US 3466439 A
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Description (OCR text may contain errors)
Sept. 9, 1969 K. M. E. sE'rALA 3,
RADIATION TREATMENT APPARATUS WITH TRANSVERSELY GAPPED TABLE Filed March 25, 1966 S Sheets-Sheet 1 INVENTOR fl/mzmvfowmfmu ATTOR EYS Sept.'9, 1969 K. M. E. sETALA 3,466,439
RADIATION TREATMENT APPARATUS WITH TRANSVERSELY GAPPED TABLE Filed March 25, 1966 3 Sheets-Sheet 2 I +2/ 1 :l i :1: i=1?! *1: ll l 9 l l I )-----fuf J INVENTOR I fl mmvflmwfmm Ma 9M5 AT TO NEYS Sept. 9, 1969 K. M. E. sE'rALA' 3,456,439
RADIATION TREATMENT APPARATUS WITH TRANSVERSELY GAPPED TABLE Filed March 25, 1966 .5 Sheets-Sheet 3 INVENTOR. I m 0mm [0mm Jam/1 lam 9W2" ATTO R N EYS United States Patent 3,466,439 RADIATION TREATMENT APPARATUS WITH TRANSVERSELY GAPPED TABLE Kai Martin Edvard Setiilii, Uudenkaupungintie 8, Helsinki, Finland Filed Mar. 25, 1966, Ser. No. 537,381
Int. Cl. G01n 23/00 U.S. Cl. 250-54 13 Claims ABSTRACT OF THE DISCLOSURE This invention relates to a radiation treatment apparatus, and in particular to a radiation treatment apparatus by which any portion of the patients body may be treated by radiation without the necessity of moving the patient.
It is now normal procedure to administer radiation treatment to a patient, such as one suffering from a malignant tumor, by placing the patient on a radiation treatment table and exposing the affected portion of the body to radiation such as X-rays. However, when employing known radiation treatment apparatus, it is feasible to direct the radiation only from above or from the sides of the patient, since the top of the treatment table either partially or entirely prevents the application of radiation from below the patient. As a malignant tumor may appear in any organ or tissue of the body, it is often necessary to apply the radiation from a different direction, including a direction beneath or below the patient. In order to apply this treatment from below the patient, it is now necessary to turn the patient over on the examination table from an abdominal position to a dorsal positon and vice Versa/When the patients position is thus altered, there is a resulting modification in the body contour of the patient causing a similar modification in the dimensions, shape and topography of the inner organs. This modification of the position of the patient also modifies location of the region to which radiation is to be applied, as this region is no longer situated in the location which it occupied prior to the alteration of the patients position. As a result the beam of radiation from the radiation source will not strike the region being treated as before, because the position of this region was previously determined on the basis of the patients original position. As a result of this modification of the patients position, and in particular, situations in which small tumors are being treated by radiation, the beam of rays may even be partially or entirely directed so as to impinge upon the body away from the tumor, thereby negating the entire purpose of the radiation treatment and possibly causing damage to adjoining tissues. Alteration of the location of the tumor with respect to the X-ray beam caused by modifying the patients position also may result in a plurality of radiation beams being directed towards the tumor from different directions which will intersect at a common point, causing an excessive radiation to strike the body at undesirable body portions.
It is therefore a general object of the present invention to provide a radiation treatment apparatus which prov 3,466,439 Patented Sept. 9, 1969 vides for radiation treatment which will avoid the disadvantages of known radiation treatment apparatus.
It is a further object of the present invention to provide a radiation treatment apparatus with which it is possible to determine accurately the direction of the X-ray beams and the amount of radiation, as well as a most suitable distance between the radiation source and the treatment area prior to commencement of the treatment. This apparatus is known as a simulator which can then be utilized to direct the radiation source correctly at the portion of the body under treatment.
It is a further object of the'invention to provide an X-ray table wherein there is no restriction upon the area of the patients body toward which the X-rays may be directed without changing the patients position thereon.
It is a still further object of the invention to provide such a table together with associated apparatus which may be adjusted through 360 around the table in a vertical plane and which may be further adjusted longitudinally of the table.
