System and method of hybrid surface radiotherapy with ultrasound control
SUBSTANCE: system for radiation treatment of affected skin areas contains a small-sized mobile basic module containing at least one processor for performing data collection and processing operations used during planning and delivery of radiation treatment, a high-frequency ultrasound image forming device connected to the main module via a wire, which is designed to scan and collect image data relating to the anatomy and topology of the patient's skin, and to supply image data to at least one processor, wherein the high-frequency ultrasonic device designed to operate at an ultrasonic frequency in the range from 20 to 70 MHz to produce images of the affected area, present within at least one of the skin layers selected from the group consisting of epidermis, deris and subdermis. Processor is configured to execute instructions saved in a memory unit, for performing operations including reception of a plurality of two-dimensional image layers from high frequency ultrasonic imaging device, wherein each image layer passes through the specified plurality of skin layers, separation of the affected area inside the skin layers, which includes edges of the affected area, in each of the plurality of two-dimensional image layers to obtain a plurality of processed image layers, integration of at least a part of the plurality of two-dimensional image processed layers to form a three-dimensional model of the affected area, which includes parts under the affected area surface and edges under the affected area surface inside the plurality of skin layers, analysis of the three-dimensional model of the affected area inside the plurality of skin layers to determine affection type, affected area dimension, affected area edges and affected area depth, determination of therapeutic dosimetry, wherein parameters of the therapeutic dosimetry include energy level, dose location and three-dimensional dose boundaries set inside the plurality of skin layers, a radiotherapeutic device mounted on a small-sized mobile main module, comprising a therapeutic bar and a therapeutic head, wherein the therapeutic bar is made swivel, at least one positioning system, configured to obtain positional data and adjust the therapeutic head in accordance with the dose location and the three-dimensional dose boundaries for the affected area. The system is equipped with a device readable by a computer. The method for treating the affected skin area involves the use of the system.
EFFECT: expansion of the range of technical means for radiotherapy with ultrasound control.
20 cl, 11 dwg
SUBSTANCE: present invention relates to electron beam systems. The disclosed electron beam application system comprises a source of one electron beam for generating an electron beam using a linear accelerator, wherein the electron beam source and the linear accelerator are arranged such that the generated electron beam exits the linear accelerator substantially collinear to the direction of movement of electrons in the accelerator, an applicator configured to correctly define one or more of the shape, size and flatness of the generated electron beam, and a moderator mounted on the path of the generated electron beam. If the moderator is mounted on the path, the generated electron beam exits the system with a lower energy level than when the moderator is not mounted on the path. The moderator includes at least one element an atomic number higher than 4.
EFFECT: enabling use at a medical centre with very little radiation shielding, in conjunction with low-z moderators which reduce the energy level of the electron beam without the need for complex or expensive energy control systems, and enabling treatment of patients in an unshielded room.
28 cl, 6 dwg
SUBSTANCE: group of inventions relate to medicine, namely to methods and devices for brachytherapy. Method includes implantation of applicator, which has receiving channel for source of radiation into soft tissues, adjacent to target area, subjected to irradiation, planning image with high resolution of target area, containing applicator, is formed; planning image with high resolution is used to determine three-dimensional treatment plan; position of applicator relative to target area and treatment plan is traced, with tracing of position including measurement by perception of shape by means of optic fibre, location and shape of receiving channel for radiation source. device includes applicator, means for planning image formation, device for tracing applicator position and device for delivery with optic fibre.
EFFECT: application of invention provides reduction of unwanted radiation on healthy tissue in the process of brachytherapy and higher accuracy of irradiation in desired locations of exposure.
31 cl, 12 dwg
SUBSTANCE: invention relates to medicine, namely to haematology, and can be used for hormonal and radiation preparation to the following radiation chemotherapy in the treatment of patients with chronic lymphocytic leukaemia. For this purpose prednisolone is introduced in a dose of 0.9-1.1 mg/kg of weight per day. Exposure to radiation in the doses and regimens, conventional for the treatment of lymphoid tumours of a low-degree of malignancy is also carried out in the term from 72 to 168 hours after the beginning of prednisolone introduction. After obtaining 2/3-3/4 of the total dose of the radiation impact, reduction of the dose of introduced prednisolone is realised with its cancellation by the end of the radiation impact. Exposed to radiation are: involved into the leukemic process lymphatic organs from the group: lymph nodes, tonsils, spleen and liver.
