed in synchronization with body movement. Patent Document 1 describes a body motion synchronization signal generation device that generates a heart beat synchronization signal by means of an electrocardiogram detection sensor affixed to a patient's chest. Since the body motion synchronization signal generation device described in Patent Document 1 is connected to a CT scan device that captures a tomographic image of the heart, the CT scan device is controlled in synchronization with the heartbeat. Therefore, the CT scanning apparatus can take a tomographic image without being affected by the heartbeat, and a clear tomographic image of the heart can be obtained. However, in the body movement synchronization signal generation device described in Patent Document 1, the breathing motion is not considered. Accordingly, when tomography is performed on a portion other than the heart, the tomographic image becomes blurred due to respiratory motion.

JP 2001-61835 A JP 2001-187030 A

Also known is a respiratory synchronization signal generation device that detects respiratory motion, and can be connected to a tomography apparatus. In such a respiratory synchronization signal generator, known methods for detecting respiration include, for example, a method for detecting vertical movement of the chest, a method for detecting expansion and contraction of the abdomen, and a method for detecting skin tension. ing. The method of detecting the vertical movement of the chest includes a method using a marker and a method using a measuring rod. The method using the marker detects the vertical movement of the chest by monitoring the marker attached to the chest of the patient with an external CCD camera. In the method using a measuring rod, one end of the measuring rod is brought into contact with the patient's chest, a fulcrum of the measuring rod is provided near the patient, and the vertical movement of the chest is amplified at the other end. It is a method to detect. The method for detecting the expansion and contraction of the abdomen is a method for detecting the expansion and contraction of the abdomen by detecting the change in the tension of the belt wound around the abdomen or the air pressure in the hollow belt. Is a method in which a strain sensor is affixed to the patient's body surface and the tension of the skin is detected to detect breathing motion.

Patent Document 2 describes a sheet-like piezoelectric sensor that is provided on a bed on which a patient lies, and that can detect body movements due to breathing motion by contacting the patient's back. The piezoelectric sensor described in Patent Document 2 is a sensor having a so-called laminated structure in which a pressure detection element made of a PVDF film or an aluminum nitride thin film is sandwiched between thin resin sheets, and is a body movement caused by breathing motion. Can be detected as a change in voltage.

If the method for detecting the movement of breathing as described above is performed or the piezoelectric sensor described in Patent Document 2 is used, body movement due to the movement of breathing can be detected. Therefore, if body movement due to respiration is detected and a synchronization signal is transmitted to the tomography apparatus, tomography can be performed in synchronization with the respiration operation. Then, it is possible to obtain a clear tomographic image that is not affected by body movements caused by breathing motion. However, there are some problems to be solved. First, the above-described method for detecting a breathing motion is intended for detection of abdominal breathing that has a large body motion and is relatively easy to detect. Abdominal breathing has a long cycle. In tomography, it is necessary to repeatedly shoot from multiple directions and positions. If the tomography device is driven in synchronism with the long-period abdominal breathing operation, it takes a considerable amount of time for tomography. End up. If it does so, a patient will get tired and the operation rate of a tomography apparatus will fall and it will become high-cost. Because of these problems, tomography in synchronization with respiration has hardly been performed.

Although specific means and methods are not shown here, the problem that the cycle is long can be solved if the patient can breathe every minute with a short cycle. In other words, it is possible to perform tomography in a relatively short time if the patient is breathed in small steps, and this is detected and synchronized with the breathing, so there is a problem of high costs due to patient fatigue and reduced availability. Is resolved. In this case, it is necessary to have means for making a small breath and a means for detecting such a small breath. Examining the latter, it is impossible to accurately detect respiration even with the above-described method for detecting respiration. In other words, in the method using the marker and the method using the measuring rod, the respiration is detected by detecting the vertical movement of the chest, but since the displacement of the chest is small, the respiration cannot be detected accurately, and the abdomen is inflated and contracted. In the detection method, since the displacement is small even in the abdomen, respiration cannot be detected with high accuracy. In addition, in the method of detecting the skin tension, when the patient's skin is slack, the detection accuracy is deteriorated, so that high-precision detection cannot be expected.

