JP7713260B1 - Ultrasonic therapy device - Google Patents

Abstract

An object of the present invention is to facilitate the task of aligning the position of an affected area with the focal position of therapeutic ultrasound in an ultrasonic therapy device.
[Solution] A HIFU control unit 26 executes a B-mode image generation process, a target setting process, a focal position determination process, and a display process. The B-mode image generation process is a process of causing an ultrasound probe 10 to transmit and receive imaging ultrasound, and generating B-mode image data based on a received signal output from the ultrasound probe 10. The target setting process is a process of setting an irradiation target region 50 in an image indicated by the B-mode image data. The focal position determination process is a process of determining the position of the focal point of therapeutic ultrasound. The display process is a process of displaying a focal point indicator 52 and an irradiation target region 50 on a guidance display 40 by superimposing them on a B-mode image.
[Selected Figure] Figure 1

Description

The present invention relates to an ultrasonic therapy device, and in particular to a technique for aligning the affected area with the focal point of therapeutic ultrasonic waves.

Treatment devices that use high intensity focused ultrasound are widely used. These treatment devices are called HIFU irradiation devices or HIFU irradiation systems, and irradiate the treatment area with focused ultrasound to cause necrosis of biological tissue.

In general, a HIFU irradiation device is equipped with multiple ultrasonic transducers for treatment arranged along the concave surface. The multiple ultrasonic transducers are arranged so that the ultrasonic waves emitted from each are irradiated to a single point to form a focal point. During treatment, the focal point is aligned with the treatment area and ultrasonic waves are irradiated. To confirm the irradiation position, an ultrasonic diagnostic device that shows the focus on an ultrasound image is used.

The following Patent Document 1 describes an ultrasound treatment device that observes the position of the focal point using an ultrasound diagnostic device that displays B-mode images (tomographic images). In this device, a therapeutic ultrasound transducer emits low-level ultrasound that does not affect tissue, and an ultrasound imaging probe transmits and receives ultrasound to display a tomographic image. Since the acoustic properties of the patient's tissue change in response to changes in the tissue's temperature, the position of the focal point is indicated in the tomographic image by changes in brightness. Also, as shown in Non-Patent Document 1, the irradiation of the patient's tissue with ultrasound causes displacement, and therefore the position of the focal point is indicated in the tomographic image by changes in brightness.

Japanese Patent Application Publication No. 8-71069

Tissue hardness measurement using ARFI Internet <https://www.innervision.co.jp/sp/ad/suite/siemens/technical_notes/140368>

The affected area of a patient moves with the patient's breathing. However, in treatment using high-intensity focused ultrasound, the patient must stop breathing once the affected area has been aligned with the focal position of the therapeutic ultrasound. With conventional technology, it was sometimes difficult for the patient to stop breathing so that the affected area could be aligned with the focal position.

The object of the present invention is to make it easier to align the affected area with the focal point of therapeutic ultrasound in an ultrasound therapy device.

The present invention includes a therapeutic ultrasound radiator that transmits ultrasound so as to form a focus in biological tissue, an ultrasound probe, a control unit that controls the therapeutic ultrasound radiator and the ultrasound probe, and a guidance display. The control unit causes the ultrasound probe to transmit and receive imaging ultrasound, and executes a B-mode image generation process that generates B-mode image data based on a reception signal output from the ultrasound probe, a target setting process that sets an irradiation target area in an image represented by the B-mode image data, a focus position determination process that determines the position of the focus in the image represented by the B-mode image data, and a display process that displays a focus indicator that indicates the focus and the irradiation target area on the guidance display by superimposing them on the image represented by the B-mode image data. The B-mode image generation process sequentially generates the B-mode image data over time. the target setting process includes a process of tracking the irradiation target area based on the B-mode image data generated sequentially over time, and the display process includes a process of superimposing a focus indicator indicating the focus and the tracked irradiation target area on each image indicated by the B-mode image data generated sequentially over time and displaying them on the guidance display in real time , the target setting process includes a process of predicting a position of the irradiation target area after a predetermined predicted time based on the B-mode image data generated sequentially over time, and the display process includes a process of superimposing a focus indicator indicating the focus and a predicted area indicating the irradiation target area after the predicted time, together with the tracked irradiation target area, on each image indicated by the B-mode image data generated sequentially over time and displaying them on the guidance display sequentially .

