DEDICATED BREAST RADIATION IMAGING/THERAPY SYSTEM

• US 20090080594A1
• Filed: 11/21/2007
• Published: 03/26/2009
• Est. Priority Date: 08/03/2006
• Status: Active Grant

• Current Assignee: Hologic Incorporated
• Original Assignee: Hologic Incorporated
• Inventors: BROOKS, Kenneth, SMITH, Andrew P., STEIN, Jay A.
• Granted Patent: US 7,957,508 B2
• Time in Patent Office: Days
• US Class Current: 378/4
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/0414 with compression means
• CPC Class Codes: A61B 6/4258 for detecting non x-ray radiation, e.g. gamma radiation A61B6/037 takes precedence
• CPC Class Codes: A61B 6/502 for diagnosis of breast, i.e. mammography
• CPC Class Codes: A61N 2005/1058 using ultrasound imaging
• 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 2005/1097 Means for immobilizing the patient
• CPC Class Codes: A61N 5/10 X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy A61N5/01 takes precedence
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam
• 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

Abstract

System, apparatus and methods specialized for breast and related tissue radiation therapy and imaging of a prone patient but also usable for supine patient if desired or needed. A special treatment radiation source such as a LINAC unit generates radiation of types and energy ranges specifically matched to breast tissue. Any one or more of several imaging technologies may be used to localize the tissue to be irradiated and to generate information for therapy planning, adjustment, and verification.

Claims

1. A method of treating breast-related tissue of a prone patient comprising:

placing the patient on a surface of a patient table in a prone position, with a patient'"'"'s breast protruding downward from the table surface through an opening or into a depression in the table;

irradiating the breast-related tissue with treatment radiation from a source mounted for movement about an upwardly extending axis to emit a treatment radiation beam that originates below the table surface; and

selectively angling the beam to irradiate with primary radiation portions of the prone patient'"'"'s breast-related tissue that are above the table surface.

2. A method as in claim 1 including imaging the patient placed on the table, before said irradiating step, with an imaging apparatus keyed to a spatial frame of reference to which said source also is keyed, to develop, adjust or verify a radiation treatment plan.

3. A method as in claim 2 in which said imaging comprises three-dimensional (3D) imaging.

4. A method as in claim 3 in which said 3D imaging comprises one or more of ultrasound, x-ray imaging, and imaging using radiation emitted from within the patient.

5. A method as in claim 1 including introducing into the patient one or more sensors for at least one of position and radiation dose and utilizing said sensors in at least one of developing, adjusting, and verifying a radiation treatment plan for the patient.

6. A method as in claim 1 including interacting with a prone patient'"'"'s breast for imaging and radiation treatment with a device that both tends to pull the breast from the patient'"'"'s chest wall and to secure the breast in a selected position.

7. A method as in claim 1 including imaging the patient'"'"'s breast with CT scanning while the patient is in the position on the patient table in which said irradiating is carried out.

8. A method as in claim 1 including detecting treatment radiation delivered to a target volume in or at breast-related tissue of the patient and delivering information regarding said detecting to one or more utilizing stations associated with the treatment system.

9. A method as in claim 1 including moving the source of the radiation to selectively irradiate patient tissue from a number of selected directions and selectively varying the distance between the source of the radiation and target tissue.

10. A system for radiation treatment of breast-related tissue comprising:

a patient table having an upper surface for supporting a patient, said table having a selectively revealed opening or depression for a patient breast to extend downwardly from the patient table surface when the patient is in the prone position on said table;

a therapy radiation source selectively emitting therapy radiation and a mounting structure supporting the source and selectively moving the source in a first motion in which it irradiates a first target volume with a primary radiation beam that has a centerline below the table surface and in a second motion in which it irradiates a second target volume with a with primary radiation beam that has a centerline angled from the horizontal and intersecting the table surface.

11. A system as in claim 10 in which the first target volume is at a downwardly protruding breast of a patient in the prone position on the patient table and the second target volume is at the patient'"'"'s axilla.

