Real time brachytherapy spatial registration and visualization system

• US 7,201,715 B2
• Filed: 12/23/2002
• Issued: 04/10/2007
• Est. Priority Date: 11/24/1997
• Status: Expired due to Term

• Current Assignee: IMPAC Medical Systems, Inc. (Elekta AB)
• Original Assignee: Computerized Medical Systems, Inc. (Elekta AB)
• Inventors: Burdette, Everette C., Komandina, Bruce M.
• Primary Examiner(s): Smith; Ruth S.
• Application Number:
  US10/329,281
• Publication Number:
  US 20030229282A1
• Time in Patent Office: 1,569 Days
• Field of Search: 600/427, 600/439, 600/3, 600/7, 600/8, 600/1
• US Class Current: 600/3
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/3411 with a plurality of holes, e.g. holes in matrix arrangement
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/42 Details of probe positioning or probe attachment to the patient
• CPC Class Codes: A61B 8/4209 by using holders, e.g. positioning frames
• CPC Class Codes: A61B 8/5238 for combining image data of patient, e.g. merging several images from different acquisition modes into one image for image registration algorithms G06T7/30
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61M 37/0069 Devices for implanting pellets, e.g. markers or solid medicaments for introducing of radioactive sources for interstitial radiation therapy, i.e. brachytherapy A61N5/1027
• CPC Class Codes: A61N 2005/1011 Apparatus for permanent insertion of sources
• CPC Class Codes: A61N 2005/1012 Templates or grids for guiding the introduction of sources
• CPC Class Codes: A61N 5/00 Radiation therapy ultrasound therapy A61N7/00; devices or apparatus applicable to both therapy and diagnosis A61B6/00
• CPC Class Codes: A61N 5/1001 using radiation sources introduced into or applied onto the body; brachytherapy
• CPC Class Codes: A61N 5/1002 : Intraluminal radiation therapy
• CPC Class Codes: A61N 5/1007 : Arrangements or means for the introduction of sources into the body
• CPC Class Codes: A61N 5/1027 : Interstitial radiation therapy
• CPC Class Codes: A61N 5/103 : Treatment planning systems
• 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

Abstract

A method and system for monitoring loading of radiation into an insertion device for use in a radiation therapy treatment to determine whether the treatment will be in agreement with a radiation therapy plan. In a preferred embodiment, optical sensors and radiation sensors are used to monitor loading of radioactive seeds and spacers into a needle as part of a prostate brachytherapy treatment.

Claims

1. A system for monitoring loading of radiation into an insertion device for use in a radiation therapy treatment to determine whether the treatment will be in agreement with a radiation therapy plan, the system comprising:

at least one radioactive source for providing radiation therapy to a treatment region of the patient;

an insertion device, the insertion device being configured to hold the at least one radioactive source, the insertion device for insertion into the treatment region to provide therapy to the treatment region of the patient via the at least one radioactive source held thereby;

a computer automated optical sensor that is positioned to automatically sense loading of the at least one radioactive source into the insertion device and generate optical sensor output data indicative thereof;

a radiation sensor that is positioned to sense a radiation pattern of the at least one radioactive source loaded in the insertion device and generate radiation sensor output data indicative thereof; and

a processor in communication with the computer automated optical sensor and the radiation sensor, the processor being configured to (1) interface with an external device to receive data representative of the radiation therapy plan, the plan data defining (a) a number of radioactive sources to be loaded into the insertion device and (b) a radiation pattern for the planned treatment, (2) process the optical sensor output data to determine a quantity of radioactive sources that are currently present in the insertion device, (3) process the radiation sensor output data to determine an actual radiation pattern emitted by the at least one radioactive source held by the insertion device, and (4) compare the determined quantity and the determined actual radiation pattern with the plan data to thereby determine whether the actual treatment agrees with the therapy plan.

2. The system as defined in claim 1 wherein the insertion device comprises at least one selected from the group consisting of a needle and a catheter.

3. The system as defined in claim 1 wherein a plurality of radioactive sources are loaded into and held by the insertion device, the system further including:

at least one spacer for placement adjacent at least some of the radioactive sources within the insertion device,

a first container for holding at least one of said plurality of the radioactive sources;

a second container for holding the at least one spacer; and

another computer automated optical sensor that is positioned to automatically sense loading of at least one spacer into the insertion device and generate another optical sensor output data indicative thereof; and

wherein the radiation therapy plan further defines a number of spacers to be loaded into the insertion device, and wherein the processor is further configured to process the another optical sensor output data to determine a quantity of spacers to be loaded into the insertion device and compare the determined spacer quantity with the plan data to thereby determine whether the actual treatment agrees with the therapy plan.