The present invention also provides a therapeutic ultrasound radiation unit that transmits ultrasound so that a focus is formed in biological tissue, an ultrasound probe, a control unit that controls the therapeutic ultrasound radiation unit and the ultrasound probe, and a guidance display. The control unit causes the ultrasound probe to transmit and receive imaging ultrasound, and performs a B-mode image generation process that generates B-mode image data based on a received signal output from the ultrasound probe, a target setting process that sets an irradiation target area in an image indicated by the B-mode image data, a focus position determination process that determines the position of the focus, and a display process that displays a focus indicator indicating the focus and the irradiation target area on the guidance display by superimposing the focus indicator and the irradiation target area on the image indicated by the B-mode image data, the B-mode image generation process includes a process of generating the B-mode image data sequentially over time, the target setting process includes a process of predicting the position of the irradiation target area after a predetermined prediction time based on the B-mode image data sequentially generated over time, and the display process includes a process of superimposing the focus indicator indicating the focus and the predicted area indicating the irradiation target area after the predicted time on each image indicated by the B-mode image data sequentially generated over time, and sequentially displaying the focus indicator indicating the focus and the predicted area indicating the irradiation target area after the predicted time on the guidance display.

In one embodiment, the therapeutic ultrasound emission unit includes a plurality of ultrasound transducers, and the control unit determines the position of the focal point based on a control state determined according to the delay time of the ultrasound emitted by each of the ultrasound transducers .

The present invention also provides a therapeutic ultrasound radiation unit that transmits ultrasound so that a focus is formed in biological tissue, an ultrasound probe, a control unit that controls the therapeutic ultrasound radiation unit and the ultrasound probe, and a guidance display. The control unit causes the ultrasound probe to transmit and receive imaging ultrasound, and performs a B-mode image generation process that generates B-mode image data based on a received signal output from the ultrasound probe, a target setting process that sets an irradiation target area in an image indicated by the B-mode image data, a focus position determination process that determines the position of the focus in the image indicated by the B-mode image data, and a display process that displays a focus indicator indicating the focus and the irradiation target area on the guidance display by superimposing them on the image indicated by the B-mode image data. The therapeutic ultrasound radiation unit includes a plurality of ultrasound transducers, and the control unit determines the position of the focus based on a control state determined according to the delay time of the ultrasound emitted by each of the ultrasound transducers . The display process includes a process of sequentially displaying an irradiation target viewer in which the position of the irradiation target area is projected onto a band-shaped figure, together with each image indicated by the B-mode image data that is sequentially generated over time, on the guidance display . In one embodiment, when executing the focal position determination process, the control unit executes a transmission process that causes the therapeutic ultrasound emission unit to transmit ultrasound that is weaker than that used during treatment, and determines the position of the focal point based on the B-mode image data.

In one embodiment, the display process includes a process of sequentially displaying, on the guidance display, an irradiation target viewer in which the position of the irradiation target area is projected onto a band- shaped figure, together with each image represented by the B-mode image data sequentially generated over time.

The present invention makes it easier to align the affected area with the focal point of therapeutic ultrasound in an ultrasound treatment device.

FIG. 1 is a diagram showing the configuration of a HIFU irradiation device. FIG. 13 is a diagram showing an example of a positioning image. FIG. 13 is a diagram showing an example of a positioning image. FIG. 13 is a diagram showing an example of a positioning image. 1 is a flowchart illustrating an example of a process executed by a HIFU irradiation device. FIG. 13 illustrates an example of an illumination target viewer. FIG. 13 illustrates an example of an illumination target viewer. FIG. 13 is a diagram showing an example of a predicted positioning image. FIG. 13 is a diagram showing an example of a predicted positioning image. FIG. 13 is a diagram showing an example of a predicted positioning image in which the trajectory of an irradiation target area is depicted. FIG. 13 is a diagram showing an example of a predicted positioning image in which the trajectory of an irradiation target area is depicted. 1 is a flowchart illustrating an example of a process executed by a HIFU irradiation device.

An embodiment of the present invention will be described with reference to each drawing. The same components shown in multiple drawings are given the same reference numerals to simplify the description. FIG. 1 shows the configuration of a HIFU irradiation device 100 (ultrasonic treatment device) according to an embodiment of the present invention. The HIFU irradiation device 100 includes an ultrasonic probe 10, a therapeutic ultrasonic radiation unit 12, a coupling bag 14, a robot arm 18, a controller 22, a practitioner display 24, and a guide display 40. In FIG. 1, a surface (observation target surface) on which an ultrasonic image such as a B-mode image is to be observed in a patient 30 is a surface parallel to the yz coordinate plane, and a coordinate axis perpendicular to the yz coordinate plane is the x-axis.

The therapeutic ultrasound emitting unit 12 includes a transducer housing 16 having a concave surface 8 with an opening facing downward, and a plurality of ultrasound transducers 36 arranged along the concave surface 8 in the transducer housing 16 and fixed to the transducer housing 16. The therapeutic ultrasound emitting unit 12 does not necessarily have to have an actual concave surface 8. In this case, the plurality of ultrasound transducers 36 may be fixed to the transducer housing 16 so as to be arranged along a virtual concave surface 8.

