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WO1999048558A1 - Controle de la mise en oeuvre de radiotherapies - Google Patents

Controle de la mise en oeuvre de radiotherapies Download PDF

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Publication number
WO1999048558A1
WO1999048558A1 PCT/GB1999/000886 GB9900886W WO9948558A1 WO 1999048558 A1 WO1999048558 A1 WO 1999048558A1 GB 9900886 W GB9900886 W GB 9900886W WO 9948558 A1 WO9948558 A1 WO 9948558A1
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WO
WIPO (PCT)
Prior art keywords
leaf
leaves
mlc
intensity
diaphragm
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/GB1999/000886
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English (en)
Inventor
David John Convery
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Elekta AB
Original Assignee
Elekta AB
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Elekta AB filed Critical Elekta AB
Priority to CA002324446A priority Critical patent/CA2324446A1/fr
Priority to JP2000537601A priority patent/JP2002507462A/ja
Priority to EP99911913A priority patent/EP1064051A1/fr
Priority to KR1020007010391A priority patent/KR20010042049A/ko
Publication of WO1999048558A1 publication Critical patent/WO1999048558A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1042—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy with spatial modulation of the radiation beam within the treatment head
    • G—PHYSICS
    • G21—NUCLEAR PHYSICS; NUCLEAR ENGINEERING
    • G21K—TECHNIQUES FOR HANDLING PARTICLES OR IONISING RADIATION NOT OTHERWISE PROVIDED FOR; IRRADIATION DEVICES; GAMMA RAY OR X-RAY MICROSCOPES
    • G21K1/00—Arrangements for handling particles or ionising radiation, e.g. focusing or moderating
    • G21K1/02—Arrangements for handling particles or ionising radiation, e.g. focusing or moderating using diaphragms, collimators
    • G21K1/04—Arrangements for handling particles or ionising radiation, e.g. focusing or moderating using diaphragms, collimators using variable diaphragms, shutters, choppers
    • G—PHYSICS
    • G21—NUCLEAR PHYSICS; NUCLEAR ENGINEERING
    • G21K—TECHNIQUES FOR HANDLING PARTICLES OR IONISING RADIATION NOT OTHERWISE PROVIDED FOR; IRRADIATION DEVICES; GAMMA RAY OR X-RAY MICROSCOPES
    • G21K1/00—Arrangements for handling particles or ionising radiation, e.g. focusing or moderating
    • G21K1/02—Arrangements for handling particles or ionising radiation, e.g. focusing or moderating using diaphragms, collimators
    • G21K1/04—Arrangements for handling particles or ionising radiation, e.g. focusing or moderating using diaphragms, collimators using variable diaphragms, shutters, choppers
    • G21K1/046—Arrangements for handling particles or ionising radiation, e.g. focusing or moderating using diaphragms, collimators using variable diaphragms, shutters, choppers varying the contour of the field, e.g. multileaf collimators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/103—Treatment planning systems
    • A61N5/1036—Leaf sequencing algorithms

