SYSTEM AND METHOD FOR MOTION ADAPTIVE OPTIMIZATION FOR RADIATION THERAPY DELIVERY

• US 20090252291A1
• Filed: 03/05/2009
• Published: 10/08/2009
• 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 8,467,497 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;

positioning the patient to receive radiation;

monitoring machine parameters in substantially real-time, the monitoring including analyzing information regarding the machine parameters and how the parameters affect dose delivered to the patient;

optimizing at least a portion of the treatment plan in substantially real-time to incorporate the analyzed information from the monitored machine parameters; 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 accumulating an amount of radiation dose delivered to the patient substantially in real-time.

3. The method of delivering a radiation therapy treatment of claim 2 wherein accumulating the amount of radiation dose delivered to the patient includes using dose calculations on a 4D representation of the patient.

4. The method of delivering a radiation therapy treatment of claim 2 further comprising estimating an amount of radiation dose to be delivered to the patient in a future projection.

5. The method of delivering a radiation therapy treatment of claim 4 further comprising adjusting the treatment plan based on the estimated amount of radiation dose to be delivered to the patient in the future projection and the predicted position of a patient target during the future projection.

6. The method of delivering a radiation therapy treatment of claim 2, wherein accumulating dose delivered substantially in real-time incorporates information relating to at least one of delivery instructions, delivery error detection and patient motion detection.

7. The method of delivering a radiation therapy treatment of claim 2, wherein accumulating the dose includes accumulating current dose plus previous dose delivered plus future dose to be delivered so that the optimized plan best matches or improves the planned dose.

8. The method of delivering a radiation therapy treatment of claim 2, wherein the accumulating of dose is based on real-time modification of treatments.

9. 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.

10. The method of delivering a radiation therapy treatment of claim 9 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.

11. The method of delivering a radiation therapy treatment of claim 10 wherein the accumulated delivery errors include delivery errors from previous fractions.

12. The method of delivering a radiation therapy treatment of claim 9, wherein the accumulated delivery errors include linear accelerator output factor variations.

13. The method of delivering a radiation therapy treatment of claim 9, wherein the accumulated delivery errors include MLC leaf position errors.

14. The method of delivering a radiation therapy treatment of claim 9, wherein the accumulated delivery errors include one of linac position errors, couch position errors, jaw position errors, and compensator errors.

15. The method of delivering a radiation therapy treatment of claim 9, wherein the accumulated delivery errors are compensated in subsequent treatment delivery.

16. 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 closed feedback loop.

17. The method of delivering a radiation therapy treatment of claim 1 further comprising monitoring changes to the patient in substantially real-time.

18. The method of delivering a radiation therapy treatment of claim 17, wherein monitoring changes to the patient in substantially real-time includes detection of patient breathing phases.

19. The method of delivering a radiation therapy treatment of claim 17, wherein monitoring changes to the patient in substantially real-time includes detection of tumor motion or tumor deformation.

20. The method of delivering a radiation therapy treatment of claim 17, wherein monitoring changes to the patient in substantially real-time includes prediction of patient breathing phases.

21. The method of delivering a radiation therapy treatment of claim 17, wherein monitoring changes to the patient in substantially real-time includes prediction of tumor motion or tumor deformation.

22. The method of delivering a radiation therapy treatment of claim 17, wherein optimizing at least a portion of the plan in substantially real-time comprises predicting patient changes.

23. The method of delivering a radiation therapy treatment of claim 1, wherein optimizing at least a portion of the plan in substantially real-time comprises predicting machine parameters.

24. The method of delivering a radiation therapy treatment of claim 23, wherein the prediction is based upon an a priori model about machine parameters.

25. The method of delivering a radiation therapy treatment of claim 23, wherein the prediction is based on a dynamic model about machine parameters.

26. The method of delivering a radiation therapy treatment of claim 1, wherein optimizing at least a portion of the plan in substantially real-time includes utilizing dynamic programming for optimization of treatment delivery instructions.