Frameless radiosurgery treatment system and method

• US 8,086,299 B2
• Filed: 01/20/2009
• Issued: 12/27/2011
• Est. Priority Date: 03/16/1999
• Status: Expired due to Fees

• Current Assignee: Accuray Incorporated
• Original Assignee: Accuray Incorporated
• Inventors: Adler, John R., Schweikard, Achim
• Primary Examiner(s): Cheng, Jacqueline
• Application Number:
  US12/356,442
• Publication Number:
  US 20090129545A1
• Time in Patent Office: 1,071 Days
• Field of Search: 600/427, 600/428, 600/534
• US Class Current: 600/427
• CPC Class Codes: A61B 10/0233 Pointed or sharp biopsy instruments
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00694 with means correcting for movement of or for synchronisation with the body
• CPC Class Codes: A61B 2017/00699 correcting for movement caused by respiration, e.g. by triggering
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2090/101 for stereotaxic radiosurgery
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/4458 the source unit or the detector unit being attached to robotic arms
• CPC Class Codes: A61B 6/527 using data from a motion artifact sensor
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• 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 5/1048 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: A61N 5/1067 : in real time, i.e. during treatment
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

A method and apparatus for selectively and accurately localizing and treating a target within a patient are provided. A three dimensional mapping of a region surrounding the target is coupled to a surgical intervention. Two or more diagnostic beams at a known non-zero angle to one another may pass through the mapping region to produce images of projections within the mapping region in order to accurately localize and treat the target wherein the images are captured using one or more image recorders.

Claims

1. A system for directing a treatment beam towards an internal target region in a patient, comprising:

a treatment bed configured to support the patient during a treatment;

a respiratory motion detection system configured to track a respiration cycle of the patient based on monitoring external patient motion;

one or more diagnostic beam generators configured to generate diagnostic beams directed towards the patient at one or more particular points of the respiration cycle during one or more occurrences of the respiration cycle, wherein the one or more particular points comprise less than an entirety of the respiration cycle, the one or more diagnostic beam generators being located at one or more predetermined positions, wherein at least one beam from the one or more diagnostic beam generators is at a predetermined non-zero angle with respect to additional beams of the one or more diagnostic beam generators;

an image recording device located opposite the one or more diagnostic beam generators configured to receive the diagnostic beams from the one or more diagnostic beam generators, wherein the image recording device is configured to capture intra-treatment images of the patient from the diagnostic beams;

a processor configured to compare the intra-treatment images to a pre-treatment image to determine a location of the internal target region at the one or more particular points of the respiration cycle; and

a treatment beam generator configured to energize the treatment beam at a distinct point of the respiration cycle during a distinct occurrence of the respiration cycle during the treatment.

2. The system of claim 1, wherein the one or more diagnostic beam generators comprise one or more x-ray beam generators.

3. The system of claim 1, wherein the image recording device comprises an amorphous silicon image recorder.

4. The system of claim 1, further comprising a linear accelerator to generate the treatment beam.

5. The system of claim 1, wherein the processor is further configured to deform the intra-treatment images or the pre-treatment image, wherein the deformed intra-treatment images or deformed pre-treatment image are adapted to improve a match between the intra-treatment images and the pre-treatment image.

6. The system of claim 1, wherein the processor is further configured to generate a 3D intra-treatment image from the intra-treatment images and to compare the 3D intra-treatment image to a 3D pre-treatment image of the patient generated prior to treatment to determine the location of the internal target region.

7. The system of claim 1, wherein the distinct point of the respiration cycle does not correspond to any of the one or more particular points of the respiration cycle, and wherein the distinct occurrence of the respiration cycle corresponds to one of the one or more occurrences of the respiration cycle.

8. The system of claim 1, further comprising:

adjusting a targeting of the treatment beam to compensate for changes in the location of the internal target region, wherein the changes are identified based on the comparison of the intra-treatment images to the pre-treatment image.

9. The system of claim 1, wherein the image recording device is located adjacent the treatment bed.

10. The system of claim 1, wherein the processor is further configured to generate a correlation between the one or more particular points of the respiration cycle and locations of the internal target region.

