Apparatus and method for compensating for respiratory and patient motion during treatment

• US 6,144,875 A
• Filed: 03/16/1999
• Issued: 11/07/2000
• Est. Priority Date: 03/16/1999
• Status: Expired due to Term

• Current Assignee: Accuray Incorporated
• Original Assignee: Accuray Incorporated
• Inventors: Adler, John R., Schweikard, Achim
• Primary Examiner(s): Lateef, Marvin M.
• Assistant Examiner(s): MANTIS MERCADER, ELENI M
• Application Number:
  US09/270,404
• Time in Patent Office: 602 Days
• Field of Search: 600/425, 600/426, 600/427, 600/437, 600/439, 600/429, 600/428, 606/130, 378/69, 378/205, 356/375
• US Class Current: 600/427
• CPC Class Codes: A61B 10/0233 Pointed or sharp biopsy instruments
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00694 with means correcting for movement of or for synchronisation with the body
• CPC Class Codes: A61B 2017/00699 correcting for movement caused by respiration, e.g. by triggering
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61N 2005/1061 using an x-ray imaging system having a separate imaging source
• 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
• CPC Class Codes: A61N 5/107 in real time, i.e. during treatment
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

An apparatus and method for performing treatment on an internal target region while compensating for breathing and other motion of the patient is provided in which the apparatus comprises a first imaging device for periodically generating positional data about the internal target region and a second imaging device for continuously generating positional data about one or more external markers adapted to be attached to the patient'"'"'s body or any external sensor such as a device for measuring air flow. The apparatus further comprises a processor that receives the positional data about the internal target region and the external markers in order to generate a correspondence between the position of the internal target region and the external markers and a treatment device that directs the treatment towards the position of the target region of the patient based on the positional data of the external markers.

Claims

1. An apparatus for compensating for breathing and other motions of the patient during treatment, the apparatus comprising:

a first detection device for periodically generating positional data about a target region internal to the body of the patient;

a second detection device for continuously generating positional data about one or more sensors external to the body of the patient; and

a processor that receives the periodic positional data about the internal target region and the continuous position data from the external sensors in order to generate a correspondence between the position of the internal target region and the external sensors so that the treatment is directed towards the position of the internal target region of the patient based on the positional data obtained from the external sensors to compensate for motions of the patient.

2. The apparatus of claim 1, wherein the first detection device comprises one or more markers adapted to be attached to the internal target region within the patient'"'"'s body and an imaging device for imaging the markers within the patient'"'"'s body.

3. The apparatus of claim 2, wherein the imaging device comprises a stereotaxic x-ray device.

4. The apparatus of claim 3, wherein the one or more markers comprise metal beads adapted to be attached to the internal target region.

5. The apparatus of claim 1, wherein the first detection device comprises an ultrasound device for imaging the internal target region prior to treatment.

6. The apparatus of claim 5, wherein the first detection device further comprises an imaging device for detecting movement of the patient during the treatment.

7. The apparatus of claim 6, wherein the imaging device comprises a stereotaxic x-ray device.

8. The apparatus of claim 1, wherein the second detection device comprises one or more infrared markers adapted to be attached to the body of the patient and an infrared imaging device for imaging the infrared markers.

9. The apparatus of claim 1, wherein the second detection device comprises a visible imaging device.

10. The apparatus of claim 1, wherein the second detection device comprises a flow meter that measures respiration of the patient.

11. The apparatus of claim 10, wherein the second detection device further comprises means for compressing the abdomen of the patient to limit respiratory motion.

12. The apparatus of claim 1, wherein the processor further comprises means for correlating the periodic positional data of the internal target region with the positional data of the external markers.

13. The apparatus of claim 1, wherein the treatment comprises radiation treatment.

14. The apparatus of claim 1, wherein the treatment comprises a biopsy needle.

15. The apparatus of claim 1, wherein the treatment comprises a laser beam treatment.

16. The apparatus of claim 1, wherein the treatment comprises a focused energy treatment including one of ablation and ultrasound.

