Radiation therapy and real time imaging of a patient treatment region

• US 6,512,942 B1
• Filed: 05/18/2000
• Issued: 01/28/2003
• Est. Priority Date: 11/24/1997
• Status: Expired due to Term

• Current Assignee: IMPAC Medical Systems, Inc. (Elekta AB)
• Original Assignee: Computerized Medical Systems, Inc. (Elekta AB)
• Inventors: Burdette, Everette C., Komandina, Bruce M.
• Primary Examiner(s): Shaw, Shawn J.
• Application Number:
  US09/573,415
• Time in Patent Office: 985 Days
• Field of Search: 600/427, 600/439, 600/3, 600/7, 600/407, 600/1, 600/459, 128/920, 128/922, 604/57, 604/60, 348/7
• US Class Current: 600/427
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/3411 with a plurality of holes, e.g. holes in matrix arrangement
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 6/00 Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment instruments measuring radiation intensity for application in the field of nuclear medicine, e.g. in vivo counting, G01T1/161; apparatus for taking X-ray photographs G03B42/02
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/42 Details of probe positioning or probe attachment to the patient
• CPC Class Codes: A61B 8/4209 by using holders, e.g. positioning frames
• CPC Class Codes: A61B 8/5238 for combining image data of patient, e.g. merging several images from different acquisition modes into one image for image registration algorithms G06T7/30
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61M 37/0069 Devices for implanting pellets, e.g. markers or solid medicaments for introducing of radioactive sources for interstitial radiation therapy, i.e. brachytherapy A61N5/1027
• CPC Class Codes: A61N 2005/1011 Apparatus for permanent insertion of sources
• CPC Class Codes: A61N 2005/1012 Templates or grids for guiding the introduction of sources
• CPC Class Codes: A61N 5/1001 using radiation sources introduced into or applied onto the body; brachytherapy
• CPC Class Codes: A61N 5/1002 : Intraluminal radiation therapy
• CPC Class Codes: A61N 5/1007 : Arrangements or means for the introduction of sources into the body
• CPC Class Codes: A61N 5/1027 : Interstitial radiation therapy
• CPC Class Codes: A61N 5/103 : Treatment planning systems
• 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

Abstract

A method and apparatus for three-dimensional imaging and treatment of a patient'"'"'s body. The method and apparatus utilize a system for developing a therapy plan for treatment of an organ of the patient, a device for generating ultrasound image data from a treatment region and a device for providing a translucent volume image of a portion of a patient'"'"'s body and a separate translucent image of the patient organ and a three dimensional viewing device to superimpose a translucent article image to enable viewing of the article image simultaneously with the patient organ and a portion of the patient'"'"'s body.

Claims

1. A system for providing therapy of a treatment region of the body of a patient, comprising:

at least one radioactive source for providing therapy to the treatment region of the patient by placement of the radioactive source in the treatment region of the patient'"'"'s body;

an automated device for holding and positioning the at least one radioactive source; and

a sensor positioned to monitor insertion of the at least one radioactive source into the patient;

at least one insertion device for receiving the radioactive source.

2. The system as defined in claim 1 further including a microprocessor coupled to an automatic loading device configured for inputting said at least one radioactive source and said plurality of spacers into said insertion device.

3. The system as defined in claim 2 further including a monitor for displaying to an operator an identifier of said insertion device and status of loading said at least one radioactive source and said spacers into said insertion device.

4. The system as defined in claim 2 further including a system computer having dose plan information which can be downloaded into said microprocessor for automatically loading said at least one radioactive source and said spacers into said insertion device in accordance with the dose plan information.

5. The system as defined in claim 2 further including a storage system for a plurality of said at least one insertion device and said storage system coupled to said microprocessor for automated positioning of the plurality of insertion devices for loading with said at least one radioactive source and said spacers in response to dose plan information.

6. A system for providing therapy of a treatment region of the body of a patient, comprising:

at least one radioactive source for providing therapy to the treatment region of the patient by placement of the radioactive source in the treatment region of the patient'"'"'s body;

a sensor positioned to monitor insertion of the at least one radioactive source into the patient; and

a microprocessor coupled to said sensor and configured to monitor input into the patient'"'"'s body of said at least one radioactive source.

7. A system for providing therapy of a treatment region of the body of a patient, comprising:

at least one radioactive source for providing therapy to the treatment region of the patient by placement of the radioactive source in the treatment region of the patient'"'"'s body;

a sensor positioned to monitor insertion of the at least one radioactive source into the patient;

a microprocessor coupled to said sensor and configured to monitor input into the patient'"'"'s body of said at least one radioactive source;

a plurality of spacers for placement adjacent at least some of said at least one radioactive source;

a container for holding said at least one radioactive source and a container for holding a plurality of said spacers;

an insertion device for receiving the at least one radioactive source and said spacers; and

a device to determine whether said insertion device is engaged to both said containers for input of said at least one radioactive source and at least one of said plurality of said spacers into said insertion device.

