Abstract:
Provided is an intrauterine radiation device and system having individually inflating balloons, which constantly expand the inside of the vagina to a desired degree using the balloons in accordance with treatment planning during uterine brachytherapy, which enable the position of a radiation applicator to be accurately reproduced, and which apply a precise dose of radiation determined according to the treatment planning.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    This application claims priority to and the benefit of Korean Patent Application No. 2009-0040218, filed May 8, 2009, the disclosure of which is incorporated herein by reference in its entirety. 
       BACKGROUND 
       [0002]    1. Field of the Invention 
         [0003]    The present invention relates to an intrauterine radiation device and system, and more particularly, to an intrauterine radiation device and system having individually inflatable balloons, which constantly expand the inside of the vagina to a desired degree using the balloons in accordance with treatment planning during uterine brachytherapy, which enable the position of a radiation applicator to be accurately reproduced, and which apply a precise dose of radiation determined according to the treatment planning. 
         [0004]    2. Discussion of Related Art 
         [0005]    In general, to treat a patient for a disease occurring in the uterus such as uterine cancer, brachytherapy is performed on the uterus by applying radiation to a diseased part of the uterus. To apply the radiation, radiation source mobile instruments are used. The radiation source mobile instruments are devices that move a radiation source, and generally include a tandem and an ovoid. 
         [0006]    When the treatment is performed using the radiation source mobile instruments, the vagina is first expanded using a speculum. In this state, an operator inserts an intrauterine insertion instrument called a tandem into the uterus while directly looking at the tandem. 
         [0007]    Subsequently, the speculum is removed from the vagina, and then an intravaginal insertion instrument called an ovoid is pushed into the vagina. In this case, since the operator does not look at a depth of insertion of the ovoid, the operator intuitively pushes the ovoid into the vagina. Here, the speculum is removed in order to insert the ovoid into the vagina to prevent the ovoid from being caught by the speculum due to a size of the ovoid when the ovoid is inserted. 
         [0008]    To immobilize the radiation source mobile instruments, i.e. the tandem and the ovoid, which have been inserted in this way, and to prevent unnecessary radiation from being applied to organs such as the bladder and the rectum adjacent to the vagina, the operator directly inserts and packs gauze into the vagina and the uterus. 
         [0009]    Such radiation source mobile instruments have the following problems. 
         [0010]    First, the gauze is packed around the tandem and the ovoid. An amount, a thickness, an insertion depth, an insertion direction, etc. of the gauze are difficult to equally reproduce whenever the treatment is performed. If the radiation source mobile instrument packed with the gauze is changed in position whenever the treatment is performed, it is difficult to perform an accurate operation. 
         [0011]    Second, the number of radiation source mobile instruments used is generally three. Thus, it is difficult to obtain more diverse, selective distributions of the radiation dose. 
         [0012]    Third, when radiating from the radiation source, the radiation generally has a characteristic of being constantly emitted from the same center toward its surroundings. Thus, if a position of a tumor is biased in one direction or the tumor has an irregular shape, the radiation source mobile instrument does not apply the radiation only to the tumor, but to the surrounding normal organs. As a result, the radiation source mobile instrument may actually have an adverse effect on the normal organs. 
       SUMMARY OF THE INVENTION 
       [0013]    The present invention is directed to providing an intrauterine radiation instrument and system having individually inflatable balloons, which allow radiation to be applied only to a specific tumor so as to reduce an adverse effect on normal organs. 
         [0014]    The present invention is also directed to providing an intrauterine radiation instrument and system having individually inflatable balloons, which allow radiation source mobile instruments to be accurately located at desired positions whenever treatment is performed. 
         [0015]    The present invention is also directed to providing an intrauterine radiation instrument and system having individually inflatable balloons, which are capable of obtaining diverse distributions of a dose of radiation. 
         [0016]    The present invention is also directed to providing an intrauterine radiation instrument and system having individually inflatable balloons, which are capable of measuring a dose of radiation. 
         [0017]    An aspect of the present invention provides an intrauterine radiation device having individually inflatable balloons, which includes: a hollow cylindrical cylinder in which a plurality of air tubes are installed and into which radiation source mobile instruments are inserted; and a plurality of front balloons that are mounted on an outer circumferential surface of a front end of the cylinder in a direction in which the cylinder is inserted, and that are connected with the air tubes so as to be individually inflated. 
