SYSTEM AND METHOD FOR MOTION ADAPTIVE OPTIMIZATION FOR RADIATION THERAPY DELIVERY

• US 20090116616A1
• Filed: 10/27/2008
• Published: 05/07/2009
• Est. Priority Date: 10/25/2007
• Status: Active Grant

• Current Assignee: Accuray Incorporated
• Original Assignee: TomoTherapy Incorporated (Accuray Incorporated)
• Inventors: Ruchala, Kenneth J., Lu, Weiguo, Chen, Mingli, Chen, Quan, Olivera, Gustavo H.
• Granted Patent: US 8,509,383 B2
• Time in Patent Office: Days
• US Class Current: 378/65
• 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

Abstract

A system and method of optimizing delivery of a radiation therapy treatment. The system optimizes treatment delivery in real-time to take into account a variety of factors, such as patient anatomical and physiological changes (e.g., respiration and other movement, etc.), and machine configuration changes (e.g., beam output factors, couch error, leaf error, etc.).

Claims

1. A method of delivering a radiation therapy treatment, the method comprising:

generating a treatment plan for a patient, the treatment plan specifying a beam intensity;

positioning the patient to receive radiation;

optimizing at least a portion of the treatment plan in substantially real-time to incorporate changes to one of the patient and a machine configuration; and

delivering at least a portion of the optimized treatment plan to the patient.

2. The method of delivering a radiation therapy treatment of claim 1 further comprising detecting a change in configuration of the patient during a first projection.

3. The method of delivering a radiation therapy treatment of claim 2 further comprising accumulating an amount of radiation dose delivered to the patient through the first projection.

4. The method of delivering a radiation therapy treatment of claim 3 wherein accumulating the amount of radiation dose delivered to the patient through the first projection includes using dose calculations on a 4D representation of the patient.

5. The method of delivering a radiation therapy treatment of claim 3 wherein accumulating the amount of radiation dose delivered to the patient through the first projection includes using in vivo dosimetry to measure delivered dose.

6. The method of delivering a radiation therapy treatment of claim 3 further comprising estimating an amount of radiation dose to be delivered to the patient in a second projection.

7. The method of delivering a radiation therapy treatment of claim 6 further comprising predicting a change in configuration of the patient for the second projection.

8. The method of delivering a radiation therapy treatment of claim 7 wherein the change in configuration of the patient includes a change in position of the target.

9. The method of delivering a radiation therapy treatment of claim 7 further comprising adjusting the treatment plan based on the estimated amount of radiation dose to be delivered to the patient in the second projection and the predicted position of the target during the second projection.

10. The method of delivering a radiation therapy treatment of claim 1 wherein changes to the patient include motion of a target within the patient.

11. The method of delivering a radiation therapy treatment of claim 1 wherein changes to the patient include deformation of a target within the patient.

12. The method of delivering a radiation therapy treatment of claim 1 wherein changes to the patient include motion of a sensitive structure within the patient.

13. The method of delivering a radiation therapy treatment of claim 1 wherein changes to the patient include deformation of a sensitive structure within the patient.

14. The method of delivering a radiation therapy treatment of claim 1 wherein optimizing at least a portion of the treatment plan includes optimizing at least one projection of the treatment plan.

15. The method of delivering a radiation therapy treatment of claim 1 wherein the treatment plan includes a plurality of projections, and wherein optimizing at least a portion of the treatment plan includes optimizing an amount of radiation dose to be delivered in one of the projections to compensate for accumulated delivery errors that occurred in previous projections.

16. The method of delivering a radiation therapy treatment of claim 15 wherein the accumulated delivery errors are based on the accumulated radiation dose from previous projections, an estimated radiation dose to be delivered in future projections, and a predicted configuration of the patient during a next projection.

17. The method of delivering a radiation therapy treatment of claim 16 wherein the accumulated delivery errors include delivery errors from previous fractions.

18. The method of delivering a radiation therapy treatment of claim 1 wherein optimizing at least a portion of the treatment plan includes incorporating changes to the treatment plan via a negative feedback loop.

19. The method of delivering a radiation therapy treatment of claim 1 wherein optimizing at least a portion of the treatment plan to incorporate changes to the machine configuration includes adjusting a pattern of a multi-leaf collimator supported by a radiation delivery system.

20. The method of delivering a radiation therapy treatment of claim 1 wherein optimizing at least a portion of the treatment plan to incorporate changes to the machine configuration includes adjusting a velocity of a couch of a radiation delivery system.

21. The method of delivering a radiation therapy treatment of claim 1 wherein optimizing at least a portion of the treatment plan to incorporate changes to the machine configuration includes one of a position of a couch, an angle of a gantry, a velocity of a gantry, and output of a linac, the couch, gantry, and linac supported by a radiation delivery system.

22. The method of delivering a radiation therapy treatment of claim 1 wherein the treatment plan includes a plurality of projections, each projection defining a time period.

23. The method of delivering a radiation therapy treatment of claim 22 wherein generating the treatment plan for the patient includes adjusting the time period of each projection beyond a total time period of all projections established in the treatment plan.

24. A method of delivering a radiation therapy treatment, the method comprising:

generating a treatment plan for a patient, the treatment plan including an amount of radiation dose to be delivered to the patient based on a predetermined position of a target within the patient;

monitoring the position of the target in the patient during delivery of the radiation therapy treatment;

modifying the delivery of the radiation therapy treatment in substantially real-time to compensate for a position of the target different than the predetermined position; and

substantially maintaining the amount of radiation dose to be delivered to the patient according to the treatment plan.