EFFECT: method ensures an increased efficiency of chemotherapeutical programmes due to the preliminary impact, making it possible to reduce the involvement of organs into the leukemic process, increased sensitivity of leukemic lymphocytes to the following chemotherapeutic impact , with the reduction of a probability of development of complications, for instance, such as febrile neutropenia.
SUBSTANCE: invention relates to medicine, namely to oncology, and can be applied for the treatment of adenogenous locally advanced cancer of the rectum. For this purpose chemotherapy with 5-fluorouracil, medical therapy, gamma-therapy are realised by a method of dynamic fractioning of a dose. 5-fluorouracil is introduced into the pararectal cellular tissue, adjacent to a tumour, in a volume of 5-15 ml 5-15 min before an irradiation session of before the first three large fractions. As the drug therapy realised is infusion introduction of Mabthera in a dose of 50-70 70 mg/m2 50-60 minutes before radiotherapy on the 1, 7 and 14 days of treatment. From the 1 to 12 days from the treatment beginning radiotherapy is performed on the tumour zone and the zone of regional metastases from 2-4 fields in a mode of dynamic fractioning with SFD=3.6 Gy 3 times and further with SFD=2.2-2.4 Gy 9 times to TFD=32.4-34.8 Gy.
EFFECT: method ensures the reduction of the volume and size of the initial tumour, transfer of non-operable and conditionally operable stages of the disease into the operable state and a possibility of carrying out radical operations with an increase of therapy tolerance as a result of reduction of toxic and cytotoxic effects of the treatment, increase of protective powers of the organism and a possibility of carrying of radiotherapy in the total volume.
SUBSTANCE: operation is carried out and 3 weeks after the operation the total irradiation of the brain by a single focal dose of 2.4 Gy is performed. 5 hours after that the local irradiation of the bed of the removed tumour by a single focal dose of 0.6 Gy is carried out in such a way that the total dose of 15 fractions for the entire brain constitutes 40 isoGy, and on the bed of the tumour - 60 isoGy. At the same time at the background of irradiation on the 1-st, 3-rd, 5-th, 7-th, 9-th, 11-th, 13-th and 15-th days one hour before carrying out the total irradiation of the brain through an installed port-system the intra-arterial drop introduction of 5-fluorouracil is carried out in a dose of 100 mg/m2, diluted per 100 ml of a 0.9% solution of sodium chloride, and on the 2-nd, 4-th, 6-th, 8-th, 10-th, 12-th and 14-th days one hour after the total irradiation the intra-arterial drop introduction of 200 ml of ozonised 5% glucose is carried out.
EFFECT: method makes it possible to increase the duration and improve the life quality of the patients with metastatic injuries of the brain.
SUBSTANCE: invention refers to a method and a system for improved planning and radiation therapy delivery. Substance of the invention consists in planning the radiation therapy; the radiation therapy plan consists of a number of exposure doses; pre-therapeutic target volume (30) and off-target volumes images are presented; the target volume (30) and at least one off-target volume are contoured and positioned on the basis of the presented pre-therapeutic image; an exposure dose is supplied; the exposure dose contains a number of radiation beam traces and at least one radiation beam geometry; an actual exposure dose delivered to each area of the target volume (30) and at least one off-target volume is determined on the basis of the determined contours and positions and at least one radiation beam geometry; the method additionally comprises the stages, whereat supplying the exposure dose accompanies forming a number of one-dimensional therapeutic target volume (30) and off-target volumes images; the target volume (30) and at least one off-target volume are contoured and positioned on the basis of the one-dimensional therapeutic image presentation; an actual exposure dose supplied to each area of the target volume (30) and at least one off-target volume is determined on the basis of their specified contours and positions according to the presented pre-therapeutic images and presented therapeutic one-dimensional images, radiation beam traces and at least one radiation beam geometry.