         [0018]    Here, the intrauterine radiation device may further include a middle balloon that is spaced apart from the front balloons, mounted on the outer circumferential surface of the cylinder, and connected with the air tube so as to be inflated. 
         [0019]    Further, the front end of the cylinder may be bent in a radially inward direction, and the front balloons may be mounted on an outer surface of the front end, and simultaneously inflated in thickness and insertion directions of the cylinder. 
         [0020]    Also, the front end of the cylinder may be partitioned into a plurality of split sleeves, and the front balloons may be mounted on the split sleeves, and simultaneously inflated in thickness and insertion directions of the cylinder. 
         [0021]    Further, the split sleeves may be hinged with the cylinder, and formed to be bent at front ends thereof in a radially inward direction. 
         [0022]    Meanwhile, the intrauterine radiation device may further include at least one holder that is formed on an inner circumferential surface of the cylinder. 
         [0023]    Further, the holder may protrude from the inner circumferential surface of the cylinder in a radially inward direction and have a semi-circular cross section. 
         [0024]    Also, the holder may be recessed from the inner circumferential surface of the cylinder. 
         [0025]    In addition, after the radiation source mobile instrument is mounted on the holder, a shield may be mounted around the radiation source mobile instrument so as to shield the radiation. 
         [0026]    As described above, when uterine brachytherapy is performed with the intrauterine radiation instrument or system having individually inflatable balloons according to the present invention, the inside of the vagina can be constantly expanded to a desired degree in a desired direction, and the positions of the radiation source mobile instruments, each of which moves a radiation source, can be accurately reproduced. Further, an accurate dose of radiation determined according to treatment planning can be applied. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0027]    The above and other objects, features and advantages of the present invention will become more apparent to those of ordinary skill in the art by describing in detail exemplary embodiments thereof with reference to the attached drawings, in which: 
           [0028]      FIG. 1  is a conceptual view showing an auxiliary instrument for uterine brachytherapy according to an exemplary embodiment of the present invention; 
           [0029]      FIG. 2  is a conceptual view showing a state in which the auxiliary instrument for uterine brachytherapy shown in  FIG. 1  is located inside a vagina; 
           [0030]      FIGS. 3 to 6  are partial cross-sectional views showing an operation of the auxiliary instrument for uterine brachytherapy according to the exemplary embodiment of the present invention; and 
           [0031]      FIGS. 7 and 8  are partial cross-sectional views showing an operation of an auxiliary instrument for uterine brachytherapy according to another exemplary embodiment of the present invention. 
       
    
    
     DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTS 
       [0032]    An intrauterine radiation device having individually inflatable balloons according to an exemplary embodiment of the present invention will be described below in detail with reference to the appended drawings. 
         [0033]    The appended drawings show illustrative forms of the invention, and are merely provided to describe the invention in greater detail. Thus, the technical scope of the invention is not limited to the drawings. 
         [0034]      FIG. 1  is conceptual view showing an intrauterine radiation device having individually inflatable balloons according to an exemplary embodiment of the present invention. 
         [0035]      FIG. 2  is a conceptual view showing a state in which the intrauterine radiation device shown in  FIG. 1  is located inside a vagina.  FIGS. 3 ,  4 ,  5  and  6  are partial cross-sectional views showing an operation of the intrauterine radiation device according to the exemplary embodiment of the present invention.  FIGS. 7 and 8  are partial cross-sectional views showing an operation of an intrauterine radiation device according to another exemplary embodiment of the present invention. 
       Embodiment 1 
       [0036]    The intrauterine radiation device  100  having individually inflatable balloons according to the exemplary embodiment of the present invention includes a hollow cylindrical cylinder  110 , and front balloons  120  mounted on the cylinder  110  (see  FIGS. 1 to 3 ). 
         [0037]    The cylinder  110  is equipped therein with a plurality of air tubes  140 , and radiation source mobile instruments O and T (see  FIG. 2 ). 