11. The system of claim 1, wherein the respiratory motion detection system tracks the respiration cycle based on tracking positions of external markers disposed on the patient, and wherein the processor is further configured to determine a correlation between the positions of the external markers and locations of the internal target region.

12. The system of claim 1, wherein the processor is further configured to verify a correlation model between the respiration cycle and the location of the internal target region.

13. The system of claim 1, wherein the distinct point of the respiration cycle corresponds to one of the one or more particular points of the respiration cycle, and wherein the distinct occurrence of the respiration cycle is a subsequent occurrence of the respiration cycle.

14. The system of claim 1, wherein the treatment beam generator is further configured to shut off the treatment beam at a subsequent point during the distinct occurrence of the respiration cycle.

15. A method for directing a treatment beam towards an internal target region in a patient, comprising:

monitoring external movement of the patient to identify a respiration cycle of the patient;

energizing one or more diagnostic beams from one or more positions at a particular point of the respiration cycle within a particular occurrence of the respiration cycle to determine a location of the internal target region during a treatment;

generating a correlation model between locations of the internal target region and one or more points of the respiration cycle; and

energizing the treatment beam over at least one of the particular point of the respiration cycle or an additional point of the respiration cycle during the particular occurrence of the respiration cycle or a subsequent occurrence of the respiration cycle based on the correlation model to treat the internal target region.

16. The method of claim 15, wherein locating the internal target region during treatment comprises:

comparing intra-treatment images generated from the one or more diagnostic beams to a 3D pre-treatment image of the patient generated prior to treatment to identify changes in the location of the internal target region.

17. The method of claim 16, further comprising:

deforming the intra-treatment images or the 3D pre-treatment image, wherein the deformed intra-treatment images or deformed 3D pre-treatment image are adapted to improve a match between the intra-treatment images and the 3D pre-treatment image.

18. The method of claim 16, further comprising:

adjusting a targeting of the treatment beam to compensate for the changes in the location of the internal target region.

19. The method of claim 15, wherein locating the internal target region during treatment comprises:

generating a 3D intra-treatment image from 2D intra-treatment images generated from the one or more diagnostic beams; and

comparing the 3D intra-treatment image to a 3D pre-treatment image of the patient generated prior to treatment.

20. The method of claim 15, further comprising:

energizing the treatment beam at the same particular point of the respiration cycle during a subsequent occurrence of the respiration cycle.

21. The method of claim 15, further comprising:

energizing an additional diagnostic beam from a new position that is different from the one or more positions so that the additional diagnostic beam passes through the internal target region at a predetermined non-zero angle with respect to the one or more diagnostic beams, wherein the additional diagnostic beam is energized at the particular point of the respiration cycle within an additional occurrence of the respiration cycle.

22. The method of claim 15, further comprising:

tracking the external movement of the patient by tracking the movement of one or more external markers by a tracking system.

23. An apparatus for directing a treatment beam towards an internal target region in a patient, comprising:

means for generating a three-dimensional image of the patient prior to the treatment;

means for determining a respiration cycle of the patient from external movement of the patient;

means for energizing one or more diagnostic beams at a particular point of the respiration cycle during a particular occurrence of the respiration cycle to determine a position of the internal target region during a treatment;

means for generating a correlation model between locations of the internal target region and one or more points of the respiration cycle; and

means for energizing the treatment beam over at least one of the particular point of the respiration cycle or an additional point of the respiration cycle during the particular occurrence of the respiration cycle or a subsequent occurrence of the respiration cycle based on the correlation model to treat the internal target region.

24. The apparatus of claim 23, further comprising:

means for comparing images derived from the one or more diagnostic beams to the three-dimensional image to determine the position of the internal target region at the point of the respiration cycle; and

means for adjusting a targeting of the treatment beam in response to the comparison of the three-dimensional image and the images derived from the one or more diagnostic beams.

25. The apparatus of claim 23, wherein the means for adjusting further comprises a computer-controlled robot for positioning the treatment beam.