4. The system of claim 3 wherein the plurality of radioactive sources comprise radioactive sources of at least two different levels of radioactivity.

5. The system of claim 4 wherein the first container comprises at least a first bin and a second bin, each bin for holding radioactive sources of different radioactivity levels.

6. The system of claim 3 further comprising:

a controller in communication with the processor; and

an auto-loader in communication with the controller, wherein the auto-loader is configured to automatically load the radioactive sources and the at least one spacer into the insertion device under command of the controller; and

wherein the controller is configured to receive plan data from the processor and provide commands to the auto-loader to perform automatic loading of the radioactive sources and the at least one spacer in accordance with the plan data.

7. The system as defined in claim 6 further comprising a template having a plurality of openings for receiving the insertion device during the treatment, each opening corresponding to a template coordinate location.

8. The system of claim 7 wherein the therapy plan comprises a plurality of insertion devices to be placed into different template openings, the plan data further defining, for each of the insertion devices, (1) a number of radioactive sources to be loaded into that insertion device, (2) a number of spacers to be loaded into that insertion device, (3) a radiation pattern for that insertion device, and (4) a template coordinate location for that insertion device, and wherein the auto-loader is further configured to automatically load the radioactive sources and the at least one spacer into the plurality of insertion devices under command of the controller, and wherein the auto-loader further comprises a display, the display being configured to display to the user the template coordinate location that corresponds to the insertion device being loaded and a status for loading each insertion device as the insertion devices are being loaded.

9. The system of claim 8 wherein the plan data further defines an identifier for each insertion device, and wherein the auto-loader display is further configured to display to the user the identifier for the insertion device as that insertion device is being loaded.

10. The system of claim 9 further comprising an alarm for notifying the user if the processor determines that the actual treatment does not agree with the therapy plan.

11. The system of claim 8 wherein the auto-loader is further configured to load radioactive sources and spacers into the insertion devices one at a time.

12. The system as defined in claim 1 wherein the processor is further configured to compare the determined quantity and the determined actual radiation pattern with the plan data to thereby determine whether the actual treatment agrees with the therapy plan before the insertion device is actually inserted into the treatment region of the patient.

13. The system of claim 12 wherein the processor comprises a plurality of redundant microprocessors.

14. The system of claim 13 wherein the optical sensor comprises a plurality of redundant optical sensors.

15. The system of claim 14 wherein the radiation sensor comprises a plurality of redundant radiation sensors.

16. The system of claim 13 wherein the radiation sensor comprises a plurality of redundant radiation sensors.

17. The system of claim 12 wherein the optical sensor comprises a plurality of redundant optical sensors.

18. The system of claim 12 wherein the radiation sensor comprises a plurality of redundant radiation sensors.

19. The system as defined in claim 1 wherein a plurality of radioactive sources are loaded into and held by the insertion device, the system further including:

at least one spacer for placement adjacent at least some of the radioactive sources within the insertion device;

a first container for holding at least one of said plurality of the radioactive sources;

a second container for holding the at least one spacer; and

wherein the optical sensor is further configured to sense loading of the at least one spacer into the insertion device, wherein the radiation therapy plan further defines a number of spacers to be loaded into the insertion device, and wherein the processor is further configured to process the optical sensor output data to determine a quantity of radioactive sources and spacers to be loaded into the insertion device and compare the determined quantity with the plan data to thereby determine whether the actual treatment agrees with the therapy plan.

20. A method for loading a plurality of radioactive sources into an insertion device in accordance with a plan, the method comprising:

reading data that describes the plan, the plan data defining (1) a number of radioactive sources to be loaded into the insertion device and (2) a radiation pattern for the plan;

loading a plurality of radioactive sources into the insertion device;

optically sensing the loading of the radioactive sources into the insertion device;

detecting a radiation pattern emitted by the loaded insertion device;

determining from the optically sensing step a quantity of radioactive sources within the insertion device;

comparing the determined radioactive source quantity and the detected radiation pattern with the plan data to thereby determine whether the loaded insertion device is in accordance with the plan.

21. The method of claim 20 wherein the plan data further defines a number of spacers to be loaded into the insertion device, the method further comprising:

loading at least one spacer into the insertion device, the at least one spacer interspersed within the insertion device between radioactive sources;

optically sensing the loading of the at least one spacer; and

determining from the spacer optically sensing step a quantity of spacers within the insertion device; and

wherein the comparing step further comprises comparing the determined spacer quantity with the plan data to thereby determine whether the loaded insertion device is in accordance with the plan.

