Dynamic/adaptive treatment planning for radiation therapy

• US 20060078086A1
• Filed: 07/25/2005
• Published: 04/13/2006
• Est. Priority Date: 07/23/2004
• Status: Active Grant

• Current Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Original Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Inventors: Mate, Timothy P., Wright, J. Nelson, Dimmer, Steven C., Meier, Eric, Riley, James K.
• Granted Patent: US 8,437,449 B2
• Time in Patent Office: Days
• US Class Current: 378/65
• CPC Class Codes: A61N 5/103 Treatment planning systems
• CPC Class Codes: A61N 5/1038 taking into account previously administered plans applied to the same patient, i.e. adaptive radiotherapy
• CPC Class Codes: A61N 5/1048 Monitoring, verifying, controlling systems and methods

Abstract

A facility for facilitating custom radiation treatment planning is described. During a distinguished radiation treatment session for a patient, the facility collects data indicating positioning of a predefined treatment site of the patient relative to a target treatment location throughout the distinguished radiation treatment session. The facility associates the collected positioning data with data describing one or more other aspects of the distinguished radiation treatment session. The facility provides the associated data to a treatment planning facility to determine a treatment plan for future radiation treatment sessions for the patient.

Claims

1. A method in a computing system for facilitating custom radiation treatment planning, comprising:

during a distinguished radiation treatment session for a patient, collecting data indicating positioning of a predefined treatment site of the patient relative to a target treatment location throughout the distinguished radiation treatment session;

associating the collected positioning data with data describing one or more other aspects of the distinguished radiation treatment session; and

providing the associated data to a treatment planning facility to determine a treatment plan for a future radiation treatment session for the patient.

2. The method of claim 1 wherein the positioning data is associated with information describing delivery of radiation during the distinguished radiation treatment session.

3. The method of claim 1 wherein the positioning data is associated with other data stored in a treatment plan prepared for the distinguished radiation treatment session.

4. The method of claim 1 wherein the positioning data is associated with other data stored in a record and verify system.

5. The method of claim 1 wherein the positioning data is associated with data describing a plurality of radiation treatment fields used during the treatment session.

6. The method of claim 1 further comprising, before providing the associated data to a treatment planning facility, discarding portions of the associated data corresponding to time periods during which radiation was not delivered to the distinguished patient.

7. The method of claim 1 wherein the collected data indicates a vector between the target treatment location and the predefined treatment site of the patient.

8. The method of claim 1 wherein the collected data indicates an orientation of the patient relative to a source of radiation treatment.

9. The method of claim 1 wherein the provided data is provided as a time series.

10. The method of claim 1 wherein the data is processed or reduced in order to facilitate treatment planning including, but not limited, to smoothing, regression analysis, characterizing motion, or, characterizing the overall state of the system accounting for deformations due to real-time changes or day-to-day changes.

11. The method of claim 1 wherein the provided data comprises information related to the healthy tissue surrounding the tumor which may be used to adapt the treatment plan.

12. The method of claim 1 wherein the provided data comprises information related to bone or tissue that does not contain markers or fiducials but can be estimated or inferred from the existing measurements through data analysis.

13. The method of claim 1 wherein the provided data further comprises data indicating, throughout the distinguished radiation treatment session, a measure of the rate at which radiation energy is delivered.

14. The method of claim 1 wherein the provided data further comprises data indicating, throughout the distinguished radiation treatment session, a cross-sectional shape of a radiation beam in which radiation energy is delivered.

15. The method of claim 1 wherein the provided data further comprises data indicating, throughout the distinguished radiation treatment session, a direction of a radiation beam in which radiation energy is delivered.

16. A computing system for facilitating custom radiation treatment planning, comprising:

a data collection subsystem that collects data describing a distinguished radiation treatment session for a distinguished patient, the collected data including (a) data indicating positioning of a predefined treatment site of the distinguished patient relative to a target treatment location and (b) data reflecting the delivery of radiation energy throughout the distinguished radiation treatment session;

a data correlation subsystem that performs a time-correlation on the collected data; and

a data provision subsystem that provides the data connected by the data correlation subsystem to a treatment planning facility for the purpose of determining a treatment plan for a future radiation treatment session for the distinguished patient.

17. A computer-readable medium whose contents cause a computing system to facilitate custom radiation treatment planning, the method comprising:

throughout an observation period for a patient, collecting data indicating positioning of a predetermined treatment site of the patient; and

providing the associated data to a treatment planning facility for the purpose of determining a treatment plan for future radiation treatment session for the patient that is based upon the collected positioning data.

18. The computer-readable medium of claim 17 wherein the collected positioning data is expressed relative to a defined point on the exterior of the patient'"'"'s body.

