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WO2025046583A1 - Planification de traitement d'irradiation pour évitement de collision dans une salle de traitement - Google Patents

Planification de traitement d'irradiation pour évitement de collision dans une salle de traitement Download PDF

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Publication number
WO2025046583A1
WO2025046583A1 PCT/IL2024/050871 IL2024050871W WO2025046583A1 WO 2025046583 A1 WO2025046583 A1 WO 2025046583A1 IL 2024050871 W IL2024050871 W IL 2024050871W WO 2025046583 A1 WO2025046583 A1 WO 2025046583A1
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WIPO (PCT)
Prior art keywords
treatment
platform
patient
fields
treatment plan
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PCT/IL2024/050871
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English (en)
Inventor
Shimshon WINOGRAD
Michael Marash
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P Cure Ltd
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P Cure Ltd
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Publication of WO2025046583A1 publication Critical patent/WO2025046583A1/fr
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Classifications

    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F30/00—Computer-aided design [CAD]
    • G06F30/20—Design optimisation, verification or simulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/04—Positioning of patients; Tiltable beds or the like
    • 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
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • 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
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
    • G—PHYSICS
    • G05—CONTROLLING; REGULATING
    • G05B—CONTROL OR REGULATING SYSTEMS IN GENERAL; FUNCTIONAL ELEMENTS OF SUCH SYSTEMS; MONITORING OR TESTING ARRANGEMENTS FOR SUCH SYSTEMS OR ELEMENTS
    • G05B19/00—Programme-control systems
    • G05B19/02—Programme-control systems electric
    • G05B19/18—Numerical control [NC], i.e. automatically operating machines, in particular machine tools, e.g. in a manufacturing environment, so as to execute positioning, movement or co-ordinated operations by means of programme data in numerical form
    • G05B19/406—Numerical control [NC], i.e. automatically operating machines, in particular machine tools, e.g. in a manufacturing environment, so as to execute positioning, movement or co-ordinated operations by means of programme data in numerical form characterised by monitoring or safety
    • G05B19/4061—Avoiding collision or forbidden zones
    • 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
    • A61N2005/1085—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy characterised by the type of particles applied to the patient
    • A61N2005/1087—Ions; Protons

Definitions

  • the present disclosure generally relates to the fields of irradiation treatment and particularly to planning an irradiation treatment in a treatment room.
  • Teletherapy is defined as a treatment methodology in which an irradiation source is at a distance from a body to be treated.
  • X-rays and electron beams have long been used in teletherapy to treat various cancers.
  • X-rays exhibit a linear energy transfer approaching an exponential attenuation function and are therefore of minimal safe use for deeply embedded growths.
  • the use of heavy particles, particularly hadrons and more particularly protons, in teletherapy has found increasing acceptance, due to the ability of heavy particles to penetrate to a specific depth without appreciably harming intervening tissue.
  • the linear energy transfer of hadrons exhibits an inversed depth profile with a marked Bragg peak defined as the point at which the hadrons deposit most of their energy and occurs at the end of the hadrons path.
  • the Bragg peak is not observable due to high scattering.
  • increased energy can be directed at an embedded growth as compared to X-rays and electron beams, which particularly harm intervening tissues.
  • hadrons include a wide range of particles, practically, protons and various ions are most widely used in therapy. For clarity, this document will describe treatment as being accomplished with protons, however this is not meant to be limiting in any way.
  • the protons or ions can be focused to a target volume of variable penetration depth. In this way the dose profile can be matched closely to the target volume with a high precision.
  • a proton beam can conform to the shape and depth of a target growth, such as a tumor, so as to avoid irradiating healthy body tissue while delivering a lower total body irradiation dose.
  • proton therapy can allow for escalated dosages as compared to conventional external beam therapies, which may be particularly beneficial for certain treatments, for example, ocular tumors or skull base and paraspinal tumors.
  • Proton therapy may also enable high precision treatment plans with reduced side effects, such as for pediatric treatments or prostate cancer treatments.
  • the isocenter In order to ensure complete irradiation of a target growth, a plurality of beams arriving at the embedded growth from several different directions is usually applied. The point at which the plurality of beams intersects, whether they are beamed sequentially or simultaneously, is termed the “isocenter”. To maximize biological effectiveness, the isocenter must be precisely collocated with the target growth.
  • Irradiation treatment is performed on a target tissue in a well-defined process.
  • the target tissue is imaged and a treatment plan is established.
  • the treatment plan includes a series of treatment fields, each field defining at least a dosage, a target tissue position and orientation, and irradiation angles, for each irradiation dose. Placement or fiducial markers are defined respective of the patient, for guiding patient positioning for the treatment.
  • irradiation is performed responsive to the developed treatment plan, at a plurality of treatment sessions over a period of time.
  • Positioning of the patient responsive to the markers may be performed based on visualization of the patient in relation to the defined markers.
  • the patient prior to the treatment session the patient is brought into an initial setup position by positioning a platform supporting the patient such that the fiducial markers converge with an isocenter of the treatment room.
  • a treatment plan is then executed in relation to this setup position, resulting in the target tissue localized at the treatment room isocenter.
  • the patient is repositioned relative to the setup position in accordance with the treatment plan requirements.
  • the target tissue is sequentially repositioned with respect to the beam nozzle of the irradiation beam delivery device, which may have a fixed position or be capable of limited movement, such as by means of a gantry.
  • the treatment room isocenter may be designated by a visual indication, such as a plurality of laser beams.
  • the setup positioning of the patient may be verified using image guided radiation therapy (IGRT) techniques.
  • Stabilization mechanisms may be applied to ensure patient positioning is maintained relative to the isocenter during the treatment, such as a mask or shield to affix the face or a body part of the patient.
  • Irradiation treatments are typically administered while the patient is in a lying or recumbent position, where the patient body is aligned substantially horizontal to the ground and supported by an underlying platform surface.
  • a recumbent positioned patient may be in a supine posture, with their back resting against the underlying surface and their face positioned upwards, or in a prone posture, with their chest against the underlying surface and their face pointed downwards.
  • certain treatments may be difficult to perform on a recumbent patient, such as due to the location of the target tissue in the body, and such treatments may require or be facilitated by an upright or seated (i.e., nonhorizontal) positioning.
  • the patient may be situated on a reclining chair that may be repositioned and reoriented along multiple axes in three- dimensional space.
  • An upright or seated positioning may provide greater patient comfort relative to a recumbent positioning, such as for patients suffering from breathing complications. Upright positioning may also be associated with cost benefits and greater compatibility with existing equipment. Furthermore, upright positioning may affect changes in the volume, location, and/or motion of body organs, such as the lungs and heart, compared to recumbent positioning, which could have beneficial impacts in certain clinical situations.
