SYSTEM AND METHOD OF DELIVERING RADIATION THERAPY TO A MOVING REGION OF INTEREST

• US 20070076846A1
• Filed: 07/21/2006
• Published: 04/05/2007
• Est. Priority Date: 07/22/2005
• Status: Active Grant

• Current Assignee: TomoTherapy Incorporated (Accuray Incorporated)
• Original Assignee: TomoTherapy Incorporated (Accuray Incorporated)
• Inventors: Hughes, John, Lu, Weiguo, Schnarr, Eric, Mackie, Thomas, Reckwerdt, Paul, Ruchala, Kenneth, Kapatoes, Jeffrey, Olivera, Gustavo
• Granted Patent: US 8,767,917 B2
• Time in Patent Office: Days
• US Class Current: 378/65
• CPC Class Codes: A61N 2005/1061 using an x-ray imaging system having a separate imaging source
• CPC Class Codes: A61N 5/103 Treatment planning systems
• CPC Class Codes: A61N 5/1042 with spatial modulation of the radiation beam within the treatment head
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam
• CPC Class Codes: A61N 5/1067 in real time, i.e. during treatment
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A system for and method of delivering radiation therapy to a moving region of interest is disclosed. The method, in one implementation, includes the acts of generating a plurality of treatment plans for providing radiation therapy, delivering radiation therapy to the patient following one of the plurality of treatment plans, monitoring the patient while providing radiation therapy, and changing the treatment plan based at least in part on monitoring the patient.

Claims

1. A method of delivering radiation therapy to a patient when a region of interest is moving, the method comprising:

generating a plurality of treatment plans for delivering radiation therapy;

delivering radiation therapy to the patient by following one of the plurality of treatment plans;

monitoring the patient during the delivering radiation therapy; and

changing to another treatment plan during the delivering radiation therapy based at least in part on the monitoring the patient.

2. A method as set forth in claim 1 wherein at least two of the plurality of treatment plans correlate to a specific patient breathing phase.

3. A method as set forth in claim 1 wherein at least two of the plurality of treatment plans begin at a different breathing phase.

4. A method as set forth in claim 1 and further comprising, prior to the changing the treatment plan, anticipating that the patient proceeds to a different breathing phase.

5. A method as set forth in claim 4 wherein the changing to another treatment plan is further based on the anticipating act.

6. A method as set forth in claim 1 and further comprising, prior to the changing the treatment plan, determining that the patient proceeds to a different breathing phase.

7. A method as set forth in claim 6 wherein the changing to another treatment plan is further based on the determining act.

8. A method as set forth in claim 1 wherein at least two of the plurality of treatment plans are based on a predetermined patient breathing track.

9. A method as set forth in claim 8 and further comprising, prior to changing the treatment plan, determining that a portion of the patient breathing pattern better matches a different predetermined breathing track.

10. A method as set forth in claim 9 wherein the changing to another treatment plan is further based on the determining act.

11. A method as set forth in claim 8 and further comprising, prior to changing the treatment plan, anticipating that an upcoming portion of the patient breathing pattern will be better matched to a different predetermined breathing track.

12. A method as set forth in claim 11 wherein the changing to another treatment plan is further based on the anticipating act.

13. A method as set forth in claim 1 wherein at least two of the plurality of treatment plans are based at least in part on margins of the regions of interest.

14. A method as set forth in claim 1 wherein at least two of the plurality of treatment plans are based at least in part on probability distribution functions of the region of interest.

15. A method as set forth in claim 1, wherein the changing to another treatment plan includes selecting the another treatment plan based on a likelihood a region of interest better matches the another treatment plan.

16. A method as set forth in claim 1, further comprising determining a consistency of the movement of the region of interest, and wherein changing to another treatment plan includes selecting the another treatment plan based on the consistency of the movement.

17. A method as set forth in claim 1, further comprising determining an erratic event for the movement of the region of interest, and pausing the system based on the erratic event.

18. A method as set forth in claim 1 wherein the changing the treatment plan includes dynamically changing the treatment plan during the monitoring the patient.

19. A method as set forth in claim 1 wherein the treatment plan includes an anticipated movement path for the patient, wherein the method further comprises instructing the patient to follow the movement path.