Definitions

  • the present invention relates to a method of controlling the delivery of radiotherapy. It uses a multileaf collimator to deliver radiation doses which vary over the treatment area.
  • intensity-modulated fields for conformal radiotherapy can be implemented by either dynamic multileaf collimation (for example, Kallman et al ( 1 988), Convery and Rosenbloom ( 1 992), Spirou and Chui ( 1 994), Stein et al ( 1 994), Svensson ef a/ ( 1 994), Yu et al ( 1 995), van Santvoort and Heijmen ( 1 996) Hill et al ( 1 997)) or by multiple static fields (for example, Galvin et a/ ( 1 993), Bortfield et al ( 1 994) .
  • dynamic multileaf collimation for example, Kallman et al ( 1 988), Convery and Rosenbloom ( 1 992), Spirou and Chui ( 1 994), Stein et al ( 1 994), Svensson ef a/ ( 1 994), Yu et al ( 1 995), van Santvoort and Heijmen ( 1 996) Hill
  • US 5663999 discloses a method in which the treatment area is divided into a plurality of sections which are treated individually.
  • the present invention provides a method of delivering a radiotherapy treatment using a linear accelerator, the linear accelerator comprising a source of radiation, the output of which is iimited by a multi-leaf collimator and a further collimator comprising at least two diaphragms; the method comprising the steps of: notionally dividing the treatment area into an array of cells distributed along lines parallel to the movement directions of the leaves; assigning an intended dose to each cell; during irradiation, adjusting the position of the leaves so as to provide the intended dose to each cell, wherein during irradiation, the diaphragms are advanced beyond one or more leaves when necessary to maintain leaf separation and prevent overdosing.
  • the diaphragms are normally maintained behind the outermost leaf, but are on occasions advanced beyond one or more leaves so that they provide the primary shield against dosing. This effectively permits one or more leaves to be withdrawn, allowing an opposing leaf to be advanced so as to limit dosage without infringing minimal leaf separation.
  • Figures 1 a and 1 b show a typical discretely-intensity modulated beam
  • Figure 2a and 2b illustrates the minimum leaf separation constraint
  • Figure 4 shows a schematic flow diagram
  • Figure 5 illustrates the control point sequence to achieve the beam of Figures 1 a and 1 b.
  • a discretely-intensity-modulated beam is here taken to mean one which is divided into a number of smaller beam elements. Within each beam element the intensity is constant but each element may be at a different intensity level.
  • An example is shown in Figure 1 . This is for the posterior oblique field of a prostate plan with 10% intensity stratification and 1 cm x 1 cm beam elements at the isocentre plane, planned with Corvus planning system (example courtesy of NOMOS) .
  • Figure 1 a shows the example in grey-scales
  • Figure 1 b shows the intensity matrix.
  • Beam elements hereafter referred to as "bixels" (by analogy with image pixels) typically measure 1 cm x 1 cm at the isocentre.
  • Discrete beam intensity modulation is assumed by some inverse treatment planning systems.
  • Hill et al ( 1 997) is an extension of that used by Bortfield et al ( 1 994) for generating discrete intensity-modulated beams by summing a series of static MLC fields.
  • the intensity profile along each leaf pair is examined independently. For each profile, rising and falling edges of the intensity pattern are paired to give a series of static fields, which can be ordered to give a unidirectional "sweep" of the leaves across the field.
  • Hill et al ( 1 997) transform this multiple static field sequence into a single dynamic sequence during which leaves can be either stationary or moving at the maximum allowed speed and the previously described ramp down and ramp up of intensity across bixels then overlap to give uniform bixel intensities. No consideration of tongue-and-groove artefacts (van Santvoort and Heijmen ( 1 996)) is made in the algorithm.
  • the minimum allowed leaf separation in dynamic mode is set to 1 cm with this restriction also applying to opposite but adjacent leaves so that no leaf overlap can occur.
  • the most leading left leaf must not only maintain the necessary minimum separation with the opposite right 5 leaf but also with the right leaves above and below.
  • the same minimum separation distance applies between the backup diaphragms.
  • the MLC leaf width is 1 .Ocm and their range of travel is 20cm from the beam axis to 1 2.5cm over midline.
  • the MLC's backup diaphragms have the same range of travel, while the collimator pair perpendicular to this can travel from 20cm from the beam axis up to midline. Details of the Elekta MLC and its characterisation for static field use has been given previously by Jordan and Williams ( 1 994) .
  • Dynamic control of the MLC leaves and diaphragms is specified in the algorithm described herein through the use of the "control point" formalism employed by the Elekta dynamic MLC control system.
  • a control point specifies the machine configuration (field size and shape, gantry angle, etc.) at a particular percentage of the set beam monitor units (MU) .
  • MU set beam monitor units
  • a dynamic delivery is defined, for example as shown in Figure 3.
  • the desired value of any parameter e.g. an MLC leaf position
  • dynamic beam prescriptions are readily scaled with the set MU for the field. Control points do not need to be evenly spaced.
  • Any beam must be defined by at least two control points, an initial control point (control point 0) that defines the starting configuration and one defining the stop configuration. Control points defining intermediate configurations can be added.
  • this formalism can be used to define static and move-only beams or beam segments.
  • a static beam segment is defined by two consecutive control points having the same parameter values but different percentage MU, whilst a move-only step can 6 be implemented by two control points with the same percentage MU but different parameter values. The beam is cut off during such move-only steps by inhibiting the radiation output from the linear accelerator. Combinations of static, dynamic and move-only segments may be mixed within a single beam prescription.
  • the process described above requires that the leaves or collimators can close in to zero separation at the start and end of the exposure. As has 7 been noted, this is not possible on all MLCs. However, according to the invention, it can by simulated by combining the motion of the MLC leaves and with that of the backup diaphragms (collimator jaws) in the dynamic beam prescription. In this case the positions of the leaves and backup diaphragms are offset such that the required gap between the MLC leaves is "hidden" under the backup diaphragm. This is illustrated at Figure 2(b) .
  • Central blocking - that is, blocking a region inside the main field boundary - can also be achieved during a single dynamic exposure without having to close the leaves together, in which case the necessary leaf gap is again hidden under a backup diaphragm in the region to be blocked, as in Figure 2(b).
  • Minimum leaf separation constraints and in particular constraints on the allowed positioning of adjacent leaf pairs ( Figure 2(a)), impose restrictions on the way in which a beam's modulation can be delivered. Specifically, when generating a two-dimensional (2D) intensity modulation within a beam a trailing leaf of one leaf pair may need to be moved forwards to shield a region so as to prevent it from being overexposed. Maintenance of the minimum leaf separation distance can then push a neighbouring leaf pair's leading leaf forwards, potentially leading to an overexposure here if only the MLC leaves are being used to generate the modulation.