  • the treatment planning needs to ensure that proper treatment can be provided, in view of various constraints involved.
  • the reclining chair or other patient supporting platform
  • body parts of the patient particularly extremities such as the arms or legs
  • the treatment equipment or other objects in the room such as a patient positioning device (e.g., x-ray detectors), the irradiation beam nozzle, a gantry, imaging equipment, processing equipment, and the like.
  • a patient positioning device e.g., x-ray detectors
  • the irradiation beam nozzle e.g., a gantry
  • imaging equipment e.g., processing equipment, and the like.
  • obstructions and potential collisions can significantly hinder the process of moving the patient into the setup position, which precise positioning is of utmost importance and required before the treatment can move forward.
  • Such obstructions and collisions may also impede movement of the patient during application of the treatment, particularly (but not only) for patients treated in an upright or seated manner where frequent repositioning may be required.
  • Potentially colliding objects may be difficult to account for when planning movements of the patient in the room and possible treatment angles, particularly objects that are not or cannot be imaged in conventional treatment planning systems. Collisions within the treatment room may significantly impede the execution of the treatment plan and may render the plan unfeasible.
  • a method for generating and verifying a treatment plan for an irradiation treatment includes the steps of imaging a patient on a support platform to obtain a first set of target tissue images, and determining treatment plan fields including proposed treatment angles, based on the first set of images, the treatment angles including at least one platform positioning parameter of the support platform for positioning the patient such that the target tissue is localized at an isocenter of the treatment room.
  • the method further includes the step of applying at least one first collision detection simulation to determine a feasibility of the proposed treatment angles, using a first group of simulation fields including: a three-dimensional room model of a treatment room for the irradiation treatment; platform settings of a support platform for supporting the patient during the irradiation treatment; and treatment plan fields including proposed treatment angles.
  • the method further includes the step of generating a treatment plan for the irradiation treatment based on the first collision detection simulation, such that there is no collision for each treatment angle of the generated treatment plan.
  • the method further includes the step of applying at least one second collision detection simulation to verify no collisions in movement paths between treatment angles of consecutive treatment plan fields, using a second group of simulation fields including: the three-dimensional room model; the target tissue volume; the platform settings; and treatment plan fields of the generated treatment plan.
  • the method further includes the steps of, for each of at least one collision detected in the second collision detection simulation, updating treatment plan fields of the treatment plan to avoid collisions in movement paths between treatment angles, and applying at least one updated second collision detection simulation using an updated second group of simulations fields comprising the updated treatment plan fields; and approving the treatment plan when no collision is detected in the second collision detection simulation.
  • the method may further include the steps of imaging the patient on the support platform to obtain a second set of target tissue images, and adaptively updating and validating the first treatment plan based on the second set of target tissue images.
  • the step of imaging a patient on a support platform to obtain a first set of target tissue images may be performed in an imaging room different from the treatment room.
  • the second group of simulation fields may further include at least one transition between treatment angles.
  • the treatment angles may include at least one platform positioning parameter of: a platform surface yaw angle; a platform surface pitch angle; a platform surface roll angle; and a platform surface translational displacement.
  • a platform positioning parameter of the support platform may be adjustable using a platform adjuster, configured to rotate at least one platform surface of the platform about at least one rotational axis, or to displace at least one platform surface of the platform along at least one displacement axis.
  • the support platform may be aligned such that a patient anterior or a patient posterior is directed toward an irradiation beam delivery nozzle.
  • the collision may include a collision between a first object and a second object in the treatment room.
  • At least one of the first object and the second object may be: a body part of the patient; a component of an irradiation treatment system; the support platform; the imager; an irradiation beam delivery device; a gantry; an irradiation beam generator; a covering or accessory of a component of the treatment system; a chair; a table; and/or a wall of the treatment room.
  • the patient support platform may include a chair, and the patient may be in a seated position.
  • the irradiation treatment may include a proton irradiation treatment. At least one of the first collision detection simulation and the second collision detection simulation may be performed in a room different than the treatment room.
  • an irradiation treatment plan generation and verification system configured to receive a first set of target tissue images of the patient; and to determine treatment plan fields including proposed treatment angles, based on the first set of images, the treatment angles including at least one platform positioning parameter of the support platform for positioning the patient such that the target tissue is localized at an isocenter of the treatment room.
  • the system further includes a collision detection simulator, configured to apply at least one first collision detection simulation to determine a feasibility of the proposed treatment angles, using a first group of simulation fields including: a three-dimensional room model of a treatment room for the irradiation treatment; platform settings of a support platform for supporting the patient during the irradiation treatment; and the treatment plan fields including proposed treatment angles.
  • the processor is further configured to generate a treatment plan for the irradiation treatment based on the first collision detection simulation, such that there is no collision for each treatment angle of the generated treatment plan.
  • the processor may be further configured to receive a second set of target tissue images of the patient imaged on the support platform, and to adaptively update and validate the first treatment plan based on the second set of target tissue images.
  • An imaging of the patient to obtain a first set of target tissue images may be performed in an imaging room different from the treatment room.
  • the second group of simulation fields may further include at least one transition between treatment angles.
  • the treatment angles may include at least one platform positioning parameter of: a platform surface yaw angle; a platform surface pitch angle; a platform surface roll angle; and a platform surface translational displacement.
  • a platform positioning parameter of the support platform may be adjustable using a platform adjuster, configured to rotate at least one platform surface of the platform about at least one rotational axis, or to displace at least one platform surface of the platform along at least one displacement axis.
  • the support platform may be aligned such that a patient anterior or a patient posterior is directed toward an irradiation beam delivery nozzle.
  • the collision may include a collision between a first object and a second object in the treatment room.
  • At least one of the first object and the second object may be: a body part of the patient; a component of an irradiation treatment system; the support platform; the imager; an irradiation beam delivery device; a gantry; an irradiation beam generator; a covering or accessory of a component of the treatment system; a chair; a table; and/or a wall of the treatment room.
  • the patient support platform may include a chair, and the patient may be in a seated position.
  • the irradiation treatment may include a proton irradiation treatment. At least one of the first collision detection simulation and the second collision detection simulation may be performed in a room different than the treatment room.
