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

• US 9,901,750 B2
• Filed: 08/01/2016
• Issued: 02/27/2018
• 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:
  US15/225,710
• Publication Number:
  US 20160367838A1
• Time in Patent Office: 575 Days
• Field of Search: 378 9, 378 20, 378 65
• 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 radiotherapy treatment machine is disclosed. The radiotherapy simulator and radiotherapy 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. An apparatus, comprising:

a frame;

a rotatable gantry coupled to the frame, the rotatable gantry capable of changing the speed of rotation during a continuous rotation;

a high-energy radiation source coupled to the rotatable gantry and configured to emit therapeutic radiation;

a cone-beam radiation source coupled to the rotatable gantry and configured to emit cone-beam radiation;

a flat-panel imager coupled to the rotatable gantry, the flat-panel imager being operable to capture image projection data of a patient by capturing at least a portion of the cone-beam radiation from the cone-beam radiation source while changing the speed of rotation of the rotatable gantry during a continuous rotation;

a cone-beam computed tomography (CT) reconstruction computer coupled to the rotatable gantry via a communications network, the cone-beam computed tomography (CT) reconstruction computer is operable to use the image projection data captured by the flat-panel imager to generate cone-beam computed tomography (CT) volumetric image data of the patient; and

a separate workstation computer coupled to the cone-beam computed tomography (CT) reconstruction computer via the communications network, said separate workstation computer configured to receive and store a treatment plan.

2. The apparatus of claim 1, wherein the communications network employs a protocol for selective routing of messages.

3. The apparatus of claim 1, further comprising a treatment couch, the cone-beam computed tomography (CT) reconstruction computer is operatively coupled to the treatment couch.

4. The apparatus of claim 1, further comprising an accelerator control computer, the cone-beam computed tomography (CT) reconstruction computer is operatively coupled to the accelerator control computer.

5. The apparatus of claim 1, wherein said separate workstation computer is configured to receive and store the image projection data captured by the flat-panel imager.

6. The apparatus of claim 1, further comprising a monitor, said separate workstation computer configured to display the image projection data on the monitor.

7. The apparatus of claim 6, wherein said separate workstation computer is configured to display the cone-beam computed tomography (CT) volumetric image data on the monitor.

8. The apparatus of claim 1, wherein the flat-panel imager is capable of at least one of fluoroscopic imaging, radiographic imaging, or cone-beam computed tomography (CT) imaging.

9. The apparatus of claim 1, wherein the flat-panel imager is configured to capture the image projection data at non-uniformly spaced angles with respect to rotation of the rotatable gantry.

10. An apparatus, comprising:

a radiation treatment system capable of implementing a treatment plan, the radiation treatment system comprising;

a rotatable gantry capable of changing the speed of rotation during a continuous rotation;

a high-energy radiation source coupled to the rotatable gantry to radiate a patient with therapeutic radiation;

a cone-beam radiation source coupled to the rotatable gantry to radiate the patient with cone-beam radiation;

a kV flat-panel imager coupled to the rotatable gantry, wherein the kV flat-panel imager is operable to capture image projection data of the patient by capturing at least a portion of the cone-beam radiation from the cone-beam radiation source;

a cone-beam computed tomography (CT) reconstruction computer coupled to the rotatable gantry via a communications network, wherein the cone-beam computed tomography (CT) reconstruction computer is operable to use the image projection data captured by the kV flat panel imager to generate cone-beam computed tomography (CT) volumetric image data of the patient;

an MV flat-panel imager coupled to the rotatable gantry, wherein the MV flat-panel imager is operable to capture image projection data of the patient by capturing at least a portion of the therapeutic radiation from the high-energy radiation source at non-uniformly spaced angles with respect to the rotation of the rotatable gantry while changing the speed of rotation of the rotatable gantry during a continuous rotation; and

a separate workstation computer coupled to the cone-beam computed tomography (CT) reconstruction computer via the communications network, wherein said separate workstation computer receives and stores the image projection data captured by the kV flat-panel imager and stores the treatment plan.

11. The apparatus of claim 10, wherein the communications network employs a protocol for selective routing of messages.

12. The apparatus of claim 10, further comprising a treatment couch, the cone-beam computed tomography (CT) reconstruction computer is operatively coupled to the treatment couch.

13. The apparatus of claim 10, further comprising an accelerator control computer, the cone-beam computed tomography (CT) reconstruction computer is operatively coupled to the accelerator control computer.

14. The apparatus of claim 10, wherein said separate workstation computer receives and stores the image projection data captured by the MV flat-panel imager.