EFFECT: improved exposure dose planning.
13 cl, 6 dwg
SUBSTANCE: treating locally advanced oropharyngeal cancer is ensured by a radiation therapy in the mode of dynamic dose fractionation. The radiation therapy is started by supplying a fraction dose of 2.4 Gy. After 2 days of treatment gap, the patient is exposed to total fractions at a fraction dose of 3.6Gy for three days. Each session is precede by placing high-structure hydrogel matrix of sodium alginate under a patient's tongue with metronidazole 150mg and bilberry 20-35mg pre-introduced into the matrix, for 4-5 hours twice every 1-2 hours. The two following sessions of the exposure at a fraction dose of 2.4 Gy are preceded by placing the matrix once under the tongue for 4-5 hours. After 2 days of treatment gap, the following 5 sessions of the radiation therapy are performed at a fraction dose of 2.4 Gy to a cumulative dose of 30Gy. Colegel-DNA-Ch high-structure disk is preliminary placed under the tongue for 4-5 hours.
EFFECT: method enables avoiding the compulsory gaps of the radiation therapy by reducing a rate of severe local radiation reactions, and provides the target delivery and accurate dosage of metronidazole administered into the patient's body leading to the partial death of well-oxygenated cells and re-oxygenation of hypoxic tumour cells.
SUBSTANCE: invention relates to medicine, radiotherapy and deals with treatment of prostate gland (PG) cancer recurrences after radical prostatectomy. Method includes irradiation of zones of regional metastasis, bed of ablated PG and zone of recurrence. Irradiation is performed in mode of hypofractionation with application of radiotherapy with modulation of intensity by dynamic arches according to the principle of "simultaneous integrated boost" simultaneously on zones of regional metastasis SFD 1.8 Gy, bed of ablated prostate gland SFD 2.35 Gy and recurrence zone SFD 2.5 Gy. Irradiation in quantity of 26 fractions is carried out 5 times per week.
EFFECT: method provides reduction of radiotherapy duration, reduction of radiation load on healthy tissues and organs, reduced risk of their affection.
SUBSTANCE: brain angiography is performed to find an intraglomerular region of the most significant afferent vessel of the arteriovenous malformation (AVM). That is followed by the stereotactic single exposure to a through proton beam of a power of 1000 MeV with delivering a dos field of 40-60 Gy to an isocentre.
EFFECT: method enables reducing a number of radiation complications accompanying the radiation dose reduction that is ensured by irradiating the intraglomerular region of the most significant afferent vessel of the AVM.
8 dwg, 2 ex
SUBSTANCE: brain angiography is performed to find an intraglomerular region of the most significant afferent vessel of the arteriovenous malformation. That is followed by photon stereotactic therapy by the exposure of this region during the sessions 3 times a week in a dose of 6-7 Gy to a total basic dose of 36-42 Gy.
EFFECT: method enables reducing a number of radiation complications accompanying the radiation dose reduction that is ensured by irradiating the intraglomerular region of the most significant afferent vessel of the AVM.
7 dwg, 2 ex
SUBSTANCE: to determine density of otospongiosis focuses computer tomography of temporal bones with densitometry is carried out. Treatment duration is determined on the basis of obtained values of density. If density of otospongiosis focuses is less than 300 units HU, 4 courses of complex inactivating therapy are carried out. If density is 300-600 HU units -2 courses, if density is 600-900 units HU - 1 course. Duration of one course constitutes 3 months. During a year not more than two courses of therapy are carried out. Course of inactivating complex therapy includes intake of the following medications: bisphosphonates, sodium fluoride, calcium carbonate and vitamin D3. As bisphosphonates medication Bonviva is applied.
EFFECT: method makes it possible to increase efficiency of inactivating therapy in patients with different forms of active otosclerosis due to differential approach in selection of individual duration of carried out therapy.