  • Figure 1 is a schematic illustration of an irradiation treatment system, constructed and operative in accordance with an embodiment of the present disclosure
  • Figure 2 is a schematic illustration of an irradiation treatment plan generation and verification system, constructed and operative in accordance with an embodiment of the present disclosure
  • Figure 3 is an illustration of an exemplary set of simulation fields for a treatment plan simulation, operative in accordance with an embodiment of the present disclosure
  • Figure 4 is a perspective view visual representation of a first exemplary treatment plan simulation applied for a treatment plan in a treatment room, operative in accordance with an embodiment of the present disclosure
  • Figure 5 is a perspective view visual representation of a second exemplary treatment plan simulation applied for a treatment plan in a treatment room, operative in accordance with an embodiment of the present disclosure
  • Figure 6 is a visual representation of an irradiation beam directed to a target tissue imaging volume of a patient in the exemplary treatment plan simulation of Figure 5, operative in accordance with an embodiment of the present disclosure
  • Figure 7 is a perspective view visual representation of a third exemplary treatment plan simulation applied for a treatment plan in a treatment room, operative in accordance with an embodiment of the present disclosure
  • Figure 8 is a perspective view visual representation of a fourth exemplary treatment plan simulation applied for a treatment plan in a treatment room, operative in accordance with an embodiment of the present disclosure
  • Figure 10 is a flow diagram of a method for generating and verifying a treatment plan for an irradiation treatment, operative in accordance with an embodiment of the present disclosure.
  • the disclosed embodiments may overcome the disadvantages of the prior art by providing a novel method and system for verifying an irradiation treatment plan to avoid potential collisions or interference from objects in the treatment room, such as when positioning the patient for treatment, and without requiring a customized verification process for different treatment rooms, for different patient support platforms, and/or for different patients.
  • doctor is used herein to refer to any individual person or group of persons operating a method or system according to a disclosed embodiment, such as a medical practitioner involved in performing and/or planning an irradiation treatment procedure (e.g., a radiation oncologist, a radiation therapy nurse, a medical radiation physicist, a radiation therapist, a dosimetrist, and the like).
  • a medical practitioner involved in performing and/or planning an irradiation treatment procedure e.g., a radiation oncologist, a radiation therapy nurse, a medical radiation physicist, a radiation therapist, a dosimetrist, and the like.
  • subject and “patient” are used interchangeably herein to refer to an individual upon which a method or system according to a disclosed embodiment is performed, such as a person undergoing a proton therapy procedure.
  • the subject may be any living entity, such as a person, human or animal, characterized with body tissue subject to irradiation treatment.
  • proton therapy and “proton treatment” are used interchangeably herein to broadly encompass all forms of particle therapy or hadron therapy that applies beams of energized ionizing particles for radiotherapy purposes, including but not limited to protons, neutrons and other types of ions (all of which are considered encompassed herein by the term “protons”).
  • protons all of which are considered encompassed herein by the term “protons”.
  • irradiation therapy and “irradiation treatment” as used herein encompasses proton therapy and other treatments involving applied radiation.
  • Treatment system 110 includes an irradiation beam generator 112, an irradiation beam delivery device 114, an imager 116, a positioning verifier 117, a controller 118, a database 119, a patient support platform 122, and a platform adjuster 124.
  • Controller 118 is communicatively coupled with beam generator 112, with beam delivery device 114, with imager 116, with positioning verifier 117, with database 119, and with platform adjuster 124.
  • Treatment system 110 is configured to be deployed for treating a patient 120 in a treatment room 100, which is generally characterized with shielding properties to limit radiation from penetrating beyond the treatment area. Some of the components of treatment system 110 may reside outside room 100.
  • Patient support platform 122 is configured for supporting a patient 120 during a treatment session or planning stage.
  • patient support platform 122 includes a reclining chair, such that patient 120 may be in a sitting position and supported by a pelvis support member 121 , such as a seat, and a back support member 123, such as a back rest (as illustrated in FIG.1 ).
  • Patient support platform 122 may also include or be converted into a bed, such that patient 120 may be in a lying or recumbent position (i.e. , horizontal to the ground) supported by the bed.
  • Patient support platform 122 is mounted on an adjustable platform base 126, coupled to platform adjuster 124.
  • Pelvis support member 121 may be tilted relative to platform base 126, such as defining an inclination angle (e.g., 10° inclination) relative to a vertical axis.
  • Back support member 123 may be tilted relative to platform base 126, such as defining an inclination angle (e.g., 20° inclination) relative to a horizontal axis.
  • platform adjuster 124 may include a first mechanism for adjusting a height of platform base 126, and a second mechanism for rotating platform 122 (e.g., by manipulating an orientation of platform base 126) about pitch, yaw, and roll axes, respectively (e.g., causing patient 120 to lay back, tip sideways, or swivel, respectively).
  • a rotational adjustment mechanism may rotate platform 122 (or platform base 126) about three orthogonal axes 125R, 127R, 129R, where a first axis 125R is parallel to a floor 102 of the treatment room 100, a second axis 127R is parallel to floor 102 and orthogonal to first axis 125R, and a third axis 129R is orthogonal to floor 102.
  • the rotation of patient support platform 122 causes a rotation of patient 120 about three orthogonal axes 125P, 127P, 129P, where a first axis 125P is parallel to a longitudinal axis of platform base 126, a second axis 127P is parallel to a longitudinal axis of platform base 126 and orthogonal to first axis 125P, and a third axis 129P is orthogonal to a longitudinal axis of platform base 126.
  • axes 125P, 127P and 129P correspond to axes 125R, 127R and 129R, respectively.
  • Irradiation beam generator 112 includes components and techniques for generating an irradiation therapy proton beam, such as a particle accelerator.
  • generator 112 may include a cyclotron or a synchrotron particle accelerator.
  • Irradiation beam delivery device 114 includes components and techniques for delivering at least one irradiation dose 115 to patient 120 from a generated proton beam.
  • beam delivery device 114 may operate using a pencil beam scanning (PBS) mechanism.
  • Beam delivery device 114 may optionally be coupled with a rotatable gantry (not shown), configured for positioning and orienting the beam nozzle about multiple axes in 3D space, for directing a delivered irradiation dose 115 to a selected position and orientation (i.e., a selected isocenter).
  • treatment system 110 may operate without a rotatable gantry, which may provide increased treatment flexibility for different anatomical sites and may facilitate upright positioning of patient 120.
  • Imager 116 is configured for imaging patient 120, such as during a treatment planning stage and/or a treatment session.
  • imager 116 may be a medical imaging device used in a medical treatment setting, including but not limited to: a computed tomography (CT) scanner, a four-dimensional computed tomography (4DCT) scanner, an X-ray computed tomography (X-ray CT) scanner, an optical coherence tomography (OCT) scanner, a magnetic resonance imaging (MRI) scanner, and an ultrasound imager.
  • CT computed tomography
  • 4DCT computed tomography
  • 4DCT X-ray computed tomography
  • OCT optical coherence tomography
  • MRI magnetic resonance imaging
  • ultrasound imager ultrasound imager.