The concave surface 8 of the transducer housing 16 may have a shape similar to the side of a pyramid. Here, a pyramid refers to a three-dimensional shape formed by a collection of straight lines extending from a point in space to the bottom surface. The concave surface 8 of the transducer housing 16 may also have a dome-like bulge on the upper side. Each ultrasonic transducer 36 is fixed to the transducer housing 16 so that when each ultrasonic transducer 36 emits ultrasound, the intensities of the ultrasound waves are mutually enhanced at the focal point F in the biological tissue below the transducer housing 16.

The ultrasonic probe 10 is attached to the transducer housing 16 so that ultrasonic waves are transmitted and received at a position below the transducer housing 16 and above the focal point F. In this embodiment, the ultrasonic probe 10 passes through the apex of the transducer housing 16 in the vertical direction, and the probe tip 32 that transmits and receives ultrasonic waves is directed downward. The ultrasonic probe 10 has directionality, and ultrasonic waves are transmitted and received on an observation surface that faces in a direction according to the structure of the ultrasonic probe 10. The ultrasonic probe 10 may be movable in the vertical direction. The ultrasonic probe 10 may also be rotatable around a longitudinal axis.

Below the therapeutic ultrasound emission unit 12, a coupling bag 14 is provided to match the acoustic impedance between each ultrasound transducer 36 and the patient 30, and between the ultrasound probe 10 and the patient 30. The coupling bag 14 may be a bag filled with a liquid such as water. The coupling bag 14 holds the liquid between the ultrasound probe 10 and the patient 30. The coupling bag 14 may be formed of a material that transmits light, and may be transparent or translucent.

The ultrasound probe 10, the therapeutic ultrasound emitting unit 12, and the coupling bag 14 are attached to the tip of a robot arm 18 that serves as a transport mechanism. The robot arm 18 is composed of multiple arms 18a connected by joints 18b, and is attached to the housing of a controller 22 via the joints 18b. Each arm 18a swings around the joint 18b as the axis of rotation, causing the robot arm 18 to transport the movable body 20, which includes the ultrasound probe 10, the therapeutic ultrasound emitting unit 12, and the coupling bag 14, in three directions: the x-axis, y-axis, and z-axis.

The controller 22 includes a HIFU control unit 26, an operating device 42, and a robot control unit 28. The HIFU control unit 26 includes a computer, an electric circuit for controlling the ultrasound probe 10, and an electric circuit for controlling the therapeutic ultrasound emission unit 12. The computer included in the HIFU control unit 26 may be a business computer, a personal computer, a tablet computer, or the like. The computer executes a program to perform a process for generating each image and a process for displaying each image. The HIFU control unit 26 is connected to an operating device 42 that allows the practitioner (user) to operate the HIFU irradiation device 100. The operating device 42 may include a mouse, a touch panel integrated with the practitioner display 24, a switch, a keyboard, or the like.

The HIFU control unit 26 executes processing for operating the ultrasound probe 10 and the therapeutic ultrasound emission unit 12. For example, the HIFU control unit 26 causes the ultrasound probe 10 to transmit and receive imaging ultrasound for image generation. The HIFU control unit 26 generates B-mode image data based on a reception signal based on the imaging ultrasound received by the ultrasound probe 10, and causes the practitioner display 24 to display a B-mode image. The HIFU control unit 26 also causes each ultrasound transducer 36 provided in the therapeutic ultrasound emission unit 12 to transmit therapeutic ultrasound. The practitioner display 24 and the guidance display 40 described below may be a display device such as a liquid crystal panel or an organic EL panel, or a portable information processing device such as a tablet computer equipped with a display function.

The robot control unit 28 may control the robot arm 18 in response to the control of the HIFU control unit 26, and cause the robot arm 18 to transport the movable body 20. The robot control unit 28 may also include a robot arm operation device 44 such as a lever or button for operating the robot arm 18. In this case, the robot control unit 28 may control the robot arm 18 in response to the operation of the robot arm operation device 44 by the practitioner.

Before therapeutic ultrasound is irradiated from the therapeutic ultrasound emission unit 12 to the patient 30, the following positioning process is performed. The position and orientation of the ultrasound probe 10 are set so that the observation surface of the ultrasound probe 10 coincides with the observation surface of the patient 30. The HIFU control unit 26 causes the ultrasound probe 10 to repeatedly scan the observation surface of the patient 30 with an ultrasound beam, and generates B-mode image data every time the scan is performed a predetermined number of times (for example, every time it is performed once). In this way, the HIFU control unit 26 sequentially generates B-mode image data over time.

The HIFU control unit 26 displays positioning images on the practitioner display 24 and the guidance display 40 based on the B-mode image data generated sequentially over time. The positioning images are images that show the irradiation target area and the focus indicator superimposed on the B-mode image in real time. The irradiation target area indicates the area occupied by the affected area, and the focus indicator indicates the planned position of the focus of the therapeutic ultrasound.

