Methods and apparatus for the planning and delivery of radiation treatments

• US 9,687,674 B2
• Filed: 09/15/2016
• Issued: 06/27/2017
• Est. Priority Date: 07/25/2005
• Status: Active Grant

• Current Assignee: Siemens Healthineers International AG
• Original Assignee: Varian Medical Systems International AG (Siemens AG)
• Inventors: Otto, Karl
• Primary Examiner(s): Matthews, Christine H
• Assistant Examiner(s): LANNU, JOSHUA DARYL DEANON
• Application Number:
  US15/266,225
• Publication Number:
  US 20170001033A1
• Time in Patent Office: 285 Days
• CPC Class Codes: A61B 2034/101 Computer-aided simulation of surgical operations
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/113 occurring during breathing
• CPC Class Codes: A61N 2005/1032 Genetic optimization methods
• CPC Class Codes: A61N 2005/1034 Monte Carlo type methods; particle tracking
• CPC Class Codes: A61N 2005/1035 Simulated annealing
• 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 5/1036 Leaf sequencing algorithms
• CPC Class Codes: A61N 5/1037 taking into account the movement of the target, e.g. 4D-image based planning
• 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 5/1049 for verifying the position of the patient with respect to the radiation beam
• CPC Class Codes: A61N 5/107 in real time, i.e. during treatment
• CPC Class Codes: A61N 5/1077 Beam delivery systems
• CPC Class Codes: A61N 5/1082 having multiple beam rotation axes

Abstract

Systems for delivering radiation dose to a target area within a subject comprise: a radiation source for outputting a radiation beam; a support for supporting the subject; a movement mechanism for moving the radiation source relative to the subject along a trajectory; one or more sensors for monitoring a position of the subject; and a controller configured, in accordance with a radiation delivery plan, to: determine the position from one or more signals received from the one or more sensors; deactivate delivery of the treatment radiation beam upon determining that the position is outside of an acceptable range; and reactivate delivery of the treatment radiation beam upon determining that the position is within the acceptable range, to thereby deliver dose to the subject according to the radiation delivery plan.

Claims

1. A system for delivery of radiation dose to a target area within a subject, the system comprising:

a treatment radiation source for outputting a treatment radiation beam;

a support for supporting the subject;

a movement mechanism for moving the treatment radiation source relative to the subject along a trajectory;

one or more sensors for monitoring a position of the subject;

a controller configured, in accordance with a radiation delivery plan, to;

cause the treatment radiation source to deliver the treatment radiation beam to the subject while causing the movement mechanism to effect relative movement between the treatment radiation source and the subject along the trajectory;

while causing the movement mechanism to effect relative movement between the treatment radiation source and the subject along the trajectory, cause the treatment radiation source to vary at least one of an intensity of the treatment radiation beam by varying a radiation output rate of the treatment radiation source according to the radiation delivery plan over at least a portion of the trajectory and a shape of the radiation treatment beam over at least a portion of the trajectory;

determine the position from one or more signals received from the one or more sensors;

deactivate delivery of the treatment radiation beam upon determining that the position is outside of an acceptable range; and

reactivate delivery of the treatment radiation beam upon determining that the position is within the acceptable range;

to thereby deliver dose to the subject according to the radiation delivery plan.

2. A system according to claim 1 wherein the subject is a living subject.

3. A system according to claim 1 wherein the position of the subject comprises a location of the target area and wherein the one or more sensors sense a location of the target area.

4. A system according to claim 1 wherein the controller is configured to vary both the intensity of the treatment radiation beam and the shape of the treatment radiation beam over at least a portion of the trajectory.

5. A system according to claim 1 comprising an imaging apparatus for obtaining two-dimensional projection images of the target area at a plurality of locations along the trajectory while the movement mechanism effects relative movement between the treatment radiation source and the subject along the trajectory.

6. A system according to claim 1 wherein the movement mechanism effects continuous relative movement between the treatment radiation source and the subject along the trajectory.