  • imager 116 may include any type of imaging sensor capable of acquiring and storing an image representation of an object or scene.
  • image refers to any form of output from such an imager, including any optical or digital representation of a scene acquired at any wavelength or spectral region, and encompasses both a single image frame and a sequence of image frames (i.e., a “video image”).
  • An image rotation mechanism (not shown) may be configured to rotate imager 116 about at least one axis, to enable imaging from selected directions or viewing angles.
  • Positioning verifier 117 is configured for verifying that patient 120 is properly positioned in a designated setup position for treatment.
  • Positioning verifier 117 may be embodied, for example, by an X-ray imaging device including a set of complementary X-ray emitter and detector pairings located around the treatment isocenter, where the respective pairings are in perpendicular alignment to one another (i.e., to enable three-dimensional localization).
  • Alternative approaches for position verification may include surface guided radiation therapy (SGRT) 3D imaging techniques, and cone beam computed tomography (CBCT) imaging techniques.
  • SGRT surface guided radiation therapy
  • CBCT cone beam computed tomography
  • Controller 118 is configured to selectively control the operation of components of treatment system 110 and may dynamically adjust operational parameters thereof. Controller 118 is further configured to receive and provide instructions and data from/to components of system 110 and to perform required data processing.
  • Database 119 stores relevant information to be retrieved and processed by processor 114, such as captured images.
  • Database 119 may be embodied by one or more local servers or by remote and/or distributed servers, such as in a cloud storage platform.
  • Treatment plan generation and verification system 130 includes a processor 132 and a collision detection simulator 135.
  • Processor 132 is coupled with simulator 135 and is configured to receive instructions or data from one or more external components via a communication channel 138.
  • System 130 may reside at least partially at a dedicated location 131.
  • Treatment system 110 or treatment plan generation and verification system 130 may be conveyed between the components of treatment system 110 or treatment plan generation and verification system 130 over any suitable data communication channel or network, using any type of channel or network model and any data transmission protocol (e.g., wired, wireless, radio, WiFi, Bluetooth, and the like).
  • the components and devices of treatment system 110 or treatment plan generation and verification system 130 may be based in hardware, software, or combinations thereof. It is appreciated that the functionality associated with each of the devices or components of treatment system 110 or treatment plan generation and verification system 130 may be distributed among multiple devices or components, which may reside at a single location or at multiple locations.
  • controller 118 may be distributed between separate components, such as at least one control unit and at least one processing unit (e.g., which may be part of a server or a remote computer system accessible over a communications network, such as a cloud computing platform). Controller 118 may also be at least partially integrated with other components of system 110 (such as incorporated within a dedicated local control unit).
  • at least one control unit and at least one processing unit (e.g., which may be part of a server or a remote computer system accessible over a communications network, such as a cloud computing platform).
  • Controller 118 may also be at least partially integrated with other components of system 110 (such as incorporated within a dedicated local control unit).
  • Treatment plan generation and verification system 130 may include a user interface (not shown) for allowing a user to provide instructions or control various parameters or settings associated with system 130, and/or a display device (not shown) for visually displaying information relating to the operation of system 130.
  • patient 120 is imaged on support platform 122.
  • patient 120 is mounted and positioned on a selected support platform 122, representing a platform on which the irradiation treatment will be performed (i.e. , the same platform or a similar type of platform).
  • the selected platform 122 for treatment may be selected from multiple support platforms, each of which may have adjustable moving parts and accessories.
  • platform 122 is a reclining chair and patient 120 is supported in an upright or seated position. Parameters or configuration settings of the selected platform 122 are obtained when mounting patient 120 onto platform 122.
  • Platform settings may include a platform type (e.g., type of bed or chair), features (e.g., reclining, non-reclining, maximum reclining angle), dimensions, accessories, default position/orientation, and the like.
  • the platform settings may include how to mount the patient on the platform and which platform accessories should be employed during treatment. For example, certain patients, such as those of a diminutive stature, may be situated on one or more booster seats in order to elevate their position upon the platform. Accordingly, the platform settings may include: whether a booster seat is applied; type of booster seat; amount and order of booster seats; and the like.
  • platform accessory may be an armrest, in which case the platform settings may include: whether an arm rest is utilized; angle at which armrest is aligned; height at which armrest is attached to the platform; and the like.
  • the obtained platform settings are stored, to be applied for the respective patient 120 during the treatment, and for performing the treatment plan simulation as will be described hereinbelow.
  • Patient 120 is then positioned with respect to imager 116 (e.g., a CT scanner) to allow for imaging of the target tissue via imager 116.
  • Patient 120 is brought into an imaging position, such as by moving platform 122 into a field of view of imager 116, and/or adjusting the positioning of patient 120 on platform 122.
  • Imager 116 then images a target tissue of patient 120 to be treated, such as capturing a plurality of images from multiple imaging angles.
  • the imaging may take place in treatment room 100 where the patient treatment will take place, or in a different location, such as an imaging room, which may contain similar system elements as treatment room 100.
  • the imaging room may contain at least one support platform similar as and registered to the actual support platform to be used for the patient treatment.
  • the patient imaging may be performed by a first operator, such as a CT imaging technician.
  • a treatment plan is established.
  • the treatment planning may be performed by a second operator or a treatment planner, such as a medical physicist.
  • the treatment planning may be performed in the absence of patient 120, at a subsequent date following the patient imaging.
  • the treatment planner receives treatment prescriptions for an irradiation treatment of patient 120.
  • the treatment prescriptions may include details relating to the target tissue (e.g., type, shape, size, location in body), and recommended doses (e.g., recommended minimum and/or maximum doses) to be applied to the target tissue.
  • the treatment planner generates a treatment plan in accordance with the received treatment prescriptions and the imaging of the target tissue (during the previous imaging session).
  • the treatment plan may include a series of irradiation parameters or “treatment fields” for at least one treatment session, each treatment field defined at least by a dosage, a position and orientation of the target tissue (e.g., relative to an isocenter), and an irradiation angle, for each irradiation dose.
  • the treatment plan may define a series of treatment angles for directing a respective irradiation dose to the target tissue coordinates according to an irradiation angle.
  • These treatment angles may include a sequence of three-dimensional (3D) rotations and translations for repositioning support platform 122 in a 3D coordinate system, such as rotations respective of pitch, yaw and roll axes of platform base 126, and at least one translation of a displacement axis of platform base 126.
  • the treatment plan preparation may utilize a 3D model of the target tissue generated from captured images.
  • the target tissue model may be a computed tomography (CT) imaging volume.
  • CT computed tomography
  • the target tissue imaging volume may be constructed using auxiliary imaging devices, such as stereoscopic imaging.
