Fiducial marker / cancer imaging and treatment apparatus and method of use thereof

• US 10,357,666 B2
• Filed: 02/08/2018
• Issued: 07/23/2019
• Est. Priority Date: 04/16/2010
• Status: Active Grant

• Current Assignee: ProTom International Holding Corporation
• Original Assignee: ProTom International Holding Corporation
• Inventors: Lee, W. Davis, Amato, Mark R., Ruebel, Nick, Reno, Jillian, Michaud, Susan L.
• Primary Examiner(s): McCormack, Jason L
• Application Number:
  US15/892,305
• Publication Number:
  US 20180178041A1
• Time in Patent Office: 530 Days
• Field of Search: 2504921, 2504923, 2504931
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• 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 2005/1054 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 5/1049 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 fiducial marker—fiducial detector based treatment room position determination/positioning system apparatus and method of use thereof. A set of fiducial markers and fiducial detectors are used to mark/determine relative position of static and/or moveable objects in a treatment room using photons passing from the markers to the detectors. Further, position and orientation of at least one of the objects is calibrated to a reference line, such as a zero-offset beam treatment line passing through an exit nozzle, which yields a relative position of each fiducially marked object in the treatment room. Treatment calculations are subsequently determined using the reference line and/or points thereon. The treatment calculations are optionally and preferably performed without use of an isocenter point, such as a central point about which a treatment room gantry rotates, which eliminates mechanical errors associated with the isocenter point being an isocenter volume in practice.

Claims

1. A method for determining a position of a tumor in a patient for treatment using positively charged particles, comprising the steps of:

providing at least a first fiducial indicator mechanically coupled to a nozzle system, the positively charged particles passing through said nozzle system during use;

providing at least a second fiducial indicator mechanically coupled to a first movable object in a treatment room;

a controller determining, using said first fiducial indicator and said second fiducial indicator, a first position of said first movable object relative to said nozzle system;

targeting the tumor with the positively charged particles using knowledge of said nozzle system and the first position of said first movable object; and

said controller prognosticating a conflict between the first movable object and a treatment beam path of the positively charged particles using;

(1) a known geometry of the first movable object and (2) at least two positions, at separate times, of the first movable object determined using said second fiducial indicator.

2. The method of claim 1, further comprising the steps of:

providing a set of fiducial indicators, said set of fiducial indicators comprising;

said first fiducial indicator;

said second fiducial indicator;

a set of fiducial markers; and

a set of fiducial detectors;

providing a set of movable objects, said set of movable objects comprising said first movable object;

placing at least one member of said set of fiducial indicators on each member of said set of movable objects in a treatment room, said set of objects comprising;

(1) a nozzle system, said nozzle system connected to a synchrotron via a first beam transport line;

(2) an imaging system; and

(3) a patient positioning system;

using said set of fiducial detectors to detect photons from said set of fiducial markers;

determining, using said controller, a relative position of said nozzle system and the tumor using output from said set of fiducial detectors; and

targeting the tumor, with the positively charged particles, using the relative position of said nozzle system and the tumor.

3. The method of claim 2, further comprising the step of:

using input from said set of fiducial indicators, said controller controlling position of at least three movable objects, of said set of movable objects in the treatment room.

4. The method of claim 2, further comprising the steps of:

linking said controller to said set of fiducial indicators; and

using input from said set of fiducial indicators, said controller controlling the positively charged particles.

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

said controller, using output from said set of fiducial indicators, monitoring rotation of at least one of;

said nozzle system, said imaging system, and said patient positioning system.

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

said controller, using first output from said set of fiducial indicators, determining relative current positions of each of said set of objects after movement of any of said set of objects.

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

said controller adjusting position of said patient positioning system based on the output from said set of fiducial indicators.

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

said controller dynamically adjusting a relative position of the tumor and a beam position of the positively charged particles using second output from said imaging system.

9. The method of claim 8, said imaging system comprising a proton tomography imaging system.

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

upon determination of the conflict, said controller automatically adjusting a radiation treatment plan for treatment of the tumor.

12. The method of claim 2, further comprising the step of:

said controller tracking position of at least two of said set of movable objects in the treatment room.

13. The method of claim 2, further comprising the step of:

using a tomography system, linked to said set of fiducial indicators via said controller, to image the tumor using the positively charged particles.

14. The method of claim 13, said step of using said tomography system further comprising the step of:

determining a relative position of a scintillation material, of said tomography system, and the patient using said set of fiducial indicators.

15. The method of claim 13, said step of using said tomography system further comprising the step of:

determining relative positions of a scintillation material, of said tomography system, the patient, and said patient positioning system using said set of fiducial indicators.

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

marking a patient movement assist device with a third fiducial indicator, said patient movement assist device movable from outside of the treatment room into the treatment room.

18. The method of claim 2, further comprising the step of:

said controller, using input from said set of fiducial indicators, verifying a clear field treatment vector from said nozzle system to the patient.

11. A method for determining a position of a tumor in a patient for treatment using positively charged particles, comprising the steps of:

providing at least a first fiducial indicator, mechanically coupled to a nozzle system, the positively charged particles passing through said nozzle system during use;

providing at least a second fiducial indicator mechanically coupled to a first movable object in a treatment room;

a controller determining, using said first fiducial indicator and said second fiducial indicator, a first position of said first movable object relative to said nozzle system;

targeting the tumor with the positively charged particles using knowledge of said nozzle system and the first position of said first movable object;

providing a set of fiducial indicators, said set of fiducial indicators comprising;

said first fiducial indicator;

said second fiducial indicator;

a set of fiducial markers; and

a set of fiducial detectors;

providing a set of movable objects, said set of movable objects comprising said first movable object;

placing at least one member of said set of fiducial indicators on each member of said set of movable objects in a treatment room, said set of objects comprising;

(1) a nozzle system, said nozzle system connected to a synchrotron via a first beam transport line;

(2) an imaging system; and

(3) a patient positioning system;

using said set of fiducial detectors to detect photons from said set of fiducial markers;

determining, using said controller, a relative position of said nozzle system and the tumor using output from said set of fiducial detectors; and

targeting the tumor, with the positively charged particles, using the relative position of said nozzle system and the tumor;

linking said controller to said set of fiducial indicators; and

using input from said set of fiducial indicators, said controller controlling the positively charged particles; and

said controller, upon observing a loss of an expected signal from said set of fiducial indicators, preventing the positively charged particles from striking the patient.

16. A method for determining a position of a tumor in a patient for treatment using positively charged particles, comprising the steps of:

providing at least a first fiducial indicator, mechanically coupled to a nozzle system, the positively charged particles passing through said nozzle system during use;

providing at least a second fiducial indicator mechanically coupled to a first movable object in a treatment room;

a controller determining, using said first fiducial indicator and said second fiducial indicator, a first position of said first movable object relative to said nozzle system;

targeting the tumor with the positively charged particles using knowledge of said nozzle system and the first position of said first movable object;

attaching a third fiducial indicator to an operator in the treatment room; and

using output from said third fiducial indicator, said controller preventing the positively charged particles from striking the operator.