Orthovoltage radiotherapy

• US 7,680,245 B2
• Filed: 01/31/2008
• Issued: 03/16/2010
• Est. Priority Date: 10/16/2006
• Status: Active Grant

• Current Assignee: Carl Zeiss Meditec Incorporated (Carl-Zeiss-Stiftung)
• Original Assignee: Oraya Therapeutics, Inc.
• Inventors: Gertner, Michael
• Primary Examiner(s): KAO, CHIH CHENG G
• Application Number:
  US12/023,954
• Publication Number:
  US 20080181362A1
• Time in Patent Office: 775 Days
• Field of Search: 378/65, 606/4
• US Class Current: 378/65
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• CPC Class Codes: A61F 9/009 Auxiliary devices making contact with the eyeball and coupling in laser light, e.g. goniolenses apparatus for eye examination A61B3/0008
• CPC Class Codes: A61N 2005/105 using a laser alignment system
• CPC Class Codes: A61N 2005/1056 by projecting a visible image of the treatment field
• CPC Class Codes: A61N 2005/1091 Kilovoltage or orthovoltage range photons
• CPC Class Codes: A61N 5/1017 Treatment of the eye, e.g. for "macular degeneration"
• CPC Class Codes: A61N 5/103 Treatment planning systems
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam

Abstract

A radiosurgery system is described that is configured to deliver a therapeutic dose of radiation to a target structure in a patient. In some embodiments, inflammatory ocular disorders are treated, specifically macular degeneration. In some embodiments, the ocular structures are placed in a global coordinate system based on ocular imaging. In some embodiments, the ocular structures inside the global coordinate system lead to direction of an automated positioning system that is directed based on the ocular structures within the coordinate system. In some embodiments, the position of the ocular structure is tracked and related to the status of the radiosurgery system. In some embodiments, a treatment plan is utilized in which beam energy and direction and duration of time for treatment is determined for a specific disease to be treated and/or structures to be avoided. In some embodiments, the structure is an eye and the eye is tracked by the system. In some embodiments, the eye is held in place and in some embodiments, the eye is fixed by the patient. In some embodiments, a fiducial is placed on the eye to aid in positioning. In some embodiments, a reflection off the eye is used to aid in positioning. In some embodiments, radiodynamic therapy is described in which radiosurgery is used in combination with other treatments and can be delivered concomitant with, prior to, or following other treatments.

Claims

1. A patient ocular interface, for assisting treatment of an ocular structure with x-rays, comprising:

an x-ray system that emits an x-ray beam during a treatment period; and

an eye holder, having an eye-contacting surface that engages an outer surface of an eye, the eye holder coupling with the x-ray system during the treatment period, the eye holder maintaining the eye in substantially a fixed position during the treatment period and providing an indication to a sensor whether the eye is substantially in the fixed position during the treatment period;

wherein, when the indication is that the eye is not substantially in the fixed position, the x-ray system is configured to;

(i) move the eye, with the eye holder, to be in substantially the fixed position, or

(ii) adjust a trajectory of the x-ray beam based on data from the sensor.

2. The patient ocular interface of claim 1, wherein the eye-contacting surface is adapted to engage the sclera of the eye.

3. The patient ocular interface of claim 1, wherein the eye holder is electrically coupled to the x-ray system.

4. The patient ocular interface of claim 1, wherein the sensor is located in or on the eye holder.

5. The patient ocular interface of claim 1, further comprising an x-ray source.

6. The patient ocular interface of claim 1, wherein the eye holder comprises a material that is at least partially transmissive of the x-ray beam.

7. The patient ocular interface of claim 1, wherein the eye holder is coupled to an x-ray emitter that is part of the x-ray system.

