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

• US 7,945,021 B2
• Filed: 12/18/2002
• Issued: 05/17/2011
• 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: Johnsen, Stanley W., Pavkovich, John M., Colbeth, Richard E., Munro, Peter, Shapiro, Edward G., Seppi, Edward J.
• Primary Examiner(s): Ho; Allen C.
• Application Number:
  US10/324,227
• Publication Number:
  US 20040120452A1
• Time in Patent Office: 3,072 Days
• Field of Search: 378/19, 378/65, 378/98.8, 378/9, 378/209, 378/15, 378/196, 378/197, 250/367, 250/370.09, 250/370.11
• US Class Current: 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 treatment machine is disclosed. The radiotherapy simulator and 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 radiation treatment system capable of implementing a treatment plan, the system comprising;

a frame;

a rotatable gantry coupled to the frame;

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;

a flat-panel imager coupled to the rotatable gantry, wherein the flat-panel imager is operable to capture image projection data of the patient from the cone-beam radiation source to generate cone-beam computed tomography (CT) volumetric image data of the patient; and

a computing unit, coupled to the rotatable gantry via a communications network, to store the image projection data captured by the flat-panel imager.

2. The apparatus of claim 1, wherein the flat-panel imager is capable of fluoroscopic imaging, radiographic imaging, and cone-beam CT imaging.

3. The apparatus of claim 1, wherein the computing unit generates a treatment plan based on the image projection data.

4. The apparatus of claim 1, wherein the computing unit generates a three-dimensional image of a target volume based on the captured image projection data.

5. The apparatus of claim 1, wherein the cone-beam CT radiation source is a kilovoltage radiation source and the high-energy radiation source is a megavoltage radiation source.

6. The apparatus of claim 1, wherein the rotatable gantry is capable of 360 degree rotation.

7. The apparatus of claim 1, wherein the high-energy source comprises a megavoltage radiation source to radiate a target volume with radiation.

8. The apparatus of claim 1, wherein the frame comprises a drive stand pivotably coupled to the rotatable gantry at a pivotable attachment at which the gantry pivots about an isocenter.

9. The apparatus of claim 1, wherein the cone-beam source and high-energy radiation source are different from one another, and the cone-beam source comprises a KV source and wherein the high-energy radiation source comprises a MV source coupled to the rotatable gantry to radiate a patient with therapeutic radiation.

10. The apparatus of claim 1, wherein the rotatable gantry is coupled to the frame at a rotational axis of the gantry;

wherein the cone-beam radiation source is a cone-beam imaging source coupled to a first end of a first arm, the first arm having a second end coupled to the gantry;

wherein the flat-panel imager is coupled to a first end of a second arm, the second arm having a second end coupled to the gantry; and

wherein the high-energy radiation source comprises a high-energy cone-beam source.

11. An apparatus, comprising:

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

a frame;

a rotatable gantry coupled to the frame;

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; and

a flat-panel imager coupled to the rotatable gantry, wherein the flat-panel imager is operable to capture image projection data of the patient from the cone-beam radiation source to generate cone-beam computed tomography (CT) volumetric image data of the patient, wherein the flat-panel imager includes an amorphous silicon sensor array, and wherein the flat-panel imager includes a cesium iodide scintillator for kilovoltage imaging.

12. The apparatus of claim 11, wherein the scintillator includes cesium iodide crystals coated with a reflective powder and epoxy mixture in a large matrix for megavoltage imaging.

13. An apparatus, comprising:

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

a frame;

a rotatable gantry coupled to the frame;

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; and

a flat-panel imager coupled to the rotatable gantry, wherein the flat-panel imager is operable to capture image projection data of the patient from the cone-beam radiation source to generate cone-beam computed tomography (CT) volumetric image data of the patient, wherein the flat-panel imager is capable of generating image projection data at 15 to 30 frames per second.