  • 2D two-dimensional
  • the backup diaphragm can be used as part of the dynamic collimation process then the leading leaf bank's backup diaphragm can be used to provide the necessary shielding, so allowing the leading leaf to move forwards whilst avoiding any overexposure.
  • the Bixel Beam Intensity Modulation algorithm (Bixel BIM) is an iterative scheme to derive MLC leaf and backup diaphragm motion to deliver discrete beam-element (bixel) intensity modulated fields subject to restrictions on the allowed leaf separation.
  • the algorithm progressively derives the motion of all involved leaf pairs and the MLC's backup diaphragms control-point-by-control-point as they track across the field ratherthan by considering each leaf pair's derivation separately, and includes a means of feeding back information on minimum leaf gap violations in order to derive deliverable dynamic prescriptions. It is assumed in what follows, without any loss of generality, that the leaves and diaphragms move from left to right across the field. 9
  • the first, shield is defined for each bixel at each control point. It is set to "true” if a bixel must be shielded at the given control point; shielding may be by left or right MLC leaf or backup diaphragm.
  • the second array, right diaphragm shield is defined for each column in the field for each control point. If this is set to true for a given control point, then this entire column of bixels must be shielded by the right backup diaphragm (collimator jaw) at this control point.
  • the algorithm deals in integer units of bixel intensity, where one unit is equivalent to the intensity delivered in the time it takes for a leaf or diaphragm to travel the width of one bixel.
  • the absolute magnitude of this intensity therefore depends on the width of the bixel, the maximum available leaf speed and on the dose rate used to deliver the field.
  • MLC leaves and diaphragms are allowed to travel a distance of one bixel-width per control point and the minimum leaf separation is specified within the algorithm in units of bixel-widths.
  • the mapping of a desired intensity distribution into bixel intensity units, and the control of the delivery resolution, is discussed in detail below.
  • the minimum separation distance is expressed in units of bixel widths.
  • the left leaves are set at the furthest left boundary of the field and the right leaves lie a distance equal to the minimum separation (in units of bixel-widths) into the field.
  • the backup diaphragms are offset from these by a distance equal to this minimum bixel- unit separation so that the right diaphragm is at the left boundary and the left diaphragm is outside of the field.
  • a left (trailing) MLC leaf is only moved forward when the bixel after its current position is to be occluded at this control point (found by checking the cumulative intensity so far delivered there). If at least one more control point is needed to complete its irradiation, it maintains its position from the previous control point. 1 1 Set right MLC leaf positions
  • the right backup diaphragm position at each control point is set to the position of the furthest-most right MLC leaf. However, it may be set less far into the field if the right_diaphragm_shie/d logical array is set to "true" for this column and control point, so that the diaphragm is being used to proving the necessary shielding here. Likewise, it may be necessary to hold the right diaphragm at the right field boundary to prevent overdosage outside of the field.
  • the backup diaphragm separation is checked first since their positioning can affect how MLC leaf separation violations are resolved. If it is less than the minimum allowed, then the right diaphragm is moved forward one bixel width unless it is acting to shield the column it is currently 1 2 above (as indicated by the right _diaphragm_shield logical array), in which case the left diaphragm must instead be set back one bixel width. If the left diaphragm has been moved back, it is then necessary to further check if this will then overexpose anything the diaphragm had been shielding. If this is found to be the case then right jdiaphragm shie/d is set to "true" for this column up until the current control point and the motion derivation restarted taking this new information into account.
  • the MLC leaf positions can then be assessed.
  • section 2 for designs such as the Elekta MLC the minimum separation requirement applies not only to each individual leaf pair but also to the positions of the neighbouring leaves, each of which must therefore be checked.
  • a leaf separation check is made for each right leaf in turn. This check could of course be carried out for each left leaf.
  • the right leaf end If the bixel the right leaf end is currently above does not need to be shielded at this control point or if it does need to be shielded and right _diaphragm_shie/d is also set, then the right leaf can be moved forwards.
  • the input intensity distribution (which may of course be arbitrarily normalised) is scaled according to the "nominal dose" to be delivered by the field. This is done to control the resolution of the delivered intensity distribution and to ensure that the dynamic beam prescription, when delivered, will not require leaf speeds in excess of those the MLC is capable of (see below) .
  • the result can then be treated as a monitor unit distribution, specifying the MU each element in the beam should receive. Note, however, that the exact value used for the nominal dose is not critical (it is only used as a guide) since the beam prescription file is based on control points at percentage monitor unit points and is therefore scalable with set monitor 1 6 units.
  • the "basic" intensity resolution for delivery within this scheme is governed by the intensity delivered during the time it takes a leaf or diaphragm to cross the width of a beam element (bixel) . This depends on the maximum allowed leaf speed, the dose rate at which the field is to be delivered and the element width. For example, for a 1 cm-wide beam element, treating at 400MU/min with a maximum leaf speed of 1 cm/sec results in a basic resolution for delivery of 6.67MU, i.e. ⁇ 3.3MU.
  • the monitor unit distribution i.e. the scaled intensity distribution
  • This resolution of delivery can, however, easily be improved by simply subdividing as necessary the beam elements in the original distribution along 1 7 the direction of leaf travel before rounding to give the bixel-intensity-unit array.
  • the resulting delivery resolution would be improved to ⁇ 1 .1 MU.
  • the penalty paid for this is an increased number of control points required to define the dynamic prescription. It does not, however, affect the MLC delivery efficiency, i.e. the number of MU required to deliver the field.
  • the algorithm becomes independent of 1 8 the quantity we are actually concerned with modulating, which may for example variously be the total intensity of fluence "in-air" at the isocentre plane, the dose at peak depth at the isocentre plane, the dose at some reference depth under specified reference conditions, or some other quantity.
  • the algorithm's application is also independent of the method used to calculate these quantities, so that it may therefore be used within different planning systems or software modules without modification, so ensuring portability and wider applicability.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Physics & Mathematics (AREA)
  • General Health & Medical Sciences (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pathology (AREA)
  • Spectroscopy & Molecular Physics (AREA)
  • General Engineering & Computer Science (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