8. The system as defined in claim 7 wherein said insertion device comprises one of a needle and a catheter.

9. A system for providing therapy of a treatment region of the body of a patient, comprising:

at least one radioactive source for providing therapy to the treatment region of the patient by placement of the radioactive source in the treatment region of the patient'"'"'s body;

an insertion device for receiving the radioactive source;

a sensor positioned to monitor insertion of the at least one radioactive source into the patient; and

means for implanting which includes a holder positioned adjacent the patient, said holder including a template having openings for receiving said insertion device and the template comprising a disposable material for a single use.

10. A method for radiation treatment of a treatment region of the body of a patient, comprising the steps of:

using a computer automated device responsive to a computer generated therapeutic radiation plan for inputting at least one radioactive source into an insertion device for placement into treatment region;

sensing passage at least into the insertion device of the at least one radioactive source; and

passing the insertion device into the body of the patient proximate the treatment region.

11. The method as defined in claim 10 further including the step of positioning a holder for the insertion device adjacent the patient.

12. A method for radiation treatment of a treatment region of the body of a patient, comprising the steps of:

inputting at least one radioactive source into an insertion device and then to the treatment region;

sensing passage at least into the insertion device of the at least one radioactive source;

using a computer configured for implementing stepwise movement of an imaging probe relative to the patient for obtaining images of structure of the treatment region of the patient before implanting said insertion device into the patient; and

passing the insertion device into the body of the patient proximate the treatment region in accordance with the obtained images.

13. The method as defined in claim 12 wherein images of the treatment region are formed at a plurality of stepwise positions established by the stepwise movement of the imaging probe.

14. The method as defined in claim 12 further including the step of establishing the relative spatial position of each of the images.

15. The method as defined in claim 14, further including the step of using the computer to implement stepwise movement of the imaging probe relative to the patient for obtaining images of structure of the treatment region of the patient during passing of said insertion device into the patient.

16. A system for irradiation therapy of a treatment region of the body of a patient, comprising:

means for moving an imaging device into the patient to establish a digitized position of images of the treatment region;

means for positioning a holder adjacent the body of the patient;

means for passing at least one insertion device through openings in the holder and into the body of the patient; and

an automated device for inputting at least one radioactive source and at least one spacer into the insertion device responsive to a therapeutic radiation plan for irradiation of at least a portion of the treatment region.

17. The system as defined in claim 16 further including a sensor for detecting passage at least into the least one insertion device of the at least one radioactive source.

18. A system for irradiation therapy of a treatment region of the body of a patient, comprising:

means for moving an imaging device into the patient to establish a digitized position of images of the treatment region;

means for positioning a holder adjacent the body of the patient and the holder including a template having openings for receiving at least one insertion device and the template composed of a disposable material for a single use;

means for passing the at least one insertion device through openings in the holder and into the body of the patient; and

an automated device for inputting at least one radioactive source and at least one spacer into the insertion device responsive to a therapeutic radiation plan for irradiation of at least a portion of the treatment region.

19. A system for providing therapy of a treatment region of the body of a patient in accordance with a radiation therapy plan, comprising:

at least one radioactive source for patient treatment by placement of the radiation source within the treatment region;

an insertion device positionable at least in part within the body of the patient and having a passageway to receive the radioactive source and enable placement of the radioactive source in the treatment region in accordance with the radiation therapy plan; and

a sensor coupled to a computing device configured to automatically monitor passage of the radioactive source at least one of into and through the insertion device.

20. The system as defined in claim 19 wherein the insertion device is selected from the group consisting of a cylindrical hollow needle and a catheter.

21. The systems defined in claim 19 further including means for holding and positioning the insertion device.

22. A system for providing therapy of a treatment region of the body of a patient in accordance with a therapy plan, comprising:

at least one radioactive source for patient treatment within the treatment region;

an insertion device positionable at least in part within the body of the patient and having a passageway to receive the radioactive source and enable placement of the radioactive source in the treatment region in accordance with the therapy plan;

a sensor positioned to monitor passage of the radioactive source at least one of into and through the insertion device; and

means for holding and positioning the insertion device which comprises an automated device.

23. A system for providing therapy of a treatment region of the body of a patient in accordance with a therapy plan, comprising:

at least one radioactive source for patient treatment within the treatment region;

an insertion device positionable at least in part within the body of the patient and having a passageway to receive the radioactive source and enable placement of the radioactive source in the treatment region in accordance with the therapy plan;

a sensor positioned to monitor passage of the radioactive source at least one of into and through the insertion device;

means for holding and positioning the insertion device; and

a microprocessor coupled to said sensor and configured to monitor input of said at least one radioactive source.