19. The computer-readable medium of claim 17 wherein the collected positioning data is expressed relative to a frame of reference external to the patient'"'"'s body.

20. The computer-readable medium of claim 17 wherein the observation period does not coincide with the provision of radiation therapy.

21. The computer-readable medium of claim 17 wherein the collection is performed while the patient is not inside a radiation therapy treatment vault.

22. The computer-readable medium of claim 17 wherein the observation period intersects with a radiation therapy session for the patient.

23. One or more propagated data signals collectively conveying an adaptive treatment planning data structure for a patient, comprising:

information identifying a completed radiation treatment session in which the patient was treated; and

information indicating the location throughout the identified treatment session of a predefined treatment site of the patient relative to a machine isocenter,

such that the contents of the adaptive treatment planning data structure may be used to generate a treatment plan for a future radiation treatment session for the patient.

24. The data signals of claim 23 wherein the information indicating the location throughout the identified treatment session of a predefined treatment site of the patient relative to a target treatment location is structured as a time series that identifies, for a series of times during the treatment session occurring at substantially equal intervals, the location of the predefined treatment site of the patient relative to the target treatment location.

25. The data signals of claim 23 wherein the adaptive treatment planning data structure further comprises information identifying the patient.

26. The data signals of claim 23 wherein the adaptive treatment planning data structure is organized using data description tags.

27. The data signals of claim 23 wherein the adaptive treatment planning data structure is stored in XML format.

28. The data signals of claim 23 wherein the adaptive treatment planning data structure is stored in an extended DICOM format.

29. One or more computer memories collectively containing an adaptive treatment planning data structure, comprising:

information identifying a completed radiation treatment session in which the patient was treated; and

information indicating the location throughout the identified treatment session of a predefined treatment site of the patient relative to a target treatment location,

such that the contents of the adaptive treatment planning data structure may be used to generate a treatment plan for a future radiation treatment session for the patient.

30. A method in a computing system for performing custom radiation treatment planning for a distinguished patient, comprising:

receiving data indicating, during a foregoing distinguished radiation treatment session for a distinguished patient, positioning of a predefined treatment site of the distinguished patient relative to a machine isocenter throughout the distinguished radiation treatment session; and

determining a radiation treatment plan for a future radiation treatment session for the distinguished patient in a manner responsive to the received data.

31. The method of claim 30, further comprising treating the distinguished patient in accordance with determined radiation treatment plan.

32. The method of claim 30 wherein the determined radiation treatment plan includes a specification of a rate at which radiation energy is to be delivered to the distinguished patient throughout the future radiation treatment session, and wherein the specified rate is responsive to the received data.

33. The method of claim 30 wherein the determined radiation treatment plan includes a specification of a duration for the future radiation treatment session, and wherein the specified duration is responsive to the received data.

34. The method of claim 30 wherein the determined radiation treatment plan includes a specification of a total amount of radiation energy that is to be delivered to the distinguished patient throughout the future radiation treatment session, and wherein the specified amount is responsive to the received data.

35. The method of claim 30 wherein the determined radiation treatment plan includes a specification of a direction in which radiation energy is to be delivered to the distinguished patient throughout the future radiation treatment session, and wherein the specified direction is responsive to the received data.

36. The method of claim 30 wherein the determined radiation treatment plan includes a specification of a treatment site location of the distinguished patient toward which radiation energy is to be delivered throughout the future radiation treatment session, and wherein the treatment site location is responsive to the received data.

37. The method of claim 30 wherein the determined radiation treatment plan includes a specification of one or more cross-sectional shape of a radiation beam in which radiation energy is to be delivered throughout the future radiation treatment session, and wherein the specified shapes are responsive to the received data.

38. The method of claim 30 wherein the determined radiation treatment plan includes a specification of one or more orientations of a radiation beam in which radiation energy is to be delivered throughout the future radiation treatment session, and wherein the specified orientations are responsive to the received data.

39. The method of claim 30 wherein the received data was generated using magnetic localization.

40. The method of claim 30 wherein the received data was generated using visual localization.

41. The method of claim 30 wherein a radiation treatment plan for future radiation treatment session is determined with reference to a library of solutions to tracking patterns observed in other patients.

42. The method of claim 30 wherein the determined radiation treatment plan specifies a plurality of treatment fields in radiation energy delivery parameters for each field of the plurality.

43. The method of claim 30 wherein the radiation treatment plan for a future radiation treatment session is determined in part based upon treatment site tracking performed in the absence of radiation energy delivery.