In the case of using the piezoelectric sensor described in Patent Document 2, it is considered that detection can be performed to some extent even for small respiration with small displacement. This is because the piezoelectric sensor described in Patent Document 2 has high sensitivity and is considered to be able to detect even a slight body movement due to respiration. However, there are other problems. For example, the piezoelectric sensor described in Patent Document 2 is used so as to be in contact with the back of a patient who is supine. There is also a problem inherent to pressure sensing elements made of PVDF films or aluminum nitride thin films, and such pressure sensing elements are not highly durable. Even if these pressure detection elements are sandwiched between protective thin resin sheets, if the pressure detection elements are repeatedly pressed by the patient's back, the pressure detection elements deteriorate early. If the thickness of the resin sheet sandwiching the pressure detection element is increased, the durability is improved to some extent, but another problem that the sensitivity of the sensor is lowered occurs. In addition, a signal line for transmitting the detected voltage to the outside is provided in such a pressure detection element, but since the pressure detection element is formed in a thin film shape, the junction between the pressure detection element and the signal line The strength of is weak and problematic. In the case of the piezoelectric sensor described in Patent Document 2, since the pressure detection element is directly placed on the patient's back to detect pressure fluctuation, the joint portion is damaged early and the signal line is disconnected. There is a high risk of losing. In addition, since aluminum nitride can generally be manufactured only in a small area, the back portion where the change in pressure can be detected becomes a small area, and depending on the portion to be contacted, the respiratory action cannot be detected reliably. . Furthermore, since the pressure received from the patient's back does not necessarily act uniformly on the piezoelectric sensor, the pressure received by the pressure detection element may be uneven, and the sensor detection accuracy may not be sufficient. . That is, depending on the position, area, etc. where the patient's back is in contact with the piezoelectric sensor, pressure fluctuations accompanying patient movement may not be detected accurately. Therefore, there is a problem in using the piezoelectric sensor described in Patent Document 2 for detecting respiration even in small increments.

The present invention has been made in view of the above-described problems. Specifically, the patient is forced to take short breaths in a short cycle, and the short-lived breathing is performed by a highly durable body motion detection sensor. A respiratory synchronization signal generation device and a respiratory synchronization signal generation device capable of detecting a signal with high accuracy, generating a respiratory synchronization signal synchronized with respiration, and transmitting the generated signal to a tomography apparatus, a radiation therapy apparatus, or the like Another object of the present invention is to provide a tomographic apparatus, a radiotherapy simulator apparatus, and a radiotherapy apparatus.

In order to achieve the above object, the present invention provides a respiratory synchronization signal generator, a trunk fixture for fixing a patient's trunk, a diaphragm compression device for pressing the lower part of the patient's season and pressing the diaphragm, and a patient A body motion detection sensor that detects body motion due to respiration as a change in pressure in contact with the body, and a controller that receives an output from the body motion detection sensor and generates a respiratory synchronization signal synchronized with respiration. The body motion detection sensor includes a hollow pressure receiving container that is flexible and has a flat sheet shape, a hollow sensor storage container that communicates with the pressure receiving container via a predetermined conduit, and a sensor. It is composed of a thin film sensor element made of PVDF, aluminum nitride, or zinc oxide stored in a storage container, and a fluid such as air or silicon oil that is hermetically or liquid-tightly sealed in these containers. The trunk fixing tool is constituted by a body frame having a predetermined shape, a vacuum pillow provided in the body frame, and a suction pump connected to the vacuum pillow via a predetermined pipe line. Since the vacuum pillow is formed of a predetermined bag having flexibility and airtightness and a predetermined amount of fine polystyrene foam filling material put in the bag, the patient is placed on the supine to lie on the inside of the bag. When air is aspirated, it can be solidified in close contact with the back and sides of the patient.

Thus, in order to achieve the above-mentioned object, the invention according to claim 1 provides a CT scanning device, a PET device, a radiation treatment simulation device, or a radiation treatment device controlled in synchronization with an input synchronization signal to a patient's treatment. A respiratory synchronization signal generation device that transmits a synchronization signal synchronized with respiration, wherein the respiratory synchronization signal generation device is provided on a bed on which a patient lies and fixes a trunk portion of the patient, A diaphragm compression tool provided in the vicinity of the abdomen of the patient, a body motion detection sensor that detects body motion due to breathing in contact with the patient, and an output from the body motion detection sensor A controller that generates a signal for respiratory synchronization that is synchronized with breathing, and the diaphragm compression device includes a support base that is installed above the abdomen of the patient, and an upper and lower part of the support base. And a compression plate provided at the tip of the drive shaft, and when the drive shaft is driven downward, the compression plate pushes the lower part of the patient's seasoning to form a diaphragm The body motion detection sensor communicates with the pressure receiving container via a predetermined pressure line and a hollow pressure receiving container that is flexible and has a flat sheet shape as a whole. A hollow sensor storage container, a thin film sensor element made of PVDF, aluminum nitride, or zinc oxide stored in the sensor storage container, and hermetically or liquid-tightly sealed in the pressure receiving container and the sensor storage container. The pressure acting on the pressure receiving container is detected by acting on the thin film sensor element via the fluid, and the pressure receiving container includes the patient and the compression plate. During or configured so as to be interposed between the patient and the body trunk fixture.