14. An apparatus, comprising:

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

a frame;

a rotatable gantry coupled to the frame;

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;

a flat-panel imager coupled to the rotatable gantry, wherein the flat-panel imager is operable to capture image projection data of the patient from the cone-beam radiation source to generate cone-beam computed tomography (CT) volumetric image data of the patient; and

a translatable treatment couch coupled to the rotatable gantry via a communications network.

15. The apparatus of claim 14, wherein the translatable treatment couch is capable of movement in three planes plus angulation.

16. An apparatus, comprising:

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

a frame;

a rotatable gantry coupled to the frame;

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;

a flat-panel imager coupled to the rotatable gantry, wherein the flat-panel imager is operable to capture image projection data of the patient from the cone-beam radiation source to generate cone-beam computed tomography (CT) volumetric image data of the patient, wherein the a flat-panel imager is a flat-panel KV imager; and

a flat-panel MV portal imager coupled to the rotatable gantry, wherein the MV imager is operable to capture image projection data of the patient produced by the high-energy MV radiation source.

17. A method to perform a clinical treatment, comprising:

rotating a gantry pivotably coupled at a pivot point to a frame of a clinical radiation treatment machine capable of implementing a treatment plan;

irradiating a patient with a radiation source;

using the clinical radiation treatment machine to capture image projection data from a flat-panel imager for generating cone-beam computed tomography (CT) volumetric image data; and

modifying a treatment plan for the clinical treatment machine based on the cone-beam volumetric image data.

18. The method of claim 17, further comprising:

generating a treatment plan for the clinical treatment machine based on the cone-beam volumetric image data; and

transferring the treatment plan to the clinical treatment machine, wherein the clinical treatment machine implements the treatment plan.

19. The method of claim 17, wherein the radiation source is a cone-beam computed tomography radiation source, and wherein the image projection data is generated from a flat-panel imager capturing radiation from the cone-beam computed tomography radiation source passing through a target volume.

20. The method of claim 19, wherein the radiation source is a kilovoltage radiation source.

21. The method of claim 17, wherein the image projection data is fluoroscopic image projection data.

22. The method of claim 17, further comprising:

generating a treatment plan for the clinical treatment machine based on the cone-beam volumetric image data; and

using the treatment plan to instruct the clinical treatment machine to at least adjust a therapeutic radiation source into position to align a treatment volume with the therapeutic radiation.

23. The method of claim 17, further comprising:

generating a treatment plan for the clinical treatment machine based on the cone-beam volumetric image data.

24. The method of claim 17, further comprising:

positioning a patient based on the cone-beam volumetric image data.

25. The method of claim 17, wherein the clinical radiation treatment machine comprises a drive stand pivotably coupled to the rotatable gantry at a pivotable attachment at which the gantry pivots about an isocenter.

26. A method to perform a clinical treatment, comprising:

rotating a gantry pivotably coupled at a pivot point to a frame of a clinical radiation treatment machine capable of implementing a treatment plan;

irradiating a patient with a radiation source; and

capturing image projection data from a flat-panel imager using the clinical radiation treatment machine, the image projection data for generating cone-beam computed tomography (CT) volumetric image data, wherein capturing comprises capturing the image projection data at a frame rate in the range of 15-30 frames per second.

27. A method to perform a clinical treatment, comprising:

rotating a gantry pivotably coupled at a pivot point to a frame of a clinical radiation treatment machine capable of implementing a treatment plan;

irradiating a patient with a radiation source;

using the clinical radiation treatment machine to capture image projection data from a flat-panel imager for generating cone-beam computed tomography (CT) volumetric image data, wherein the radiation source is a cone-beam computed tomography radiation source, wherein the image projection data is generated from a flat-panel imager capturing radiation from the cone-beam computed tomography radiation source passing through a target volume;

deriving a master clock signal from a synchronization signal of the radiation source;

using the master clock signal to generate a first control pulse to gate the radiation source on and off and a second control pulse to trigger reading of an image from the imager; and

selecting a timing of the first control pulse as compared to the second control pulse to read out the image while the radiation source is off.

