Multi-mode cone beam CT radiotherapy simulator and treatment machine with a flat panel imager

• US 9,421,399 B2
• Filed: 09/15/2014
• Issued: 08/23/2016
• Est. Priority Date: 12/18/2002
• Status: Expired due to Term

• Current Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Original Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Inventors: Shapiro, Edward G., Seppi, Edward J., Pavkovich, John M., Johnsen, Stanley W., Colbeth, Richard E.
• Primary Examiner(s): Ho, Allen C.
• Application Number:
  US14/486,819
• Publication Number:
  US 20150043709A1
• Time in Patent Office: 708 Days
• Field of Search: 378/19, 378/65
• US Class Current: 1/1
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/035 Mechanical aspects of CT
• CPC Class Codes: A61B 6/04 Positioning of patients; Tiltable beds or the like operating tables A61G13/00; operating chairs A61G15/00
• CPC Class Codes: A61B 6/0407 Supports, e.g. tables or beds, for the body or parts of the body
• CPC Class Codes: A61B 6/0487 Motor-assisted positioning
• CPC Class Codes: A61B 6/4085 Cone-beams
• CPC Class Codes: A61B 6/42 Arrangements for detecting radiation specially adapted for radiation diagnosis
• CPC Class Codes: A61B 6/4208 characterised by using a particular type of detector
• CPC Class Codes: A61B 6/4233 using matrix detectors
• CPC Class Codes: A61B 6/4241 using energy resolving detectors, e.g. photon counting
• CPC Class Codes: A61B 6/44 Constructional features of apparatus for radiation diagnosis
• CPC Class Codes: A61B 6/4429 related to the mounting of source units and detector units
• CPC Class Codes: A61B 6/4435 the source unit and the detector unit being coupled by a rigid structure
• CPC Class Codes: A61B 6/4447 Tiltable gantries
• CPC Class Codes: A61B 6/461 Displaying means of special interest
• CPC Class Codes: A61B 6/487 involving fluoroscopy
• CPC Class Codes: A61N 2005/1054 using a portal imaging system
• CPC Class Codes: A61N 2005/1061 using an x-ray imaging system having a separate imaging source
• CPC Class Codes: A61N 5/10 X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy A61N5/01 takes precedence
• CPC Class Codes: A61N 5/103 Treatment planning systems
• CPC Class Codes: A61N 5/1031 : using a specific method of dose optimization
• CPC Class Codes: A61N 5/1039 : using functional images, e.g. PET or MRI
• CPC Class Codes: A61N 5/1042 : with spatial modulation of the radiation beam within the treatment head
• CPC Class Codes: A61N 5/1045 : using a multi-leaf collimator, e.g. for intensity modulated radiation therapy or IMRT
• CPC Class Codes: A61N 5/1047 : with movement of the radiation head during application of radiation, e.g. for intensity modulated arc therapy or IMAT
• 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: G01T 1/202 : the detector being a crystal

Abstract

A multi-mode cone beam computed tomography radiotherapy simulator and treatment machine is disclosed. The radiotherapy simulator and treatment machine both include a rotatable gantry on which is positioned a cone-beam radiation source and a flat panel imager. The flat panel imager captures x-ray image data to generate cone-beam CT volumetric images used to generate a therapy patient position setup and a treatment plan.

Claims

1. A method to perform a clinical treatment, comprising:

receiving a treatment plan at a computer of a radiation treatment machine;

storing reference image data on said computer;

positioning a patient at an initial position on a treatment couch of the radiation treatment machine;

rotating a gantry coupled to a frame of the radiation treatment machine;

emitting cone-beam radiation from a radiation source coupled to the gantry;

transmitting at least a portion of the cone-beam radiation through said patient;

capturing first image projection data using a flat-panel kV imager coupled to the gantry, wherein capturing the first image projection data includes capturing at least a portion of the portion of the cone-beam radiation transmitted through said patient;

generating cone-beam computed tomography (CT) volumetric image data from the first image projection data;

registering said cone-beam computed tomography (CT) volumetric image data with said reference image data;

repositioning the patient based on the cone-beam computed tomography (CT) volumetric image data, wherein repositioning the patient comprises moving said treatment couch prior to beginning the clinical treatment;

applying therapeutic radiation to a target volume using the treatment plan;

capturing second image projection data using a flat-panel MV imager coupled to the gantry, wherein capturing the second image projection data includes capturing at least a portion of the therapeutic radiation applied to the target volume; and

changing the speed of rotation of the gantry during rotation of the gantry.

