Auto-updated and implemented radiation treatment plan apparatus and method of use thereof

• US 10,179,250 B2
• Filed: 04/10/2017
• Issued: 01/15/2019
• Est. Priority Date: 04/16/2010
• Status: Active Grant

• Current Assignee: ProTom International Holding Corporation
• Original Assignee: ProTom International Holding Corporation
• Inventors: Ruebel, Nick, Michaud, Susan L., Amato, Mark R., Reno, Jillian, Lee, W. Davis, Bennett, James P.
• Primary Examiner(s): Vanore, David A
• Application Number:
  US15/483,714
• Publication Number:
  US 20170209715A1
• Time in Patent Office: 645 Days
• Field of Search: 2504923, 2504921, 250396 R, 2505051, 25049222, 25037011, 378 65, 378 68, 378 69, 378 97, 315503, 600427, 600411, 600425, 600426, 600534
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/037 Emission tomography
• CPC Class Codes: A61B 6/4258 for detecting non x-ray radiation, e.g. gamma radiation A61B6/037 takes precedence
• CPC Class Codes: A61B 6/5205 involving processing of raw data to produce diagnostic data
• CPC Class Codes: A61N 2005/1051 using an active marker markers in general A61B90/39
• CPC Class Codes: A61N 2005/1052 using positron emission tomography [PET] single photon emission computer tomography [SPECT] imaging
• CPC Class Codes: A61N 2005/1054 using a portal imaging system
• CPC Class Codes: A61N 2005/1061 using an x-ray imaging system having a separate imaging source
• CPC Class Codes: A61N 2005/1087 Ions; Protons
• CPC Class Codes: A61N 2005/1095 Elements inserted into the radiation path within the system, e.g. filters or wedges
• CPC Class Codes: A61N 2005/1097 Means for immobilizing the patient
• CPC Class Codes: A61N 5/1037 taking into account the movement of the target, e.g. 4D-image based planning
• CPC Class Codes: A61N 5/1039 using functional images, e.g. PET or MRI
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam
• CPC Class Codes: A61N 5/1067 in real time, i.e. during treatment
• CPC Class Codes: A61N 5/1069 Target adjustment, e.g. moving the patient support
• CPC Class Codes: A61N 5/107 in real time, i.e. during treatment
• CPC Class Codes: A61N 5/1077 Beam delivery systems
• CPC Class Codes: A61N 5/1081 Rotating beam systems with a specific mechanical construction, e.g. gantries
• CPC Class Codes: A61N 5/1082 having multiple beam rotation axes
• CPC Class Codes: G21K 1/08 : Deviation, concentration or focusing of the beam by electric or magnetic means electron-optical arrangements in electric discharge tubes H01J29/46; details, e.g. electric or magnetic deviating means for direct voltage accelerators or in accelerators using single pulses H05H5/02; arrangements for injecting particles into orbits H05H7/08; arrangements for ejecting particles from orbits H05H7/10
• CPC Class Codes: G21K 5/04 : with beam-forming means

Abstract

The invention comprises a method and apparatus for treating a tumor, comprising the steps of: (1) a main controller implementing an initial radiation treatment plan, as a current radiation treatment plan, using positively charged particles delivered from a synchrotron, along a beam transport line, through a nozzle system proximate the treatment room, and into the tumor; (2) concurrent with the step of implementing, imaging the tumor, such as with protons, to generate a current image; (3) upon detection of movement of the tumor relative to surrounding constituents of the patient using the current image, the main controller, using computer implemented code, automatically generating an updated treatment plan, the updated treatment plan becoming the current radiation treatment plan; and (4) repeating the steps of implementing, imaging, and generating an updated treatment plan at least n times, where n is a positive integer of at least one.