         [0038]    The front balloons  120  are radially mounted on an outer circumferential surface of a front end of the cylinder  110  in a direction in which the cylinder  110  is inserted (direction I, see  FIGS. 1 and 2 ), and are connected with the air tubes  140  so as to be individually inflated. 
         [0039]    The front balloons  120  may be inflated by external injection means  200 . The injection means  200  injects air or water through the air tubes  140 , and may include a pneumatic system  210  or a hydraulic system  220 . 
         [0040]    Here, the front balloons  120  are mounted in a mutually separated pattern, and are individually inflated by injection of air from the air tubes  140 . 
         [0041]    As shown in  FIG. 3 , the front balloons  120  may be disposed on upper, lower, left and right sides, i.e. a total of four sides, of the front end of the cylinder  110 . 
         [0042]    Here, the front balloons  120  may be connected to the air tubes  140 , respectively. Otherwise, a pair of left and right or upper and lower front balloons may be connected to one air tube. Here, the number of front balloons  120  and the number of air tubes  140  may be changed. For example, as shown in  FIG. 3 , five air tubes  140  may be provided to inject air to four front balloons  120  and one middle balloon  130  to be described below. 
         [0043]    Meanwhile, as shown in  FIG. 1 , the front end  110   a  of the cylinder  110  is bent toward the inside (an inward direction of the cylinder). The front balloons  120  can be mounted on an outer surface of the front end  110   a.    
         [0044]    Thereby, the front balloons  120  can be inflated in a thickness direction (direction II) or an inserting direction (direction I) of the cylinder  110 , or in the two directions at the same time, i.e. in a resultant direction (direction III). 
         [0045]    Meanwhile, as shown in  FIGS. 1 and 2 , the intrauterine radiation device  100  may further include a middle balloon  130  that is spaced apart from the front balloons  120 , mounted on the outer circumferential surface of the cylinder  110 , and connected with the air tube  140  so as to be inflated. 
         [0046]    The middle balloon  130  is inflated on a mouth side of the vagina, thereby preventing the intrauterine radiation device  100  of the present invention from being pushed out of the vagina and securing the mouth of the vagina. 
         [0047]    Meanwhile, the front balloons  120  and the middle balloon  130  can be inflated or contracted by injecting or discharging external air or water, and may be formed of one of resins having excellent inflatability without restriction, for instance, a polyvinyl resin. 
         [0048]    An operation of the intrauterine radiation device  100  as described above will be described with reference to  FIG. 2 . 
         [0049]    First, the intrauterine radiation device  100  is inserted into the vagina. Then, the front balloons  120  are located at an inner end of the vagina, and are individually inflated to push normal organs B and R. Here, B indicates the bladder, and R indicates the rectum. 
         [0050]    Particularly, a plurality of front balloons  120  (e.g. four front balloons  120  in this embodiment) are provided in a circumferential direction of the cylinder  110 , and are connected with a plurality of air tubes  140  so that the front balloons  120  can be inflated so as to have different volumes. Thereby, the present invention has an advantage in that the intrauterine radiation device  100  can be immobilized by adjusting a degree of inflation of each front balloon  120  to expand the inside of the vagina in a desired shape. 
         [0051]    The present invention resolves a conventional problem that, since gauze is packed around each radiation source mobile instrument and since the packed gauze varies in an amount or an angle, radiation cannot be applied to a previously set accurate position when a future operation is performed. That is, the present invention has an advantage in that, since an amount of air or water injected into each front balloon  120  can be checked, only such an amount is injected when a future operation is performed, so that the future operation can be performed by disposing the radiation source mobile instruments O and T at positions at which the previous operation was performed. A degree of injection of air for expanding the vagina can be checked using a gauge, and is recorded so as to secure reproducibility of the expansion. 
         [0052]    Further, the present invention can minimize conventional geometrical errors of a tandem T (see  FIG. 2 ) or an ovoid O (see  FIG. 2 ), the errors of which may occur during treatment due to the packed gauze, and reduce a treatment preparing time and discomfort of a patient because the packed gauze can be omitted if necessary. 