SUBSTANCE: curvature of a root canal of a tooth is investigated by means of Picasso Trio, cone-beam computerised tomography with Ezlmplant software. The computerised tomography processes an image and transmits it to the computer. The Ezmplant software contains four active windows of object images: upper and lower teeth in frontal (coronal view), sagittal (sagittal view), axial (axial view) projections, and an object 3D-reconstruction. A section thickness of the dentofacial tissues is specified at 1 mm for all active windows of the image; after that an image of the examined tooth is selected in the required active window. The mouse cursor is passed in the active window, and the button Enter on the keyboard is pressed to remove the axes; the primary mouse button is pressed in the Measure section of the menu on the left to activate the function Angle. That activates the section Tool Options in the menu automatically, wherein the angle 4-point measurement method 4-Point Click is selected. Then the mouse cursor is passed beyond the tooth being guided by a tooth canal orifice and the mort actual point of the root canal lumen curvature for display purposes; the mouse button is pressed beyond the tooth to display the first point of the first line. The first line is drawn approximately through an apex of a triangle to be constructed and extends behind the tooth to cover the root canal lumen. The mouse button is pressed again to mark the second point of the first line; line No. 1 is produced as one side of the determined curvature angle of the root canal of the tooth - points 1 and 2. The cursor is moved onto the expected apex of the angle of the triangle describing the root canal curvature with the lines being continuous. The mouse button is pressed to mark the first point of the second line that is the third point. The cursor is displaced towards the root apex by drawing a line through it behind the tooth. The function Angle is deactivated; all four points of the angular structure are activated; their position is specified to produce the final curvature angle in degrees to be calculated automatically. The root canal curvature is taken into consideration when choosing the instruments for the high-grade endodontal treatment of the root canal.
EFFECT: method enables measuring all the root canal curvature angles precisely by enabling the multiple activation of all the elements of the angular structure and correcting positions of the points and lines of the angular structure.
5 dwg, 2 ex
FIELD: physics, computer engineering.
SUBSTANCE: invention relates to computer systems for diagnostic imaging. Disclosed is a system for delineating anatomical features in images used for image-guided therapy planning. The system includes a processor which receives an initial image of an anatomical structure in a patient from an imaging device. Said processor also detects anatomical landmarks in the initial image and compares positions of the detected anatomical landmarks with reference landmarks in a reference contour corresponding to the anatomical structure. The processor also compares the detected anatomical landmarks with the reference landmarks.
EFFECT: high accuracy of identifying anatomical features on an image through automated delineation of said features.
20 cl, 5 dwg
SUBSTANCE: invention relates to the field of medical diagnostics and is aimed at the creation of an ultrasonic nonlinear tomograph, which contains a small quantity of receiving and transmitting transformers, mainly for mammography, defectoscopy and nondestructive testing of different objects. The ultrasonic tomorgaph includes a receiving-emitting device with receiving-emitting piezotransformers, to an inlet of which connected is a channel of the emitted signal formation, and to an outlet - a channel of the received signal analysis. The receiving-emitting device contains, at least, two emitting cylindrical piezotransformers with a broad band of emitted coded signals and, at least, one receiving cylindrical piezotrasformer with a broad band of the received signal, a longitudinal axis of which is located vertically, and a system of acoustic mirrors, which includes vertically located above each other lower smaller acoustic mirrors and an upper larger acoustic mirror, made in the form of coaxial truncated cones with an equal angle of conicity and height and a different mean radius. The emitting and accepting piezotransformers are placed at the level of the lower smaller acoustic mirror, and their height constitutes 0.8÷0.9 of the height of each of the acoustic mirrors.
EFFECT: application of the invention makes it possible to increase the resolving capacity of restoring an image of internal soft structures with the reduction of a quantity of the transformers.
4 cl, 3 dwg
SUBSTANCE: disclosed is a method of obtaining a structural image of a biological object in optical coherence tomography. The method includes breaking down a source colour vide frame into non-overlapping spatial blocks consisting of more than one pixel. A structural image is obtained via small-angle raster scanning in the arm of an optical coherence tomography sample. The obtained image with a size of Piskh bytes is broken down into non-overlapping spatial blocks only on columns; adjacent column blocks are averaged pixel by pixel to form a new image with a size of Pstl bytes; the new image is broken down into non-overlapping spatial blocks only on rows; adjacent row blocks are averaged pixel by pixel to form a resultant image with a size of Pres bytes, and the averaging process is controlled based on an exponential relationship Pstl from the number of averaging column blocks Ustl and Pres from the number of averaging row blocks - Ustr.