According to a second aspect of the present invention, in the respiratory synchronization signal generation device according to the first aspect, the trunk fixing tool includes a body frame having a predetermined shape including a bottom plate and a pair of side plates having a predetermined shape, A vacuum pillow provided in a body frame and comprising a predetermined bag having flexibility and airtightness and a predetermined amount of fine polystyrene foam filler contained in the bag; and a predetermined pipe line through the bag. When the patient is laid on the vacuum pillow and air is sucked by the suction pump, the vacuum pillow is in close contact with the back and sides of the patient and solidifies. Consists of.
According to a third aspect of the present invention, in the respiratory synchronization signal generating device according to the first or second aspect, the pressure receiving container and the sensor storage container are formed from the same container. Is done.
The invention according to claim 4 is the respiratory synchronization signal generation device according to any one of claims 1 to 3, wherein the fluid is a liquid made of silicon oil or mineral oil, or air or inert. It is configured to be a gas consisting of gas.
Further, the invention according to claim 5 is the respiratory synchronization signal generation device according to any one of claims 1 to 4, wherein the controller is provided with an image output terminal to which a monitor is connected, It is configured so that a respiratory waveform and a respiratory synchronization signal can be graphed and output. The invention described in claim 6 is configured as a tomographic apparatus including the respiratory synchronization signal generation device according to any one of claims 1 to 5, and the invention according to claim 7 is a claim. The radiation therapy simulation apparatus includes the respiratory synchronization signal generation apparatus according to any one of Items 1 to 5, and the invention according to Claim 8 is described in any one of Claims 1 to 5. It is comprised as a radiotherapy apparatus provided with the signal generation apparatus for respiratory synchronization.

As described above, according to the present invention, the respiratory synchronization signal generation device includes the trunk fixing device that fixes the patient's trunk, and the diaphragm compression device that presses the lower part of the patient's season to compress the diaphragm. The patient's trunk can be substantially fixed, and the patient can be forced to breathe through the thorax, i.e., chest breathing. Since chest respiration has a short cycle, tomography and treatment can be completed in a short time even if the tomography apparatus, radiotherapy apparatus, etc. are controlled in synchronization with respiration. If it does so, a patient's fatigue can be suppressed to the minimum, the operation rate of a tomography apparatus, a radiotherapy apparatus, etc. will become high, and cost can be reduced. In addition, a body motion detection sensor that detects body motion due to breathing as a change in pressure communicates with a hollow pressure receiving container that is flexible and has a generally flat sheet shape, and a pressure receiving container via a predetermined pipe line. A hollow sensor storage container, a thin film sensor element made of PVDF, aluminum nitride, or zinc oxide stored in the sensor storage container, and a pressure receiving container and the sensor storage container are hermetically or liquid-tightly sealed. The pressure acting on the pressure receiving container is detected by acting on the thin film sensor element via the fluid, so that the pressure is reliably and accurately detected via the fluid. be able to. The thin film sensor element is not subjected to direct force but pressure is applied via the fluid, so that the thin film sensor element does not deteriorate at an early stage, and the signal line connected to the thin film sensor element is not affected. Since no direct load is applied, the signal line is not disconnected and high durability is obtained. In addition, since the pressure receiving container of the body motion detection sensor is provided so as to be sandwiched between the compression plate of the patient and the diaphragm compression tool or between the patient and the trunk fixing tool, the sensor collides with the tomography apparatus. Neither does it interfere with radiation therapy. Since only the pressure receiving container is in direct contact with the patient, the sensor is not captured during tomography. Therefore, a clear tomographic image can be obtained. Further, since the thin film sensor element is stored in a sensor storage container that is a container different from the pressure receiving container that directly receives pressure, the thin film sensor element does not bend or deteriorate. Furthermore, there is no possibility that the signal line connected to the thin film sensor element is disconnected from the thin film sensor element. That is, the durability is very high.

