Patient alignment system and procedure for radiation treatment

• US 5,117,829 A
• Filed: 03/31/1989
• Issued: 06/02/1992
• Est. Priority Date: 03/31/1989
• Status: Expired due to Term

• Current Assignee: LOMA Linda University Medical Center LOMA Linda CA 92350
• Original Assignee: LOMA Linda University Medical Center (Mission Healthcare Services LLC)
• Inventors: Miller, Daniel W., Slater, James M.
• Primary Examiner(s): Cohen, Lee S.
• Assistant Examiner(s): ZELE, KRISTA MICHELLE
• Application Number:
  US07/332,549
• Time in Patent Office: 1,159 Days
• Field of Search: 600/2, 128/653 R, 378/4, 378/20, 378/145, 378/147, 378/162-164, 378/205, 378/208, 378/901, 378/65, 378/68, 378/209, 250/396 R, 250/398, 250/491.1, 250/370.09
• US Class Current: 600/427
• CPC Class Codes: A61B 2090/101 for stereotaxic radiosurgery
• CPC Class Codes: A61B 6/08 Auxiliary means for directing the radiation beam to a particular spot, e.g. using light beams
• CPC Class Codes: A61N 2005/1061 using an x-ray imaging system having a separate imaging source
• CPC Class Codes: A61N 2005/1062 using virtual X-ray images, e.g. digitally reconstructed radiographs [DRR]
• CPC Class Codes: A61N 2005/1087 Ions; Protons
• CPC Class Codes: A61N 2005/1097 Means for immobilizing the patient
• 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 5/1069 Target adjustment, e.g. moving the patient support

Abstract

Accurate and repeatable patient alignment with a charged-particle beam of a radiation beam therapy system, such as a proton beam delivery system, is provided. The patient is immobilized within a form-fit patient pod. Reference radiographs are prepared that are used for repositioning the patient within the pod on subsequent occasions. CT scan data of a particular tissue volume of interest, such as a region of the patient wherein a cancerous tumor is located, is obtained while the patient remains in the pod. The CT scan data is used to prepare a treatment plan for the patient. The treatment plan includes identifying an isocenter within the tissue volume at which the beam is to be directed from a selected angle(s). A computer simulation of the treatment plan may be performed to optimize the treatment plan, i.e., to help identify the number of beams and treatment angles that will best irradiate the cancerous cells. Once the treatment plan is finalized, the patient is repositioned within the pod and a physical simulation of the treatment plan is carried out to verify that the selected cancerous cells will be properly irradiated. Finally, the treatment plan is carried out by irradiating the cancerous cells with the charged-particle beam in accordance with the treatment plan.

Claims

1. A method for irradiating a volume of tissue within a patient with a charged-particle beam, said method comprising the steps of:

(a) immobilizing the patient;

(b) obtaining CT scan data of a region of tissue within said immobilized patient that includes said volume of tissue;

(c) preparing a treatment plan using said CT scan data by identifying an isocenter point having a fixed geometrical relationship relative to said volume of tissue at which said charged-particle beam is to be directed, determining an entry angle for said charged-particle beam, and generating an image reconstructed from said CT scan data that identifies how the volume of tissue should appear when viewed along said entry angle through said isocenter point;

(d) verifying said treatment plan by performing a physical simulation of the irradiation of said volume of tissue by said charged particle beam, said physical simulation including, (1) directing an image-forming beam along said entry angle at said isocenter point, said image-forming beam producing an image of the tissue through which it passes, and (2) comparing the image formed by said image-forming beam with said reconstructed image from said CT scan data along said entry angle verify that the charged particle beam will properly irradiate said volume of tissue;

(e) executing said treatment plan by directing said charged-particle beam at said isocenter point.

2. The method of claim 1 wherein the step of immobilizing the patient comprises immobilizing the patient relative to a holding device, and wherein the method further includes preparing repositioning reference radiographs of the patient and the holding device before releasing the patient from the holding device, said repositioning reference radiographs providing reference information that identifies the position of the immobilized patient relative to the holding device.

3. The method of claim 2 further including the steps of:

releasing the patient from the holding device after said CT scan data has been obtained; and

repositioning said patient within said holding device prior to verifying said treatment plan, said repositioning being performed by using said reference information to verify that the patient is positioned relative to said holding device in the same manner as the patient was originally positioned relative to said holding device.