L'invention porte sur un algorithme produisant des modulations discrètes de l'intensité de rayons par collimation dynamique multifoliaire (MLC) incluant des contraintes quant aux séparations minimales permises entre feuilles. L'information MLC de positionnement est extraite simultanément pour toutes les paires de feuilles et pour les diaphragmes de sauvegarde alors qu'ils progressent dans le champ et qu'un mécanisme de rétroaction autorise les corrections à appliquer pour éliminer les violations potentielles des conditions de séparation minimale et toute sous-exposition pouvant apparaître dans la zone interfoliaire des languettes et rainures. Le mouvement résultant, qui produit correctement la modulation souhaitée, est physiquement réalisable. Les résultats de l'algorithme peuvent en variante s'interpréter comme définissant une série de champs statiques produisant la même modulation.
PCT/GB1999/000886 1998-03-20 1999-03-19 Controle de la mise en oeuvre de radiotherapies Ceased WO1999048558A1 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
CA002324446A CA2324446A1 (fr) 1998-03-20 1999-03-19 Controle de la mise en oeuvre de radiotherapies
JP2000537601A JP2002507462A (ja) 1998-03-20 1999-03-19 放射線療法の制御デリバリ
EP99911913A EP1064051A1 (fr) 1998-03-20 1999-03-19 Controle de la mise en oeuvre de radiotherapies
KR1020007010391A KR20010042049A (ko) 1998-03-20 1999-03-19 방사선 요법의 분출 제어

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB9806057A GB2335583B (en) 1998-03-20 1998-03-20 Controlling delivery of radiotherapy
GB9806057.7 1998-03-20