In accordance with the above-mentioned objects the present invention principally provides a'radiation table having a top portion on which the patient reclines in either the abdominal or dorsal position. The table top consists of two parts lying in a common plane in longitudinally spaced relationship, and having a gap between the parts extending completely across the width of the table top so that the area under and adjacent the gap is free. Thus, an apparatus which is utilizable for the treatment together with associated equipment, such as a radiation source, X-ray tube or the like, can be freely moved through an angle of 360 in a plane containing the longitudinal axis of the gap around the table top and the patient. The radiation source may be directed at the desired angle towards the position of the patients body which bridges the gap for treatment of that portion. As the size of a tumor may vary, at least one of the parts of the table top is arranged to be longitudinally movable, and it is also provided that both parts may be raised or lowered with respect to the base supporting the table. With apparatus according to the present invention, the radiation source or X-ray tube, or any other necessary apparatus may be freely moved around the table and the patient and be directed towards the patient at an angle which can be preselected. This has particular relevance to known radiation sources which may be rotated over 360 around their mounting axis which in addition may be lowered or raised so that the distance to the portion to be radiation will be suitable or proper, for the type of the radiation treatment being performed.
According to a preferred embodiment of the present invention, a table plate is surrounded by a circular frame positioned transversely to the longitudinal direction of the table top. This frame is provided with elements for mounting the apparatus desired in each operation, such as the radiation source or X-ray tube, when the apparatus is used as a simulator. The frame is preferably arranged to be movable in a longitudinal direction of the table top, and the element for attaching the apparatus consists preferably of a ring mounted rotatably with respect to the frame.
The invention described above provides great possibilities for hospital personnel accurately and quickly to carry out measurements, calculations and other steps necessary for a reliable radiation treatment, and it is also possible to carry out the necessary control and additional measures without the need for altering the patients posi-- tion on the table. There are, however, cases in which it would be desirable and even necessary to be able to carry out these measures still more freely, e.g. when the radiation source is to be directed at a greater or lesser anglewith respect to the patients longitudinal direction, which of course presupposes that the preparative measures can be carried out at the same angular direction.
To achieve this result, the above described apparatus has been further developed to permit the relative rotational movement between the table top (and the patient) and the transverse gap. This is realized in this invention by providing a preferably circular plate between the table top parts provided with a diametrically extending gap. The plate consists preferably of two segment-shaped parts.
The relative rotational movement can be obtained either by rotating the plate, together with the circular frame, with respect to the stationary table top, or by rotating the table plate around its center with respect to the stationary table and the similarly stationary frame.
Embodiments of the apparatus according to the invention are described more fully in the following specification with reference to the accompanying drawings, in which:
FIG. 1 is a schematic, perspective view of a radiation treatment apparatus having a stationary frame;
FIG. 2 is a schematic, perspective view of a second embodiment of a radiation treatment apparatus;
FIG. 3 is a plan view of the embodiment illustrated in FIG. 2; and
FIG. 4 is a plan view similar to FIG. 3, showing certain parts thereof on a larger scale, illustrating different positions on the table plate.
In FIG. 1, the reference numbers 1 and 2 refer totwo table top parts situated in the same plane in longitudinally spaced relationship, having a gap 3 between the table top parts. Part 1 is supported by a stand 4 so that it can be moved in the horizontal direction for altering the Width of the gap 3. This can be achieved by means such as a rack and pinion (not shown). The pinion is rotated by means of a handwheel 5. The edge of the table top 1 is provided with a scale 6 for reading the width of the gap with respect to the position of the table top parts. The table top part 2 is supported in a similar manner by a stand 7 and is movable with respect thereto.
Between stands 4 and 7, there is provided a carriage 8, which is connected to stand 4 by means of guide members 9. The carriage rests on a base 11 connecting the stands 4 and 7 and is movable longitudinally of the table along rails on base member 11. To carriage 8 is attached a stationary frame 12 lying in the longitudinal plane of the gap and surrounding the table. On annular frame 12 is mounted a rotatable ring 13 which is provided with attachment elements for attaching thereto a radiation source, an X-ray tube 14 or the like, which can be directed at any de sired angle toward the gap 3. An X-ray screen, plate holder, picture amplifier or a television screen can be attached diametrically with respect of the X-ray tube 14 at the opposite side of frame 13, but these items have, for sake of clarity, been omitted from FIG. 1. The stationary frame 12, or the rotatable ring 13 or both, are provided with scales (not shown) for reading the angular position of the apparatus. The carriage 8, with the attached members 12, 13 and 14, is movable in the longitudinal direction of the table and can also be raised and lowered together with stand 4. The table is shown with carriage 8 and the frame 12 in the raised position by dash lines in FIG. 1.
When. radiation treatment is to be administered, the patient is laid on table parts 1 and 2 in the same position as in a previous treatment, and said position and the location and width of the gap are checked by means of the scales 15. Radation treatment may be given by means of a freely movable radiation source, which is placed in the desired position with respect to the gap and directed at the desired angle toward the part of the patients body that bridges the gap. During this time the carriage together with the frame is moved aside. It is however also possible to attach the radiation source to the frame in the same manner as the X-ray tube 14.