28. A method to perform a clinical treatment, comprising:

rotating a gantry pivotably coupled at a pivot point to a frame of a clinical radiation treatment machine capable of implementing a treatment plan;

irradiating a patient with a radiation source;

using the clinical radiation treatment machine to capture image projection data from a flat-panel imager for generating cone-beam computed tomography (CT) volumetric image data, wherein the radiation source is a cone-beam computed tomography radiation source, wherein the image projection data is generated from a tlat-panel imager capturing radiation from the cone-beam computed tomography radiation source passing through a target volume;

continuously rotating the radiation source about the target volume while capturing image projection data; and

one of capturing image projection data at non-uniformly spaced angles with respect to the rotation, and changing the speed of rotation of the gantry during a rotation.

29. A method to perform a clinical treatment, comprising:

rotating a gantry pivotably coupled at a pivot point to a frame of a clinical radiation treatment machine capable of implementing a treatment plan;

irradiating a patient with a radiation source;

using the clinical radiation treatment machine to capture image projection data from a flat-panel imager for generating cone-beam computed tomography (CT) volumetric image data, wherein the radiation source is a cone-beam computed tomography radiation source, wherein the image projection data is generated from a flat-panel imager capturing radiation from the cone-beam computed tomography radiation source passing through a target volume; and

continuously rotating the radiation source about the target volume while capturing image projection data.

30. An apparatus, comprising:

one of a radiation simulation system comprising logic configured to determine a patient position relative to a high-energy radiation treatment beam and a radiation treatment system comprising logic configured to implement a treatment plan for a high-energy radiation treatment, the logic comprising at least one of hardwired logic and a programmable computer component, the system comprising;

a frame;

a rotatable gantry pivotably coupled to the frame at a pivot point;

means for applying a cone-beam computed tomography (CT) radiation beam coupled to the rotatable gantry; and

means for capturing image projection data with a flat-panel imager, coupled to the rotatable gantry, to generate cone-beam computed tomography (CT) volumetric image data of a patient'"'"'s anatomy.

31. The apparatus of claim 30, wherein the means for capturing includes an amorphous silicon sensor array.

32. The apparatus of claim 31, wherein the means for capturing includes a cesium iodide scintillator for kilovoltage imaging.

33. The apparatus of claim 32, wherein the scintillator includes cesium iodide crystals coated with a reflective powder and epoxy mixture in a large matrix.

34. The apparatus of claim 30, wherein the means for capturing is capable of fluoroscopic imaging, radiographic imaging, and cone-beam CT imaging.

35. The apparatus of claim 30, wherein the means for capturing captures the image data at 15 to 30 frames per second.

36. The apparatus of claim 30, further comprising:

means for storing the captured image projection data is coupled to the rotatable gantry via a communications network.

37. The apparatus of claim 30, further comprising:

means for generating a treatment plan based on the image projection data coupled to the means for capturing via a communications network.

38. The apparatus of claim 37, wherein the means for generating generates a three-dimensional age of a target volume based on the captured image projection data.

39. The apparatus of claim 30, wherein the means for applying includes a kilovoltage radiation source.

40. The apparatus of claim 30, further comprising a translatable treatment couch coupled to the rotatable gantry via a communications network.

41. The apparatus of claim 40, wherein the translatable treatment couch is capable of movement in three planes plus angulation.

42. The apparatus of claim 30, wherein the rotatable gantry is capable of 360-degree rotation.

43. The apparatus of claim 30, further comprising:

means for generating a treatment plan for a clinical treatment machine based on the cone-beam volumetric image data; and

means for treating a patient according to the treatment plan including providing synchronization and gate control between the imager and the radiation beam during treatment.

44. The apparatus of claim 43, wherein treating includes means for coordinating acquisition by the flat panel imager and pulsing by the radiation source.

45. The apparatus of claim 30. wherein the radiation simulation system comprises logic configured to determine a patient position relative to a high-energy radiation treatment beam of a treatment machine to be simulated by the simulation system, the logic comprising at least one of hardwired logic and a programmable computer component;

and wherein the radiation treatment system includes a high-energy radiation treatment beam source.