Claims

1. A method for treating a tumor of a patient with positively charged particles in a treatment room, comprising the steps of:

providing an initial radiation treatment plan;

a main controller implementing the initial radiation treatment plan, as a current radiation treatment plan, using the positively charged particles delivered from a synchrotron, along a beam transport line, through a nozzle system proximate the treatment room, and into the tumor;

concurrent with said step of implementing, imaging the tumor to generate a current image, said step of imaging further comprising the step of;

generating a positron emission tomogram of the tumor while the positively charged particles are being delivered to the patient;

upon detection of movement of the tumor relative to surrounding constituents of the patient using the current image, said main controller automatically generating an updated treatment plan, the updated treatment plan becoming the current radiation treatment plan; and

repeating said steps of implementing, imaging, and generating an updated treatment plan at least n times, where n is a positive integer of at least one.

2. The method of claim 1, said step of imaging further comprising the step of:

calculating a beam path of an individual proton, of the positively charged particles, using output of a first detector sheet positioned between the patient and a scintillation detector positioned on an opposite side of the patient relative to an entry point of the individual proton into the patient.

3. The method of claim 1, further comprising the step of:

an unsupervised computer implemented algorithm automatically providing at least changes in the updated treatment plan relative to a prior version of the current radiation treatment plan and proceeding with said step of repeating.

4. The method of claim 1, further comprising the step of:

said unsupervised computer implemented algorithm automatically proceeding with said step of repeating without an explicit real-time provided approval input to continue.

5. A method for treating a tumor of a patient with positively charged particles in a treatment room, comprising the steps of:

providing an initial radiation treatment plan;

a main controller implementing the initial radiation treatment plan, as a current radiation treatment plan, using the positively charged particles delivered from a synchrotron, along a beam transport line, through a nozzle system proximate the treatment room, and into the tumor;

concurrent with said step of implementing, imaging the tumor to generate a current image;

upon detection of movement of the tumor relative to surrounding constituents of the patient using the current image, said main controller automatically generating an updated treatment plan, the updated treatment plan becoming the current radiation treatment plan, said step of automatically generating an updated treatment plan further comprising the step of;

an unsupervised computer implemented algorithm using a set of computer coded inputs to automatically generate the updated treatment plan the updated treatment plan requiring an unplanned for, in the original radiation treatment plan, movement of said nozzle system; and

repeating said steps of implementing, imaging, and generating an updated treatment plan at least n times, where n is a positive integer of at least one.

6. The method of claim 5, further comprising the step of:

a coded algorithm automatically generating the original radiation treatment plan using inputs comprising all of;

a set of images of the tumor;

dose distribution parameters;

patient motion parameters; and

a known geometry of a dynamically movable treatment room object.

7. The method of claim 6, further comprising the steps of:

using output from a fiducial marker system, comprising a fiducial marker and a fiducial detector, in said step of automatically generating the updated radiation treatment plan, said output generated using detected photons, the photons passing from said fiducial marker to said fiducial detector; and

automatically increasing energy of particles extracted from said synchrotron to yield a radiation treatment plan energy of the positively charged particles after loss of energy passing through the movable treatment room object.

8. A method for treating a tumor of a patient with positively charged particles in a treatment room, comprising the steps of:

providing an initial radiation treatment plan;

a main controller implementing the initial radiation treatment plan, as a current radiation treatment plan, using the positively charged particles delivered from a synchrotron, along a beam transport line, through a nozzle system proximate the treatment room, and into the tumor;

concurrent with said step of implementing, imaging the tumor to generate a current image;

upon detection of movement of the tumor relative to surrounding constituents of the patient using the current image, said main controller automatically generating an updated treatment plan, the updated treatment plan becoming the current radiation treatment plan; and

repeating said steps of implementing, imaging, and generating an updated treatment plan at least n times, where n is a positive integer of at least one,

the updated treatment plan directing an originally unplanned for, in the original radiation treatment plan, movement of said nozzle system.

9. The method of claim 8, further comprising the step of:

the updated treatment plan directing a disconnect of said nozzle system from said beam transport line and a connection of said nozzle system to a second beam transport line.