Examples of positioning images are shown in Figures 2A to 2C. The positioning images shown in Figures 2A to 2C are displayed on the practitioner display 24 and the guidance display 40 at different times. The area indicated by diagonal lines in each figure is the irradiation target area 50. The figure indicated in white is the focus indicator 52, which indicates the focus. The area sandwiched between the dashed line extending diagonally upward to the right from the focus indicator 52 and the dashed line extending diagonally upward to the left from the focus indicator 52 corresponds to the area through which therapeutic ultrasound propagates. These dashed lines do not necessarily have to be displayed. The detailed process of displaying the irradiation target area 50 and the focus indicator 52 will be described later.

The irradiation target area 50 fluctuates due to the patient's respiratory movement. FIG. 2A shows a positioning image when the patient is inhaling, and FIG. 2C shows a positioning image when the patient is exhaling. FIG. 2B shows a positioning image in a transition state in which the patient is transitioning from an inhalation state to an exhalation state.

The HIFU control unit 26 changes the display mode of the focus indicator 52 when the irradiation target area 50 and the focus indicator 52 overlap. When the irradiation target area 50 and the focus indicator 52 overlap, either one may be displayed in front.

In the example shown in FIG. 2B, the HIFU control unit 26 changes the color of the focus indicator 52 when the irradiation target area 50 and the focus indicator 52 overlap. The HIFU control unit 26 may change the display mode by, for example, increasing the brightness of the focus indicator 52 when the irradiation target area 50 and the focus indicator 52 overlap.

During treatment, the practitioner controls the robot arm 18 using the robot arm operation device 44 and adjusts the position of the therapeutic ultrasound emission unit 12 so that the focus indicator 52 is located on the trajectory of the irradiation target area 50, which moves with the patient's breathing. When the focus indicator 52 is not located on the trajectory of the irradiation target area 50, the practitioner operates the robot arm 18 by operating the robot arm operation device 44 to change the position or posture of the ultrasound probe 10 and the therapeutic ultrasound emission unit 12. After confirming that the focus indicator 52 is located on the trajectory of the irradiation target area 50, the practitioner continues the positioning process.

After positioning the focus indicator 52 on the trajectory of the irradiation target area 50, the practitioner instructs the patient 30 to refer to the positioning image displayed on the guidance display 40. The practitioner also instructs the patient 30 to check the positions of the irradiation target area 50 and the focus indicator 52 displayed in the positioning image. The practitioner further instructs the patient 30 to stop breathing when the irradiation target area 50, which moves with breathing, and the focus indicator 52 overlap.

With the patient 30 holding his/her breath so that the irradiation target area 50 and the focus indicator 52 overlap, the practitioner operates the operating device 42 to cause the therapeutic ultrasound emitter 12 to transmit therapeutic ultrasound. This causes the affected area at the focus to be irradiated with therapeutic ultrasound, cauterizing the affected area.

As described above, the HIFU irradiation device 100 according to an embodiment of the present invention is an ultrasonic treatment device that includes a HIFU control unit 26 that performs the following processes as a control unit. That is, the HIFU control unit 26 performs B-mode image generation processing, target setting processing, focal position determination processing, and display processing.

The B-mode image generation process is a process in which the ultrasound probe 10 transmits and receives imaging ultrasound, and generates B-mode image data based on the received signal output from the ultrasound probe 10. The target setting process is a process in which an irradiation target area 50 is set in the image represented by the B-mode image data. The focal position determination process is a process in which the position of the focal point is determined. The display process is a process in which a focal point indicator 52 indicating the focal point and the irradiation target area 50 are displayed on the guidance display 40, superimposed on the image represented by the B-mode image data.

By displaying a positioning image in which the irradiation target area 50 and focus indicator 52 are superimposed on the B-mode image on the guidance display 40 and having the patient 30 refer to it, it becomes easier for the patient 30 to hold their breath at the appropriate time. This makes the positioning process easier and reduces the burden on the patient 30 during treatment.

A specific example of the process of drawing the irradiation target area 50 and the focus indicator 52 will be described. Before treatment is started, the HIFU irradiation device 100 is in a state where a B-mode image is displayed on the practitioner display 24. This B-mode image may be a still image that is not updated over time, or may be a real-time image that is updated over time.

In this state, the practitioner operates the operation device 42 connected to the HIFU control unit 26 to set the irradiation target area 50 on the B-mode image displayed on the practitioner display 24. The irradiation target area 50 may be set by drawing a curve surrounding the irradiation target area 50 that appears in the B-mode image, or by applying a pattern to the irradiation target area 50. The HIFU control unit 26 generates irradiation target data that shows an image of the irradiation target area 50.