  • Placement markers may be positioned on or around patient 120 or support platform 122 to ensure proper targeting for each irradiation dose and to avoid harming non-treatment organs or tissue (in the vicinity of the target tissue) during the irradiation treatment.
  • System 130 receives a 3D room model of the treatment room 100.
  • the room model includes representations of objects and system components that will be present in room 100 during the treatment.
  • the room model may be generated during the treatment planning or during a previous stage (prior to treatment planning), using 3D modeling techniques known in the art.
  • the room model may be previously uploaded to system 130 or obtained from an external source.
  • the Simulation fields include platform settings of support platform 122, which may be obtained when mounting patient 120 onto platform 122 during the patient imaging session.
  • the platform settings may include 3D coordinates of platform 122 in room 100 during the treatment sessions.
  • the platform settings may further include additional parameters relating to support platform 122, such as platform type, features, dimensions, accessories, and the like.
  • the simulation fields further include 3D coordinates of the target tissue (e.g., a tumor), such as in relation to an imaging coordinate system respective of imager 116.
  • the target tissue coordinates may be extracted from the generated treatment plan and/or from captured images (e.g., from a CT imaging volume).
  • the simulation fields further include treatment angles of patient 120 for directing irradiation doses during a treatment session, which may be extracted from the generated treatment plan.
  • the treatment angles may include a set of inclination angles at which a platform surface 121 , 123 of platform 122 (i.e., pelvis support member 121 and/or back support member 123) is rotated in a 3D angular coordinate system, such as respective of pitch, yaw and roll angular rotations.
  • the treatment angles may include a “platform yaw angle”, also referred to as a “patient support angle”, defining an angle at which a platform surface 121 , 123 is aligned with respect to an axis orthogonal to the floor, such as by a side- to-side swiveling rotation (i.e., a yaw rotation).
  • the treatment angles may further include a “platform pitch angle”, also referred to as a “table top pitch angle”, defining an angle at which a platform surface 121 , 123 is aligned with respect to a transverse axis thereof, such as by a forward or backward tilting rotation (i.e., a pitch rotation).
  • the simulation fields may further include at least one direction or alignment of at least one portion of platform adjuster 124 or platform base 126, under limitations or constraints of treatment room 100.
  • platform adjuster 124 may include at least one robotic arm (not shown) which may be selectively positioned in a particular orientation, such as a right side orientation or a left side orientation, which may be referred to as a “robotic elbow direction”.
  • the simulation fields may optionally include additional parameters, such as imaging parameters relating to imager 116 (e.g., viewing angle, focal length, field of view, resolution, lighting conditions), or parameters relating to beam delivery device 114 (e.g., distance from isocenter, range shifter existence, different possible covers or accessories).
  • imaging parameters relating to imager 116 e.g., viewing angle, focal length, field of view, resolution, lighting conditions
  • parameters relating to beam delivery device 114 e.g., distance from isocenter, range shifter existence, different possible covers or accessories.
  • the simulation fields generally include information relating to all objects or elements present in room 100, where such elements are predefined and measured as part of the 3D room model.
  • each of the simulation fields may be dynamic and may include a plurality of respective fields, such as a sequence of treatment parameters to be executed over time during at least one treatment session.
  • the table top pitch and roll angles may be associated with a sequence of respective angles, for directing a sequence of irradiation doses to the target tissue as defined by the treatment plan.
  • the exemplary simulation fields includes: a set of imaging coordinates (i.e., representing the location coordinates of platform adjuster 124 during the planning stage imaging); an imaging orientation of 0° (relative to a reference orientation); target tissue coordinates; a patient support angle of 270°; a table top pitch angle of 20°; a table top roll angle of 0°; and a robot elbow direction of “right” side.
  • a set of imaging coordinates i.e., representing the location coordinates of platform adjuster 124 during the planning stage imaging
  • an imaging orientation of 0° relative to a reference orientation
  • target tissue coordinates a patient support angle of 270°
  • a table top pitch angle of 20° a table top roll angle of 0°
  • robot elbow direction of “right” side.
  • simulator 135 performs a collision simulation on the 3D room model of treatment room 100 in accordance with the extracted simulation fields.
  • Simulator 135 may execute the simulation using at least one designated simulation program, configured to simulate an irradiation treatment of a patient within a treatment room according to treatment parameters defined by the simulation fields, based on the generated treatment plan.
  • the executed simulation may provide an indication of a potential collision during the simulated treatment plan. For example, a collision may occur when repositioning platform 122 during the treatment, such as by modifying a table top pitch angle or roll angle, so as to direct a selected irradiation dose to a designated location respective of the target tissue coordinates, as defined by the generated treatment plan.
  • a collision may also occur by platform 122 itself, such as a platform surface 121 , 123 impacting a system component or another object in room 100, when being repositioned in accordance with the defined treatment angles.
  • a collision may be defined in accordance with selected criteria, such as, for example, any impact between any two objects in treatment room 100, or only impacts involving one or more selected objects in room 100 (e.g., only involving patient 120 or platform 122), or only impacts that substantially hinder the continuation of the treatment.
  • the treatment plan verification may be performed by the treatment planner. It is noted that the treatment plan verification and simulation may be done at any location and does not need to be performed at the treatment room 100.
  • Simulator 135 may display a visual depiction of the simulation, which may be observed by the operator for determining feasibility of the simulated treatment plan.
  • the operator may view a visual representation of the executed simulation portraying an imaging volume of the treated target tissue and changing positions and orientations of patient 120 and support platform 122 within treatment room 100, during the simulated treatment session.
  • the operator may visually perceive a collision during the simulation, and/or may receive an alert from simulator 135 in the event of a collision, such as via a visual notification (e.g., text or graphical symbol) or audible notification.
  • the alert may include further information relating to the detected collision, such as objects involved in the collision, and a projected seventy level.
  • Simulator 135 may provide possible modifications to one or more treatment parameters to avoid the collision (e.g., while still meeting treatment planning requirements).
  • the operator may then modify one or more simulation fields so as to avoid a collision, and may perform an updated simulation with the modified simulation fields. Additional simulations may be performed iteratively with different simulation fields, in order to identify at least one set of treatment parameters that would avoid collisions during the treatment session.
  • the operator may then determine an optimal set of treatment parameters that meets treatment plan requirements and additional optional conditions, and finalize a treatment plan accordingly. After the treatment plan has been finalized, the irradiation treatment may be performed during one or more future treatment sessions.
  • Figure 4 is a perspective view visual representation of a first exemplary treatment plan simulation applied for a treatment plan in a treatment room, operative in accordance with an embodiment of the present disclosure.
  • the simulation is applied in accordance with exemplary simulation fields, such as simulation fields 140 of Figure 3.