         [0053]    In addition, since the front balloons  120  can be independently inflated or contracted, the normal organs B and R (see  FIG. 2 ) move away in predetermined directions (e.g. in upward and downward directions), so that an unnecessary dose of radiation can be prevented from being applied to the normal organs. Here, the front balloons are inflated to such a degree that a patient does not suffer pain in the other directions (e.g. in leftward and rightward directions), so that more comfortable treatment can be provided to the patient. For example, if the front balloons are excessively inflated in the upward and downward directions, normal endovaginal tissues become narrow, and thus an unnecessary dose of radiation may be applied to these tissues. As such, it is necessary to somewhat inflate the front balloons in the leftward and rightward directions. 
         [0054]    To this end, the front balloons  120  bring the air tubes  140  into a relation of one-to-one correspondence, so that they can be filled with fluid such as air or water. 
         [0055]    Meanwhile, the number of front balloons  120  is not substantially restricted. As described above, the four front balloons may be symmetrical with respect to the central line of the cylinder  110 . 
         [0056]    The intrauterine radiation device  100  may further include at least one holder  160  formed on an inner circumference surface of the cylinder  110  at intervals (see  FIGS. 3 and 4 ). 
         [0057]    The tandem T (see  FIG. 2 ) or the ovoid O (see  FIG. 2 ) may be mounted in the holder  160 . As shown in  FIGS. 3 to 5 , the holder  160  is formed so as to protrude from the inner circumference surface of the cylinder  110  in a radially inward direction in a semi-circular cross-sectional shape (hereinafter referred to as “convex holder”). 
         [0058]    As shown in  FIG. 6 , the holder may be formed so as to protrude from the inner circumference surface of the cylinder  110  in a radially outward direction (hereinafter referred to as “concave holder  170 ”). 
         [0059]    A plurality of convex or concave holders  160  or  170  may be formed to additionally mount the radiation source mobile instruments. 
         [0060]    As described above, the three radiation source mobile instruments, i.e. a pair of ovoids O (see  FIG. 2 ) and one tandem T (see  FIG. 2 ), are used in the related art. As such, it is difficult to obtain various and selective distribution of the dose of radiation. However, the present invention has an advantage in that it can obtain more various and selective distribution of the dose of radiation than the related art by installing the additional ovoids on the plurality of holders  160  or  170  or mounting them at various positions. 
         [0061]    Meanwhile, when the concave holders  170  are formed as shown in  FIG. 6 , the radiation source mobile instruments may be mounted in the holders  170 , and then a shield  180  may be mounted around the radiation source mobile instruments. Radiation is applied in a specific direction by the shield  180 , so that the normal organs can be protected. The shield  180  may be inserted into the cylinder  110  as a semi-circular shield  181  or as a quadrant shield  182 . The shield  180  may be formed of lead (Pb). A shape of the shield  180  may be dependent on the number of radiation source mobile instruments or a shape of the radiation source mobile instrument. As the material of the shield  180 , any material that is able to shield the radiation may be used. 
         [0062]    A thermoluminescence dosimeter (TLD) may be installed in the cylinder  110  or the front balloon  120  so as to be able to measure an actual dose of radiation applied to a desired position. Thus, a dose of radiation planned by a computer is compared with an absolute dose of radiation, so that accurate treatment can be performed. When exposed to radiation, the TLD contains the radiation, and releases a dose of radiation when heated. Thus, an actual dose of radiation can be measured at a desired position by the TLD, and an accurate operation can be performed in future treatment. 
         [0063]    Meanwhile, the front end  110   a  of the cylinder  110  is partitioned into a plurality of split sleeves, and the front balloons  120  may be mounted on the split sleeves. As shown in  FIG. 7 , four split sleeves  111 ,  112 ,  113  and  114  are formed, and the four front balloons  120  may be mounted on the four split sleeves  111 ,  112 ,  113  and  114 , respectively. The number of split sleeves and the number of front balloons may vary. 
         [0064]    As described above, the front balloons  120  can be inflated in the thickness direction (direction II, see  FIG. 2 ) or the inserting direction (direction I, see  FIG. 2 ) of the cylinder  110 , or in the two directions at the same time. 
         [0065]    As shown in  FIG. 8 , the front end  110   a  of the split sleeves  111 ,  112 ,  113  and  114  may be bent in a radially inward direction as described above. Since the front end  110   a  has elasticity, the front end  110   a  can be deformed in a radially outward direction of the cylinder  110 , and then be restored to an original shape by the elasticity. 