15. The apparatus of claim 10, further comprising a monitor, said separate workstation computer can be used to display said kV image projection data or said MV image projection data on the monitor.

16. The apparatus of claim 10, further comprising a monitor, wherein said separate workstation computer can be used to display cone-beam computed tomography (CT) volumetric image data on the monitor.

17. The apparatus of claim 10, wherein said kV flat panel imager is capable of fluoroscopic imaging, radiographic imaging, and cone-beam computed tomography (CT) imaging.

18. A method, comprising:

receiving data for providing therapeutic radiation to a target volume at a computer, the data comprising a treatment plan and reference image data;

emitting cone-beam radiation from a radiation source coupled to a rotatable gantry, the rotatable gantry and the radiation source being coupled to a frame;

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

registering cone-beam computed tomography (CT) volumetric image data with the reference image data stored on the computer, the cone-beam computed tomography (CT) volumetric image data being associated with the first image projection data;

applying with the radiation source therapeutic radiation to the target volume based on the treatment plan stored on the computer;

capturing second image projection data of the target volume using the flat-panel kV imager coupled to the rotatable gantry while changing a speed of the rotatable gantry during a continuous rotation; and

supporting the patient on a treatment couch in a first position before the applying, the treatment couch being in a second position during the applying,

wherein capturing the second image projection data includes capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the rotatable gantry.

19. The method of claim 18, further comprising:

generating the cone-beam computed tomography (CT) volumetric image data based on the first image projection data using a first logic.

20. The method of claim 19, further comprising:

controlling the treatment couch using a second logic to place a patient in an operative position to begin a treatment based on the cone-beam computed tomography (CT) volumetric image data or the second image projection data.

21. The method of claim 20, wherein using the first logic and using the second logic includes using at least one of hard-wired logic and a programmable computer component and wherein the programmable computer component includes a processor.

22. The method of claim 20, wherein controlling the treatment couch using the second logic to place the patient in an operative position to begin the treatment includes:

positioning the patient on the treatment couch; and

controlling the treatment couch to re-position the patient so that a center of the radiation source is matched with a center of the treatment plan.

23. The method of claim 22, wherein positioning the patient on the treatment couch includes placing the patient on the treatment couch, and then positioning the treatment couch to place a target volume of the patient within a range of operation (1) of the radiation source, and (2) of the flat-panel kV imager;

and wherein controlling the treatment couch to re-position the patient comprises controlling the treatment couch to re-position the target volume based on comparing (1) the cone-beam computed tomography (CT) volumetric image data or the second image projection data showing the center of the radiation source with (2) reference images of the treatment plan showing the center of the treatment plan.

24. A method to perform a treatment, comprising:

emitting a cone-beam from a radiation source;

capturing first image projection data from a flat-panel imager for generating cone-beam computed tomography (CT) volumetric image data capable of being used to reposition a treatment couch;

transmitting at least a portion of the cone-beam through a target volume;

receiving a treatment plan;

continuing to rotate a rotatable gantry on which the flat-panel imager is mounted while capturing second image projection data; and

capturing the second image projection data at non-uniformly spaced angles with respect to a rotation while changing the speed of rotation of the rotatable gantry during a continuous rotation.

25. The method of claim 24, further comprising:

using a first logic to generate the cone-beam computed tomography (CT) volumetric image data based on the first image projection data.

26. The method of claim 25, further comprising:

using a second logic to control the treatment couch and place a patient in an operative position to begin a treatment based on the cone-beam computed tomography (CT) volumetric image data or the second image projection data.

27. The method of claim 26, wherein using the first logic and using the second logic includes using at least one of hard-wired logic and a programmable computer component and wherein the programmable computer component includes a processor.

28. The method of claim 26, wherein using the second logic to control the treatment couch and place the patient in an operative position to begin the treatment includes:

positioning the patient on the treatment couch; and

controlling the treatment couch to re-position the patient so that a center of the radiation source is matched with a center of a treatment plan.

29. The method of claim 28, wherein positioning the patient on the treatment couch includes placing the patient on the treatment couch, and then positioning the treatment couch to place a target volume of the patient within a range of operation (1) of the radiation source, and (2) of the flat-panel imager;

and wherein controlling the treatment couch to re-position the patient comprises controlling the treatment couch to re-position the target volume based on comparing (1) the cone-beam computed tomography (CT) volumetric image data or the second image projection data showing the center of the radiation source with (2) reference images of the treatment plan showing the center of the treatment plan.

30. The method of claim 24, wherein the flat-panel imager generates the first image projection data at 15 to 30 frames per second.