Frameless radiosurgery treatment system and method

• US 6,778,850 B1
• Filed: 09/15/2000
• Issued: 08/17/2004
• 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): MANTIS MERCADER, ELENI M
• Application Number:
  US09/663,104
• Time in Patent Office: 1,432 Days
• Field of Search: 600/427, 600/429, 600/439, 600/437, 600/428, 600/425, 600/426, 600/407, 378/69, 378/205, 378/196, 378/197, 378/198, 378/4, 356/375, 606/130
• 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 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2090/101 for stereotaxic radiosurgery
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 6/4458 the source unit or the detector unit being attached to robotic arms
• CPC Class Codes: A61B 6/527 using data from a motion artifact sensor
• 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 5/103 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
• CPC Class Codes: A61N 5/1064 for adjusting radiation treatment in response to monitoring
• CPC Class Codes: A61N 5/1067 : in real time, i.e. during treatment
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

A method and apparatus for selectively and accurately localizing and treating a target within a patient are provided. A three dimensional mapping of a region surrounding the target is coupled to a surgical intervention. Two or more diagnostic beams at a known non-zero angle to one another may pass through the mapping region to produce images of projections within the mapping region in order to accurately localize and treat the target wherein the images are captured using one or more image recorders.

Claims

1. A system for treating a target region by directing a treatment beam towards the target region, comprising:

a treatment beam generator for generating a radiosurgical treatment beam;

one or more diagnostic x-ray beam generators for generating during treatment a plurality of diagnostic beams, each diagnostic beam being directed towards and through the target region, each diagnostic beam being generated from a different position so each diagnostic beam passes through the target region at a predetermined non-zero angle with respect to each other;

at least one imagining device for receiving each the plurality of diagnostic beams after each diagnostic beam has passed through the target region, and for generating a 2-D diagnostic image of the target region from each received diagnostic beam; and

a processor for synthesizing a relatively low clarity intra treatment 3-D image of the target region from said plurality of 2-D diagnostic images, and for comparing said synthesized 3-D image with a relatively high clarity pre-operative three-dimensional CT scan image to determine the position of the target region, so that said radiosurgical treatment beam can be continuously focused onto the target region.

2. A system in accordance with claim 1 further comprising a respiratory motion detection system for sensing the respiratory motion of the patient during the treatment so as to determine the respiratory cycle of said patient.

3. A system in accordance with claim 2, further comprising means for activating said one or more diagnostic x-ray beam generators at one or more predetermined points within said respiratory cycle.

4. A system in accordance with claim 1 further comprising means for generating the three-dimensional pre-operative CT scan image of the target region, and means for adjusting the targeting of a treatment beam in response to the comparison of the synthesized 3-D image with the three-dimensional pre-operative CT scan image so that said treatment beam can be continuously focused onto the target region.

5. The system of claim 4, wherein the adjusting means further comprises a computer-controlled robot for positioning the treatment beam.

6. A system in accordance with claim 4, wherein said three-dimensional pre-operative CT scan image of the target region comprises a CT (computer tomography) scan.

7. A system in accordance with claim 1 wherein comprising means for generating a plurality of diagnostic beams comprise one or more x-ray beam generators.

8. A system in accordance with claim 1, wherein the image receiver comprises an amorphous silicon image receiver.

9. A system in accordance with claim 1, wherein said treatment beam generator comprises an x-ray source having a linear accelerator.

10. A system in accordance with claim 1, wherein said processor further comprises means for deforming the pre-operative image so that the visible structures in the pre-operative image and the diagnostic beam images match, and means for determining the location of a target region based on the deformation.

11. A system in accordance with claim 1, wherein said processor further comprises means for deforming the diagnostic beam images so that the visible structures in the pre-operative image and the diagnostic beam images match, and means for determining the location of a target region based on the deformation.

12. A system in accordance with claim 1, wherein a means for synthesizing said 3-D image comprises means for processing said plurality of 2-D diagnostic images with one or more algorithms used in computed tomography.

13. A system in accordance with claim 1, further comprising a track that supports at least one diagnostic beam generator to move said diagnostic beam generator between a plurality of different positions at which each diagnostic beam is generated.

14. A method for treating a patient, comprising:

generating a relatively high clarity three-dimensional pre-operative CT scan image of an anatomical region of the patient, said anatomical region including a target region to be treated by a radiosurgical treatment beam;

generating during treatment a plurality of diagnostic x-ray beams from different positions and directing said diagnostic x-ray beams towards at least one image receiver and through said target region of the patient, so that each beams passes through the target region at predetermined non-zero angles with respect to each other;

receiving said plurality of diagnostic x-ray beams from said at least one image receiver when the diagnostic x-ray beams have passed through the target region, so as to generate a plurality of 2-D diagnostic images, one for each diagnostic x-ray beam;

synthesizing a relatively low clarity intra-treatment 3-D image from said plurality of 2-D diagnostic images; and

comparing said sythesized 3-D image to the relatively high clarity three-dimensional CT scan image in order to control the movement of the treatment beam during the treatment so that said treatment beam remains focused onto said target region.

15. The method of claim 14, wherein said three-dimensional pre-operative CT scan mapping of said anatomical region comprises a three-dimensional computer tomography mapping of said anatomical region.

16. A method in accordance with claim 14, further comprising the step of sensing the respiratory motion of the patient during treatment so as to determined the respiratory cycle of said patient.

17. A method in accordance with claim 16, further comprising the step of activating one or more diagnostic x-ray beam generators at one or more predetermined points within said respiratory cycle so that each of said plurality of diagnostic beams is generated at a corresponding predetermined point in said respiratory cycle.

18. A method in accordance with claim 17, further comprising the step of activating a treatment beam generator at one or more predetermined points within said respiratory cycle so that said radiosurgical treatment beam is generated at said one or more predetermined points.

19. A method in accordance with claim 14, wherein the step of comparing the images further comprises the steps of deforming the pre-operative CT scan image so that the visible structures in the pre-operative CT scan image and the 3-D sythesized image match, and determining the location of a target region based on the deformation.

20. The method of claim 14, wherein comparing the images further comprises deforming the synthesized intra-treatment 3-D image so that the visible structures in the pre-operative CT scan image and the intra-treatment 3-D image match, and determining the location of a target region based on the deformation.

21. A method in accordance with claim 14, wherein the step of synthesizing said 3-D image comprises the step of processing said plurality of 2-D diagnostic images with one or more CT-like algorithms.