12. A system as in claim 10 further the mounting structure includes structure supporting the source for motion in which the source emits a therapy beam from a location above the table surface to directly irradiate breast-related tissue of a patient in the supine position on said table surface.

13. A system as in claim 10 including a table support and a an interlock mechanism configured to releasably secure the table at a selected position relative to a system frame of reference in which the source is at a known position, said interlock mechanism also configured to mate with a separate imaging device operative to generate imaging information for a radiation treatment plan for the patent, said treatment plan being spatially referenced to an interlocked position of the table to the imaging device.

14. A system as in claim 10 including a CT scanner mounted in the system and selectively brought in position for CT imaging of a patient in the prone position on said patient table.

15. A system as in claim 10 including an imaging system mounted in a known frame of reference relative to the therapy radiation source for selectively imaging breast-related tissue.

16. A system as in claim 15 in which said imaging system selectively provides 2D images of said tissue.

17. A system as in claim 15 in which said imaging system selectively provides 3D imaging information of said tissue.

18. A system as in claim 10 in which said mounting structure includes a positioning mechanism selectively varying a distance between said source of therapy radiation and said target volume.

19. A system as in claim 10 including a control unit directing the radiation source in accordance with previously generated treatment plans.

20. A system as in claim 10 in which said mounting structure comprises a rotating plate support on which said therapy radiation source is mounted for rotation about an axis extending along a length of said patient table.

21. A system for radiation treatment of breast-related tissue comprising:

a patient table having an upper surface for supporting a patient, said table having a selectively revealed opening or depression for a patient breast to extend downwardly from the patient table surface when the patient is in the prone position on said table;

a therapy radiation source selectively emitting therapy radiation and a mounting structure supporting the source and selectively moving the source in a first motion in which it irradiates a first target volume with a primary radiation beam that has a centerline below the table surface and in a second motion in which it irradiates a second target volume with a with primary radiation beam that has a centerline angled from the horizontal and intersecting the table surface; and

wherein said therapy radiation comprises heavy charged particles having average energy in excess of 20 MeV and having a characteristic dose distribution with depth in breast tissue that has a Bragg peak followed by a rapid fall-off.

22. A system as in claim 21 wherein said average energy exceeds 80 MeV.

23. A system as in claim 22 wherein said average energy is in the range of approximately 80-180 MeV.

26. A method as in claim 22 wherein said average energy is in the range of approximately 80-180 MeV.

24. A method of treating breast-related tissue of a prone patient comprising:

placing the patient on a surface of a patient table in a prone position, with a patient'"'"'s breast protruding downward from the table surface through an opening or into a depression in the table;

irradiating the breast-related tissue with treatment radiation from a source mounted for movement about an upwardly extending axis to emit a treatment radiation beam that originates below the table surface; and

selectively angling the beam to irradiate with primary radiation portions of the prone patient'"'"'s breast-related tissue that are above the table surface;

said treatment radiation comprising heavy charged particles having average energy in excess of 20 MeV and having a characteristic dose distribution with depth in breast tissue that has a Bragg peak followed by a rapid fall-off.

25. A method as in claim 24 wherein said average energy exceeds 80 MeV.

27. A method of verifying brachytherapy treatment comprising:

placing a patient in a prone position on a patient table surface having an opening or depression in which a patient'"'"'s breast involved in brachitherapy treatment pendulously extends downwardly;

imaging the breast with radiation to verify brachytherapy related parameters using an imaging device located below the patient table surface; and

generating image data for the patent'"'"'s breast for assessing brachytherpay-related parameters.

28. A method as in claim 27 including delivering therapy radiation from an external source to the patient'"'"'s breast and/or related anatomy while the patient is in said prone position.

29. A method as in claim 27 in which said image data includes data for verifying the position of brachytherapy devices relative to anatomy in the patient'"'"'s breast.

30. A method as in claim 27 in which said image data includes data for verifying effects of brachytherapy on anatomy in the patent'"'"'s breast.