The HIFU control unit 26 may generate irradiation target data based on a template matching process for the B-mode image data, regardless of the operation of the practitioner. In this case, the HIFU control unit 26 stores the template image data in advance. For example, the HIFU control unit 26 executes a correlation calculation between the B-mode image indicated by the B-mode image data and the template image indicated by the template image data, while changing the positional relationship between the B-mode image and the template image and the enlargement/reduction ratio of the template image. The HIFU control unit 26 recognizes the irradiation target area 50 based on the positional relationship between the B-mode image and the template image and the enlargement/reduction ratio of the template image when the correlation value obtained by the correlation calculation exceeds a predetermined threshold and becomes maximum. The HIFU control unit 26 may perform a correlation calculation for a plurality of template images having different characteristics of the affected area, and generate irradiation target data for affected areas having various characteristics.

The process of the HIFU control unit 26 displaying the positioning image on the practitioner display 24 and the guidance display 40 will be described. The HIFU control unit 26 tracks and displays the irradiation target area 50 in the real-time positioning image based on the irradiation target data. That is, the HIFU control unit 26 tracks an area that is highly similar to the image indicated by the irradiation target data in each B-mode image indicated by the B-mode image data generated sequentially over time. Here, tracking refers to a process of identifying the position of an area that is highly similar to the image indicated by the irradiation target data on each B-mode image. The area that is highly similar may be, for example, an area where the correlation value with the image indicated by the irradiation target data exceeds a predetermined threshold value or is maximized.

The HIFU control unit 26 displays the focus indicator 52 and an image in which the irradiation target area 50 tracked on each B-mode image is superimposed on each B-mode image as a positioning image on the practitioner display 24 and the guidance display 40.

The display position of the focus indicator 52 is determined by the control state of each ultrasound transducer 36 provided in the therapeutic ultrasound emission unit 12. The control state of each ultrasound transducer 36 is determined, for example, according to the delay time of the ultrasound emitted by each ultrasound transducer 36. Therefore, the HIFU control unit 26 may determine the position of the focus based on the control state of the therapeutic ultrasound emission unit 12, and determine the display position of the focus indicator 52.

The display position of the focus indicator 52 may be determined as follows. That is, the HIFU control unit 26 may execute a transmission process to cause the therapeutic ultrasound emitter 12 to transmit ultrasound waves weaker than those used during treatment, and the HIFU control unit 26 may determine the position at which a change in brightness appears on the B-mode image as the display position of the focus indicator 52. In this case, when executing the above-mentioned focus position determination process, the HIFU control unit 26 may execute a transmission process to cause the therapeutic ultrasound emitter 12 to transmit ultrasound waves weaker than those used during treatment, and execute a process to determine the position of the focus that appears in the image indicated by the B-mode image data.

Figure 3 shows a flowchart showing an example of processing executed by the HIFU irradiation device 100 from the start of the positioning process to the end of treatment. The HIFU control unit 26 sets the irradiation target area 50 on the B-mode image displayed on the practitioner display 24 in accordance with the operation of the practitioner (S101). The HIFU control unit 26 tracks and displays the irradiation target area 50 in the positioning image (S102). The following steps S103 to S105 are executed sequentially over time while the positioning image is displayed.

The HIFU control unit 26 calculates the judgment distance between the position of the irradiation target area 50 and the position of the focus indicator 52 for the positioning images displayed sequentially over time (S103). Here, the position of the irradiation target area 50 may be a representative point that is predetermined in the irradiation target area 50. This representative point may be, for example, the center of gravity of the irradiation target area 50.

When the judgment distance is equal to or less than a predetermined threshold, the HIFU control unit 26 displays a message on the practitioner display 24 indicating that therapeutic ultrasound can be emitted, and changes the display mode of the focus indicator 52 displayed on the practitioner display 24 and the guidance display 40 (S104).

The HIFU control unit 26 determines whether or not a treatment operation for irradiating therapeutic ultrasound has been performed by the practitioner (S105). If no treatment operation has been performed, the HIFU control unit 26 returns to the process of step S102. On the other hand, if a treatment operation has been performed, the HIFU control unit 26 causes the therapeutic ultrasound emission unit 12 to transmit therapeutic ultrasound (S106) and executes the treatment.

The HIFU control unit 26 may display an irradiation target viewer, in which the position of the irradiation target region 50 is projected on a straight line, on the guidance display 40 together with the positioning image. An example of an irradiation target viewer 60 is shown in FIG. 4A and FIG. 4B. The irradiation target viewer 60 is composed of a respiratory phase presentation bar 62 and an irradiation target indicator 64. The respiratory phase presentation bar 62 is a strip-shaped figure extending horizontally on the display screen of the guidance display 40. The irradiation target viewer 60 may be displayed superimposed on the positioning image, or may be displayed next to the positioning image. The irradiation target indicator 64 moves left and right along the respiratory phase presentation bar 62 as the irradiation target region 50 moves.