46. A machine-readable medium selected from the group consisting of solid-state memories, optical disks, and magnetic disks;

the machine-readable medium having instructions to cause a machine to perform a method to perform a clinical treatment, the method comprising;

rotating a gantry pivotably coupled at a pivot point to a frame of a clinical radiation treatment machine capable of implementing a treatment plan;

irradiating a patient with a radiation source; and

instructing the clinical radiation treatment machine to capture image projection data from a flat-panel imager for generating cone-beam computed tomography (CT) volumetric image data.

47. The machine-readable medium of claim 46, further comprising:

generating a treatment plan for the clinical treatment machine based on the cone-beam volumetric image data; and

transferring the treatment plan to the clinical treatment machine, wherein the clinical treatment machine implements the treatment plan.

48. The machine-readable medium of claim 46, wherein capturing comprises capturing the image projection data at a frame rate in the range of 15-30 frames per second.

49. The machine-readable medium of claim 46, further comprising:

generating a treatment plan for the clinical treatment machine based on the cone-beam volumetric image data; and

using the treatment plan to instruct the clinical treatment machine to at least adjust a therapeutic radiation source into position to align the treatment volume with the therapeutic radiation.

50. The machine-readable medium of claim 46, wherein instructing further comprises instructing the clinical radiation treatment machine to capture partial cone image data to reconstruct one of a head size and a body size.

51. The machine-readable medium of claim 46, further comprising instructing a megavoltage radiation source to radiate a target volume with radiation.

52. The machine-readable medium of claim 46, wherein the clinical radiation treatment machine comprises a drive stand pivotably coupled to the rotatable gantry at a pivotable attachment at which the gantry pivots about an isocenter.

53. An apparatus, comprising:

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

a frame;

a rotatable gantry coupled to the frame;

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; and

a flat-panel imager coupled to the rotatable gantry, wherein the flat-panel imager captures fluoroscopic or cone-beam CT imaging image projection data of the patient from the cone-beam radiation source to generate fluoroscopic or cone-beam computed tomography (CT) volumetric image data of the patient.

54. The apparatus of claim 53, wherein the flat-panel imager includes an amorphous silicon sensor array capable of fluoroscopic imaging, radiographic imaging, and cone-beam CT imaging.

55. The apparatus of claim 54, wherein the cone-beam CT radiation source is a kilovoltage radiation source, and the flat-panel imager includes a cesium iodide scintillator for kilovoltage imaging.

56. The apparatus of claim 55, wherein the scintillator includes cesium iodide crystals coated with a reflective powder and epoxy mixture in a large matrix for megavoltage imaging.

57. The apparatus of claim 53, further comprising:

a treatment plan for the clinical treatment machine based on the cone-beam volumetric image data; and

a computing unit, coupled to the rotatable gantry via a communications network, to store the image projection data captured by the flat-panel imager, wherein the computing unit generates the treatment plan based on the image projection data.

58. The apparatus of claim 57, wherein the computing unit generates a three-dimensional image of a target volume based on the captured image projection data.

59. The apparatus of claim 58, wherein the high-energy radiation source comprises:

a megavoltage radiation source coupled to the rotatable gantry to radiate the volume with radiation, wherein the megavoltage radiation source comprises a source of between 4 and 25 mega-volts of radiation.

60. The apparatus of claim 53, further comprising a translatable treatment couch coupled to the rotatable gantry via a communications network, wherein the translatable treatment couch is capable of movement in three planes plus angulation.

61. The apparatus of claim 53, wherein the rotatable gantry is capable of 360 degree rotation and the imager is capable of capturing image projection data while continuously rotating about a target volume.

62. The apparatus of claim 53, wherein the cone-beam source and high-energy radiation source are different from one another, and the cone-beam source comprises a KV source and wherein the high-energy radiation source comprises a MV source coupled to the rotatable gantry to radiate a patient with therapeutic radiation.