4. The method of claim 1 wherein the step of preparing said treatment plan includes:

identifying a tissue isocenter within said volume of tissue defined by said CT scan data that is to be irradiated with said charged-particle beam;

marking said identified tissue isocenter; and

reconstructing orthogonal reference radiographs from the CT scan data that pass through said marked tissue isocenter.

5. The method of claim 4, wherein the step of preparing said treatment plan further includes performing a computer simulation of irradiation with said charged-particle beam.

6. The method of claim 5 wherein said computer simulation is performed by directing a simulated charged-particle beam at said isocenter point through said marked tissue isocenter of said CT scan data.

7. The method of claim 4 wherein said physical simulation further includes:

positioning the immobilized patient to receive said image-forming beam;

comparing the image formed by said image-forming beam with at least one of the reconstructed orthogonal radiographs; and

adjusting the position of the immobilized patient relative to the image-forming beam as required in order to align the image focused by said image-forming beam with said at least one of the reconstructed orthogonal radiographs.

8. The method of claim 7 wherein the step of executing said treatment plan includes delivering said charged-particle beam to the volume of tissue within said patient only when the position of the patient relative to the charged-particle beam is adjusted so that the charged-particle beam enters the patient with the same alignment as said image-forming beam.

9. A method for aligning a charged-particle beam with a volume of tissue, such as a tumor, of a patient undergoing radiation therapy, said method comprising the steps of:

immobilizing the patient;

digitally mapping tissue densities of the patient in a region surrounding said volume of tissue;

within data defining said digitally mapped tissue densities identifying and marking a portion of the data that defines the volume of tissue to be irradiated by said charged-particle beam;

reconstructing at least one image of the tissue densities from said digitally mapped tissue densities, said at least one reconstructed image having a view line normal thereto that passes through said marked data;

forming a radiographic image of the tissue of said patient taken along said view line;

quantitatively comparing said radiographic image to said reconstructed image;

adjusting the position of the immobilized patient relative to the radiographic image until any difference between said radiographic image and said reconstructed image is minimized; and

aligning the charged-particle beam to be delivered to said volume of tissue with the view line of said radiographic image after the step of adjusting has been completed.

10. The alignment method of claim 9 wherein the step of reconstructing at least one image of the tissue densities comprises reconstructing at least two orthogonal images from the digitally mapped tissue densities.

11. The alignment method of claim 9 wherein the step of quantitatively comparing said radiographic image to said reconstructed image comprises comparing distances between anatomical landmarks appearing in both images to a common reference point.

12. The alignment method of claim 9 wherein the step of immobilizing the patient comprises immobilizing the patient relative to a holding device, and wherein the method further includes preparing repositioning reference radiographs of the patient and the holding device before releasing the patient from the holding device, said repositioning reference radiographing providing reference information that identifies the position of the immobilized patient relative to the holding device.

13. The method of claim 12 further including the steps of:

removing the patient from the holding device once the digitally mapped tissue densities has been obtained; and

repositioning the patient in said holding device prior to forming the radiographic image of the patient along said view line.

14. A system for aligning a charged-particle beam with a volume of tissue in a patient undergoing radiation therapy, said system comprising:

means for immobilizing the patient;

means for digitally mapping tissue densities of the patient in a region surrounding said volume of tissue, said digitally mapping means providing digitally mapped tissue density data that defines the tissue surrounding and including said volume of tissue;

means for identifying and marking data within said digitally mapped tissue density data that defines the volume of tissue that is to be irradiated by a charged-particle beam;

means for reconstructing at least one image of the tissue densities from said digitally mapped tissue density data, said at least one reconstructed image having a view line normal thereto that passes through said marked data;

means for forming a radiographic image of the tissue of said patient taken along said view line;

means for quantitatively comparing said radiographic image to said reconstructed image;

means for adjusting the immobilized patient until any postition difference between said radiographic image and said reconstructed image are minimized; and

means for aligning the charged-particle beam to be delivered to said volume of tissue with the view line of said radiographic image after the differences between the radiographic and reconstructed images have been minimized.

15. The alignment system of claim 14 wherein said means for reconstructing at least one image comprises means for reconstructing two orthogonal images.

16. The alignment system of claim 15 wherein said orthogonal images comprise AP (Anterior Posterior) and lateral images.

17. The alignment system of claim 16 wherein said means for reconstructing at least one image includes means for reconstructing a beam'"'"'s eye view image, said beam'"'"'s eye view image comprising an image depicting the tissue densities as would be seen by an eye placed at the source of the image forming beam.