         [0066]    Since a diameter of the uterus is greater than that of the vagina, the organs around the front balloons may not be easily pushed only by the inflation of the front balloons  120 . As such, as shown in  FIG. 8 , the split sleeves  111 ,  112 ,  113  and  114  are pushed in the inserting direction (direction IV) of the cylinder  110 , and thus are rotated in an outward direction (direction V) of the cylinder  110 . Then, the front balloons  120  are inflated to be able to push the surrounding organs. 
         [0067]    Meanwhile, the split sleeves  111 ,  112 ,  113  and  114  may have elasticity so as to be able to return to their original positions after being rotated in the direction V. Further, the split sleeves  111 ,  112 ,  113  and  114  may be coupled with the cylinder  110  using respective hinges Z so as to be able to be rotated in the direction V. The front end  110  a of the split sleeves  111 ,  112 ,  113  and  114  may also be bent in a radially inward direction. Here, the hinge Z is a device that allows one member to be pivoted relative to another member. This hinge is well known, and thus is conceptually shown in  FIG. 8 . 
         [0068]    As shown in  FIG. 8 , the split sleeves  111 ,  112 ,  113  and  114  may be rotated in a radially outward direction of the cylinder  110 , i.e. in the direction V, by pushing push rods D in the direction IV. 
       Embodiment 2 
       [0069]    In this embodiment, a method S 100  of applying intrauterine radiation using the intrauterine radiation device  100  described in Embodiment 1 will be described. 
         [0070]    First, after the intrauterine radiation device  100  is inserted into the vagina, the front balloons are inflated to immobilize the radiation source mobile instruments at desired positions. Then, an operation is performed. Here, a rate of flow required to inflate the front balloons is checked (S 110 ). 
         [0071]    Since the front balloons of the present invention are individually inflated, the surrounding organs can be pushed by desired distances, and thus the radiation source mobile instruments can be disposed at desired positions. This is as described above. 
         [0072]    Meanwhile, it is necessary to check the positions of the surrounding organs. Anatomical positions of the organs can be checked by injecting a contrast medium into the organs and x-raying the organs. 
         [0073]    Information about the flow rate for inflating the front balloons is obtained in step S 110 , and the subsequent step S 120  is performed. 
         [0074]    Step S 120  is applied to an additional operation after a first operation has been performed. After the intrauterine radiation device  100  is inserted into the vagina, the checked flow rate is injected into the front balloons, and thus the radiation source mobile instruments are disposed at positions at which the first operation was performed. Then, the radiation is applied to perform the additional operation. 
         [0075]    That is, the information about the flow rate for inflating the front balloons is first obtained by this method S 100 . Then, the front balloons are inflated based on the obtained information about the flow rate when the future operation is performed. Thereby, the conditions in which the first operation was performed can be accurately reproduced. 
         [0076]    In this manner, since the present invention can obtain predetermined information about the flow rate after the first operation has been performed, and the obtained conditions of the first operation can be accurately reproduced when the future operation is performed, it resolves the conventional problem occurring when the radiation source mobile instruments are packed using the gauze (i.e. the problem that the positions of the radiation source mobile instruments when the first operation is performed are changed by repetition of the operation because an amount, an angle, etc. of packed gauze vary whenever the operation is performed). 
       Embodiment 3 
       [0077]    In this embodiment, a method S 200  of applying intrauterine radiation will be described as in Embodiment 2. 
         [0078]    In detail, the method S 200  includes inserting the intrauterine radiation device  100  into the vagina, inflating the front balloons in such a manner that the balloon adjacent to a diseased part is less inflated than the other balloons, and concentrating the radiation radiating from the radiation source mobile instruments on a diseased part. 
         [0079]    The method S 200  of the present invention allows a distance between the diseased part and the radiation source mobile instrument to be reduced to focus the radiation on the diseased part. 
         [0080]    Further, since the balloons adjacent to the normal organs are relatively more inflated, a distance between the normal organs and the radiation source mobile instrument is increased, so that a dose of the radiation applied to the normal organs can be remarkably reduced. 
         [0081]    While the invention has been shown and described with reference to certain exemplary embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the appended claims.