44. A computer-readable medium whose contents cause a computing system to perform a method for performing custom radiation treatment planning for a distinguished patient, comprising:

receiving data indicating, during a foregoing distinguished radiation treatment session for a distinguished patient, actual positioning of a predefined treatment site of the distinguished patient relative to a target treatment location throughout the distinguished radiation treatment session; and

determining a radiation treatment plan for a future radiation treatment session for the distinguished patient in a manner responsive to the received data.

45. A method for providing adaptive radiation treatment for a distinguished patient, comprising:

in a first radiation treatment session, delivering radiation energy to a machine isocenter in the presence of the distinguished patient;

throughout the first radiation treatment session, tracking the location of a predefined treatment site of the patient relative to the machine isocenter; and

in a second radiation treatment session, delivering radiation energy in the presence of the distinguished patient in a manner responsive to the actual location tracking.

46. The method of claim 45, further comprising determining for the first radiation treatment session an actual radiation dosage delivered to a treatment volume about the predefined treatment site of the patient, and wherein radiation energy is delivered in the second radiation treatment session in a manner responsive to the determined actual radiation dosage.

47. The method of claim 45 wherein radiation energy is delivered in the second radiation treatment session in a manner responsive to migration of the predefined treatment site reflected in the location tracking.

48. The method of claim 45 wherein the tracking includes tracking a plurality of markers collectively tagging a treatment volume, and wherein radiation energy is delivered in the second radiation treatment session in a manner responsive to changes in the relative locations of the markers indicating a change in the shape of the treatment volume.

49. The method of claim 45 wherein the tracking includes tracking a plurality of markers collectively tagging a treatment volume, and wherein radiation energy is delivered in the second radiation treatment session in a manner responsive to changes in the relative locations of the markers indicating a change in the mass of the treatment volume.

50. The method of claim 45 wherein the tracking includes tracking a plurality of markers collectively tagging a treatment volume, and wherein radiation energy is delivered in the second radiation treatment session in a manner responsive to changes in the relative locations of the markers indicating a change in the volume of the treatment volume.

51. A computer-readable medium whose contents cause a computing system to perform a method for providing adaptive radiation treatment for a distinguished patient, comprising:

in a first radiation treatment session, delivering radiation energy to a machine isocenter in the presence of the distinguished patient;

throughout the first radiation treatment session, tracking the location of a predefined treatment site of the patient relative to the machine isocenter;

determining for the first radiation treatment session an actual radiation dosage delivered to a region surrounding the predefined treatment site; and

in a second radiation treatment session, delivering radiation energy in the presence of the distinguished patient in a manner responsive to the actual radiation dosage determined for the first radiation treatment session.

52. A method for providing adaptive radiation treatment for a distinguished patient during a distinguished radiation treatment session, comprising:

during the distinguished radiation treatment session, initially delivering radiation energy to a machine isocenter in accordance with initial radiation energy delivery parameters;

throughout the distinguished radiation treatment session, tracking the location of a predefined treatment site of the patient relative to the machine isocenter; and

altering the radiation energy delivery parameters in accordance with which radiation energy is delivered in the distinguished radiation treatment session in a manner responsive to the location tracking.

53. The method of claim 52 wherein the radiation energy delivery parameters include radiation energy delivery rate, and wherein radiation energy delivery rate is altered.

54. The method of claim 52 wherein the radiation energy delivery parameters include radiation energy delivery direction, and wherein radiation energy delivery direction is altered.

55. The method of claim 52 wherein the radiation energy delivery parameters include radiation energy beam shape, and wherein radiation energy beam shape is altered.

56. The method of claim 52 wherein the radiation energy delivery parameters include radiation energy beam cross-sectional area, and wherein radiation energy beam cross-sectional area is altered.

57. The method of claim 52 wherein the radiation energy delivery parameters include location of a table supporting the distinguished patient relative to the machine isocenter wherein the location of the table relative to the machine isocenter is altered.

58. The method of claim 52 wherein the radiation energy delivery parameters include orientation of a table supporting the distinguished patient relative to the machine isocenter wherein the orientation of the couch relative to the machine isocenter is altered.

59. A computer-readable medium whose contents cause a computing system to perform a method for providing adaptive radiation treatment for a distinguished patient during a distinguished radiation treatment session, the method comprising:

during the distinguished radiation treatment session, initially delivering radiation energy to a machine isocenter in accordance with initial radiation energy delivery parameters;

throughout the distinguished radiation treatment session, tracking the location of a predefined treatment site of the patient relative to the machine isocenter; and

altering the radiation energy delivery parameters in accordance with which radiation energy is delivered in the distinguished radiation treatment session in a manner responsive to the location tracking.