The position of the right end of the respiratory phase presentation bar 62 corresponds to the position on the positioning image when the irradiation target area 50 is in the exhalation phase position (the position when the patient is exhaling) in the positioning image. The position of the left end of the respiratory phase presentation bar 62 corresponds to the position on the positioning image when the irradiation target area 50 is in the inhalation phase position (the position when the patient is inhaling) in the positioning image. The position of the horizontal axis coordinate on the respiratory phase presentation bar 62 is normalized so that the length between the exhalation phase position and the inhalation phase position corresponds to the length of the respiratory phase presentation bar 62. The position of the right end of the respiratory phase presentation bar 62 may correspond to the average value of the H-axis coordinate value when the irradiation target area 50 has reached the exhalation phase position for a predetermined number of times, including the time when the irradiation target area 50 last reached the exhalation phase position, going back from the time when the irradiation target area 50 last reached the exhalation phase position. Here, the H-axis is a coordinate axis defined in the positioning image with the right direction being positive. Similarly, the inhalation phase position may be associated with the average value of the H-axis coordinate values when the irradiation target region 50 reaches the inhalation phase position a predetermined number of times, going back from the last time the irradiation target region 50 reached the inhalation phase position to the last time the irradiation target region 50 reached the inhalation phase position. The respiratory phase presentation bar 62 shows a focus mark 66 corresponding to the position of the focus.

FIG. 4B shows an example of the irradiation target viewer 60 when the irradiation target area 50 and the focus indicator 52 overlap in the positioning image. When the irradiation target area 50 and the focus indicator 52 overlap, the irradiation target indicator 64 is displayed in a highlighted manner compared to when the irradiation target area 50 and the focus indicator 52 do not overlap. In the example shown in FIG. 4B, when the irradiation target area 50 and the focus indicator 52 overlap, the irradiation target indicator 64 is displayed larger compared to when the irradiation target area 50 and the focus indicator 52 do not overlap. Note that the highlighting of the irradiation target indicator 64 may be performed by changing the color or brightness.

In the above, an embodiment has been shown in which a positioning image showing the irradiation target area 50 and the focus indicator 52 in real time is displayed. In addition to such a positioning image, a predicted positioning image may be displayed which sequentially shows the predicted area 70 predicted as the irradiation target area 50 a predetermined predicted time T later, the irradiation target area 50, and the focus indicator 52 over time.

Examples of predicted positioning images are shown in Figures 5A and 5B. Figure 5A shows a predicted positioning image when the patient is exhaling, and Figure 5B shows a predicted positioning image in a transition state in which the patient is inhaling from an exhaling state. The area surrounded by dashed lines in Figures 5A and 5B is a predicted area 70 for the irradiation target area 50.

The HIFU control unit 26 sequentially generates B-mode image data over time, and determines the position and range of the predicted region 70 a predicted time T after the latest B-mode image data was generated based on past B-mode image data sequentially generated over time. The predicted region 70 may be determined by applying an estimation algorithm such as a Kalman filter to the past B-mode image data. The predicted time T is, for example, 0.3 to 2 seconds, and preferably 0.5 to 1.5 seconds.

The HIFU control unit 26 generates predicted image data showing predicted positioning images sequentially over time. The predicted positioning images are images in which the irradiation target area 50, predicted area 70, and focus indicator 52 are superimposed on a B-mode image. The HIFU control unit 26 causes the practitioner display 24 and the guidance display 40 to display the predicted positioning images sequentially over time based on the predicted image data generated sequentially over time.

The irradiation target area 50 and the predicted area 70 shown on the B-mode image on the practitioner display 24 and the guidance display 40 move in sequence over time in accordance with the patient's breathing. When at least one of the irradiation target area 50 and the predicted area 70 overlaps with the focus indicator 52, the HIFU control unit 26 may change the display mode of the focus indicator 52, such as the color, brightness, size, etc.

Depending on the location of the affected area on the patient, it may be difficult to stop breathing when the current irradiation target area 50 and the focus indicator 52 overlap. For example, if the patient begins to stop breathing when he or she visually confirms that the current irradiation target area 50 and the focus indicator 52 overlap, breathing may stop when the irradiation target area 50 passes the position of the focus indicator 52. In this case, the practitioner instructs the patient to stop breathing when the predicted area 70 and the focus indicator 52 overlap. This increases the likelihood that breathing will be stopped when the irradiation target area 50 and the focus indicator 52 overlap.

The HIFU control unit 26 may display the past trajectory and future trajectory of the irradiation target region 50 on the predicted positioning images that are displayed sequentially over time. Examples of predicted positioning images displaying the past trajectory and future trajectory of the irradiation target region 50 are shown in Figs. 6A and 6B. Fig. 6A shows a predicted positioning image in a state where the patient is exhaling, and Fig. 6B shows a predicted positioning image in a transition state in the middle of the patient's inhaling state from an exhaling state. The past trajectory of the irradiation target region 50 is displayed based on previously generated B-mode image data. In addition, the past trajectory of the irradiation target region 50 is displayed by applying an estimation algorithm such as a Kalman filter to previously generated B-mode image data.

