Apparatus and method for radiosurgery
First Claim
1. A method of treating a moving target in a patient by applying to said target one or more radiosurgical beams generated from a radiosurgical beam source, the method comprising:
- generating a pre-operative 3D scan of said target and of a surrounding region, said 3D scan indicating the position of said target relative to said surrounding region;
based on said 3D scan, generating a treatment plan defining a plurality of radiosurgical beams appropriate for creating at least one radiosurgical lesion on said target;
in near real time, detecting the motion of a target to determine the position of said target at a current time, and generating one or more signals representative of said motion of said target;
in near real time based on the generated one or more signals, determining a difference in the position of said target at said current time, as compared to the position of said target as indicated in said 3D scan;
in near real time, adjusting the relative position of said radiosurgical beam source and said target in order to accommodate for said difference, and applying x-rays to said target from said adjusted position of said radiosurgical beam source;
wherein said motion of said target is a composite motion that is caused by a combination of;
respiration of the patient; and
pumping of the heart of the patient; and
wherein generating one or more signals representative of said motion of said target comprises;
establishing a look-up table of positional data for said composite motion of said data, by imaging said target and said surrounding region while the target undergoes said composite motion;
establishing a look-up table of cardiac motion data for a succession of points along a heartbeat cycle of said patient, by imaging said target and said surrounding region while the patient is holding his breath;
establishing a look-up table of respiratory motion data for a succession of points along a respiratory cycle of said patient, by subtracting said cardiac motion data from said positional data for said composite motion of said data;
generating a first signal representative of the respiratory motion of patient from the data from said look-up table of respiratory motion, said first signal being characterized by a first frequency representative of the respiratory motion of said patient; and
generating a second signal representative of the cardiac motion of said patient from the data from said look-up table of cardiac motion data, said second signal being characterized by a second frequency representative of the cardiac motion of said patient.
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Abstract
A method and system is presented for treating moving target regions in a patient'"'"'s anatomy by creating radiosurgical lesions. The method includes determining a pulsating motion of a patient separately from a determining of a respiratory motion, and directing a radiosurgical beam, from a radiosurgical beam source, to a target in the patient based on the determining of the pulsating motion. Directing the radiosurgical beam to the target may include creating a lesion in the heart to inhibit atrial fibrillation. The method may further include determining the respiratory motion of the patient, and compensating for movement of the target, due to the respiratory motion and the pulsating motion of the patient, in the directing of the radiosurgical beam based on the determining of the respiratory motion and the determining of the pulsating motion.
252 Citations
27 Claims
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1. A method of treating a moving target in a patient by applying to said target one or more radiosurgical beams generated from a radiosurgical beam source, the method comprising:
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generating a pre-operative 3D scan of said target and of a surrounding region, said 3D scan indicating the position of said target relative to said surrounding region; based on said 3D scan, generating a treatment plan defining a plurality of radiosurgical beams appropriate for creating at least one radiosurgical lesion on said target; in near real time, detecting the motion of a target to determine the position of said target at a current time, and generating one or more signals representative of said motion of said target; in near real time based on the generated one or more signals, determining a difference in the position of said target at said current time, as compared to the position of said target as indicated in said 3D scan; in near real time, adjusting the relative position of said radiosurgical beam source and said target in order to accommodate for said difference, and applying x-rays to said target from said adjusted position of said radiosurgical beam source;
wherein said motion of said target is a composite motion that is caused by a combination of;respiration of the patient; and pumping of the heart of the patient; and wherein generating one or more signals representative of said motion of said target comprises; establishing a look-up table of positional data for said composite motion of said data, by imaging said target and said surrounding region while the target undergoes said composite motion; establishing a look-up table of cardiac motion data for a succession of points along a heartbeat cycle of said patient, by imaging said target and said surrounding region while the patient is holding his breath; establishing a look-up table of respiratory motion data for a succession of points along a respiratory cycle of said patient, by subtracting said cardiac motion data from said positional data for said composite motion of said data; generating a first signal representative of the respiratory motion of patient from the data from said look-up table of respiratory motion, said first signal being characterized by a first frequency representative of the respiratory motion of said patient; and generating a second signal representative of the cardiac motion of said patient from the data from said look-up table of cardiac motion data, said second signal being characterized by a second frequency representative of the cardiac motion of said patient. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A method of treating a moving target in a patient by applying one or more radiosurgical beams, generated from a radiosurgical beam source, to said target, the method comprising:
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generating a treatment plan containing information defining the positions, angles, and intensities of one or more radiosurgical beams that are adapted to create, when applied to said target, at least one radiosurgical lesion, said treatment plan being based on 3D scan data that indicates the position of said target at treatment planning time; in near real time, monitoring the motion of said target to determine the difference between the position of the target at a current time, as compared to the position of said target at treatment planning time as indicated by said 3D scan data; in near real time, adjusting the relative position of the radiosurgical beam source and said target to account for the difference in target position using a robotic controller; and applying one or more radiosurgical beams from said adjusted position of said radiosurgical beam source; and wherein said motion of said target is caused by the respiration and the heart beat of said patient; and
wherein the adjusting said relative position of said radiosurgical beam source to account for the difference in target position comprises;sensing the motion of said target during a time interval, using a breathing sensor and a heart beat sensor; extrapolating said motion into a complete cycle; and synchronizing said robotic controller with said extrapolated motion of said target.
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15. A system for treating a moving target in a patient by forming a radiosurgical lesion on said target, the system comprising:
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an apparatus for generating 3D scan data representative of a pre-operative 3D diagnostic image of said target and a surrounding region; a processor including treatment planning software for generating, based on said 3D scan data, a base treatment plan defining a plurality of x-ray beams appropriate for creating at least one lesion in said target; a beam source for generating one or more radiosurgical beams adapted to create at least one lesion in said target; a positioning system that controls the relative position of said beam source and said target; imaging means for generating at least one real-time x-ray image of said target; means for sensing the motion of said target, and for generating at least one signal representative of said motion; and means for generating from said at least one signal at least one correction factor that is effective, when applied to said positioning system, to modify the position of said beam source relative to said target to accommodate for the difference in position of said target at a current time as compared to the position of said target in said pre-operative diagnostic image; a signal processor coupled to the processor, the signal processor to process said at least one signal to generate a first signal substantially characterized by a first frequency, and a second signal substantially characterized by a second frequency; means for generating from said first signal a first correction factor, and for generating from said second signal a second correction factor; and means for superposing said first correction factor and said second correction factor to obtain said correction factor that is effective, when applied to said positioning system, to modify the position of said beam source relative to said target so as to accommodate for the difference in position of said target at a current time as compared to the position of said target in said pre-operative diagnostic image. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27)
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Specification