2. The method of claim 1, wherein capturing the second image projection data includes capturing the second image projection data while changing the speed of rotation of the gantry during a continuous rotation of the gantry about the target volume.

17. The method as in one of claim 1, 3, 6, 9, 11 or 14, further comprising adjusting a therapeutic radiation source into a position to align the target volume with the therapeutic radiation.

18. The method of claim 17, wherein said capturing first image projection data captures the first image projection data at a rate of at least 5 frames per second.

19. The method of claim 17, wherein said capturing first image projection data captures the first image projection data at a rate of at least 15 frames per second.

20. The method of claim 17, further comprising storing the treatment plan and the first image projection data on said computer.

21. The method of claim 20, further comprising displaying said first image projection data on a monitor.

22. The method of claim 21, further comprising using said second image projection data to verify that the target volume is properly targeted.

23. The method of claim 20, further comprising displaying said second image projection data on a monitor.

24. The method of claim 23, further comprising using said second image projection data to verify that the target volume is properly targeted.

25. The method of claim 20, further comprising displaying said cone-beam computed tomography (CT) volumetric image data on a monitor.

26. The method of claim 25, further comprising using said second image projection data to verify that the target volume is properly targeted.

27. The method of claim 17, further comprising using said second image projection data to verify that the target volume is properly targeted.

3. A method to perform a clinical treatment, comprising:

receiving a treatment plan at a computer of a radiation treatment machine;

storing reference image data on said computer;

positioning a patient at an initial position on a treatment couch;

rotating a gantry coupled to a frame of the radiation treatment machine;

emitting cone-beam radiation from a radiation source coupled to the gantry;

transmitting at least a portion of the cone-beam radiation through said patient;

capturing first image projection data using a flat-panel kV imager coupled to the gantry, wherein capturing the first image projection data includes capturing at least a portion of the portion of the cone-beam radiation transmitted through said patient;

generating cone-beam computed tomography (CT) volumetric image data from the first image projection data;

registering said cone-beam computed tomography (CT) volumetric image data with reference image data;

repositioning the patient based on the cone-beam computed tomography (CT) volumetric image data, wherein repositioning the patient comprises moving said treatment couch prior to beginning the clinical treatment;

applying therapeutic radiation to a target volume using the treatment plan; and

capturing second image projection data using a flat-panel MV imager coupled to the gantry, wherein capturing the second image projection data includes capturing at least a portion of the therapeutic radiation applied to the target volume at non-uniformly spaced angles with respect to rotation of the gantry.

4. The method of claim 3, wherein capturing the second image projection data includes continuously rotating the gantry about the target volume while capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry.

5. The method of claim 4, wherein capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry comprises predetermining non-uniformly spaced angles with respect to rotation of the gantry.

6. A method to perform a clinical treatment, comprising:

receiving a treatment plan at a computer of a radiation treatment machine;

storing reference image data on said computer;

positioning a patient at an initial position on a treatment couch;

rotating a gantry coupled to a frame of the radiation treatment machine;

emitting cone-beam radiation from a radiation source coupled to the gantry;

transmitting at least a portion of the cone-beam radiation through said patient;

capturing first image projection data using a flat-panel kV imager coupled to the gantry;

generating cone-beam computed tomography (CT) volumetric image data from the first image projection data;

registering said cone-beam computed tomography (CT) volumetric image data with reference image data;

repositioning the patient based on the cone-beam computed tomography (CT) volumetric image data, wherein repositioning the patient comprises moving said treatment couch prior to beginning the clinical treatment;

applying therapeutic radiation to a target volume using the treatment plan;

capturing second image projection data using a flat-panel MV imager coupled to the gantry, wherein capturing the second image projection data includes capturing at least a portion of the therapeutic radiation applied to the target volume at non-uniformly spaced angles with respect to rotation of the gantry; and

wherein capturing the second image projection data includes changing the speed of rotation of the gantry during rotation of the gantry.

