System for delivering conformal radiation therapy while simultaneously imaging soft tissue

• US 10,688,319 B2
• Filed: 02/17/2017
• Issued: 06/23/2020
• Est. Priority Date: 02/20/2004
• Status: Active Grant

• Current Assignee: University of Florida Research Foundation, Incorporated (State University System of Florida)
• Original Assignee: University of Florida Research Foundation, Incorporated (State University System of Florida)
• Inventors: Dempsey, James F.
• Primary Examiner(s): Santos Rodriguez, Joseph M
• Application Number:
  US15/436,620
• Publication Number:
  US 20170203126A1
• Time in Patent Office: 1,222 Days
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61N 2005/1055 using magnetic resonance imaging [MRI]
• 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 5/1042 with spatial modulation of the radiation beam within the treatment head
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam
• CPC Class Codes: A61N 5/1064 for adjusting radiation treatment in response to monitoring
• CPC Class Codes: A61N 5/1067 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: G01R 33/34061 Helmholtz coils
• CPC Class Codes: G01R 33/381 using electromagnets
• CPC Class Codes: G01R 33/4808 Multimodal MR, e.g. MR combined with positron emission tomography [PET], MR combined with ultrasound or MR combined with computed tomography [CT]
• CPC Class Codes: G01R 33/4812 MR combined with X-ray or computed tomography [CT]

Abstract

A device and a process for performing high temporal- and spatial-resolution MR imaging of the anatomy of a patient during intensity modulated radiation therapy (IMRT) to directly measure and control the highly conformal ionizing radiation dose delivered to the patient for the treatment of diseases caused by proliferative tissue disorders. This invention combines the technologies of open MRI, multileaf-collimator or compensating filter-based IMRT delivery, and cobalt teletherapy into a single co-registered and gantry mounted system.

Claims

1. A computer program product comprising a non-transitory machine-readable medium storing instructions that, when executed by at least one programmable processor, cause the at least one programmable processor to perform operations comprising:

commencing a radiation treatment with an initial intensity modulated radiation therapy (IMRT) treatment plan optimized for a patient;

receiving magnetic resonance imaging data captured by a magnetic resonance imaging system during radiation therapy of the patient during a treatment fraction, the magnetic resonance imaging data acquired at a rate sufficient to capture intra-fraction organ motions;

receiving data indicating ionizing radiation delivered to the patient; and

generating a reoptimized IMRT treatment plan after therapy has commenced, the reoptimized IMRT treatment plan recalculated and reoptimized utilizing the magnetic resonance imaging data and the delivered ionizing radiation data.

2. The computer program product of claim 1, wherein re-optimizing the initial IMRT treatment plan occurs when the magnetic resonance imaging data indicates the presence of intra-fraction organ motion during the radiation therapy.

3. The computer program product of claim 1, wherein the initial IMRT treatment plan is reoptimized during radiation therapy of the patient.

4. The computer program product of claim 1, wherein the initial IMRT treatment plan is reoptimized after the treatment fraction.

5. The computer program product of claim 1 further comprising determining an actual dose deposition in the patient from the magnetic resonance imaging data and the delivered ionizing radiation data by summing doses delivered to the patient over at least a portion of the treatment fraction.

6. The computer program product of claim 5, wherein the reoptimizing of the initial IMRT treatment plan also utilizes the determined actual dose deposition.

7. The computer program product of claim 1, wherein the magnetic resonance imaging data comprises three dimensional data.

8. A system comprising:

a multileaf collimator configured for attenuation of a beam delivering ionizing radiation to a patient during a treatment fraction, the patient having moving tissues during the treatment fraction;

a magnetic resonance imaging system configured to acquire magnetic resonance imaging data of patient anatomy fast enough to capture intra-fraction organ motion during the treatment fraction; and

a computer configured to perform operations comprising;

commencing a radiation treatment with an initial intensity modulated radiation therapy (IMRT) treatment plan optimized for a patient; and

generating a reoptimized IMRT treatment plan after therapy has commenced, the reoptimized IMRT treatment plan recalculated and reoptimized utilizing the magnetic resonance imaging data.

9. The system of claim 8, wherein the computer is configured to reoptimize the initial IMRT treatment plan when the magnetic resonance imaging data indicates the presence of intra-fraction organ motion during the treatment fraction.

10. The system of claim 8, wherein the computer reoptimizes the initial IMRT treatment plan during the treatment fraction.

11. The system of claim 8, wherein the computer reoptimizes the initial IMRT treatment plan after the treatment fraction.

12. The system of claim 8, wherein the computer is further configured to determine an actual dose deposition in the patient from the magnetic resonance imaging data and delivered ionizing radiation by summing doses delivered to the patient over at least a portion of the treatment fraction.

13. The system of claim 12, wherein the computer is configured to reoptimize the initial IMRT treatment plan also utilizing the determined actual dose deposition.

14. The system of claim 12, wherein the computer is configured to stop the delivery of ionizing radiation if the actual dose deposition evidences a dosimetric error.

15. The system of claim 8, wherein the computer and multileaf collimator are configured to rapidly adjust to account for intra-fraction organ motions.

16. The system of claim 8, wherein the computer and magnetic resonance imaging system are further configured to monitor the patient'"'"'s response to therapy during the treatment fraction.

17. The system of claim 8, wherein the magnetic resonance imaging system is configured to operate at a field strength below 1.0 T.

18. The system of claim 8, wherein the magnetic resonance imaging system is configured to operate at a field strength of between 0.2 and 0.5 T.

19. The system of claim 8, wherein the magnetic resonance imaging data comprises three dimensional data.