7. A system according to claim 1 wherein the movement mechanism effects non-self-overlapping relative movement between the treatment radiation source and the subject.

8. A system according to claim 1 wherein the movement mechanism comprises a plurality of motion axes and effects relative movement between the treatment radiation source and the subject by moving the plurality of motion axes.

9. A system according to claim 1 wherein the system is configured to:

deactivate relative movement between the treatment radiation source and the subject upon determining that the position is outside of the acceptable range; and

reactivate relative movement between the treatment radiation source and the subject upon determining that the position is within the acceptable range.

10. A system according to claim 1 wherein the trajectory comprises a non-self-overlapping trajectory which involves non-self-overlapping relative movement between the treatment radiation source and the subject.

11. A system according to claim 1 wherein a start of the trajectory and an end of the trajectory comprise a same relative position between the treatment radiation source and the subject and the trajectory comprises otherwise non-self-overlapping relative movement between the treatment radiation source and the subject.

12. A system according to claim 11 wherein the trajectory comprises relative movement between the treatment radiation source and the subject within a plane.

13. A system according to claim 1 wherein the controller is configured to:

deactivate delivery of the treatment radiation beam upon determining that respiration of the subject has caused the position to be outside of the acceptable range; and

reactivate delivery of the treatment radiation beam upon determining that respiration of the subject has caused the position to be inside of the acceptable range.

14. A system according to claim 13 wherein the one or more sensors comprise at least one sensor selected from the group consisting of:

respirometers, infrared position sensors, and electromyogram sensors, for determining respiration of the subject.

15. A system according to claim 1 wherein the trajectory comprises a plurality of arcs, each arc involving relative movement between the treatment radiation source and the subject within a corresponding plane.

16. A system according to claim 15 wherein, between successive ones of the plurality of arcs, the trajectory comprises inter-arc relative movement between the treatment radiation source and the subject, the inter-arc relative movement comprising movement such that the corresponding planes associated with each arc intersect one another.

17. A system according to claim 15 wherein, between successive ones of the plurality of arcs, the trajectory comprises inter-arc relative movement between the treatment radiation source and the subject, the inter-arc relative movement comprising movement such that the corresponding planes associated with each arc are parallel with one another.

18. A system for delivery of radiation dose to a target area within a subject, the system comprising:

a treatment radiation source for outputting a treatment radiation beam;

a support for supporting the subject;

a movement mechanism for moving the treatment radiation source relative to the subject along a trajectory;

one or more sensors for monitoring a position of the subject;

a controller configured, in accordance with a radiation delivery plan, to;

cause the treatment radiation source to deliver the treatment radiation beam to the subject while causing the movement mechanism to effect relative movement between the treatment radiation source and the subject along the trajectory;

while causing the movement mechanism to effect relative movement between the treatment radiation source and the subject along the trajectory, cause the treatment radiation source to vary at least one of an intensity of the treatment radiation beam by varying a radiation output rate of the treatment radiation source according to the radiation delivery plan over at least a portion of the trajectory and a shape of the radiation treatment beam over at least a portion of the trajectory;

determine the position from one or more signals received from the one or more sensors;

deactivate delivery of the treatment radiation beam upon determining that the position is outside of an acceptable range; and

reactivate delivery of the treatment radiation beam upon determining that the position is within the acceptable range;

to thereby deliver dose to the subject according to the radiation delivery plan;

wherein a start of the trajectory and an end of the trajectory comprise a same relative position between the treatment radiation source and the subject and the movement mechanism effects otherwise non-self-overlapping relative movement between the treatment radiation source and the subject along the trajectory.