22. The method of claim 21 wherein the loading of the radioactive sources and the at least one spacer is performed automatically based on the plan data.

23. The method of claim 22 wherein the plan corresponds to a plurality of insertion devices being loaded with radioactive sources and spacers, the method further comprising performing the aforementioned steps for each of the insertion devices.

24. The method of claim 22 further comprising notifying a user via an alarm if the comparing step determines that the loaded insertion device is not in agreement with the plan.

25. The method of claim 22 wherein the step of optically sensing loading of the radioactive sources comprises optically sensing loading of the radioactive sources via a plurality of redundant optical sensors.

26. The method of claim 22 wherein the step of detecting the radiation pattern comprises detecting the radiation pattern via a plurality of redundant radiation sensors.

27. The method of claim 22 further comprising performing the aforementioned steps in preparation for a prostate brachytherapy procedure.

28. The method of claim 22 further comprising performing the aforementioned steps in preparation for a tissue ablation procedure.

29. A loading system for preparation for therapy of a treatment region of the body of a patient in accordance with a therapy plan, the system comprising:

a first container for holding a plurality of seeds for treatment of the patient, each seed held by the first container emitting a first amount of radiation;

a second container for holding a plurality of seeds for treatment of the patient, each seed held by the second container emitting a second amount of radiation;

a third container for holding a plurality of spacers;

an insertion device for holding selected ones of the first container seeds, second container seeds, and spacers, the insertion device for insertion into the treatment region of the patient to deliver therapy thereto;

a processor configured to read data describing the plan, the plan data defining how selected ones of the first container seeds, second container seeds, and spacers to be loaded into the insertion device;

an auto-loader for automatically loading selected ones of the first container seeds, second container seeds, and spacers into the insertion device in accordance with the plan data;

a plurality of passageways leading from the auto-loader to the insertion device, each passageway corresponding with a different one of the containers, wherein the auto-loader is configured to automatically load selected ones of the first container seeds, second container seeds, and spacers into the insertion device through the passageways; and

a plurality of automated sensors positioned to automatically monitor passage of first container seeds, second container seeds, and spacers into the insertion device, thereby generating sensor output data indicative thereof, wherein the plurality of automated sensors comprise (1) at least one automated sensor positioned to monitor passage of a first container seed through the passageway corresponding to the first container, (2) at least one automated sensor positioned to monitor passage of a second container seed through the passageway corresponding to the second container, (3) at least one automated sensor positioned to monitor passage of a spacer through the passageway corresponding to the third container, and (4) at least one automated sensor positioned to monitor passage into the insertion device of all of the selected ones of the first container seeds, second container seeds, and spacers; and

wherein the processor is in communication with the automated sensors and is further configured to (1) process the sensor output to determine a quantity of the selected ones of the first container seeds, second container seeds, and spacers that have been loaded into the insertion device, and (2) compare the determined quantity with the plan data to thereby determine whether the loaded insertion device complies with the plan.

30. The system of claim 29 wherein the automated sensors comprise optical sensors.

31. The system of claim 30 wherein the plurality of automated optical sensors further comprise:

a plurality of redundant automated optical sensors positioned to monitor passage of a first container seed through the passageway corresponding to the first container;

a plurality of redundant automated optical sensors positioned to monitor passage of a second container seed through the passageway corresponding to the second container;

a plurality of redundant automated optical sensors positioned to monitor passage of a spacer through the passageway corresponding to the third container; and

a plurality of redundant automated optical sensors positioned to monitor passage into the insertion device of all of the selected ones of the first container seeds, second container seeds, and spacers.

32. The system of claim 30 wherein the seeds comprise radioactive sources, the first container radioactive sources emitting a first level of radioactivity, the second container radioactive source emitting a second level of radioactivity, wherein the plan data further defines a level of radiation activity and a radiation contour for the plan, the system further comprising:

at least one radiation sensor positioned to detect a level of radiation activity and a radiation contour collectively emitted by the selected ones of the first container radioactive sources, second container radioactive sources, and spacers that have been loaded into the insertion device; and

wherein the processor is in communication with the at least one radiation sensor and is further configured to compare the detected radiation activity level and the detected radiation contour with the plan data to thereby determine whether the loaded insertion device complies with the plan.

33. The system of claim 32 wherein the at least one radiation sensor comprises a plurality of redundant radiation sensors.