17. The apparatus of claim 1, wherein the external markers comprises a device worn around the waist of the user with the one or more external markers attached to the device, the device comprising one of a belt, ring and vest.

18. The apparatus of claim 1 further comprising means for altering the treatment in response to changes in the position of the target region.

19. The apparatus of claim 18, wherein the altering means comprises means for moving the treatment relative to the patient.

20. The apparatus of claim 18, wherein the altering means comprises means for changing the characteristics of the treatment.

21. The apparatus of claim 20, wherein the changing means comprises means for collimating the treatment beam.

22. The apparatus of claim 20, wherein the changing means comprises means for blocking the treatment beam at predetermined times.

23. A method for compensating for breathing and other motions of the patient during treatment, the method comprising:

periodically generating positional data about a target region internal to the body of the patient;

continuously generating positional data about external motion of the patient'"'"'s body using one or more external sensors; and

generating a correspondence between the position of the internal target region and the external sensors so that the treatment is directed towards the position of the internal target region of the patient based on the positional data of the external sensors to compensate for motions of the patient.

24. The method of claim 23, wherein periodically generating positional data comprises attaching one or more markers adapted to be attached to the internal target region within the patient'"'"'s body and imaging the markers within the patient'"'"'s body.

25. The method of claim 24, wherein the imaging comprises generating a stereotaxic x-ray image of the patient.

26. The method of claim 23, wherein generating the periodic positional data comprises imaging the internal target region with an ultrasound device prior to treatment.

27. The method of claim 26, wherein generating the positional data prior to treatment further comprises detecting movement of the patient during the treatment.

28. The method of claim 23, wherein generating the positions of the external markers comprises attaching one or more infrared markers adapted to be attached to the patient and imaging the infrared markers with an infrared imaging device.

29. The method of claim 23 further comprising binding the patient to reduce respiratory motion, and wherein the external sensor comprises a flow meter that measures respiration.

30. The method of claim 23, wherein generating the correspondence further comprises correlating the periodic positional data of the internal target region with the positional data of the external sensors.

31. The method of claim 23, wherein the treatment comprises radiation treatment.

32. The method of claim 23, wherein the treatment comprises a biopsy needle.

33. The method of claim 23, wherein the treatment comprises a laser beam treatment.

34. The method of claim 23, wherein the treatment comprises a focused energy treatment including one of ablation and ultrasound.

35. The method of claim 23, wherein attaching the external markers comprises attaching a device adapted to be attached to the patient having one or more external markers attached to the device, the device comprising one or a belt, a ring and a vest.

36. The method of claim 23 further comprising altering the treatment in response to changes in the position of the target region.

37. The method of claim 36, wherein the altering comprises moving the treatment relative to the patient.

38. The method of claim 36, wherein the altering comprises changing the characteristics of the treatment.

39. The method of claim 38, wherein the changing comprises collimating the treatment beam.

40. The method of claim 38, wherein the changing comprises blocking the treatment beam at predetermined times.

41. An apparatus for performing a treatment on an internal target region while compensating for breathing and other motions of the patient, the apparatus comprising:

a first imaging device for periodically generating positional data about a target region internal to the body of the patient;

a second imaging device for continuously generating positional data about one or more external sensors attached to the patient'"'"'s body;

a processor that receives the positional data about the internal target region and the external sensors in order to generate a correspondence between the position of the internal target region and the external sensory data to compensate for motions of the patient; and

a treatment device that directs the treatment towards the position of the internal target region of the patient based on the data of the external sensors.

42. An apparatus for compensating for breathing and other motions of the patient during treatment, the apparatus comprising:

a first detection device for periodically generating positional data about a target region internal to the body of the patient;

a second detection device for continuously generating positional data about one or more external markers showing external motion of the patient'"'"'s body when the first imaging device is not active; and

a processor that determines the position of the internal target region to be treated when the first imaging device is not active to compensate for motions of the patient, the position being determined based on the generated position of the external markers which corresponds to a predetermined position of the internal target region.