EFFECT: high quality of the structural image of a biological object in optical coherence tomography.
SUBSTANCE: invention refers to medical diagnostics, namely to ultrasonic non-linear tomographs. The tomographic scanner comprises a receiving emitter with a receiving-emitting electroacoustic transducer with a signal forming channel connected to an input thereof, and a signal analysis channel connected to an output thereof. The receiving emitter comprises emitting plane electroacoustic transducers with an emitted coded ultrasonic signal broadband, and a receiving plane electroacoustic transducer with a received signal broadband. The working surface of the transducers is arranged in a tangential plane to a circle which encloses a scanned organ, and orthogonal to the circle plane, while its diameter is 1.5÷2.0 times more than a width of the working surface of the plane transducers. An angle of acoustic axes perpendicular to the working surface of the plane electroacoustic transducers for each pair of the adjoining plane electroacoustic transducers is within the range of 30° to 90°.
EFFECT: using the device provides high resolution of recovery and visualisation of internal structures of soft tissues and internal defects of various objects with a low noise level.
3 cl, 2 dwg
SUBSTANCE: complete echocardiography is performed to determine a dyssynergia index and the presence of mitral regurgitation. The findings are used to detect the presence of hemodynamically relevant coronary artery stenosis by the value of function F that is calculated by the original formula. If F=1.95, the presence of hemodynamically relevant coronary artery stenosis is diagnosed, while F=-0.766 shows the absence thereof.
EFFECT: technique enables high accuracy detection of ischemic heart disease in the patient with using no invasive method, eg coronary angiography, which ensures the lower risk of developing intraoperative complications.
2 ex, 1 tbl
SUBSTANCE: invention relates to field of medicine, namely to optic methods of biological tissue analysis. To carry out differential diagnostics of nail plate diseases analysis of patient's nail plates, preliminarily processed with 25% glycerol solution, is performed by optic coherent tomography. Nail plate is analysed in its middle part in direction from posterior wall to free edge, step-by-step with overlapping previous probe position by approximately 1/3 of probe working diameter. Image of five horizontally oriented layers of nail plate are analysed on tomograms. If the first layer is unchanged, height of the second layer is increased, signal intensity increases in the second, third and fourth layers, inhomogeneity appears within the second, third and fourth layers, contrast decreases and boundary between the third and the fourth layers disappears, inhomogeneous change of the fifth layer takes place, with irregular arch-like elements, characterised by high and low signal, psoriatic affection of nails is diagnosed. If signal intensity decreases in the first layer, thickness of the second, third and forth layers increases, signal intensity decreases within the third layer, contrast decreases and boundary between the second and third and the third and fourth layers decreases, as well as linear zones, horizontally oriented, parallel to each other, with high intensity signal appear, onychomycosis is diagnosed.
EFFECT: method provides possibility of non-invasive assessment of pathological process in nail plate.
4 ex, 4 dwg
SUBSTANCE: invention relates to field of medicine. To perform dynamic assessment of structural changes of pancreatic (P) parenchyma comparison of successive indices of X-ray density in its different parts is carried out by means of multispiral computed tomography. Absolute X-ray density (AXRD) and the largest thickness in head, body and tail of pancreas are determined on the basis of obtained tomogram. Specific density of each part of pancreas in dynamics is calculated by formula: SD1,2…n=AXRD/thickness of examined part of pancreas (mm), where SD1 is initial value of specific density of each part of pancreas, SD2…n are values of specific density of each part of pancreas in dynamics. Induration index (II) of each part of pancreas in dynamics is calculated by formula: II= SD2…n/SD1, the value of which is used to assess structural changes of pancreatic parenchyma.
EFFECT: increased accuracy and self-descriptiveness of dynamic assessment of course of inflammatory process in pancreatic parenchyma due to taking into account structural and morphological shifts in pancreatic tissue with application of dynamic computed tomography monitoring.