According to another invention, the trunk fixing tool includes a body frame having a predetermined shape, a vacuum pillow provided in the body frame, and a suction pump connected to the vacuum pillow via a predetermined pipeline. Since the vacuum pillow is formed of a predetermined bag having flexibility and airtightness and a predetermined amount of fine polystyrene foam filling material put in the bag, the patient is supine on this. When the air in the bag is sucked, the patient can easily adhere to the back and sides of the patient and solidify. That is, the patient's trunk can be easily fixed. Furthermore, according to another invention in which the pressure receiving container and the sensor storage container are formed from the same container, the body motion detection sensor can be obtained at a lower cost. In addition, if the fluid sealed in the body motion detection sensor is a liquid made of silicon oil or mineral oil, the fluid is less compressible and therefore more responsive, and the fluid is made of air or an inert gas. Then, there is an effect that there is no risk of liquid leakage. Further, according to another invention, the controller is provided with a video output terminal so that a respiratory waveform and a respiratory synchronization signal can be graphed and output, so if a monitor is installed in the operator room, a tomography apparatus, An operator operating a device such as a radiotherapy device can check the patient's breathing.

BRIEF DESCRIPTION OF THE DRAWINGS It is a figure which shows typically the CT scan apparatus provided with the signal generation apparatus for respiratory synchronization which concerns on embodiment of this invention, (a) is CT with the signal generation apparatus for respiratory synchronization which concerns on embodiment of this invention The perspective view of the scanning device, (a) is a cross-sectional view taken along the line XX of (a). It is a perspective view showing typically a body movement detection sensor concerning an embodiment of the invention. BRIEF DESCRIPTION OF THE DRAWINGS It is a figure which illustrates typically the connection part of a thin film sensor element and a flat cable of the body movement detection sensor which concerns on embodiment of this invention, The (a) shows typically the flexible IC chip which is a chip | tip for a connection. FIG. 2A is a cross-sectional view showing a state where a thin film sensor element and a flat cable are connected by a flexible IC chip. It is a graph which shows the pressure fluctuation by the body motion of the respiration detected by a body motion detection sensor, and when the upper stage is doing abdominal breathing, the lower part is a chest type compulsorily by the diaphragm compression tool concerning this embodiment. It is a graph which shows each pressure fluctuation when breathing. It is a screen displayed on the monitor connected to the video output terminal of the controller of the signal generation apparatus for respiratory synchronization which concerns on embodiment of this invention. It is a perspective view which shows typically the body movement detection sensor which concerns on other embodiment of this invention.

The respiratory synchronization signal generation apparatus according to the present embodiment is connected to a tomography apparatus such as a CT scan apparatus or a PET apparatus, a radiation therapy simulator apparatus, or a radiation therapy apparatus. Hereinafter, a CT scanning apparatus including the respiratory synchronization signal generation apparatus according to the present embodiment will be described as an example.

As shown in FIG. 1A, the CT scan apparatus 1 is roughly composed of a gantry 2 that scans a human body, a bed 3 on which a patient lies, and the like, similarly to a conventionally known CT scan apparatus. . The gantry 2 has a through hole having a predetermined inner diameter into which a human body is inserted at the center thereof. That is, the opening 5 is provided. Although not shown in FIG. 1, the gantry 2 includes an X-ray source that emits X-rays and a detector array that includes a number of sensors that detect X-rays transmitted through the human body. 5 are provided at positions facing each other. Such an X-ray source and the detector array can be rotated in the circumferential direction around the opening 5 while adopting positions facing each other with the opening 5 interposed therebetween. The gantry 2 is provided with a computer that controls the gantry 2 and the bed 3 and processes data.

The bed 3 includes a pedestal 7 installed on the floor and a table 8 having a substantially rectangular plate shape provided on the pedestal 7. Although not shown in FIG. 1A, the table 8 can be slid in the longitudinal direction by a table driving mechanism provided inside the base 7. Such a bed 3 is installed adjacent to the gantry 2, and when the table driving mechanism is driven, the table 8 is inserted into the opening 5 or retracted.

In the vicinity of the opening 5 of the gantry 2,

laser positioning devices

9 and 9 are provided to mark the patient K by irradiating the laser beam with the laser beam. Has become clear. As a result, a specific part of the patient K to be tomographed can be positioned near the isocenter, and desired tomography can be performed.

The respiratory synchronization signal generation device 10 according to the present embodiment includes a trunk fixing tool 11 fixed on a table 8, a diaphragm compression tool 12 fixed to the trunk fixing tool 11, and a patient K's It comprises a body motion detection sensor 14 that detects body motion due to respiration as a change in pressure, and a controller 16 that receives a signal detected by the body motion detection sensor 14. The trunk fixing tool 11 includes a body frame 17 having a predetermined shape fixedly placed on the table 8, a vacuum pillow 18 provided in the body frame 17, and a vacuum pillow 18 through a tube 19. And a suction pump 21 connected to each other. The body frame 17 has a cross-sectional shape from a bottom plate 17a that supports the back surface of the patient K and a pair of