10. A method for treating a tumor of a patient with positively charged particles in a treatment room, comprising the steps of:

providing an initial radiation treatment plan;

a main controller implementing the initial radiation treatment plan, as a current radiation treatment plan, using the positively charged particles delivered from a synchrotron, along a beam transport line, through a nozzle system proximate the treatment room, and into the tumor;

concurrent with said step of implementing, imaging the tumor to generate a current image;

upon detection of movement of the tumor relative to surrounding constituents of the patient using the current image, said main controller automatically generating an updated treatment plan, the updated treatment plan becoming the current radiation treatment plan; and

repeating said steps of implementing, imaging, and generating an updated treatment plan at least n times, where n is a positive integer of at least one,

the updated treatment plan directing rotational movement of a gantry about the patient, said gantry comprising a counterweight counter balance comprising a first moment of force within ten percent of a second moment of force of elements of said gantry on an opposite side of an axis of rotation of said gantry.

11. An apparatus for treating a tumor of a patient with positively charged particles in a treatment room, comprising:

a synchrotron connected to a nozzle system, proximate the treatment room, by a beam transport line;

a main controller provided an initial radiation treatment plan, said main controller configured to implement the initial radiation treatment plan, as a current radiation treatment plan, using the positively charged particles delivered from said synchrotron, along said beam transport line, through said nozzle system and into the tumor;

an imaging system configured to, concurrent with implementation of the current radiation treatment plan by said main controller, image the tumor to generate a current image, said imaging system further comprising;

a positron emission tomography system, rotatable about the patient, comprising a source and a detector continually out of a path of the positively charged particles;

said main controller configured to, upon detection of movement of the tumor relative to adjacent constituents of the patient using the current image, automatically generate an updated treatment plan, the updated treatment plan becoming the current radiation treatment plan; and

said main controller configured to repeat the implementation of the current radiation treatment plan, use the current image, and generate an updated treatment plan at least n times, where n is a positive integer of at least one.

12. The apparatus of claim 11, said imaging system further comprising:

a first sheet, positioned between said nozzle system and the patient, configured to emit first photons upon a proton, of the positively charged particles, traversing said first sheet;

a second sheet, positioned between said first sheet and the patient, configured to emit second photons upon the proton traversing said second sheet; and

a scintillation detector system positioned on an opposite side of the patient from the nozzle system configured to detect the proton.

13. The apparatus of claim 12, said imaging system further comprising:

an X-ray system configured to co-rotate and co-translate with said positron emission tomography system.

14. The apparatus of claim 12, further comprising:

a gantry configured to rotate about an axis of rotation, said gantry comprising a counterweight counter balance, on a first side of the axis of rotation, comprising a first moment of force within ten percent of a second moment of force of elements of said gantry on an opposite side of the axis of rotation.

15. An apparatus for treating a tumor of a patient with positively charged particles in a treatment room, comprising:

a synchrotron connected to a nozzle system, proximate the treatment room, by a beam transport line;

a main controller provided an initial radiation treatment plan, said main controller configured to implement the initial radiation treatment plan, as a current radiation treatment plan, using the positively charged particles delivered from said synchrotron, along said beam transport line, through said nozzle system and into the tumor;

a gantry configured to rotate about an axis of rotation passing within one meter of the patient during use, said gantry comprising;

all movable counterweight elements, on a first side of the axis of rotation comprising a first combined moment of force; and

all movable gantry elements, on a second side of the axis of rotation opposite the first side of the axis of rotation, comprising a second moment of force within ten percent of the first moment of force; and

an imaging system configured to, concurrent with implementation of the current radiation treatment plan by said main controller, image the tumor to generate a current image;

said main controller configured to, upon detection of movement of the tumor relative to adjacent constituents of the patient using the current image, automatically generate an updated treatment plan, the updated treatment plan becoming the current radiation treatment plan; and

said main controller configured to repeat the implementation of the current radiation treatment plan, use the current image, and generate an updated treatment plan at least n times, where n is a positive integer of at least one.