IMPLEMENTATION AND EXPERIMENTAL RESULTS OF REAL-TIME 4D TUMOR TRACKING USING MULTI-LEAF COLLIMATOR (MLC), AND/OR MLC-CARRIAGE (MLC-BANK), AND/OR TREATMENT TABLE (COUCH)

• US 20140107390A1
• Filed: 10/12/2012
• Published: 04/17/2014
• Est. Priority Date: 10/12/2012
• Status: Abandoned Application

• Current Assignee: Children's Medical Center Corporation, Elekta AB, Thomas Jefferson University (Main Line Health System)
• Original Assignee: Elekta AB, Thomas Jefferson University (Main Line Health System)
• Inventors: Brown, Kevin, Yu, Yan, Podder, Tarun K.
• Application Number:
  US13/650,910
• Publication Number:
  US 20140107390A1
• Time in Patent Office: Days
• US Class Current: 600/1
• CPC Class Codes: A61N 2005/1057 monitoring flexing of the patient support or the radiation treatment apparatus
• CPC Class Codes: A61N 5/1045 using a multi-leaf collimator, e.g. for intensity modulated radiation therapy or IMRT
• CPC Class Codes: A61N 5/1067 in real time, i.e. during treatment
• CPC Class Codes: A61N 5/1068 Gating the beam as a function of a physiological signal
• CPC Class Codes: A61N 5/107 in real time, i.e. during treatment

Abstract

Methods and systems of operating a support structure and beam shaping mechanism in a manner that compensates for motion patterns exhibited by a patient, promotes comfort of the patient, and optimizes accuracy of delivery of radiotherapy to a targeted location within the patient. The support structure can be a treatment table or couch and the beam shaping mechanism can be a multi-leaf collimator (MLC), and/or an MLC-bank/-carriage. The control system can utilize algorithms for predicting tumor motion and loading condition on the table/couch during radiation therapy.

Claims

1-15. -15. (canceled)

16. A method of delivering radiation or particle beam therapy to a living subject'"'"'s anatomy having physiological motion, the method comprising:

supporting the living subject by a programmable platform; and

determining an optimal counter motion strategy of the platform which results in one programmable movement from the group consisting of most tolerable, exact motion cancellation, most preferable by the subject, most preferable by a clinician, most preferable by an operator, most easily verifiable and safest movements.

22. The method of claim 113,

wherein the radiation or particle beam therapy involves motion compensated imaging studies, such that the moving anatomy of interest appears to have diminished or no motion,

the method further comprising verifying adequate cancellation of the physiological motion prior to planning or delivering radiation or particle therapy by first conducting any of the motion compensated imaging studies.

29. The method of claim 16, the method further comprising:

optimizing the counter-motion of the platform,

wherein a dosimetric treatment plan is generated for each motion strategy and the most desirable strategy is then chosen by one from the group consisting of clinician, subject, and operator, and

wherein appropriately minimized dosimetric planning margins are determined based on the chosen strategy.

46. The method of claim 16, wherein the programmable beam shaping method is a multileaf collimator (MLC).

48. The method of claim 46, wherein the moving target trajectories are further decomposed and allocated to appropriate subsystems based on the motion characteristics and conditions of the living subject, the said subsystems consisting of a programmable supporting platform, the MLC, and the carriages to which the MLC banks are separately attached.

49. The method of claim 48, wherein decomposition simplifies subsystem motions into separate orthogonal directions.

50. The method of claim 48, wherein decomposition takes into account low and high frequency components of the motion pattern, and thereafter allocates these different components according to the characteristics and optimal performance of the subsystems.

51. The method of claim 50, wherein the low frequency component of the motion pattern is allocated to the programmable supporting platform, resulting in more easily tolerated rocking motion that generates negligible voluntary/involuntary reactive movement by the living subject, and wherein the MLC subsystems further compensate the residual motion and high frequency variations.

113. The method of claim 16, further comprising:

using a programmable beam shaping method to continuously conform the beam to a desired shape, such that any residual physiological motion uncanceled by the supporting platform is further canceled by a beam shaping device.

17-21. -21. (canceled)

23-28. -28. (canceled)

30. (canceled)

31. A method of determining optimal counter motion strategies to reduce or cancel a physiological motion of a living subject'"'"'s anatomy, the method comprising:

modeling the physiological motion patterns; and

determining a number of levels of counter motion of a programmable supporting platform under the living subject, wherein the levels comprise soft, moderate and extreme, corresponding to compromised reduction, significant reduction and complete cancelation of the physiological motion, respectively.

36. The method of claim 31, further comprising having the living subject make deliberate changes to regular physiological motion.

38. The method of claim 31, further comprising verifying the effectiveness of the chosen counter motion strategy by imaging the subject on the same or similarly programmable supporting platform.

39. The method of claim 38, wherein imaging is conducted both with and without the chosen counter motion of the programmable supporting platform, and the two image sets are segmented and fused such that the moving anatomy of interest is imaged by the first set, whereas the nonmoving anatomy of the subject is imaged by the second set.