  • the simulation is applied on a 3D room model of a treatment room 200.
  • a support platform 222 for supporting a patient (not shown) is configured in accordance with selected platform settings and selected platform positioning parameters (i.e., platform surface pitch, yaw and roll angles).
  • Support platform 222 is adjustable via a platform adjuster 224, including a first robotic arm 224A and a second robotic arm 224B, configured to rotate platform 222 along respective pitch and roll axes.
  • a beam nozzle 213 of a beam delivery device 214 is depicted delivering an irradiation beam 215 toward a target tissue, represented as a CT scan imaging volume 230.
  • a gantry is configured to maneuver beam delivery device 214 and may act as a potential collision impediment.
  • a positioning verifier 217 is configured for verifying the positioning of the patient for treatment. An operator may observe a visual representation of the simulation and may receive an alert in the event of a simulated collision, and may modify the simulation fields to avoid a collision.
  • Figure 5 is a perspective view visual representation of a second exemplary treatment plan simulation applied for a treatment plan in a treatment room, operative in accordance with an embodiment of the present disclosure.
  • the simulation of Figure 5 is applied in accordance with exemplary simulation fields, such as similar to simulation fields 140 of Figure 3 but with different table top pitch and roll angles.
  • the simulation is applied on a 3D room model of a treatment room 200, with a support platform 222 configured in accordance with the designated platform positioning angles.
  • a target tissue imaging volume 232 is shown in relation to the treatment system.
  • FIG. 6 is a visual representation of an irradiation beam 215 directed to a target tissue imaging volume 232 of a patient 220 in the exemplary treatment plan simulation of Figure 5, operative in accordance with an embodiment of the present disclosure.
  • An irradiation treatment may target different body parts of a patient from different directions or angles. Accordingly, the patient may be positioned on the support platform in different alignments or anatomical positions in relation to the directed irradiation. For example, a patient may be positioned with the anterior of the patient facing the beam nozzle of the beam delivery device (as shown in Figures 4 and 5), or with a posterior of the patient facing the beam nozzle.
  • Figure 7 is a visual representation of a third exemplary treatment plan simulation applied for a treatment plan in a treatment room, operative in accordance with an embodiment of the present disclosure.
  • the simulation of Figure 7 is applied in accordance with exemplary simulation fields, such as similar to simulation fields 140 of Figure 3 but with different target tissue coordinates and different table top pitch and roll angles.
  • the simulation is applied on a 3D room model of a treatment room 200, with support platform 222 configured in a posterior alignment (i.e., with the back of the patient facing a beam nozzle of beam delivery device 215), to enable a treatment directed to the back of patient.
  • Support platform 222 is further configured for treating seated patients with legs extended and facing forward, as pelvis support member 221 of platform 222 is extended lengthwise to accommodate extended legs of a patient.
  • Support platform 222 is configured in accordance with the designated table top pitch and roll angles, which are adjustable via robotic arms 224A, 224B.
  • a target tissue imaging volume 234 is shown in relation to the platform 222 and the beam nozzle.
  • the irradiation treatment may be applied on various support platforms, each of which may include different accessories or extensions (defined as part of the simulation fields).
  • Figure 8 is a visual representation of a fourth exemplary treatment plan simulation applied for a treatment plan in a treatment room, operative in accordance with an embodiment of the present disclosure.
  • the simulation of Figure 8 is applied in accordance with exemplary simulation fields, such as simulation fields 140 of Figure 3.
  • the simulation is applied on a 3D room model of a treatment room 200, with a support platform 222 configured in a selected alignment, for treating seated or standing patients with legs lowered, where pelvis support member 221 of platform 222 is bent downwards to accommodate bent legs of a patient.
  • Support platform 222 is configured in accordance with the designated table top pitch and roll angles, which are adjustable via robotic arms 224A, 224B. No target tissue imaging volume is shown.
  • modified simulation fields may be determined so as to avoid the collision.
  • the modified simulation fields may be selected in accordance with the type and nature of the detected collision, for example which objects were involved in the detected collision, and the position and orientation of the colliding objects during and prior to the detected collision.
  • the collision may involve a body extremity of the patient or a portion of the support platform.
  • Figure 9 is a perspective view illustration of a patient support platform colliding with a component of an irradiation treatment system, operative in accordance with an embodiment of the present disclosure.
  • a pelvis support member 221 of platform 222 is portrayed in a collision with beam delivery device 214.
  • a collision may generally involve any object or accessory in the treatment room, particularly those not fully imaged by the imager. Examples may include: walls, equipment, covers, an imager (116), an auxiliary imager, such as an X-ray detector of a positioning verifier (117), a platform adjusting arm (224A, 224B), and the like.
  • the operator may apply further simulations with modified simulation fields to verify that no collision will occur.
  • the operator may then select a set of collision avoiding simulation fields for generating an updated treatment plan, based on which the irradiation treatment may later be implemented.
  • a validation of the treatment plan may be performed on site, such as by an operator physically checking and validating the feasibility of treatment plan fields (e.g., doses, patient positioning, treatment angles) at treatment room 100.
  • the disclosed embodiments may allow for verification of a proposed treatment plan during a preliminary stage, without needing to manually implement the proposed plan or to physically experiment with aspects of the plan in the treatment room itself.
  • potential collisions may be detected for a proposed treatment to be performed in a given treatment room without requiring a treatment planner to be inside the room itself. This may result in significant time savings, and may also free up the treatment room for actually performing irradiation treatments.
  • a three-dimensional visualization of a treatment room may be provided, including the patient, elements of the treatment system, and additional objects that may not be covered by the imaging, for simulating a proposed treatment plan and detecting potential collisions during a treatment plan verification stage.
  • the disclosed embodiments may provide an early indication for whether a proposed treatment plan is feasible and may facilitate the maneuvering and repositioning of the patient within the treatment room during the treatment sessions.
  • Such treatment planning may be particularly beneficial for patients treated in a seated or upright position, as well as for patients treated in a recumbent or lying position.
  • the treatment planner applies a collision detection simulation prior to generating the initial treatment plan.
  • An operator e.g., treatment planner
  • the treatment planner determines an initial set of treatment plan fields with proposed treatment angles according to the target tissue images.
  • the treatment planner executes an initial collision detection simulation via simulator 135 to check the feasibility of the proposed treatment angles in terms of whether the proposed angles may result in a collision during treatment.
  • the simulation fields for the preliminary simulation may include: the treatment room model, platform settings of support platform 122, and a target tissue volume (e.g., CT volume) derived from the initial imaging of the target tissue.
