Method for modification of radiotherapy treatment delivery
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Abstract
The present invention provides a novel method of contoured-anatomy dose repositioning (CADR) as a means to automatically reposition a patient to better recover the planned dose distribution without reoptimize the treatment plan. Specifically, CADR utilizes planning CT images, the planned dose distribution, and on-line images for repositioning dose distribution on a given day. Contours are also placed upon the images using manual, automatic, template-based, or other techniques. CADR then optimizes the rigid-body repositioning of the patient so that the daily dose distribution closely matches the planned dose distribution. The present invention also provides a method of multiple-margin optimization with daily selection (MMODS) to improve radiation delivery without reoptimization. During the initial optimization procedure, plans are optimized for several margins of various contours (e.g., tight, medium, loose, etc.), or with different objectives (e.g., aggressive treatment, sensitive structure sparing, etc.). Similarly, if multiple patient image sets are available, plans can be optimized for the different anatomical layouts, either using current information, or accumulated information regarding the superposition of organ locations in the combination of images. A user can then choose in real time from a variety of optimized plans, generally with different margins, during the treatment process, and thereby compensate for a recognized change in size or position of the tumor or neighboring tissue.
207 Citations
26 Claims
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1-13. -13. (canceled)
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14. A method for modification of radiotherapy treatment delivery, the method comprising the steps of:
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obtaining at least one treatment planning image from a patient to determine the relative location of target and sensitive structures;
preparing a treatment plan for the patient based on the at least one treatment planning image;
preparing a dose distribution plan for the patient based on the treatment plan;
obtaining at least one image from the patient at the time of treatment delivery to reposition the dose distribution for the patient, if necessary;
comparing the at least one treatment planning image to the at least one image taken of the patient at the time of treatment delivery to modify the treatment plan and dose distribution;
adjust patient position to better position patient'"'"'s internal anatomy relative to dose distribution;
optimize repositioning of the patient so that the dose distribution matches planned dose distribution;
optimize positioning of the fraction image, relative to the dose distribution, such that the dose received by relevant structures for the fraction is improved;
iterate as necessary to best combine a treatment plan and a patient position to achieve the desired dose distribution; and
deliver treatment to the patient. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26)
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Specification