19. A system for delivery of radiation dose to a target area within a subject, the system comprising:

a treatment radiation source for outputting a treatment radiation beam;

a support for supporting the subject;

a movement mechanism for moving the treatment radiation source relative to the subject along a trajectory;

one or more sensors for monitoring a respiratory cycle of the subject;

a controller configured, in accordance with a radiation delivery plan, to;

cause the treatment radiation source to deliver the treatment radiation beam to the subject while causing the movement mechanism to effect relative movement between the treatment radiation source and the subject along the trajectory;

while causing the movement mechanism to effect relative movement between the treatment radiation source and the subject along the trajectory, cause the treatment radiation source to vary at least one of an intensity of the treatment radiation beam by varying a radiation output rate of the treatment radiation source according to the radiation delivery plan over at least a portion of the trajectory and a shape of the radiation treatment beam over at least a portion of the trajectory;

deactivate delivery of the treatment radiation beam upon determining that the respiratory cycle of the subject has moved a location of the target area outside of an acceptable range; and

reactivate delivery of the treatment radiation beam upon determining that the respiratory cycle of the subject has moved the location of the target area to within the acceptable range;

to thereby deliver dose to the subject according to the radiation delivery plan.

20. A system according to claim 19 wherein the subject is a living subject.

21. A system according to claim 19 wherein the controller is configured to vary both the intensity of the treatment radiation beam and the shape of the treatment radiation beam over at least a portion of the trajectory.

22. A system according to claim 19 comprising an imaging apparatus for obtaining two-dimensional projection images of the target area at a plurality of locations along the trajectory while the movement mechanism effects relative movement between the treatment radiation source and the subject along the trajectory.

23. A system according to claim 19 wherein the movement mechanism effects continuous relative movement between the treatment radiation source and the subject along the trajectory.

24. A system according to claim 19 wherein the movement mechanism effects non-self-overlapping relative movement between the treatment radiation source and the subject.

25. A system according to claim 19 wherein a start of the trajectory and an end of the trajectory comprise a same relative position between the treatment radiation source and the subject and the movement mechanism effects otherwise non-self-overlapping relative movement between the treatment radiation source and the subject along the trajectory.

26. A system according to claim 19 wherein the movement mechanism comprises a plurality of motion axes and effects relative movement between the treatment radiation source and the subject by moving the plurality of motion axes.

27. A system according to claim 19 wherein the system is configured to:

deactivate relative movement between the treatment radiation source and the subject upon determining that the position is outside of the acceptable range; and

reactivate relative movement between the treatment radiation source and the subject upon determining that the position is within the acceptable range.

28. A system according to claim 19 wherein a start of the trajectory and an end of the trajectory comprise a same relative position between the treatment radiation source and the subject and the trajectory comprises otherwise non-self-overlapping relative movement between the treatment radiation source and the subject.

29. A system according to claim 19 wherein the one or more sensors are selected from the group consisting of:

respirometers, infrared position sensors, and electromyogram sensors.

30. A system for delivery of radiation dose to a target area within a subject, the system comprising:

a treatment radiation source for outputting a treatment radiation beam;

a support for supporting the subject;

a movement mechanism for moving the treatment radiation source relative to the subject along a trajectory;

one or more sensors for monitoring a respiratory cycle of the subject;

a controller configured, in accordance with a radiation delivery plan, to;

cause the treatment radiation source to deliver the treatment radiation beam to the subject while causing the movement mechanism to effect relative movement between the treatment radiation source and the subject along the trajectory;

while causing the movement mechanism to effect relative movement between the treatment radiation source and the subject along the trajectory, cause the treatment radiation source to vary at least one of an intensity of the treatment radiation beam by varying a radiation output rate of the treatment radiation source according to the radiation delivery plan over at least a portion of the trajectory and a shape of the radiation treatment beam over at least a portion of the trajectory;

deactivate delivery of the treatment radiation beam upon determining that the respiratory cycle of the subject has moved a location of the target area outside of an acceptable range; and

reactivate delivery of the treatment radiation beam upon determining that the respiratory cycle of the subject has moved the location of the target area to within the acceptable range;

to thereby deliver dose to the subject according to the radiation delivery plan;

wherein the trajectory comprises a non-self-overlapping trajectory which involves non-self-overlapping relative movement between the treatment radiation source and the subject.