  • a target tissue volume e.g., CT volume
  • the preliminary simulation may be based on an approximation of the target tissue location, according to the target tissue imaging volume which is virtually allocated at the treatment room isocenter and position of the support platform.
  • the simulation fields further include proposed treatment angles, such as a set of inclination angles (e.g., pitch, yaw and roll angular rotations) of platform surfaces 121 , 123 of platform 122, defining a direction vector for directing an irradiation beam 115 to the target tissue positioned at the treatment room isocenter for each irradiation dose.
  • the proposed treatment angles may be based on a default treatment plan or default values, which may be modified for the specific treatment in accordance with the target tissue images.
  • the simulation fields may optionally include additional parameters (e.g., parameters of imager 116, parameters of beam device 114, accessories of support platform 122).
  • a preliminary collision detection simulation may provide general limitations or tolerances for generating the initial treatment plan fields in a manner that minimizes potential collisions during the treatment.
  • a treatment plan based on such a preliminary collision detection simulation may eliminate a majority (e.g., about 80%) of potential collision issues during the treatment, such that the substantially few remaining collision issues can be overcome more quickly and efficiently based on further simulations applied during a subsequent verification process.
  • the treatment plan generation may be an arduous and time-consuming process (e.g., spanning several weeks), such that optimizing the generated plan may enhance overall efficiency of the pre-treatment process.
  • a secondary collision detection simulation for verifying the generated treatment plan may account for movement paths or transitions between treatment angles, rather than merely the treatment angles themselves.
  • an operator e.g., treatment plan verifier
  • the simulation fields for the secondary simulation may include: the treatment room model, platform settings of support platform 122, and the derived target tissue volume, as well as treatment plan fields of the generated treatment plan. Transitions between consecutive treatment angles may be provided as a simulation field or a further input to the simulation.
  • the secondary simulation may detect collisions resulting from a transition or movement path between one set of treatment angles to another, and the treatment plan verifier may update treatment plan fields accordingly. Further simulations may be performed to ensure the suitability of the updated treatment plan fields.
  • the treatment plan may be approved or finalized when no further movement path collisions are detected in a simulation.
  • the plan may optionally be validated based on an updated set of patient images, such as to account for possible changes in the target tissue ahead of the treatment.
  • an operator i.e., a treatment plan validator
  • the operator may examine the verified treatment plan in view of a second target tissue volume derived from a second set of images captured by imager 116.
  • the operator may examine the feasibility of treatment fields of the treatment plan (e.g., doses, patient positioning, treatment angles) in view of the second target tissue volume, and update treatment fields, if necessary, before the actual treatment takes place.
  • FIG. 10 is a flow diagram of a method for generating and verifying a treatment plan for an irradiation treatment, operative in accordance with an embodiment of the present disclosure.
  • a patient is imaged on a support platform to obtain a first set of target tissue images.
  • patient 120 is mounted on a support platform 122, representing a same or similar platform on which patient will be treated, and imager 116 images a target tissue of patient 120 supported on platform 122.
  • imager 116 captures a plurality of images of a target tissue from multiple imaging angles, from which a target tissue imaging volume may be generated, such as a CT imaging volume obtained from CT imaging.
  • the imaging may take place in an imaging room, which may be different from but contain similar system elements as treatment room 100.
  • treatment plan fields including proposed treatment angles are determined based on the first set of target tissue images.
  • an operator e.g., a treatment planner
  • a step 276 at least one first collision detection simulation is applied to determine a feasibility of the proposed treatment angles, using a first group of simulation fields including: a treatment room model; platform settings; and the determined treatment plan fields with proposed treatment angles.
  • simulator 135 executes a first collision detection simulation using a first group of simulation fields, for enabling the operator to determine a feasibility of the proposed treatment angles in the determined treatment plan fields.
  • the simulation fields include a 3D room model of treatment room 100, which includes representations of objects and components of treatment system 110 that will be present in treatment room 100 during the planned treatment.
  • the simulation fields further include platform settings of support platform 122, such as information pertaining to: a platform type, platform features, a default position and orientation, platform dimensions, platform accessories, and how to mount the patient on platform 122.
  • the simulation fields may further include a target tissue volume derived from the first set of target tissue images.
  • the target tissue volume may include coordinates of the target tissue in relation to a coordinate system of imager 116.
  • the simulation fields further include proposed treatment angles (i.e., determined in step 274), such as a set of inclination angles (e.g., pitch, yaw and roll angular rotations) of platform surfaces 121 , 123 of platform 122, defining a direction vector for directing an irradiation beam 115 to the target tissue positioned at the treatment room isocenter for each irradiation dose.
  • Simulator 135 may provide a visual representation of the executed simulation, such as shown in Figure 4, portraying a target tissue imaging volume 230 and changing positions and orientations of a support platform 222 within treatment room 100. The simulation may be executed at any location and does not require use of treatment room 100.
  • a treatment plan is generated based on the first simulation, such that there is no collision for each treatment angle of the generated treatment plan.
  • an operator i.e., a treatment planner
  • the treatment plan may include a series of treatment plan fields for at least one treatment session, each treatment plan field defined at least by a dosage, target tissue coordinates, and an irradiation angle, for each irradiation dose.
  • the treatment plan may define a series of treatment angles for directing a respective irradiation dose to the target tissue according to an irradiation angle.
  • the treatment planner generates the treatment plan based on the results of the first collision simulation, such that the treatment angles of the treatment plan will not result in a collision during the treatment.
  • the treatment plan may be based on received treatment prescriptions (e.g., target tissue characteristics, recommended doses), and the target tissue volume derived from the first set of target tissue images.
  • the treatment plan may be generated in the absence of the patient, such as during a later date following the patient imaging and/or the first simulation.
  • Steps 272, 274, 276, 278 may be implemented during a first group of sessions over a first time period, such as a period of several weeks.
  • a step 280 at least one second collision detection simulation is applied to verify no collisions in movement paths between treatment angles of consecutive treatment plan fields, using a second group of simulation fields including: a treatment room model; a target tissue volume; platform settings; and treatment plan fields of the generated treatment plan.
  • simulator 135 executes a second collision detection simulation using a second group of simulation fields, for enabling an operator (i.e. , a treatment plan verifier) to verify that there are no collisions resulting from the movement paths between treatment angles of consecutive treatment fields of the generated treatment plan.
  • the simulation includes a 3D room model of treatment room 100, which includes representations of objects and components of treatment system 110 present in treatment room 100 during the planned treatment.
  • the simulation fields further include platform settings of support platform 122, such as information pertaining to: a platform type, platform features, a default position and orientation, platform dimensions, platform accessories, and how to mount the patient on platform 122.
  • the simulation fields may further include a target tissue volume, which may be derived from the first set of target tissue images.
