Methods and apparatus for the planning and delivery of radiation treatments

• US 9,764,159 B2
• Filed: 09/15/2016
• Issued: 09/19/2017
• 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:
  US15/266,156
• Publication Number:
  US 20170001034A1
• Time in Patent Office: 369 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

Methods for delivering radiation dose to a target area within a subject comprise: defining a trajectory comprising relative movement between a treatment radiation source and the subject and determining a radiation delivery plan; and, while effecting relative movement between the treatment radiation source and the subject along the trajectory, delivering a treatment radiation beam from the treatment radiation source to the subject according to the radiation delivery plan to impart a dose distribution on the subject. Delivering the treatment radiation beam from the treatment radiation source to the subject comprises varying an intensity of the treatment radiation beam over at least a portion of the trajectory. Varying the intensity of the treatment radiation beam comprises varying a radiation output rate of the treatment radiation source in accordance with the radiation delivery plan while effecting relative movement between the treatment radiation source and the subject along the trajectory.

Claims

1. A method for delivering radiation dose to a target area within a subject, the method comprising:

defining a trajectory comprising relative movement between a treatment radiation source and the subject and determining a radiation delivery plan;

effecting relative movement between the treatment radiation source and the subject along the trajectory;

while effecting relative movement between the treatment radiation source and the subject along the trajectory, delivering a treatment radiation beam from the treatment radiation source to the subject according to the radiation delivery plan to impart a dose distribution on the subject;

wherein delivering the treatment radiation beam from the treatment radiation source to the subject comprises varying an intensity of the treatment radiation beam over at least a portion of the trajectory;

wherein varying the intensity of the treatment radiation beam over at least a portion of the trajectory comprises varying a radiation output rate of the treatment radiation source in accordance with the radiation delivery plan while effecting relative movement between the treatment radiation source and the subject along the trajectory; and

wherein effecting relative movement between the treatment radiation source and the subject along the trajectory comprises effecting non-self-overlapping relative movement between the treatment radiation source and the subject.

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

3. A method according to claim 1 wherein defining the trajectory comprises defining an initial trajectory and wherein determining the radiation delivery plan comprises modifying the initial trajectory to provide the trajectory.

4. A method according to claim 1 wherein delivering the treatment radiation beam from the treatment radiation source comprises varying a shape of the treatment radiation beam in accordance with the radiation delivery plan over at least a portion of the trajectory while effecting relative movement between the treatment radiation source and the subject along the trajectory.

5. A method according to claim 1 wherein effecting relative movement between the treatment radiation source and the subject along the trajectory comprises effecting continuous relative movement between the treatment radiation source and the subject along the trajectory.

6. A method according to claim 1 wherein effecting relative movement between the treatment radiation source and the subject along the trajectory comprises moving a plurality of motion axes of a radiation delivery apparatus.

7. A method 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.

8. A method according to claim 7 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.

9. A method according to claim 7 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.

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

11. A method for delivering radiation dose to a target area within a subject, the method comprising:

defining a trajectory comprising relative movement between a treatment radiation source and the subject and determining a radiation delivery plan;

effecting relative movement between the treatment radiation source and the subject along the trajectory;

while effecting relative movement between the treatment radiation source and the subject along the trajectory, delivering a treatment radiation beam from the treatment radiation source to the subject according to the radiation delivery plan to impart a dose distribution on the subject;

wherein delivering the treatment radiation beam from the treatment radiation source to the subject comprises varying an intensity of the treatment radiation beam over at least a portion of the trajectory;

wherein varying the intensity of the treatment radiation beam over at least a portion of the trajectory comprises varying a radiation output rate of the treatment radiation source in accordance with the radiation delivery plan while effecting relative movement between the treatment radiation source and the subject along the trajectory;

wherein the trajectory comprises a start and end at a same relative position between the treatment radiation source and the subject and the trajectory is otherwise non-self overlapping;

wherein the trajectory comprises relative movement between the treatment radiation source and the subject within a plane.