7. The method of claim 6, wherein capturing the second image projection data includes continuously rotating the gantry about the target volume (1) while capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry, and (2) while changing the speed of rotation of the gantry during rotation of the gantry.

8. The method of claim 7, wherein capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry comprises predetermining non-uniformly spaced angles with respect to rotation of the gantry.

9. A method to perform a clinical treatment, comprising:

receiving a treatment plan at a computer of a radiation treatment machine;

positioning a patient at an initial position on a treatment couch of the radiation treatment machine;

rotating a gantry coupled to a frame of the radiation treatment machine;

emitting cone-beam radiation from a radiation source coupled to the gantry;

transmitting at least a portion of the cone-beam radiation through said patient;

capturing first image projection data using a flat-panel kV imager coupled to the gantry, wherein capturing the first image projection data includes capturing at least a portion of the portion of the cone-beam radiation transmitted through said patient;

generating cone-beam computed tomography (CT) volumetric image data from the first image projection data;

repositioning the patient based on the cone-beam computed tomography (CT) volumetric image data, wherein repositioning the patient comprises moving said treatment couch prior to beginning the clinical treatment;

applying therapeutic radiation to a target volume using the treatment plan;

capturing second image projection data using a flat-panel MV imager coupled to the gantry, wherein capturing the second image projection data includes capturing at least a portion of the therapeutic radiation applied to the target volume; and

changing the speed of rotation of the gantry during rotation of the gantry.

10. The method of claim 9, wherein capturing the second image projection data includes capturing the second image projection data while changing the speed of rotation of the gantry during a continuous rotation of the gantry about the target volume.

11. A method to perform a clinical treatment, comprising:

receiving a treatment plan at a computer of a radiation treatment machine;

positioning a patient at an initial position on a treatment couch;

rotating a gantry coupled to a frame of the radiation treatment machine;

emitting cone-beam radiation from a radiation source coupled to the gantry;

transmitting at least a portion of the cone-beam radiation through said patient;

capturing first image projection data using a flat-panel kV imager coupled to the gantry, wherein capturing the first image projection data includes capturing at least a portion of the portion of the cone-beam radiation transmitted through said patient;

generating cone-beam computed tomography (CT) volumetric image data from the first image projection data;

repositioning the patient based on the cone-beam computed tomography (CT) volumetric image data, wherein repositioning the patient comprises moving said treatment couch prior to beginning the clinical treatment;

applying therapeutic radiation to a target volume using the treatment plan; and

capturing second image projection data using a flat-panel MV imager coupled to the gantry, wherein capturing the second image projection data includes capturing at least a portion of the therapeutic radiation applied to the target volume at non-uniformly spaced angles with respect to rotation of the gantry.

12. The method of claim 11, wherein capturing the second image projection data includes continuously rotating the gantry about the target volume while capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry.

13. The method of claim 12, wherein capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry comprises predetermining non-uniformly spaced angles with respect to rotation of the gantry.

14. A method to perform a clinical treatment, comprising:

receiving a treatment plan at a computer of a radiation treatment machine;

positioning a patient at an initial position on a treatment couch;

rotating a gantry coupled to a frame of the radiation treatment machine;

emitting cone-beam radiation from a radiation source coupled to the gantry;

transmitting at least a portion of the cone-beam radiation through said patient;

capturing first image projection data using a flat-panel kV imager coupled to the gantry;

generating cone-beam computed tomography (CT) volumetric image data from the first image projection data;

repositioning the patient based on the cone-beam computed tomography (CT) volumetric image data, wherein repositioning the patient comprises moving said treatment couch prior to beginning the clinical treatment;

applying therapeutic radiation to a target volume using the treatment plan;

capturing second image projection data using a flat-panel MV imager coupled to the gantry, wherein capturing the second image projection data includes capturing at least a portion of the therapeutic radiation applied to the target volume at non-uniformly spaced angles with respect to rotation of the gantry; and

changing the speed of rotation of the gantry during rotation of the gantry.

15. The method of claim 14, wherein capturing the second image projection data includes continuously rotating the gantry about the target volume (1) while capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry, and (2) while changing the speed of rotation of the gantry during rotation of the gantry.

16. The method of claim 15, wherein capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry comprises predetermining non-uniformly spaced angles with respect to rotation of the gantry.