The table top parts 1 and 2 are mounted so that they can be raised or lowered together. Driving means for this purpose can be provided e.g. inside the stand 4, wherefrom the movement can be transferred to stand 7, through a transmission device located inside the member 11.
FIG. 2 shows another embodiment of this invention, representing a further development of the principles of the invention. In FIG. 2, the table parts are indicated as 1' and 2', the stands as 4 and 7, and the frame and ring as 12 and 13 respectively, as in FIG. 1. The stands 4 and 7 are attached to the floor or a suitable base plate and can be raised and lowered by means of any suitable conventional apparatus, e.g. telescopically. The stands 4 and 7 may also be provided with rollers in order to make the table freely movable.
Rotatable ring 13 is provided with suitable elements for attachment of a radiation source 16. The radiation source is attached to ring 13 so that the center beam of the ray beam always passes through the center of the stationary frame 12 and the ring, irrespective of the position of the radiation source with respect to the frame. A nipple 17, indicating the center .point of the radiation source, is diametrically attached to rotatable ring 13 and is provided with a cross hair. Nipple 17 is also directed toward the center of the frame and thus coincides with central beam of the radiation source. A light projection of the cross hair on the patients skin will thus be located exactly at the point where the central bean of the radiation source exits from the patients body irrespective of the point of the ring at which the radiation source is situated at that moment. When an X-ray tube is being utilized, an X-ray screen or any other necessary device is attached at the dialnetral counter point of rotatable ring 13. The attachment elements are preferably so arranged, so that they are radially movable in the plane of ring 13 toward and away from the center of ring 13, so as to provide a suitable distance between the treatment field and the apparatus.
By virtue of the embodiment shown in FIG. 2, the gap 3 and the stationary frame 12 are intended to be rotatable with respect to the table parts 1 and 2. For this purpose the frame is rigidly attached to a column 18 disposed beneath the table plate by having frame 12 countersunk in the upper surface of the column, so that rotatable ring 13, with its attached apparatus, is freely movable around frame 12. The lower end of column 18 is rotatably mounted on a support plate 19, which is guided by two guide rails 20 so that support plate 19 with column 18 and frame 12 are movable in the longitudinal direction of the table. Guide rails 20 may, if desired, be connected to stands 4 and 7.
By rotating column 18 in either direction, stationary frame 12 along with rotatable ring 13 may be rotated about an axis perpendicular to the plane of the table, as more clearly appears in FIG. 3. From FIG. 3 it is also apparent that the angle of rotation of stationary frame 12 in the plane of the table is limited by the width of stands 4 and 7 and distance therebetween. The rotation angle of frame 12 is between approximately 45 to 60 degrees. When necessary this rotation angle can be altered by altering the dimensions of the table plate and the stands.
According to the embodiment of FIG. 2, the gap 3 is provided with a plate consisting of two segments 21 and 22. The gap 3 must be brought to follow the plane of the frame as the frame is rotated. The end edges of parts 1 and 2', which are directed toward each other,
are shaped to correspond to the outer edges of the segments 21 and 22, and since the gap width in this embodiment is intended to be variable, the segments are each connected to their respective table parts 1 and 2, so that the segments will participate in the movement of the table parts when the same are moved toward or away from each other (e.g. O to 60 cm.). Segments 21 and 22 are further connected to their respective parts 1 and 2' so that they'may be rotated in the plane of the table parts around the center of the plate synchronously with the rotational movement of column 18. The rotational movement of column 18 can be transmitted by any suitable conventional means, e.g. through racks and pinions, to segments 21 and 22 so that segments 21 and 22 will have imparted thereto an equal angular movement, and in the same direction of column 18. With this arrangement, gap 3 of the plate, the defining edges of which are maintained parallel with each other during the rotation, will always adjust itself on the line where the plane of the frame 12 intersects the plane of the table top. The segments 21 and 22 can in this case be guided and supported by the end surfaces of the parts 1' and 2' so that the plate will be rotated together with column 18 without cooperation of the table parts. In this case the width of the gap can also be made variable.
If one is satisfied that the width of gap 3 be constant, then the construction of the apparatus will be considerably simplified, as neither the plate parts nor the table parts need to be movable longitudinally of the table.
The relative rotational movement between the table plate and the frame may also be achieved by having the plate and the optional frame stationary, while the table top is mounted for rotation. Thus the gap in the plate will always be contained in the plane of the frame. The rotational movement can be achieved by providing circular guide elements in the floor plane for stands 4 and 7 on both sides of the frame. Also, in this case the table top parts can be moved toward and away from each other with respect to the stands spaced at a constant distance from each other.