side plates

17b and 17b that are connected to both end surfaces of the bottom plate 17a and hold both sides of the patient K. It is formed so as to exhibit a U-shape. The vacuum pillow 18 is put inside the body frame 17, and is composed of a predetermined bag having flexibility and airtightness, and a predetermined amount of fine polystyrene foam filler put in the bag, If there is sufficient air in the bag, the expanded polystyrene filler can flow in the bag. When the patient K is laid on the vacuum pillow 18, the vacuum pillow 18 is deformed so as to be in close contact with the back and sides of the patient K. When the air in the bag is sucked by the suction pump 21, The pillow 18 is solidified in a deformed state. That is, the trunk of patient K is substantially fixed.

The diaphragm compression device 12 includes a support base 23 having a bridge shape that is installed on the upper ends of a pair of side plates 17b and b of the body frame 17, and a drive shaft 24 that is supported by the support base 23 so as to be driven in the vertical direction. And a compression plate 25 provided at the tip of the drive shaft 24. More specifically, a through hole is formed in the central top portion of the support base 23, and a female screw is formed in the through hole. A male screw is formed on the drive shaft 24 and screwed into a female screw in the through hole. A handle 26 that rotates the drive shaft 24 is fixed to the rear end of the drive shaft 24. Accordingly, when the handle 26 is rotated, the drive shaft 24 is driven in the vertical direction, and the compression plate 25 is moved up and down. The support base 23 of the diaphragm compression tool 12 can be slid in the front-rear direction with respect to the body frame 17 and can be fixed at an arbitrary position. Therefore, the slide position of the support base 23 can be finely adjusted so that the compression plate 25 is positioned above the lower part of the season of the patient K who is supine.

As shown in FIG. 2, the body motion detection sensor 14 according to the present embodiment has a sheet-like hollow container that directly contacts the patient K, that is, a pressure receiving container 28 and a sensor element. A hollow container having a predetermined size, that is, a sensor storage container 29, a thin film sensor element 31 stored in the sensor storage container 29, and the like are roughly configured. The pressure receiving container 28 is a pressure receiving part that receives a pressure that fluctuates due to the body movement of the patient K. Therefore, the pressure receiving container 28 is formed of a flexible material such as polyvinyl chloride or polypropylene. Since it is a container which protects the element 31, it does not need to have flexibility in particular. Therefore, in this embodiment, it is formed from an acrylic resin. The pressure receiving container 28 and the sensor storage container 29 are connected in a gas-tight or liquid-tight manner by a connecting pipe 32 made of a flexible material, and the respective hollow portions are communicated with each other. The thin film sensor element 31 is a thin film piezoelectric element having a predetermined size made of PVDF (polyvinylidene fluorite), aluminum nitride, or zinc oxide, and is made of aluminum nitride in the present embodiment. As will be described below, a flat cable 33 is connected to the thin film sensor element 31 via a predetermined connection chip, and a transmitter 35 is connected to the flat cable 33. Accordingly, the pressure is detected as a change in voltage by the thin film sensor element 31 and transmitted from the transmitter 35. A gas fluid 37 made of air is sealed in the body motion detection sensor 14, that is, the pressure receiving container 28, the sensor storage container 29, and the connecting pipe 32. Therefore, the pressure received in the pressure receiving container 28 acts on the thin film sensor element 31 via the gas fluid 37.

The connection between the thin cable sensor element 31 made of an aluminum nitride piezoelectric element and the flat cable 33 will be described in detail. The thin film sensor element 31 and the flat cable 33 are connected by a predetermined connecting chip, that is, a flexible IC chip 38. As shown in FIG. 3A, the flexible IC chip 38 is a flat chip having a cut 39, and the first and second

conductive wires

41, 42 made of a copper thin film are cut. The first and second

small pieces

43 and 44 of the chip divided by 39 are provided in parallel to each other. The first conducting wire 41 is provided on the front surface of the chip, and the second conducting wire 42 is provided on the back surface of the chip. A method of connecting the thin film sensor element 31 to the flat cable 33 using such a flexible IC chip 38 will be described. The thin film sensor element 31 is inserted into the cut 39 by bending the flexible IC chip 38 with the first small piece 43 downward and the second small piece 44 upward. Then, as shown in FIG. 3A, the thin film sensor element 31 can be sandwiched between the first and second

small pieces

43 and 44 of the flexible IC chip 38. The thin film sensor element 31 has a structure in which a substrate 46 made of polyimide resin and an aluminum nitride crystal layer 47 deposited thereon are covered on the upper and lower surfaces by first and

second metal films

48 and 49 made of aluminum or the like. Presents. Anisotropic

conductive adhesives

50 and 50 are applied to the first and

second metal films

48 and 49 of such a thin film sensor element 31, and the first and second

small pieces

43 and 44 of the flexible IC chip 38 are pressed. And glue. Then, the first metal film 48 and the first conducting wire 41, and the second metal film 49 and the second conducting wire 42 are brought into conduction. A predetermined connector 52 is connected to the end of the flexible IC chip 38, and the flat cable 33 is connected via the connector 52. The thin film sensor element 31 and the flat cable 33 are connected. The thin film sensor element 31 thus connected to the flat cable 33 is placed in the sensor storage container 29 as described above.