24. A system for providing therapy of a treatment region of the body of a patient in accordance with a therapy plan, comprising:

at least one radioactive source for patient treatment within the treatment region;

an insertion device positionable at least in part within the body of the patient and having a passageway to receive the radioactive source and enable placement of the radioactive source in the treatment region in accordance with the therapy plan;

a sensor positioned to monitor passage of the radioactive source at least one of into and through the insertion device;

means for holding and positioning the insertion device; and

a microprocessor coupled to said sensor and configured to monitor input of at least one spacer and said at least one radioactive source.

25. A system for providing therapy of a treatment region of the body of a patient using substantially real time imaging, comprising:

a radioactive source for treatment of the patient and a therapeutic device containing the radioactive source;

a device for providing in substantially real time, image data from the treatment region of the patient'"'"'s body;

a display system for illustrating in substantially real time a therapeutic device image for placement of the therapeutic device and the radioactive source therein in conjunction with the treatment region of the patient, said display system further comprising means for providing in substantially real time a simultaneous image of the therapeutic device and the treatment region of the patient'"'"'s body; and

a holder for the therapeutic device including a template positioned adjacent the patient, the template having a plurality of openings for receiving the therapeutic device wherein the template comprises a disposable material for a single use.

26. A system for providing therapy of a treatment region of the body of a patient, comprising:

at least one radioactive source for providing therapy to the treatment region of the patient by placement of the radioactive source in the treatment region of the patient'"'"'s body;

at least one positioned and configured to at least one of (a) monitor insertion of the at least one radioactive source into the patient by a radiation sensor and (b) monitor the at least one radioactive source in the patient; and

a computer automated device for automatically inputting radioactive source into the treatment region.

27. A method for performing an automated loading of a radioactive source for radiation treatment of a treatment region of the body of a patient, comprising the steps of:

preparing at least one insertion device to be passed into the body of the patient;

automatically inputting responsive to a computer at least one radioactive source into said insertion device for placement in the treatment region of the body of the patient in accordance with a computer generated therapeutics radiation plan; and

automatically sensing passage into the insertion device of the at least one radioactive source to be used for treating the patient.

28. A system for preparation of irradiation therapy components for performing treatment of a patient, comprising:

a holder assembly;

an insertion device used for holding at least one radioactive source and at least one spacer and the insertion device passable through the holder assembly and into the patient; and

a computer automated device for inputting Into the insertion device the at least one radioactive source and the at least one spacer in accordance with a computer generated therapeutic radiation plan to treat the patient.

29. A system having a selected automated component for irradiation therapy of a treatment region of the body of a patient, comprising:

at least one radioactive source;

an insertion device used for placement of the at least one radioactive source in the patient in the treatment region; and

a computer automated device for inputting the at least one radioactive source into the insertion device responsive to a computer generated therapeutic radiation plan for irradiation of at least a portion of the treatment region.

30. A system having a selected automated component for irradiation therapy of a treatment region of the body of a patient, comprising:

at least one radioactive source;

an insertion device used for placement of the at least one radioactive source into the patient into the treatment region;

an automated device for inputting the at least one radioactive source into the insertion device responsive to a therapeutic radiation plan for irradiation of at least a portion of the treatment region; and

at least one of a holder for receiving said insertion device, a drive system for passing said at least one insertion device through openings in aholder and into the body of the patient, and an automated digitized stepper device for automatically recording relative position of the insertion device and the treatment region.

31. A system for providing therapy of a treatment region of the body of a patient and substantially real time imaging of the treatment region, comprising;

an energy source for providing therapy to the treatment region of the patient;

an insertion device for holding the energy source and having an automated positioning system to enable positioning of the energy source;

a sensor device for sensing passage of the insertion device into the treatment region and providing substantially real time imaging data of the insertion device with the sensor device further providing substantially real time image data from the treatment region of the patient'"'"'s body; and

a computer system for relating in a coordinate space the substantially real time image data from the insertion device and the treatment region to output for display a combined image in substantially real time of the insertion device and the treatment region.

32. The system as defined in claim 31 wherein the sensor device comprises an ultrasound device.

33. The system as defined in claim 31 wherein a landmark is present within the body of the patient and the sensor device provides substantially real time image data of the lrademark.

34. The system as defined in claim 33 wherein the image data from the landmark is also imaged in substantially real time with the insertion device and the treatment region.

35. The system as defined in claim 31 wherein the combined image comprises a two dimensional image.

36. A system for automatically recording positional information for providing radiation therapy of a treatment region of the body of a patient, comprising:

at least one radioactive source for patient treatment;

an insertion device for holding the radioactive source and configured for insertion into the patient for radiation therapy;

a sensor to provide substantially real time images of the treatment region; and

a digitized stepper device for automatically recording relative position of the insertion device and images of the treatment region.