ADAPTIVE RADIOTHERAPY TREATMENT USING ULTRASOUND

• US 20110009742A1
• Filed: 07/07/2010
• Published: 01/13/2011
• Est. Priority Date: 07/10/2009
• Status: Active Grant

• Current Assignee: Elekta Ltd. (Elekta AB)
• Original Assignee: Elekta Ltd. (Elekta AB)
• Inventors: Falco, Tony, Lachaine, Martin, Fortier, Philippe, Tremblay, Sebastien, Koptenko, Sergei
• Granted Patent: US 10,542,962 B2
• Time in Patent Office: Days
• US Class Current: 600/427
• CPC Class Codes: A61B 6/4225 using image intensifiers
• CPC Class Codes: A61B 6/4441 the rigid structure being a C-arm or U-arm
• CPC Class Codes: A61B 8/085 for locating body or organic structures, e.g. tumours, calculi, blood vessels, nodules
• CPC Class Codes: A61B 8/4227 characterised by straps, belts, cuffs or braces
• CPC Class Codes: A61B 8/4245 involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
• CPC Class Codes: A61B 8/4472 Wireless probes
• CPC Class Codes: A61B 8/483 involving the acquisition of a 3D volume of data
• CPC Class Codes: A61N 2005/1058 using ultrasound imaging
• 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

Radiation treatment is delivered to a patient by positioning the patient such that a radiation beam is delivered to a lesion within the patient along a beam-delivery path while securing a diagnostic imaging device about the patient such that the diagnostic imaging device does not intersect the beam-delivery path. Radiation therapy is simultaneously delivered along the beam-delivery path while diagnostic images are obtained using the imaging device.

Claims

1. A method of monitoring radiation treatment being delivered to a patient, the method comprising the steps of:

a. delivering radiation to a lesion within the patient along at least one beam-delivery path;

b. positioning a diagnostic imaging device with respect to the patient such that the diagnostic imaging device does not intersect the at least one beam-delivery path; and

c. simultaneously administering radiation therapy along at least one beam-delivery path and obtaining one or more diagnostic images using the imaging device.

2. The method of claim 1 wherein the diagnostic imaging device comprises a two-dimensional ultrasound imaging device.

3. The method of claim 1 wherein the diagnostic imaging device comprises a three-dimensional ultrasound imaging device.

4. The method of claim 3 wherein the three-dimensional ultrasound imaging device further comprises one or more tracking devices, thereby facilitating real-time positional tracking of the ultrasound imaging device.

5. The method of claim 4 further comprising combining a plurality of temporally-displaced three-dimensional ultrasound images to create a four-dimensional ultrasound image.

6. The method of claim 1 wherein the diagnostic imaging device is movable within an envelope to obtain diagnostic images from different locations, and further wherein the envelope does not intersect the beam-delivery path.

7. The method of claim 1 wherein the lesion comprises a prostate tumor and the diagnostic imaging device is positioned transperineally.

8. The method of claim 6 wherein the diagnostic imaging is attached to a brace having a range of movement confined to the envelope.

9. The method of claim 8 further comprising adjusting the position of the brace in response to the changes in radiation treatment parameters.

10. The method of claim 8 further comprising rotating the brace such that the radiation treatment device sweeps across an area of the patient during delivery of the radiation treatment.

11. The method of claim 1 wherein the diagnostic imaging device is movable within an envelope such that sonications emitted by the diagnostic imaging device do not substantially interfere with radiation delivered along the at least one beam-delivery path.

12. The method of claim 1 further comprising comparing two or more of the diagnostic images taken during the delivery of radiation therapy and adjusting one or more radiation treatment parameters based thereon.

13. The method of claim 12 further comprising obtaining one or more baseline diagnostic images of the lesion prior to the delivery of radiation therapy and including the baseline images in the comparison to the diagnostic images taken during the delivery of radiation therapy.

14. The method of claim 13 wherein the baseline diagnostic images comprise one or more of an ultrasound image or a CT image.

15. The method of claim 1 further comprising comparing one or more of the diagnostic images taken during the delivery of radiation therapy to a diagnostic image acquired during treatment and prior to the delivery of radiation therapy and adjusting one or more radiation treatment parameters based thereon.

16. The method of claim 15 wherein the diagnostic image acquired during treatment and prior to delivery of radiation therapy comprises an ultrasound image

17. The method of claim 1 further comprising obtaining one or more diagnostic images immediately prior to administration of radiation to the patient.

18. The method of claim 1 further comprising obtaining one or more diagnostic images immediately after to administration of radiation to the patient.

19. An apparatus for monitoring the delivery of radiation treatment being delivered to a patient, the apparatus comprising:

a. a diagnostic imaging device;

b. a brace for accepting the imaging device and secured to a patient-support platform, the brace facilitating movement of the imaging device according to multiple degrees of freedom relative to the patient and within an envelope outside one or more beam-delivery paths so as to avoid interference with radiation treatment during delivery thereof.

20. The apparatus of claim 19 wherein the diagnostic imaging device comprises an ultrasound imaging device.

21. The apparatus of claim 20 wherein the ultrasound imaging device comprises one or more optical tracking devices, thereby facilitating real-time positional tracking of the ultrasound imaging device.

22. The apparatus of claim 19 wherein the brace rotates to facilitate sweeping the diagnostic imaging device about an area of the patient.

23. A system for monitoring the delivery of radiation therapy to a patient, the system comprising:

a. a diagnostic imaging device for obtaining one or more diagnostic images as radiotherapy treatment is delivered to the patient;

b. a register for storing the images; and

b. a processor for (i) comparing two or more of the diagnostic images and (ii) determining adjustments to one or more radiation treatment parameters based on the results of the comparison.

24. The system of claim 23 further comprising a brace for accepting the diagnostic imaging device and movable within an envelope outside one or more beam-delivery paths of the radiation therapy treatment.

25. The system of claim 24 further comprising a controller operably connected to the processor and the brace, the controller being configured to cause positional adjustments to the brace in response to the adjustments of the treatment parameters.

26. The system of claim 23 further comprising a monitor for displaying the radiation treatment parameters and the diagnostic images.

27. The system of claim 23 wherein the register is further configured to store a baseline diagnostic scan.

28. The system of claim 27 wherein the processor is further configured to compare the baseline diagnostic scan to one or more of the diagnostic images and adjust one or more of the radiation treatment parameters based on the results of the comparison.

29. The system of claim 28 wherein the baseline diagnostic scan comprises one of an ultrasound scan or a CT scan.