It is obvious that there must be a means for observing on suitable scales, the degree of the relative rotational and longitudinal movement between the different parts contained in the apparatus. Thus in FIG. 2 at the top there is shown in an enlarged detail view, a scale 23 over the entire 360 periphery of rotatable ring 13. Scale 24 indicates the extent of the rotation of column 18 with respect to the support plate 19. There are also scales showing the displacement of parts 1' and 2 in the plane of the table plate (see 6, FIG. 1), for the gap width, and for indicating the amount of raising and lowering etc. When so desired the apparatus can be supplemented with known devices by means of which it is possible to read all the values at a common control desk in an adjacent room.
The table top, which is preferably made of transparent material, is also provided with a longitudinal center line which divides the apparatus into two similar parts in the same manner as the transversal plane through the frame divides the apparatus in similar parts. The table top can, if desired, be hinged for tipping either about its transversal axis or its longitudinal center line.
The embodiments described above are intended merely for illustration of the invention, and different ways to apply it are possible within the scope of the accompanying claims. Thus the apparatus, according to the present invention, can be combined with the apparatus described in the applicants patent application, Ser. No. 468,329, which is now Patent No. 3,398,455, so that a single apparatus can be utilized for copying the cross-sectional contour of a patients body at any desired point, for carrying out X-ray photographs, for determining the radiating angle and the distance to the radiating source, and for administering radiation treatment at practically any desired angle Without the necessity of altering the patients position.
1. A radiation treatment apparatus comprising a support means disposed in a substantially vertical plane, a source of penetrating radiation carried by said support means, means associated with said support means for rotating said source through an arc of 360 in said plane around a patient to be treated, a firm table for supporting a patient, said table having at least two coplanar parts opaque to penetrating radiation disposed in longitudinally spaced relationship and being separated by a transverse gap extending across the entire width of said sections, the longitudinal axis of the gap lying in the plane of the support means, whereby radiation from said source can reach said patient from every point in said arc.
2. Apparatus as claimed in claim 1, further comprising means for laterally moving at least one of said table parts to very the width of the gap.
3. Apparatus as claimed in claim 1, further comprising means for raising and lowering each of said table parts.
4. Apparatus as claimed in claim 1, wherein said support means comprises a circular stationary frame surrounding said table and a mounting element rotatably mounted in said frame, said mounting element being provided with means for attaching said radiation treatment means for rotation therewith.
5. Apparatus as claimed in claim 4, further com prising means for moving said frame along the longitudinal axis of said table within the gap.
6. Apparatus as claimed in claim 4, wherein said mounting element comprises a ring rotatably mounted upon said circular frame. V
7. Apparatus as claimed in claim 1, .further comprising a pair of oppositely disposed plates rotatably mounted .upon each of said table parts for rotation about a vertical axis perpendicular to the longitudinal axis of the table, wherein the opposing edges of said plates define the gap therebetween.
:8. Apparatus as claimed in claim 7, further comprising means for rotating said plate sections about a vertical axis passing through the point of intersection of the longitudinal central axes of said table end of the gap.
9. Apparatus as claimed in claim-7, wherein said plates are semi-circular in shape, and further comprising means for rotating said plates for varying the angle between the gap and the longiutdinal axis of said table.
10. Apparatus as claimed in claim 9, further comprising means for moving said plates along the longitudinal axis of said table for varying the width of the gap.
11. Apparatus as claimed in claim 9, further comprising means for rotating said support means about said vertical axis synchronously with the means for rotating said plate sections.
12. Apparatus as claimed in claim 11, wherein said synchronous rotating means comprises a support plate and a vertical column rotatably mounted in said support plate, the support means being attached to the vertical column, and the plate sections being mechanically connected to said column.
13. Apparatus as claimed in claim 12, further comprising means for relatively moving said support plate in the longitudinal direction of the table top.
References Cited UNITED STATES PATENTS 2,890,349 6/1959 Huszar 250-91 2,552,858 5/1951 Mueller et al. 25058 2,939,007 5/1960 Keesaer 250-52 3 ,349,242 10/ 1967 Braestrup 25 05 4 FOREIGN PATENTS 894,500 4/ 1962 Great Britain.
396,177 11/ 1922 Germany. 1,106,658 12/1955 France.
RALPH G. NILSON, Primary Examiner A. L. BIRCH, Assistant Examiner US. Cl. X.R.