25. The method of delivering a radiation therapy treatment of claim 24 wherein generating the treatment plan for the patient includes generated a treatment objective for the patient.

26. The method of delivering a radiation therapy treatment of claim 25 wherein the treatment objective includes tumor control probability and wherein substantially maintaining the amount of radiation dose to be delivered to the patient includes analyzing whether the treatment objective is satisfied.

27. The method of delivering a radiation therapy treatment of claim 25 wherein the treatment objective includes normal tissue compensation probability and wherein substantially maintaining the amount of radiation dose to be delivered to the patient includes analyzing whether the treatment objective is satisfied.

28. The method of delivering a radiation therapy treatment of claim 24 further comprising detecting a position of a target in the patient during a first projection.

29. The method of delivering a radiation therapy treatment of claim 28 further comprising accumulating an amount of radiation dose delivered to the patient through the first projection.

30. The method of delivering a radiation therapy treatment of claim 29 wherein accumulating the amount of radiation dose delivered to the patient through the first projection includes using dose calculations on a 4D representation of the patient.

31. The method of delivering a radiation therapy treatment of claim 29 wherein accumulating the amount of radiation dose delivered to the patient through the first projection includes using in vivo dosimetry to measure delivered dose.

32. The method of delivering a radiation therapy treatment of claim 29 further comprising estimating an amount of radiation dose to be delivered to the patient in a second projection.

33. The method of delivering a radiation therapy treatment of claim 32 further comprising predicting a change in configuration of the patient for the second projection.

34. The method of delivering a radiation therapy treatment of claim 33 wherein the change in configuration of the patient includes a change in position of the target.

35. The method of delivering a radiation therapy treatment of claim 33 further comprising adjusting the treatment plan based on the estimated amount of radiation dose to be delivered to the patient in the second projection and the predicted position of the target during the second projection.

36. The method of delivering a radiation therapy treatment of claim 24 wherein monitoring the position of the target includes monitoring motion of the target within the patient.

37. The method of delivering a radiation therapy treatment of claim 24 wherein monitoring the position of the target includes detecting deformation of the target within the patient.

38. The method of delivering a radiation therapy treatment of claim 24 wherein monitoring the position of the target includes monitoring motion of a sensitive structure within the patient.

39. The method of delivering a radiation therapy treatment of claim 24 wherein monitoring the position of the target includes detecting deformation of a sensitive structure within the patient.

40. The method of delivering a radiation therapy treatment of claim 24 wherein modifying the delivery includes optimizing at least one projection of the treatment plan.

41. The method of delivering a radiation therapy treatment of claim 24 wherein the treatment plan includes a plurality of projections, and wherein modifying the delivery includes optimizing an amount of radiation dose to be delivered in one of the projections to compensate for accumulated delivery errors that occurred in previous projections.

42. The method of delivering a radiation therapy treatment of claim 41 wherein the accumulated delivery errors are based on the accumulated radiation dose from previous projections, an estimated radiation dose to be delivered in future projections, and a predicted configuration of the patient during a next projection.

43. The method of delivering a radiation therapy treatment of claim 42 wherein the accumulated delivery errors include delivery errors from previous fractions.

44. The method of delivering a radiation therapy treatment of claim 24 wherein modifying the delivery includes incorporating changes to the treatment plan via a negative feedback loop.

45. The method of delivering a radiation therapy treatment of claim 24 wherein modifying the delivery includes incorporating changes to a machine configuration to adjust a pattern of a multi-leaf collimator supported by a radiation delivery system.

46. The method of delivering a radiation therapy treatment of claim 24 wherein modifying the delivery includes incorporating changes to a machine configuration to adjust a velocity of a couch of a radiation delivery system.

47. The method of delivering a radiation therapy treatment of claim 24 wherein modifying the delivery includes incorporating changes to a machine configuration to adjust one of a position of a couch, an angle of a gantry, a velocity of a gantry, and output of a linac, the couch, gantry, and linac supported by a radiation delivery system.

48. The method of delivering a radiation therapy treatment of claim 24 wherein the treatment plan includes a plurality of projections, each projection defining a time period.

49. The method of delivering a radiation therapy treatment of claim 48 wherein generating the treatment plan for the patient includes adjusting the time period of each projection beyond a total time period of all projections established in the treatment plan.

50. A radiation delivery system for delivering a radiation therapy treatment, the radiation delivery system comprising:

a computer processor; and

a software program stored in a computer readable medium accessible by the computer processor, the software being operable to

generate a treatment plan for a patient, the treatment plan specifying a beam intensity;

position the patient to receive radiation;

optimize at least a portion of the treatment plan in substantially real-time to incorporate changes to one of the patient and a machine configuration; and

deliver at least a portion of the optimized treatment plan

51. A computer program embodied by a computer readable medium capable of being executed by a computer, the computer program for use in a radiation delivery system, the computer program comprising:

a treatment plan module operable to generate a treatment plan for a patient, the treatment plan specifying a beam intensity;

a position module operable to position the patient with respect to the radiation delivery system;

an optimization module operable to optimize at least a portion of the treatment plan in substantially real-time to incorporate changes to one of the patient and a machine configuration; and

a treatment delivery module operable to deliver the optimized treatment plan to the patient.