5 ex, 5 dwg
SUBSTANCE: invention relates to field of medicine. In method realisation bone density in the area of tibia and femur condyles is determined by method of computed tomography. Range of scanning is determined by topogram. Axial cuts and multiplanar reconstructions are obtained. Measurements of density are carried out by Haunsfield scale in 8 points, marked on multiplanar reconstructions of knee joint in frontal plane. In case if density in points 5, 6 constitutes 351-450 HU, in points 3, 4 351-400 HU, in point 8 up to 220 HU, in point 7 up to 140 HU, in point 1 221-250 HU, in point 2 171-190 HU, data correspond to the first stage of disease under condition of their coincidence in six points of eight. In case if in the said points density constitutes: 251-350 HU, 301-350 HU, 221-240 HU, 141-170 HU, 191-220 HU, 141-170 HU, data correspond to the second stage of disease under condition of their coincidence in six points of eight. In case if in the same points density is: to 250 HU, to 300 HU, 241-260 HU, 171-200 HU, to 190 HU and to 140 HU, data correspond to the third stage of disease, under condition of their coincidence in six points of eight.
EFFECT: method makes it possible to reduce labour consumption in estimation and facilitate comparative interpretation of treatment results.
5 dwg, 2 ex
SUBSTANCE: technique involves transabdominal ultrasonography of jejumum and colon in longitudinal and transversal projections. The transabdominal ultrasonography is native with the patient positioned on his/her back. Visualising all the jejuneal segment involves taking intestinal loops without haustra as reference points. haustra are used as reference points for visualising the colon. pulsed Doppler velocimetry is conducted to determine a blood flow velocity in mesenterial arterial branches. A transperineal examination of the anorectal area is performed in the patient placed on his/her left side with bended knees. A sensor is placed into an anal pit directly and displaced from pubic to sacrum while scanning in two projections - longitudinal and longitudinal-oblique. The reference points are sacrum, symphysis, and anal canal. The state of a distal portion of rectal ampulla is assessed. The derived values are compared to the normal criteria. If observing any changes in the jejunum: wall thickening more than 2 mm, higher echogenicity, intestinal lumen narrowing; if observing any changes in the colon: haustra flatness, contour roughness, wall thickening more than 2.5 mm, mucosal thickness more than 1 mm, submucosal thickness more than 0.5 mm, the absence of clear layer differentiation, higher submucosal echogenicity, intestinal lumen narrowing, higher blood flow velocity in the mesenterial arterial branches more than 7.0 cm/sec; changes in adjoining organs: higher echogenicity of the greater omentum, envelopment of the jejuneal and colonic loops involved into the inflammatory process with the omentum, lengthening of the mesenterial, para-aortic lymph nodes more than 10 mm, free abdominal fluid, the changes in the anorectal area: rectal ampulla wall thickening more than 2.5 mm, higher echogenicity of perineal subcutaneous fat, anorectal fistulas and paraproctitis testify to the presence of colonic and jejuneal wall hyperplasia in the involved portions, mesenterial, para-aortic lymph node hyperplasia, reactive changes of the greater omentum, as well as the presence of a perineal inflammation, and Crohn's disease is diagnosed. The changes in the colon only: haustra flatness, smooth contours, wall thickening more than 2.5 mm, mucosal thickness more than 1 mm, submucosal thickness more than 0.5 mm, reduced clear differentiation, lower submucosal echogenicity, no intestinal lumen narrowing, higher blood flow velocity in the mesenterial arterial branches more than 7.0 cm/sec; changes in the adjoining organs: lengthened mesenterial and para-aortic lymph nodes more than 10 mm, no reactive changes of omentum, rectal ampulla wall thickening more than 2.5 mm without involving the perineal region testifies to colonic wall hyperplasia and mesenterial, para-aortic lymph nodes and enables diagnosing non-specific ulcerative colitis.
EFFECT: technique enables performing the early differential diagnosis of chronic inflammatory intestinal diseases by using the accurate qualitative and quantitative ultrasonic criteria.