12. A method for delivering radiation dose to a target area within a subject, the method comprising:

defining a trajectory comprising relative movement between a treatment radiation source and the subject and determining a radiation delivery plan;

effecting relative movement between the treatment radiation source and the subject along the trajectory;

while effecting relative movement between the treatment radiation source and the subject along the trajectory, delivering a treatment radiation beam from the treatment radiation source to the subject according to the radiation delivery plan to impart a dose distribution on the subject;

while effecting relative movement between the treatment radiation source and the subject along the trajectory, obtaining two-dimensional projection images of the target area at a plurality of locations along the trajectory;

wherein delivering the treatment radiation beam from the treatment radiation source to the subject comprises varying an intensity of the treatment radiation beam over at least a portion of the trajectory;

wherein varying the intensity of the treatment radiation beam over at least a portion of the trajectory comprises varying a radiation output rate of the treatment radiation source in accordance with the radiation delivery plan while effecting relative movement between the treatment radiation source and the subject along the trajectory.

13. A method according to claim 12 wherein obtaining two-dimensional projection images of the target area comprises, for each projection image, directing an imaging radiation beam toward the subject and sensing imaging radiation that is transmitted through the subject.

14. A method according to claim 13 wherein the imaging radiation beam is generated by the treatment radiation source.

15. A method according to claim 13 wherein directing the imaging radiation beam toward the subject and delivering the treatment radiation beam from the treatment radiation source to the subject comprise one of:

time division multiplexing the imaging radiation beam and the treatment radiation beam; and

non-self-overlapping relative movement between the treatment radiation source and the subject.

16. A method for delivering radiation dose to a target area within a subject, the method comprising:

defining a trajectory comprising relative movement between a treatment radiation source and the subject and determining a radiation delivery plan;

effecting relative movement between the treatment radiation source and the subject along the trajectory;

while effecting relative movement between the treatment radiation source and the subject along the trajectory, delivering a treatment radiation beam from the treatment radiation source to the subject according to the radiation delivery plan to impart a dose distribution on the subject, wherein delivering the treatment radiation beam from the treatment radiation source to the subject comprises varying an intensity of the treatment radiation beam over at least a portion of the trajectory; and

while effecting relative movement between the treatment radiation source and the subject along the trajectory, obtaining two-dimensional projection images of the target area at a plurality of locations along the trajectory.

17. A method according to claim 16 wherein the subject is a living subject.

18. A method according to claim 16 wherein defining the trajectory comprises defining an initial trajectory and wherein determining the radiation delivery plan comprises modifying the initial trajectory to provide the trajectory.

19. A method according to claim 16 wherein delivering the treatment radiation beam from the treatment radiation source to the subject further comprises varying a shape of the treatment radiation beam over at least the portion of the trajectory.

20. A method according to claim 16 wherein effecting relative movement between the treatment radiation source and the subject along the trajectory comprises effecting continuous relative movement between the treatment radiation source and the subject along the trajectory.

21. A method according to claim 16 wherein effecting relative movement between the treatment radiation source and the subject along the trajectory comprises effecting non-self-overlapping relative movement between the treatment radiation source and the subject.

22. A method according to claim 16 wherein effecting relative movement between the treatment radiation source and the subject along the trajectory comprises 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 effecting otherwise non-self-overlapping relative movement between the treatment radiation source and the subject.

23. A method according to claim 16 wherein effecting relative movement between the treatment radiation source and the subject along the trajectory comprises moving a plurality of motion axes of a radiation delivery apparatus.

24. A method according to claim 16 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.

25. A method according to claim 16 wherein the trajectory comprises a start and end at a same relative position between the treatment radiation source and the subject and the trajectory is otherwise non-self overlapping.

26. A method according to claim 16 wherein obtaining two-dimensional projection images comprises, for each projection image, directing an imaging radiation beam toward the subject and sensing imaging radiation that is transmitted through the subject.

27. A method according to claim 26 wherein directing the imaging radiation beam toward the subject and delivering the treatment radiation beam from the treatment radiation source to the subject comprise one of:

time division multiplexing the imaging radiation beam and the treatment radiation beam; and

the imaging radiation beam is generated by the treatment radiation source.