As shown in FIG. 1A, the body motion detection sensor 11 according to the present embodiment has its sensor storage container 29 and transmitter 35 fixed to a predetermined end on the side of the table 8. ing. That is, it is fixed at a position away from the patient K. Therefore, they do not interfere with tomography and do not come into direct contact with the patient K, so there is no damage or failure. On the other hand, the pressure receiving container 28 of the body motion detection sensor 11 can be arranged at an arbitrary place within a range allowed by the connecting pipe 32. Therefore, as will be described in the description of the operation, the pressure receiving container 28 can be disposed so as to be sandwiched between the abdomen of the patient K and the compression plate 25 of the diaphragm compression tool 12. Further, the pressure receiving container 28 may be disposed so as to be sandwiched between the vacuum pillow 18 and the back surface of the patient K. Since the pressure receiving container 28 can be arranged by selecting an arbitrary position of the upper body of the patient, it is possible to detect a change in body movement pressure due to the patient's breathing without being obstructed during tomography. Note that the body motion detection sensor 11 according to the present embodiment can efficiently cause pressure fluctuations to be applied to the thin film sensor element 31 by the gas fluid 37, so that the sensitivity of the sensor is maintained even if the connecting pipe 32 is relatively long. It does not decline. Therefore, the connecting pipe 32 can be set to about 3 m, for example. Then, the respiratory synchronization signal generation apparatus according to the present embodiment can be modified and the sensor storage container 29 can be installed at a place away from the bed 3. . In this case, the body motion detection sensor 11 and the controller 16 can be directly connected by a wired signal cable.

The controller 16 includes a receiver that receives a signal transmitted from the transmitter 35 connected to the body motion detection sensor 14. Since communication between the transmitter 35 and the receiver is performed by Bluetooth communication or near infrared communication, electromagnetic waves do not leak, and the CT scan apparatus 1 and medical devices installed in the vicinity may malfunction. Absent. From the received pressure change, the controller 16 generates a pulsed breathing synchronization signal synchronized with breathing by the processing of the controller 16. Since the controller 16 is connected to the synchronization signal input terminal 55 of the gantry 2 via the predetermined signal cable 54, the generated respiratory synchronization signal is input to the gantry 2. Since the controller 16 includes an open collector terminal, a TTL level line driver output terminal, a START / STOP output terminal, and an RS422 connection terminal, the signal cable 54 has an arbitrary corresponding to the synchronization signal input terminal 55 of the gantry 2. Types of cables can be selected. The controller 16 is also provided with a video output terminal that can output necessary information to an external monitor device. Although not shown in FIG. 1, the controller 16 is provided in an operator room for operating the CT scan device 1. Connected to a given monitor. The controller 16 also has a built-in microphone. In general, the CT scanning device 1 emits a predetermined warning sound that calls attention at the time of X-ray exposure, and this warning sound can be detected and taken into the controller 16 as exposure information.