In Figures 6A and 6B, the three curved lines extending horizontally and aligned vertically on the left side of the irradiation target area 50 represent the past trajectory of the irradiation target area 50. The three curved lines extending horizontally and aligned vertically on the right side of the irradiation target area 50 represent the future trajectory of the irradiation target area 50. The three curved lines extending horizontally and aligned vertically superimposed on the irradiation target area 50 represent the immediate past and immediate future trajectories of the irradiation target area 50. Note that the immediate past or immediate future trajectories of the irradiation target area 50 do not have to be displayed.

In this way, the trajectory of the irradiation target area 50 is displayed, making it easier for the patient and the practitioner to hold their breath and align the irradiation target area 50 with the focus indicator 52.

FIG. 7 shows a flowchart showing the flow of processing executed by the HIFU irradiation device 100. The HIFU control unit 26 sets the irradiation target region 50 on the B-mode image displayed on the practitioner display 24 in accordance with the practitioner's operation (S201). The HIFU control unit 26 tracks and displays the irradiation target region 50 in the predicted positioning image (S202). The HIFU control unit 26 also estimates a predicted region 70 in the positioning image, and further displays the predicted region 70 in the predicted positioning image that tracks and displays the irradiation target region 50 (S203). The following steps S204 to S206 are executed sequentially over time while the predicted positioning image is being displayed.

The HIFU control unit 26 calculates the judgment distance between the position of the prediction region 70 and the position of the focus indicator 52 for the predicted positioning images that are displayed sequentially over time (S204). Here, the position of the prediction region 70 may be a representative point that is predetermined in the prediction region 70. This representative point may be, for example, the center of gravity of the prediction region 70.

When the judgment distance is equal to or less than a predetermined threshold, the HIFU control unit 26 displays a message on the practitioner display 24 indicating that therapeutic ultrasound can be emitted, and changes the display mode of the focus indicator 52 displayed on the practitioner display 24 and the guidance display 40 (S205).

The HIFU control unit 26 determines whether or not a treatment operation for irradiating therapeutic ultrasound has been performed by the practitioner (S206). If no treatment operation has been performed, the HIFU control unit 26 returns to the process of step S202. On the other hand, if a treatment operation has been performed, the HIFU control unit 26 causes the therapeutic ultrasound emission unit 12 to transmit therapeutic ultrasound (S207) and executes the treatment.

8 concave surface, 10 ultrasound probe, 12 therapeutic ultrasound radiation unit, 14 coupling bag, 16 transducer housing, 18 robot arm, 18a arm, 18b joint, 20 movable body, 22 controller, 24 practitioner display, 26 HIFU control unit, 28 robot control unit, 30 patient, 32 probe tip, 36 ultrasound transducer, 40 guide display, 42 operation device, 44 robot arm operation device, 50 irradiation target area, 52 focus indicator, 60 irradiation target viewer, 62 respiratory phase display bar, 64 irradiation target indicator, 66 focus mark, 70 prediction area, 100 HIFU irradiation device.

Claims (7)