  • the target tissue volume may include coordinates of the target tissue in relation to a coordinate system of imager 116.
  • the simulation fields further include treatment angles of the generated treatment plan, such as pitch, yaw and roll angles of platform surfaces 121 , 123 of platform 122, defining a direction vector for directing irradiation beam 115 to the target tissue (positioned at the treatment room isocenter), for each respective irradiation dose, according to the generated first treatment plan.
  • the treatment angle may include a patient support angle, corresponding to a side-to- side swiveling rotation (yaw rotation); a table top pitch angle, corresponding to a forward or backward tilting rotation (or pitch rotation); and a table top roll angle, corresponding to a side to side pivoting rotation (or roll rotation).
  • the simulation fields may further include information relating to transitions between consecutive treatment angles or consecutive treatment fields.
  • Simulator 135 may provide a visual representation of the executed simulation, such as shown in Figure 4, portraying a target tissue imaging volume 230 and changing positions and orientations of a support platform 222 within treatment room 100. The operator may receive an alert in the event of a collision during the simulation.
  • the simulation may be executed at any location and does not require use of treatment room 100.
  • the treatment plan is updated to avoid the collision.
  • the operator i.e., treatment plan verifier
  • detects a collision in the second collision detection simulation such as a collision between the legs 244 of patient 220 and beam delivery device 214 ( Figure 9) resulting from a transition between consecutive treatment angles
  • the operator determines updated treatment plan fields with updated treatment angles for avoiding the detected collision.
  • the updated treatment plan fields for avoiding the collision may be determined in accordance with characteristics of the detected collision, such as which objects were involved, and the position and orientation of the colliding objects during and prior to the collision.
  • An updated second group of simulation fields may be determined using the updated treatment fields (e.g., with updated treatment angle transitions), and at least one further collision detection simulation may be executed using the updated second group of simulation fields, to verify that there are no collisions resulting from the updated treatment plan fields (e.g., due to movements between consecutive treatment angles). If a collision is still detected, further updated treatment plan fields may be determined, and further simulations applied using the further updated treatment plan fields, until no further collisions occur.
  • the treatment plan is approved.
  • the operator e.g., treatment plan verifier
  • the generated treatment plan may be verified and approved.
  • the approved treatment plan may include treatment plan fields for which there are no simulated collisions, including collisions resulting from the treatment angles or movement paths between consecutive treatment angles.
  • Steps 280, 282, 284 may be implemented in a second time period, which may be subsequent to the first time period of the plan generation stage (i.e. , steps 272, 274, 276, 278), such as several days, weeks, or months thereafter.
  • a step 286 the patient is imaged on a patient support platform to obtain a second set of target tissue images.
  • patient 120 is mounted on a support platform 122, representing a same or similar platform on which patient will be treated, and imager 116 captures a second set of images of the target tissue of patient 120 on support platform 122.
  • imager 116 captures a plurality of images of the target tissue from multiple imaging angles, from which a target tissue imaging volume may be generated, such as a CT imaging volume obtained from CT imaging.
  • the content of the second set of images may be slightly different from the first set of images (captured at an earlier imaging session) due to minor changes in the patient.
  • the imaging may take place in an imaging room, which may be different from but contain similar system elements as treatment room 100.
  • the treatment plan is adaptively updated and/or validated based on the second set of images.
  • An operator i.e., a treatment plan validator
  • the operator may examine the feasibility of treatment fields of the second treatment plan (e.g., doses, patient positioning, treatment angles) in view of the second target tissue volume and possible minor changes of the patient or target tissue, and update treatment plan fields if necessary, before validating the treatment plan.
  • the treatment plan may optionally undergo a further validation process with the patient physically present in the treatment room 100 before the actual treatment takes place.
  • Steps 286, 288 may be implemented in a third time period, which may be subsequent to the second time period of the plan verification stage (i.e., steps 278, 280), such as several days, weeks, or months thereafter.
  • the irradiation treatment may be performed according to the approved treatment plan during a subsequent treatment stage.
  • an irradiation treatment is applied to patient 120, during at least one future treatment session, in accordance with the treatment fields of the approved (e.g., verified and validated) treatment plan.
  • patient 120 is mounted on platform 122 and brought into a setup position in treatment room 100, such that the target tissue is centered at the treatment room isocenter.
  • the treatment plan is implemented with the patient sequentially repositioned relative to the setup position in accordance with the treatment plan requirements.
  • Positioning verifier 117 may be used for verifying proper patient positioning.
  • Auxiliary imaging may be utilized to ensure that the characteristics of the target tissue have not changed dramatically since the onset of treatment, in addition to verifying proper patient positioning.
  • Stabilization mechanisms may be applied to ensure patient positioning is maintained relative to the isocenter during the treatment, such as a mask or shield to affix the face and/or other body parts of patient 120.

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Abstract

Système et procédé de génération et de vérification d'un plan de traitement par irradiation. Un patient est imagé sur une plateforme de support pour obtenir des images de tissu cible, et des champs de plan de traitement comprenant des angles de traitement proposés sont déterminés sur la base d'images de tissu cible. Une première simulation de détection de collision est appliquée pour déterminer la faisabilité d'angles de traitement proposés, à l'aide d'un premier groupe de champs de simulation comprenant des angles de traitement proposés. Un plan de traitement est généré sur la base d'une première simulation de détection de collision. Une seconde simulation de détection de collision est appliquée pour vérifier l'absence de collision dans des trajets de mouvement entre des angles de traitement de champs de plan de traitement consécutifs, à l'aide d'un second groupe de champs de simulation comprenant un plan de traitement généré. Pour chaque collision détectée, des champs de plan de traitement mis à jour pour éviter des collisions dans des trajets de mouvement entre des angles de traitement et une seconde simulation de détection de collision mise à jour sont appliqués à l'aide d'un second groupe mis à jour de champs de simulations comprenant des champs de plan de traitement mis à jour. Le plan de traitement est approuvé lorsqu'aucune collision n'est détectée dans une seconde simulation de détection de collision.
PCT/IL2024/050871 2023-09-03 2024-08-29 Planification de traitement d'irradiation pour évitement de collision dans une salle de traitement Pending WO2025046583A1 (fr)

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US20180272151A1 (en) * 2003-08-12 2018-09-27 Vision Rt Limited Path planning and collision avoidance for movement of instruments in a radiation therapy environment
US20100303205A1 (en) * 2009-05-26 2010-12-02 Agile Planet Inc System and Method for Radiation Therapy Imaging and Treatment Workflow Scheduling and Optimization
US20170220709A1 (en) * 2016-02-03 2017-08-03 Varian Medical Systems, Inc. System and method for collision avoidance in medical systems
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