The operation of the CT scan apparatus 1 including the respiratory synchronization signal generation apparatus 10 according to the present embodiment will be described. As shown in FIG. 1A, the patient K is supine on the trunk fixing tool 11 on the table 8. The support base 23 is fixed by adjusting the slide position of the support base 23 of the diaphragm compression tool 12 so that the compression plate 25 is disposed above the lower part of the patient K's season. The suction pump 21 is driven to suck the air in the vacuum pillow 18. Then, the vacuum pillow 18 is brought into close contact with the back and sides of the patient K and is solidified. As a result, the upper body of the patient K, that is, the trunk, is fixed, but the chest is open, so that breathing is maintained. The pressure receiving container 28 of the body motion detection sensor 14 is disposed between the patient K and the compression plate 25, and the handle 26 of the diaphragm compression tool 12 is rotated. Then, as shown in FIG. 1A, the drive shaft 24 is driven downward and the compression plate 25 is driven downward. The pressure receiving container 28 is sandwiched between the compression plate 25 and the patient K, and the pressure receiving container 28 can detect a change in pressure due to the body movement of the patient K. Then, the lower part of the season of the patient K is compressed with a predetermined force by the compression plate 25. Then, the diaphragm of the patient K is compressed and the abdominal breathing by the diaphragm is suppressed, and the patient K starts to breathe through the chest only. The upper part of FIG. 4 shows a graph of pressure fluctuations due to body movements of the breathing action by abdominal breathing and the lower part of the breathing action by chest breathing. On the other hand, it can be seen that chest breathing has a short cycle and shallow breathing. In response to the pressure changing in this manner in the pressure receiving container 28, the thin film sensor element 31 detects the pressure via the gas fluid 37 and converts it into a voltage. Since the area of the pressure receiving container 28 is sufficiently large, it is possible to efficiently receive the changing pressure. And since a pressure acts uniformly on the whole surface of the thin film sensor element 31 by the gas fluid 37, the change of a pressure can be detected accurately. The detected change in voltage is transmitted to the controller 16 by the transmitter 35. The controller 16 processes the waveform of the input voltage to generate a pulse signal synchronized with respiration, that is, a respiration synchronization signal. The generated respiratory synchronization signal is input to the gantry 2. By the way, the voltage waveform includes different frequency components due to breathing motion and heartbeat, and also includes noise. Therefore, a known analysis method such as Fourier transform or wavelet transform is applied to extract a frequency component corresponding to the breathing motion. Then, the timing of breathing can be obtained. Since the input power waveform contains many frequency components that change in a short time, an analysis method using wavelet transform is particularly effective. As an analysis method, for example, the Japan Society of Mechanical Engineers [No. 01-5] Dissertation of Symposium on Welfare Engineering CD-ROM [2001.8.7, Tokyo] “W301 Study on unrestrained invasive measurement of respiratory and heart rate using PVDF sensor (2nd report: Wavelet transform) The method described in “Detection of respiratory heartbeat used)” can be applied.

The table 8 is driven to insert the patient K into the opening 5 so that the site where the tomographic image is to be taken is positioned at the center of the opening 5. In synchronization with the respiratory synchronization signal input to the gantry 2, X-rays are emitted and a tomographic image is taken. At this time, since the pressure receiving container 28 of the body motion detection sensor 14 does not absorb X-rays, the container is not reflected in the tomographic image. Subsequently, the table 8 is driven to slightly insert the patient K, and a tomographic image is taken in synchronization with the respiratory synchronization signal. Thereafter, a plurality of tomographic images are taken in the same manner. In the present embodiment, the tomographic image is taken in synchronization with the short-term chest respiration, so that the tomographic imaging can be completed in a relatively short time.

On the monitor provided in the operator room, the screen output from the controller 16 is displayed, for example, as shown in FIG. The screen displays basic information such as the patient ID and patient name assigned to the patient K, and displays the respiratory waveform of the patient K along with the respiratory synchronization signal synchronized with the respiratory waveform. The Further, information exposed by the CT scanning apparatus 1, that is, exposure information and a heartbeat signal are also displayed. The operator can monitor the breathing state while observing the display on the monitor, and give an instruction to the patient K through a voice line provided in the operator room. Then, the patient K can perform an appropriate breathing motion and can appropriately capture a tomographic image. Note that a predetermined memory is also provided in the controller 16, and information displayed on the monitor is stored. Therefore, past data can also be displayed as necessary.

FIG. 5 shows a body motion detection sensor 14 ′ according to the second embodiment. Elements similar to those of the body motion detection sensor 14 according to the above-described embodiment are assigned the same reference numerals and will not be described in detail. The body motion detection sensor 14 'according to the second embodiment is formed of a pressure receiving container 28' in which the pressure receiving container and the sensor storage container are the same container. Therefore, the thin film sensor element 31 is stored in a part of the pressure receiving container 28 '. In this way, the body motion detection sensor 14 ′ can be manufactured at a lower cost. Note that the thin film sensor element 31 can be appropriately protected by providing a predetermined reinforcing member for the portion of the pressure receiving container 28 ′ in which the thin film sensor element 31 is stored.

