Methods and apparatus for the planning and delivery of radiation treatments

• US 9,788,783 B2
• Filed: 12/16/2016
• Issued: 10/17/2017
• Est. Priority Date: 07/25/2005
• Status: Active Grant

• Current Assignee: Siemens Healthineers International AG (Siemens 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:
  US15/382,469
• Publication Number:
  US 20170095201A1
• Time in Patent Office: 305 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 and apparatus are provided for planning and delivering radiation treatments by modalities which involve moving a radiation source along a trajectory relative to a subject while delivering radiation to the subject. In some embodiments the radiation source is moved continuously along the trajectory while in some embodiments the radiation source is moved intermittently. Some embodiments involve the optimization of the radiation delivery plan to meet various optimization goals while meeting a number of constraints. For each of a number of control points along a trajectory, a radiation delivery plan may comprise: a set of motion axes parameters, a set of beam shape parameters and a beam intensity.

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;

sensing a position of the subject;

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

sensing that the position is outside of an acceptable range and deactivating delivery of the treatment radiation beam based on the sensing that the position is outside of an acceptable range; and

sensing that the position is within the acceptable range and reactivating delivery of the treatment radiation beam based on the sensing that the position is within the acceptable range; and

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 during the relative movement between the treatment radiation source and the subject along the trajectory.

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 the position of the subject comprises a location of the target area and wherein sensing the position of the subject comprises sensing a location of the target area.

5. A method according to claim 1 wherein delivering the treatment radiation beam from the treatment radiation source to the subject comprises varying a shape of the treatment radiation beam over at least a portion of the trajectory.

6. A method according to claim 1 wherein sensing the position comprises, during the 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.

7. 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.

8. A method according to claim 1 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.

9. A method according to claim 1 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.

10. 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.

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

sensing that the position is outside of the acceptable range and deactivating relative movement between the treatment radiation source and the subject based on the sensing that the position is outside of the acceptable range; and

sensing that the position is within the acceptable range and reactivating relative movement between the treatment radiation source and the subject based on the sensing that the position is within the acceptable range.

12. 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.

13. A method according to claim 1 wherein:

deactivating delivery of the treatment radiation beam based on the sensing that the position is outside of the acceptable range comprises sensing that respiration of the subject has caused the position to be outside of the acceptable range and deactivating delivery of the treatment radiation beam based on the sensing that respiration of the subject has caused the position to be outside of the acceptable range; and

reactivating delivery of the treatment radiation beam based on the sensing that the position is within the acceptable range comprises sensing that respiration of the subject has caused the position to be within the acceptable range and reactivating delivery of the treatment radiation beam based on the sensing that respiration of the subject has caused the position to be within the acceptable range.

14. A method according to claim 13 wherein sensing respiration of the subject comprises sensing respiration using one or more sensors selected from the group consisting of:

respirometers, infrared position sensors, and electromyogram sensors.

15. 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.

16. A method according to claim 1 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.

17. 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;

sensing a position of the subject;

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

sensing that the position is outside of an acceptable range and deactivating delivery of the treatment radiation beam based on the sensing that the position is outside of an acceptable range; and

sensing that the position is within the acceptable range and reactivating delivery of the treatment radiation beam based on the sensing that the position is within the acceptable range;

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

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; and

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.

18. 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;

sensing a position of the subject;

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

sensing that the position is outside of an acceptable range and deactivating delivery of the treatment radiation beam based on the sensing that the position is outside of an acceptable range; and

sensing that the position is within the acceptable range and reactivating delivery of the treatment radiation beam based on the sensing that the position is within the acceptable range;

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

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; and

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.

19. 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;

sensing a respiratory cycle of the subject;

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

sensing that the respiratory cycle of the subject has moved a location of the target area outside of an acceptable range and deactivating delivery of the treatment radiation beam based on the sensing that the respiratory cycle of the subject has moved a location of the target area outside of an acceptable range; and

sensing that the respiratory cycle of the subject has moved the location of the target area to within the acceptable range and reactivating delivery of the treatment radiation beam based on the sensing that the respiratory cycle of the subject has moved the location of the target area to within the acceptable range; and

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 during the relative movement between the treatment radiation source and the subject along the trajectory.

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

21. A method according to claim 19 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.

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

23. A method according to claim 19 wherein sensing the respiratory cycle comprises, during the 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.

24. A method according to claim 19 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.

25. A method according to claim 19 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.

26. A method according to claim 19 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.

27. A method according to claim 19 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.

28. A method according to claim 19 wherein effecting relative movement between the treatment radiation source and the subject along the trajectory comprises:

sensing that the respiratory cycle of the subject has moved the location of the target area outside of the acceptable range and deactivating relative movement between the treatment radiation source and the subject based on the sensing that the respiratory cycle of the subject has moved the location of the target area outside of the acceptable range; and

sensing that the respiratory cycle of the subject has moved the location of the target area to within the acceptable range and reactivating relative movement between the treatment radiation source and the subject based on the sensing that the respiratory cycle of the subject has moved the location of the target area to within the acceptable range.

29. A method according to claim 19 wherein sensing respiration of the subject comprises sensing respiration using one or more sensors selected from the group consisting of:

respirometers, infrared position sensors, and electromyogram sensors.

30. A method according to claim 19 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.