54. The method of claim 31, wherein, when soft or moderate tracking strategies are employed, any residual motion determined to be neglected by the platform motion is further compensated by shutting off or gating the radiation beam, wherein the radiation is paused for the brief duration wherein physiological motion excursion has exceeded the chosen range of moving platform compensation.

56. The method of claim 54 comprising coordinated compensation of physiological motion using one or more of the supporting platform, the beam shaping device and gating.

114. The method of claim 31, further comprising:

testing or training the living subject by the different levels of counter motion; and

choosing the most desirable level based on a trade off between preference, effectiveness in minimizing physiological motion, and minimization of voluntary or involuntary living subject movement in response to the motion of the programmable supporting platform.

32-35. -35. (canceled)

37. (canceled)

40-45. -45. (canceled)

47. (canceled)

52-53. -53. (canceled)

55. (canceled)

57-71. -71. (canceled)

72. A device for delivering radiation or particle beam therapy to a living subject'"'"'s anatomy having physiological motion, the device comprising:

a programmable platform for supporting the living subject; and

a system for determining an optimal counter motion strategy of the platform which results in one programmable movement from the group consisting of most tolerable, exact motion cancellation, most preferable by the subject, most preferable by a clinician, most preferable by an operator, most easily verifiable and safest movements.

102. The device of claim 72, wherein the programmable beam shaping device is a multileaf collimator (MLC).

104. The device of claim 102, wherein the moving target trajectories are further decomposed and allocated to appropriate subsystems based on the motion characteristics and conditions of the living subject, the said subsystems consisting of a programmable supporting platform, the MLC, and the carriages to which the MLC banks are separately attached to.

105. The device of claim 104, wherein decomposition simplifies subsystem motions into separate orthogonal directions, which can be for the purpose of easier tolerance by the living subject, or for the purpose of simpler operation/verification/safety or easier recording/capturing of the motion data.

106. The device of claim 104, wherein decomposition takes into account low and high frequency components of the motion pattern, and thereafter allocates these different components according to the characteristics and optimal performance of the subsystems.

107. The device of claim 106, wherein the low frequency component of the motion pattern is allocated to the programmable supporting platform, resulting in more easily tolerated rocking motion that generates negligible voluntary/involuntary reactive movement by the living subject, and wherein the MLC subsystems further compensate the residual motion and high frequency variations.

111. The device of claim 72, comprising employment of both the moving platform and the beam shaping device together to compensate but not completely eliminate the physiological motion.

115. The device of claim 72, further comprising:

a system for using a programmable beam shaping device to continuously conform the beam to a desired shape, such that any residual physiological motion uncanceled by the supporting platform is further canceled by a beam shaping device.

73-86. -86. (canceled)

87. A device for determining optimal counter motion strategies to reduce or cancel a physiological motion of a living subject'"'"'s anatomy, the device comprising:

a system for modeling the physiological motion patterns; and

a system for determining a number of levels of counter motion of a programmable supporting platform under the living subject, wherein the levels comprise soft, moderate and extreme, corresponding to compromised reduction, significant reduction and complete cancelation of the physiological motion, respectively.

92. The device of claim 87, further comprising a system adapted for having the living subject make deliberate changes to regular physiological motion.

94. The device of claim 87, further comprising a system for verifying the effectiveness of the chosen counter motion strategy by imaging the subject on the same or similarly programmable supporting platform.

95. The device of claim 94, wherein imaging is conducted both with and without the chosen counter motion of the programmable supporting platform, and the two image sets are segmented and fused such that the moving anatomy of interest is imaged by the first set, whereas the nonmoving anatomy of the subject is imaged by the second set.

98. The device for modeling of claim 87, further comprising a first novel algorithm for improved prediction tumor motions for regular motion profiles and a second novel algorithm for improved prediction tumor motions for irregular motion profiles.

99. The device of claim 98, wherein each of the first and second novel algorithms comprises acceleration-enhanced artificial neural network (AE-ANN) effectively applicable for prediction of regular/normal motion of the tumor.

100. The device of claim 98, wherein each of the first and second novel algorithms comprises acceleration-enhanced normalized least mean squares (AE-nLMS) efficacious for predicting irregular/abnormal motion of the tumor.

110. The device of claim 87, wherein, when soft or moderate tracking strategies are employed, any residual motion determined to be neglected by the platform motion is further compensated by shutting off or gating the radiation beam, wherein the radiation is paused for the brief duration wherein physiological motion excursion has exceeded the chosen range of moving platform compensation.

112. The device of claim 110 comprising coordinated compensation of physiological motion using one or more of the supporting platform, the beam shaping device and gating.

116. The device of claim 87, further comprising:

a system for testing or training the living subject by the different levels of counter motion; and

a system for choosing the most desirable level based on a trade off between preference, effectiveness in minimizing physiological motion, and minimization of voluntary or involuntary living subject movement in response to the motion of the programmable supporting platform.

88-91. -91. (canceled)

93. (canceled)

96-97. -97. (canceled)

101. (canceled)

103. (canceled)

108-109. -109. (canceled)