The tomographic image apparatus according to the present embodiment can be variously modified. For example, the respiratory synchronization signal generation device may be connected to a PET device, a radiotherapy simulator device, or a radiotherapy device instead of a CT scan device, and these devices are controlled in synchronization with the respiratory synchronization signal. Can do. The body motion detection sensor 14 and the controller 16 are described as being wirelessly communicated by a transceiver, but may be directly connected by a wired signal cable as already described. In addition, although it has been described that a gas fluid made of air is sealed in the pressure receiving container and the sensor storage container of the body motion detection sensor 14, the same can be applied to an inert gas or other gases. Further, the present invention can be similarly performed even when a liquid fluid such as silicon oil or mineral oil is used instead of the gas fluid. In the case of a liquid fluid, since the thin film sensor element 31 is completely floated in the fluid in the sensor storage container 29, it is difficult for the thin film sensor element 31 to pick up noise and to detect pressure fluctuation with high accuracy. Also, since the compressibility is small, there is an advantage that the responsiveness is improved. The trunk fixture can also be modified. For example, resin beads can be applied to the vacuum pillow filler instead of polystyrene foam. It is also possible to fix the patient's trunk with a body frame and a plurality of belts. In addition, the controller 16 may be provided with a liquid crystal screen, or another monitor may be connected to the video output terminal, so that the patient K who is lying down can check the respiratory waveform.

DESCRIPTION OF SYMBOLS 1 CT scan apparatus 2 Gantry 3 Bed 5 Opening part 7 Base 8 Table 10 Signal generator for respiratory synchronization 11 Trunk fixing tool 12 Diaphragm compression tool 14 Body motion detection sensor 16 Controller 17 Body frame 18 Vacuum pillow 21 Suction pump 23 Support stand 24 Drive shaft 25 Compression plate 28 Pressure receiving container 29 Sensor storage container 31 Thin film sensor element 35 Transmitter 37 Gaseous fluid

Claims

A respiratory synchronization signal generation device that transmits a synchronization signal synchronized with patient breathing to a CT scan device, a PET device, a radiation therapy simulation device, or a radiation therapy device controlled in synchronization with an input synchronization signal. ,
The respiratory synchronization signal generating device is provided on a bed on which a patient lies and a trunk fixing device that fixes the trunk of the patient, a diaphragm compression device provided near the abdomen of the patient, and the patient A body motion detection sensor that detects body motion due to respiration as a change in pressure, and a controller that receives an output from the body motion detection sensor and generates a breath synchronization signal that is synchronized with respiration.
The diaphragm compression tool includes a support base installed above the abdomen of the patient, a drive shaft supported by the support base so as to be vertically movable, and a compression provided at a distal end of the drive shaft. And when the drive shaft is driven downward, the compression plate presses the lower part of the patient's season and presses the diaphragm,
The body motion detection sensor includes a hollow pressure receiving container that is flexible and has a flat sheet shape as a whole, a hollow sensor storage container that communicates with the pressure receiving container via a predetermined conduit, A thin film sensor element made of PVDF, aluminum nitride, or zinc oxide stored in a sensor storage container, and the pressure receiving container and a fluid hermetically or liquid-tightly sealed in the sensor storage container, A pressure acting on the pressure receiving container is detected by acting on the thin film sensor element via the fluid;
The respiratory synchronization signal generation device, wherein the pressure receiving container is provided so as to be sandwiched between the patient and the compression plate or between the patient and the trunk fixing tool.
2. The respiratory synchronization signal generation device according to claim 1, wherein the trunk fixture is provided in a body frame having a predetermined shape including a bottom plate and a pair of side plates having a predetermined shape, and is flexibly provided in the body frame. A vacuum pillow composed of a predetermined bag having heat resistance and airtightness and a predetermined amount of fine polystyrene foam filler contained in the bag, and a suction pump connected to the bag via a predetermined pipe line The vacuum pillow is configured such that when the patient is laid on the vacuum pillow and air is sucked by the suction pump, the vacuum pillow is in close contact with the back and sides of the patient and solidifies. Respiratory synchronization signal generator.
3. The respiratory synchronization signal generation apparatus according to claim 1, wherein the pressure receiving container and the sensor storage container are formed of the same container.
The respiratory synchronization signal generation device according to any one of claims 1 to 3, wherein the fluid is a liquid made of silicon oil or mineral oil, or a gas made of air or an inert gas. Respiratory synchronization signal generator.
5. The respiratory synchronization signal generation apparatus according to claim 1, wherein the controller is provided with an image output terminal to which a monitor is connected, and graphs and outputs a respiratory waveform and a respiratory synchronization signal. A respiratory synchronization signal generation device characterized by being configured to be able to perform this.
A tomography apparatus comprising the respiratory synchronization signal generation device according to any one of claims 1 to 5.
A radiation therapy simulation apparatus comprising the respiratory synchronization signal generation apparatus according to any one of claims 1 to 5.
A radiotherapy apparatus comprising the respiratory synchronization signal generation apparatus according to any one of claims 1 to 5.