Publications (1)

Publication Number Publication Date
WO1999048558A1 true WO1999048558A1 (fr) 1999-09-30

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PCT/GB1999/000886 Ceased WO1999048558A1 (fr) 1998-03-20 1999-03-19 Controle de la mise en oeuvre de radiotherapies

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EP (1) EP1064051A1 (fr)
JP (1) JP2002507462A (fr)
KR (1) KR20010042049A (fr)
CN (1) CN1202884C (fr)
CA (1) CA2324446A1 (fr)
GB (1) GB2335583B (fr)
WO (1) WO1999048558A1 (fr)

Cited By (13)

* Cited by examiner, † Cited by third party
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EP1297863A3 (fr) * 2001-09-28 2004-01-07 Siemens Medical Solutions USA, Inc. Système et méthode d'optimisation de traitement par radiations à l'aide d'un collimateur à plusieurs feuilles modulant l'intensité tout en minimisant les jonctions
US6839405B2 (en) 2002-05-31 2005-01-04 Siemens Medical Solutions Usa, Inc. System and method for electronic shaping of X-ray beams
US6907105B2 (en) 2001-09-25 2005-06-14 Bc Cancer Agency Methods and apparatus for planning and delivering intensity modulated radiation fields with a rotating multileaf collimator
US7085348B2 (en) * 2003-12-15 2006-08-01 The University Of Florida Research Foundation, Inc. Leaf sequencing method and system
US7734010B2 (en) 2005-05-13 2010-06-08 Bc Cancer Agency Method and apparatus for planning and delivering radiation treatment
US7880154B2 (en) 2005-07-25 2011-02-01 Karl Otto Methods and apparatus for the planning and delivery of radiation treatments
US7906770B2 (en) 2005-07-25 2011-03-15 Karl Otto Methods and apparatus for the planning and delivery of radiation treatments
US8073103B2 (en) 2006-07-27 2011-12-06 British Columbia Cancer Agency Branch Systems and methods for optimization of on-line adaptive radiation therapy
US8699664B2 (en) 2006-07-27 2014-04-15 British Columbia Center Agency Branch Systems and methods for optimization of on-line adaptive radiation therapy
US9498167B2 (en) 2005-04-29 2016-11-22 Varian Medical Systems, Inc. System and methods for treating patients using radiation
US10004650B2 (en) 2005-04-29 2018-06-26 Varian Medical Systems, Inc. Dynamic patient positioning system
USRE46953E1 (en) 2007-04-20 2018-07-17 University Of Maryland, Baltimore Single-arc dose painting for precision radiation therapy
US10773101B2 (en) 2010-06-22 2020-09-15 Varian Medical Systems International Ag System and method for estimating and manipulating estimated radiation dose

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US6134296A (en) * 1999-01-20 2000-10-17 Siemens Medical Systems, Inc. Microgradient intensity modulating multi-leaf collimator
US6260999B1 (en) * 1999-07-26 2001-07-17 Siemens Medical Systems, Inc. Isocenter localization using electronic portal imaging
US6477229B1 (en) 2000-05-12 2002-11-05 Siemens Medical Solutions Usa, Inc. Radiation therapy planning
GB2370210B (en) * 2000-12-13 2004-06-02 Elekta Ab Radiotherapeutic apparatus
US6687330B2 (en) * 2001-07-31 2004-02-03 Siemens Medical Solutions Usa, Inc. System and method for intensity modulated radiation therapy
GB0310596D0 (en) * 2003-05-08 2003-06-11 Cancer Res Inst Method and apparatus for producing an intensity modulated beam of radiation