63. An apparatus, comprising:

a radiation treatment simulation system comprising logic configured to determine a patient position relative to a high-energy radiation treatment beam, the logic comprising at least one of hardwired logic and a programmable computer component, the system comprising;

a frame;

a rotatable gantry pivotably coupled to the frame at a pivot point;

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

a flat-panel imager coupled to the rotatable gantry, wherein the flat-panel imager is operable to capture image projection data of the patient to generate cone-beam computed tomography (CT) volumetric image data of the patient.

64. The apparatus of claim 63, wherein the flat-panel imager includes an amorphous silicon sensor array and a cesium iodide scintillator, and wherein the imager is capable of fluoroscopic imaging, radiographic imaging, and cone-beam CT imaging.

65. The apparatus of claim 64, wherein the imager captures fluoroscopic or cone-beam CT imaging kilovoltage image projection data to generate fluoroscopic or cone-beam computed tomography (CT) volumetric image data

66. The apparatus of claim 63, further comprising:

a computing unit, coupled to the rotatable gantry via a communications network, to store the image projection data captured by the flat-panel imager and to generate a three-dimensional image of a target volume based on the captured image projection data.

67. The apparatus of claim 63, wherein the rotatable gantry is capable of 360 degree rotation and the imager is capable of capturing image projection data while continuously rotating about a target volume.

68. A method to perform a clinical treatment simulation, comprising:

rotating a gantry pivotably coupled at a pivot point to a frame of a clinical treatment simulator machine comprising logic configured to implement a treatment plan for a high-energy radiation treatment beam, the logic comprising at least one of hardwired logic and a programmable computer component;

irradiating a patient with a radiation source; and

using the clinical treatment simulator machine to capture image projection data from a flat-panel imager for generating cone-beam computed tomography (CT) volumetric image data.

69. The method of claim 68, further comprising:

generating a treatment plan for a clinical treatment machine based on the cone-beam volumetric image data;

transferring the treatment plan to the clinical treatment machine, wherein the clinical treatment machine implements the treatment plan; and

using the treatment plan to instruct the clinical treatment machine to at least adjust a therapeutic radiation source into position to align a treatment volume with the therapeutic radiation.

70. The method of claim 68, wherein the image projection data is generated from the flat-panel imager capturing radiation from a cone-beam computed tomography radiation source passing through a target volume.

71. The method of claim 70, further comprising:

continuously rotating the radiation source about the target volume while capturing image projection data.

72. The method of claim 68, wherein rotating further comprises pivoting the gantry about an isocenter using a drive stand pivotably coupled to the rotatable gantry by a pivotable attachment.

73. The method of claim 68, further comprising:

using the flat-panel imager to capture fluoroscopic, radiographic, and cone-beam CT imaging image projection data to generate fluoroscopic, radiographic, and cone-beam computed tomography (CT) volumetric image data.

74. A method to perform a clinical treatment simulation, comprising:

rotating a gantry pivotably coupled at a pivot point to a frame of a clinical simulator machine comprising logic configured to determine a patient position relative to a high-energy radiation treatment beam, the logic comprising at least one of hardwired logic and a programmable computer component;

irradiating a patient with a radiation source; and

using the clinical simulator machine to capture fluoroscopic or cone-beam CT imaging image projection data from a flat-panel imager for generating fluoroscopic or cone-beam computed tomography (CT) volumetric image data.

75. The method of claim 74, further comprising:

generating a treatment plan for a clinical treatment machine based on the cone-beam volumetric image data;

transferring the treatment plan to the clinical treatment machine, wherein the clinical treatment machine implements the treatment plan; and

using the treatment plan to instruct the clinical treatment machine to at least adjust a therapeutic radiation source into position to align a treatment volume with the therapeutic radiation.

76. The method of claim 74, wherein rotating further comprises pivoting the gantry about an isocenter using a drive stand pivotably coupled to the rotatable gantry by a pivotable attachment.

77. The method of claim 74, further comprising:

using the flat-panel imager to capture fluoroscopic, radiographic, and cone-beam CT imaging image projection data to generate fluoroscopic, radiographic, and cone-beam computed tomography (CT) volumetric image data.