20. A method as set forth in claim 19 wherein the instructing the patient includes providing feedback to the patient.

21. A method as set forth in claim 1 wherein the monitoring the patient includes evaluating a delivery of the radiation therapy to the patient, and wherein the changing to another treatment plan includes changing the treatment plan based on the evaluating a delivery.

22. A method as set forth in claim 1 and further comprising optimizing the another treatment plan based at least in part on deformation with the previous plan.

23. A method as set forth in claim 1 wherein the changing to another treatment plan includes selecting the another plan based at least in part on dosimetric information.

24. A method as set forth in claim 23 wherein the dosimetric information comprises at least one of an accumulated dose for a current session and an accumulated dose for all sessions.

25. A method as set forth in claim 1 wherein the changing to another treatment plan includes selecting the another plan based at least in part on correcting previous delivery discrepancies.

26. A method as set forth in claim 1 and further comprising wherein the changing to another treatment plan includes selecting the another plan based at least in part on deformation of the plurality of treatment plans.

27. A method as set forth in claim 1 and further comprising wherein the changing to another treatment plan includes selecting the another plan based at least in part on biological criteria.

28. A method as set forth in claim 1 further comprising monitoring a movement of the patient and evaluating a delivered dose based at least in part on a four-dimensional image of the patient and the monitored movement.

29. A method as set forth in claim 1 wherein each of the plurality of plans can vary based at least in part on a parameter of a mechanical device of a radiation system delivering the radiation therapy.

30. A method of delivering radiation therapy to a patient when a region of interest is moving, the radiation therapy being delivered by a radiation therapy system including a multi-leaf collimator, the method comprising:

generating a treatment plan for delivering radiation therapy;

delivering radiation therapy to the patient by following the treatment plan;

monitoring the patient during the delivering radiation therapy; and

changing a leaf pattern of the multi-leaf collimator during the delivering radiation therapy based at least in part on the monitoring the patient.

31. A method as set forth in claim 30 wherein the changing a leaf pattern includes reordering the treatment plan.

32. A method as set forth in claim 30 wherein the changing a leaf pattern includes scaling the treatment plan.

33. A method as set forth in claim 30 wherein the changing a leaf pattern includes dynamically optimizing the treatment plan.

34. A method as set forth in claim 30 wherein the changing a leaf pattern is further based on dosimetric information.

35. A method as set forth in claim 34 wherein the dosimetric information comprises at least one of an accumulated dose for a current session and an accumulated dose for all sessions.

36. A method as set forth in claim 34 wherein the changing a leaf pattern includes performing deformation with the treatment plan.

37. A method of delivering radiation therapy to a patient when a region of interest is moving, the radiation therapy being delivered by a radiation therapy system, the method comprising:

generating a treatment plan for delivering radiation therapy;

delivering radiation therapy to the patient by following the treatment plan;

monitoring the patient during the delivering radiation therapy; and

changing a treatment parameter during the delivering radiation therapy based at least in part on the monitoring the patient.

38. A method as set forth in claim 37 wherein the radiation therapy is delivered by a radiation therapy system including a multi-leaf collimator (MLC), and wherein the changing a treatment parameter includes changing a MLC parameter.

39. A method as set forth in claim 38 wherein the MLC parameter includes at least one of a MLC pattern and a MLC timing.

40. A method as set forth in claim 37 wherein the radiation therapy is delivered by a radiation therapy system including a gantry, and wherein the changing a treatment parameter includes changing a gantry parameter.

41. A method as set forth in claim 40 wherein the gantry parameter includes at least one of a gantry speed and a gantry direction.

42. A method as set forth in claim 37 wherein the radiation therapy is delivered by a radiation therapy system including a patient support, and wherein the changing a treatment parameter includes changing a patient-support parameter.

43. A method as set forth in claim 42 wherein the patient-support parameter includes at least one of a patient-support speed and a patient-support direction.

44. A method as set forth in claim 37 wherein the radiation therapy is delivered by a radiation therapy system including a radiation module having a jaw, and wherein the changing a treatment parameter includes changing a jaw parameter.

45. A method as set forth in claim 44 wherein the jaw parameter includes at least one of a jaw position and a jaw direction.

46. A method as set forth in claim 37 wherein the radiation therapy is delivered by a radiation therapy system including a radiation module, and wherein the changing a treatment parameter includes changing a radiation-module parameter.

47. A method as set forth in claim 46 wherein the radiation-module parameter includes a radiation-module output.