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Cited By (31)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6907105B2 (en) 2001-09-25 2005-06-14 Bc Cancer Agency Methods and apparatus for planning and delivering intensity modulated radiation fields with a rotating multileaf collimator
EP1561490A3 (fr) * 2001-09-28 2005-11-09 Siemens Medical Solutions USA, Inc. Système et méthode d'optimisation de traitement par radiations à l'aide d'un collimateur à plusieurs feuilles modulant l'intensité tout en minimisant les jonctions
EP1297863A3 (fr) * 2001-09-28 2004-01-07 Siemens Medical Solutions USA, Inc. Système et méthode d'optimisation de traitement par radiations à l'aide d'un collimateur à plusieurs feuilles modulant l'intensité tout en minimisant les jonctions
US6839405B2 (en) 2002-05-31 2005-01-04 Siemens Medical Solutions Usa, Inc. System and method for electronic shaping of X-ray beams
US7085348B2 (en) * 2003-12-15 2006-08-01 The University Of Florida Research Foundation, Inc. Leaf sequencing method and system
US9498167B2 (en) 2005-04-29 2016-11-22 Varian Medical Systems, Inc. System and methods for treating patients using radiation
US10881878B2 (en) 2005-04-29 2021-01-05 Varian Medical Systems, Inc. Dynamic patient positioning system
US10004650B2 (en) 2005-04-29 2018-06-26 Varian Medical Systems, Inc. Dynamic patient positioning system
US9974494B2 (en) 2005-04-29 2018-05-22 Varian Medical Systems, Inc. System and methods for treating patients using radiation
US7734010B2 (en) 2005-05-13 2010-06-08 Bc Cancer Agency Method and apparatus for planning and delivering radiation treatment
US9630025B2 (en) 2005-07-25 2017-04-25 Varian Medical Systems International Ag Methods and apparatus for the planning and delivery of radiation treatments
US9764159B2 (en) 2005-07-25 2017-09-19 Varian Medical Systems International Ag Methods and apparatus for the planning and delivery of radiation treatments
US9050459B2 (en) 2005-07-25 2015-06-09 Karl Otto Methods and apparatus for the planning and delivery of radiation treatments
US8696538B2 (en) 2005-07-25 2014-04-15 Karl Otto Methods and apparatus for the planning and delivery of radiation treatments
US8658992B2 (en) 2005-07-25 2014-02-25 Karl Otto Methods and apparatus for the planning and delivery of radiation treatments
US9687676B2 (en) 2005-07-25 2017-06-27 Varian Medical Systems International Ag Methods and apparatus for the planning and delivery of radiation treatments
US9687674B2 (en) 2005-07-25 2017-06-27 Varian Medical Systems International Ag Methods and apparatus for the planning and delivery of radiation treatments
US9687678B2 (en) 2005-07-25 2017-06-27 Varian Medical Systems International Ag Methods and apparatus for the planning and delivery of radiation treatments
US9687675B2 (en) 2005-07-25 2017-06-27 Varian Medical Systems International Ag Methods and apparatus for the planning and delivery of radiation treatments
US9687677B2 (en) 2005-07-25 2017-06-27 Varian Medical Systems International Ag Methods and apparatus for the planning and delivery of radiation treatments
US9687673B2 (en) 2005-07-25 2017-06-27 Varian Medical Systems International Ag Methods and apparatus for the planning and delivery of radiation treatments
US11642027B2 (en) 2005-07-25 2023-05-09 Siemens Healthineers International Ag Methods and apparatus for the planning and delivery of radiation treatments
US9788783B2 (en) 2005-07-25 2017-10-17 Varian Medical Systems International Ag Methods and apparatus for the planning and delivery of radiation treatments
US7880154B2 (en) 2005-07-25 2011-02-01 Karl Otto Methods and apparatus for the planning and delivery of radiation treatments
US7906770B2 (en) 2005-07-25 2011-03-15 Karl Otto Methods and apparatus for the planning and delivery of radiation treatments
US10595774B2 (en) 2005-07-25 2020-03-24 Varian Medical Systems International Methods and apparatus for the planning and delivery of radiation treatments
US8073103B2 (en) 2006-07-27 2011-12-06 British Columbia Cancer Agency Branch Systems and methods for optimization of on-line adaptive radiation therapy
US8699664B2 (en) 2006-07-27 2014-04-15 British Columbia Center Agency Branch Systems and methods for optimization of on-line adaptive radiation therapy
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US10773101B2 (en) 2010-06-22 2020-09-15 Varian Medical Systems International Ag System and method for estimating and manipulating estimated radiation dose
US11986671B2 (en) 2010-06-22 2024-05-21 Siemens Healthineers International Ag System and method for estimating and manipulating estimated radiation dose

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GB2335583A (en) 1999-09-22
KR20010042049A (ko) 2001-05-25
EP1064051A1 (fr) 2001-01-03
CN1298317A (zh) 2001-06-06
CN1202884C (zh) 2005-05-25
CA2324446A1 (fr) 1999-09-30
JP2002507462A (ja) 2002-03-12
GB9806057D0 (en) 1998-05-20
GB2335583B (en) 2002-05-29

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