a therapeutic ultrasound radiation unit that transmits ultrasound so as to form a focus on biological tissue;
An ultrasonic probe;
a control unit for controlling the therapeutic ultrasound emitting unit and the ultrasound probe;
A guide display,
The control unit is
a B-mode image generating process for transmitting and receiving imaging ultrasonic waves to the ultrasonic probe and generating B-mode image data based on a reception signal output from the ultrasonic probe;
A target setting process for setting an irradiation target area in an image represented by the B-mode image data;
a focus position determination process for determining a position of the focus in an image represented by the B-mode image data;
a display process of displaying a focus indicator indicating the focus and the irradiation target area on the guidance display device by superimposing the focus indicator and the irradiation target area on an image indicated by the B-mode image data;
Run
The B-mode image generation process includes:
generating the B-mode image data sequentially over time;
The goal setting process includes:
A process of tracking the irradiation target area based on the B-mode image data sequentially generated over time,
The display process includes:
a process of superimposing a focus indicator indicating the focus and the tracked irradiation target area on each image indicated by the B-mode image data sequentially generated over time and displaying the focus indicator and the tracked irradiation target area on the guidance display in real time;
The goal setting process includes:
A process of predicting a position of the irradiation target area after a predetermined prediction time based on the B-mode image data sequentially generated over time,
The display process includes:
An ultrasonic treatment device characterized by including a process of sequentially displaying on the guidance display a focus indicator indicating the focus and a predicted area indicating the irradiation target area after the predicted time, together with the tracked irradiation target area, superimposed on each image indicated by the B-mode image data generated sequentially over time . a therapeutic ultrasound radiation unit that transmits ultrasound so as to form a focus on biological tissue;
An ultrasonic probe;
a control unit for controlling the therapeutic ultrasound emitting unit and the ultrasound probe;
A guide display,
The control unit is
a B-mode image generating process for transmitting and receiving imaging ultrasonic waves to the ultrasonic probe and generating B-mode image data based on a reception signal output from the ultrasonic probe;
A target setting process for setting an irradiation target area in an image represented by the B-mode image data;
a focus position determination process for determining a position of the focus in an image represented by the B-mode image data;
a display process of displaying a focus indicator indicating the focus and the irradiation target area on the guidance display device by superimposing the focus indicator and the irradiation target area on an image indicated by the B-mode image data;
Run
The B-mode image generation process includes:
generating the B-mode image data sequentially over time;
The goal setting process includes:
A process of tracking the irradiation target area based on the B-mode image data sequentially generated over time,
The display process includes:
a process of superimposing a focus indicator indicating the focus and the tracked irradiation target area on each image indicated by the B-mode image data sequentially generated over time and displaying the focus indicator and the tracked irradiation target area on the guidance display in real time;
The display process includes:
An ultrasonic treatment device characterized by including a process of sequentially displaying, on the guidance display, an irradiation target viewer in which the position of the irradiation target area is projected onto a band-shaped figure, together with each image represented by the B-mode image data generated sequentially over time. a therapeutic ultrasound radiation unit that transmits ultrasound so as to form a focus on biological tissue;
An ultrasonic probe;
a control unit for controlling the therapeutic ultrasound emitting unit and the ultrasound probe;
A guide display,
The control unit is
a B-mode image generating process for transmitting and receiving imaging ultrasonic waves to the ultrasonic probe and generating B-mode image data based on a reception signal output from the ultrasonic probe;
A target setting process for setting an irradiation target area in an image represented by the B-mode image data;
A focus position determination process for determining the position of the focus;
a display process of displaying a focus indicator indicating the focus and the irradiation target area on the guidance display device by superimposing the focus indicator and the irradiation target area on an image indicated by the B-mode image data;
Run
The B-mode image generation process includes:
generating the B-mode image data sequentially over time;
The goal setting process includes:
A process of predicting a position of the irradiation target area after a predetermined prediction time based on the B-mode image data sequentially generated over time,
The display process includes:
An ultrasonic treatment device characterized by including a process of superimposing a focus indicator indicating the focus and a predicted area indicating the irradiation target area after the predicted time on each image indicated by the B-mode image data generated sequentially over time, and displaying them sequentially on the guidance display. The ultrasonic treatment device according to any one of claims 1 to 3,
The therapeutic ultrasound radiation unit includes:
A plurality of ultrasonic transducers are provided.
The control unit is
An ultrasonic treatment device characterized in that the position of the focus is determined based on a control state determined according to the delay time of the ultrasonic waves emitted by each of the ultrasonic transducers. a therapeutic ultrasound radiation unit that transmits ultrasound so as to form a focus on biological tissue;
An ultrasonic probe;
a control unit for controlling the therapeutic ultrasound emitting unit and the ultrasound probe;
A guide display,
The control unit is
a B-mode image generating process for transmitting and receiving imaging ultrasonic waves to the ultrasonic probe and generating B-mode image data based on a reception signal output from the ultrasonic probe;
A target setting process for setting an irradiation target area in an image represented by the B-mode image data;
a focus position determination process for determining a position of the focus in an image represented by the B-mode image data;
a display process of displaying a focus indicator indicating the focus and the irradiation target area on the guidance display device by superimposing the focus indicator and the irradiation target area on an image indicated by the B-mode image data;
Run
The therapeutic ultrasound radiation unit includes:
A plurality of ultrasonic transducers are provided.
The control unit is
The position of the focus is obtained based on a control state determined according to a delay time of the ultrasonic waves emitted by each of the ultrasonic transducers ;
The display process includes:
An ultrasonic treatment device characterized by including a process of sequentially displaying, on the guidance display, an irradiation target viewer in which the position of the irradiation target area is projected onto a band-shaped figure, together with each image represented by the B-mode image data generated sequentially over time . The ultrasonic treatment device according to any one of claims 1 to 3 ,
The control unit is
An ultrasonic treatment device characterized in that, when performing the focal position determination process, a transmission process is performed in which ultrasonic waves weaker than those used during treatment are transmitted to the therapeutic ultrasonic radiation unit, and the position of the focal point is determined based on the B-mode image data. The ultrasonic treatment device according to claim 1 or 3 ,
The display process includes:
An ultrasonic treatment device characterized by including a process of sequentially displaying, on the guidance display, an irradiation target viewer in which the position of the irradiation target area is projected onto a band-shaped figure , together with each image represented by the B-mode image data generated sequentially over time.