ORTHOVOLTAGE RADIOTHERAPY

• US 20100067656A1
• Filed: 08/05/2009
• Published: 03/18/2010
• Est. Priority Date: 12/13/2006
• Status: Active Grant

• Current Assignee: Carl Zeiss Meditec Incorporated (Carl-Zeiss-Stiftung)
• Original Assignee: Oraya Therapeutics, Inc.
• Inventors: Gertner, Michael, Hansen, Steven D., Chell, Erik
• Granted Patent: US 7,978,819 B2
• Time in Patent Office: Days
• US Class Current: 378/65
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• CPC Class Codes: A61B 6/508 for non-human patients
• CPC Class Codes: A61N 2005/1019 Sources therefor
• CPC Class Codes: A61N 2005/1022 Generators, e.g. X-ray tubes
• CPC Class Codes: A61N 2005/105 using a laser alignment system
• CPC Class Codes: A61N 2005/1051 using an active marker markers in general A61B90/39
• CPC Class Codes: A61N 2005/1059 using cameras imaging the patient
• CPC Class Codes: A61N 2005/1091 Kilovoltage or orthovoltage range photons
• 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 5/1001 using radiation sources introduced into or applied onto the body; brachytherapy
• CPC Class Codes: A61N 5/1017 Treatment of the eye, e.g. for "macular degeneration"
• CPC Class Codes: A61N 5/1045 using a multi-leaf collimator, e.g. for intensity modulated radiation therapy or IMRT
• CPC Class Codes: A61N 5/1048 Monitoring, verifying, controlling systems and methods
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam
• CPC Class Codes: A61N 5/1064 for adjusting radiation treatment in response to monitoring
• CPC Class Codes: A61N 5/1065 Beam adjustment
• CPC Class Codes: A61N 5/1067 in real time, i.e. during treatment
• CPC Class Codes: A61N 5/1077 Beam delivery systems
• CPC Class Codes: A61N 5/1084 for delivering multiple intersecting beams at the same time, e.g. gamma knives

Abstract

A radiosurgery system is described that is configured to deliver a therapeutic dose of radiation to a target structure in a patient. In some embodiments, inflammatory ocular disorders are treated, specifically macular degeneration. In some embodiments, other disorders or tissues of a body are treated with the dose of radiation. In some embodiments, the target tissues are placed in a global coordinate system based on ocular imaging. In some embodiments, the target tissues inside the global coordinate system lead to direction of an automated positioning system that is directed based on the target tissues within the coordinate system. In some embodiments, a treatment plan is utilised in which beam energy and direction and duration of time for treatment is determined for a specific disease to be treated and/or structures to be avoided. In some embodiments, a fiducial marker is used to identify the location of the target tissues. In some embodiments, radiodynamic therapy is described in which radiosurgery is used in combination with other treatments and can be delivered concomitant with, prior to, or following other treatments.

Claims

1. A method, for treating a structure in an eye, comprising:

engaging, with an eye holder, an outer surface of an eye during a treatment period to maintain the eye in substantially a fixed position during the treatment period;

emitting an x-ray beam from an x-ray source toward the structure based on a determination of whether the eye is in substantially the fixed position during the treatment period;

acquiring optical data indicative of eye motion;

determining, from the optical data, whether the eye is in a different position than the fixed position; and

when the eye is determined to be in a different position than the fixed position;

(i) aligning the eye, with the eye holder, to be in substantially an aligned position, or

(ii) ceasing or reducing emitting of the x-ray beam from the x-ray source .

2. The method of claim 1, wherein the fixed position is substantially at a coordinate within a coordinate system, the coordinate system having a plurality of coordinates that each correspond to a different position of the eye holder relative to the x-ray source.

3. The method of claim 1, further comprising ceasing or reducing emission of the x-ray beam when the eye is determined not to be in substantially the fixed position.

4. The method of claim 1, further comprising adjusting a trajectory of the x-ray beam when the eye is determined not to be in substantially the fixed position.

5. The method of claim 1, further comprising acquiring data indicative of a different position of the eye than the fixed position, during the treatment period.

6. The method of claim 5, further comprising determining an x-ray beam trajectory based, at least in part, on the data indicative of the different position of the eye.

7. The method of claim 1, wherein the engaging comprises drawing a vacuum between the eye holder and the outer surface of the eye.

8. The method of claim 1, wherein the emitting an x-ray beam comprises emitting a plurality of x-ray beams toward the eye, each of the plurality of x-ray beams having a distinct trajectory that substantially avoids the optic nerve of the eye.

9. The method of claim 1, further comprising collimating the x-ray beam to a width of less than or equal to about 6 mm.

10. The method of claim 1, further comprising emitting the x-ray beam through material of the eye holder that is transmissive to x-ray radiation.

11. A method, of treating a structure of an eye with an x-ray beam from a radiotherapy system, comprising:

contacting a surface of the eye with an eye contact member that is coupled to the radiotherapy system;

emitting a first x-ray beam toward the structure, from the radiotherapy system located outside the eye, such that the first x-ray beam has a first trajectory that intersects a primary axis substantially at the structure;

after emitting the first x-ray beam, moving the radiotherapy system about the primary axis;

emitting a second x-ray beam toward the structure, from the radiotherapy system, such that the second x-ray beam has a second trajectory, different than the first trajectory, that intersects the primary axis substantially at the structure;

wherein the primary axis passes through the structure and the eye contact member.

12. The method of claim 11, further comprising directing the first x-ray beam through a portion of the eye contact member that is transmissive to x-ray radiation.

13. The method of claim 11, further comprising emitting a light toward the eye that provides an indication of a trajectory of the x-ray beam.

14. The method of claim 13, further comprising emitting the light through a portion of the eye contact member that is transmissive to the light.

15. The method of claim 11, further comprising substantially fixing the eye in a first position with the eye contact member.

16. The method of claim 11, further comprising detecting movement of the eye from a first position to a second position.

17. The method of claim 16, further comprising generating a signal indicative of the movement of the eye.

18. The method of claim 17, further comprising altering the emitting based on the signal.

19. The method of claim 18, wherein the altering comprises changing a trajectory of the x-ray beam.

20. The method of claim 18, wherein the altering comprises ceasing or reducing the emission of the x-ray beam when the second position is outside a determined area of eye movement.