8. A patient ocular interface, for assisting treatment of an ocular structure with radiotherapy, comprising:

a holder that maintains an eye in a substantially fixed position during a treatment period; and

a communication link that communicates information from the holder to an x-ray system, the information being indicative of a position of the eye during the treatment period, and the information determining, at least in part, a characteristic of an x-ray beam that is emitted from the x-ray system during the treatment period;

wherein the characteristic of the x-ray beam comprises at least one of a trajectory of the x-ray beam, a beam on-time, an emit/not-emit status of the x-ray system, and a target on the sclera of the eye.

9. The patient ocular interface of claim 8, wherein said holder engages an anterior surface of the eye.

10. The patient ocular interface of claim 8, wherein said holder is mechanically coupled to the x-ray system.

11. The patient ocular interface of claim 8, wherein said communication link comprises an optical link.

12. The patient ocular interface of claim 8, wherein said holder aligns the x-ray beam with an axis of the eye.

13. The patient ocular interface of claim 8, wherein said holder aligns the x-ray beam with an optical axis of the eye.

14. The patient ocular interface of claim 8, further comprising a camera that images a position of the holder during the treatment period.

15. The patient ocular interface of claim 8, further comprising a camera that images a position of the eye relative to the holder.

16. The patient ocular interface of claim 15, wherein said camera detects movement of the eye and communicates data indicative of a position of the eye, the data determining, at least in part, a change in the characteristic of the x-ray beam.

17. The patient ocular interface of claim 8, wherein said holder comprises an eye-contacting surface that is concave and that engages the sclera of the eye.

18. The patient ocular interface of claim 8, wherein said holder is at least partially transmissive of x-ray energy.

19. The patient ocular interface of claim 8, wherein said holder is configured to apply suction to the eye.

20. A patient ocular interface system, for treatment of an eye, comprising:

a light source that emits light toward the eye during a treatment period;

an eye holder, having an eye-contacting surface that engages an outer surface of the eye, the eye holder maintaining the eye in substantially a fixed position during the treatment period; and

a sensor that provides an indication, to a radiotherapy system comprising an x-ray source, of a position of the eye during the treatment period;

wherein the indication is based on the light, and wherein, when the indication is that the eye is not substantially in the fixed position, (i) the eye holder is configured to move the eye to be in substantially the fixed position, or (ii) the x-ray source is configured to move and to adjust a trajectory of the x-ray beam based on data from the sensor.

21. The patient ocular interface system of claim 20, wherein the eye holder is electrically coupled to the radiotherapy system.

22. The patient ocular interface system of claim 20, wherein the sensor is located in or on the eye holder.

23. The patient ocular interface system of claim 20, wherein the eye holder comprises a material that is at least partially transmissive of the light.

24. The patient ocular interface system of claim 20, wherein the indication determines, at least in part, a characteristic of an x-ray beam emitted toward the eye from the radiotherapy system.

25. The patient ocular interface system of claim 24, wherein the characteristic comprises at least one of a trajectory of the x-ray beam, an x-ray beam on-time, an emit/not-emit status of the radiotherapy system, and a target on the sclera of the eye.

26. The patient ocular interface system of claim 20, wherein said holder aligns an axis of the eye with an axis of the light and an axis of an x-ray beam emitted toward the eye from the radiotherapy system.

27. The patient ocular interface system of claim 20, wherein said holder comprises an eye-contacting surface that is concave and that, in use, is positioned over the cornea of the eye and engages the sclera.

28. The patient ocular interface system of claim 20, wherein said holder is configured to apply suction to the eye.

29. A patient ocular interface, for assisting treatment of an ocular structure with radiotherapy, comprising:

means for holding an eye in a substantially fixed position during a treatment period; and

means for communicating information from the means for holding to an x-ray system, the information being indicative of a position of the eye during the treatment period, and the information determining, at least in part, a characteristic of an x-ray beam that is emitted from the x-ray system during the treatment period;

wherein the characteristic of the x-ray beam comprises at least one of a trajectory of the x-ray beam, a beam on-time, an emit/not-emit status of the x-ray system, and a target on the sclera of the eye.