System for emission-guided high-energy photon delivery
61 claims: 3 independent, 58 dependent
- 1放射線療法システムであって、固定フレームと、 50RPM以上かつ 70RPM以下の最大速度で回転するように構成されている回転可能リングとを備えるガントリと、前記固定フレームと前記回転可能リングとの間に位置するスリップリングであって、前記スリップリングは、前記回転可能リングが前記最大速度で回転している間に前記固定フレームと前記回転可能リングとの間で電気信号を通信するように構成されており、前記回転可能リングは、ドラムを備え、前記ドラムは、リング状の第1の端面と、前記第1の端面の反対側のリング状の第2の端面と、前記リング状の第1の端面と前記リング状の第2の端面との間の長さに沿って延在するリブ構造とを有し、前記回転可能リングが前記最大速度で回転するときに前記第1の端面の長さと前記第2の端面の長さとの間の長さの変化が0.5mm未満である、スリップリングと、前記回転可能リング上に搭載されている治療放射線源と、前記ガントリ上に搭載されている1つ以上の陽電子放出断層撮影(PET)検出器とを備える、放射線療法システム。
- 2前記回転可能リング上に位置する第1のコントローラと、前記固定フレーム上の第2のコントローラとをさらに備え、前記第1のコントローラは、前記治療放射線源および前記1つ以上のPET検出器のための制御コマンドを生成し、前記第2のコントローラは、ガントリ運動システムのための制御コマンドを生成し、前記第1のコントローラと前記第2のコントローラとの間の同期化データは、前記スリップリングを介して転送される、請求項1に記載のシステム。
- 3前記第1のコントローラは、前記治療放射線源のアクティブ化およびPETデータの取得のための信号を生成するように構成され、前記第2のコントローラは、回転のための信号を生成するように構成されており、同期化信号は、前記治療放射線源のアクティブ化およびPETデータの取得およびガントリ運動を同期化するように、前記スリップリングを介して前記第1のコントローラと前記第2のコントローラとの間で伝送される、請求項2に記載のシステム。
- 4前記スリップリングは、データブラシブロックと電力ブラシブロックとを備える、請求項1に記載のシステム。
- 5前記ガントリを封入する容積を画定する筐体をさらに備え、前記筐体は、前記治療放射線源および前記1つ以上のPET検出器へのアクセスを可能にするように構成されている前記ドラムの長さに沿った1つ以上の側方ハッチを備える、請求項1に記載のシステム。
- 6前記回転可能リングの周囲の複数の回転子要素と、前記回転子要素の向かい側で前記固定フレーム内に封入されている固定子要素と、前記複数の回転子要素に隣接して位置する玉軸受とを備える運動システムをさらに備える、請求項1に記載のシステム。
- 7前記複数の回転子要素は、1つ以上の磁気または誘導要素を備え、前記固定子要素は、コイルを備える、請求項6に記載のシステム。
- 8前記治療放射線源は、線形加速器(リニアック)とマグネトロンとを備え、前記リニアックは、第1の搭載アセンブリによって前記ドラムの長さに沿って取り付けられており、かつ、前記リニアックおよび第1の搭載アセンブリから分離している放射線遮蔽内に封入されており、前記マグネトロンは、前記マグネトロンのカソード支持体が、前記回転可能リングが前記最大速度で回転している間に生成される求心力の方向と整合されるように、前記ドラムの長さに沿って半径方向に搭載されている、請求項1に記載のシステム。
- 9前記放射線遮蔽は、前記第1の搭載アセンブリから分離している第2の搭載アセンブリを使用して、前記ガントリに搭載されている、請求項8に記載のシステム。
- 10前記第2の搭載アセンブリは、前記第1の搭載アセンブリに直接接触しない、請求項9に記載のシステム。
- 11前記第1の搭載アセンブリおよび前記第2の搭載アセンブリは、空隙によって分離されている、請求項9に記載のシステム。
- 12前記放射線遮蔽および前記第2の搭載アセンブリは、前記リニアックに接触しない、請求項9に記載のシステム。
- 13前記リニアックおよび前記放射線遮蔽は、空隙によって分離されている、請求項9に記載のシステム。
- 14ボールねじを使用して前記リニアックおよび前記第1の搭載アセンブリに結合されているアクチュエータをさらに備え、前記リニアックの場所は、前記アクチュエータによって調節されるように構成されている、請求項9に記載のシステム。
- 15前記アクチュエータは、除去可能である、請求項14に記載のシステム。
- 16前記アクチュエータは、遠隔場所から制御可能である、請求項14に記載のシステム。
- 17前記回転可能ガントリは、部屋の中に位置し、前記遠隔場所は、前記部屋の外にある、請求項16に記載のシステム。
- 18前記回転可能リングに搭載されている第1の受信機要素と、前記固定フレームに搭載されている第1の伝送機要素とを備える第1の通信インターフェースであって、前記第1の伝送機要素は、前記回転可能リングが移動している間に第1の複数の信号を前記第1の受信機要素に伝送するように構成されている、第1の通信インターフェースと、前記回転可能リングに搭載されている第2の伝送機要素と、前記固定フレームに搭載されている第2の受信機要素とを備える第2の通信インターフェースであって、前記第2の伝送機要素は、前記回転可能リングが移動している間に第2の複数の信号を前記第2の受信機要素に伝送するように構成されている、第2の通信インターフェースとをさらに備える、請求項1に記載のシステム。
- 19前記第1の複数の信号は、前記第1の通信インターフェースを横断して伝送され、前記第2の複数の信号は、同時に前記第2の通信インターフェースを横断して伝送される、請求項18に記載のシステム。
- 20前記治療放射線源の前に配置されているマルチリーフコリメータをさらに備え、前記マルチリーフコリメータは、前記第2の受信機要素への伝送のために、前記マルチリーフコリメータの個々のリーフの位置データを前記第2の伝送機要素に伝送するように構成されている、請求項18に記載のシステム。
- 21前記第2の複数の信号は、ガントリ回転速度データを備える、請求項18に記載のシステム。
- 22前記第2の複数の信号は、前記1つ以上のPET検出器からの陽電子放出データを備える、請求項18に記載のシステム。
- 23前記治療放射線源の向かい側で前記回転可能リング上に搭載されている放射線検出器をさらに備え、前記第2の複数の信号は、前記放射線検出器からの放射線データを備える、請求項18に記載のシステム。
- 24前記回転可能リング上に位置する第1のコントローラと、前記固定フレーム上の第2のコントローラとをさらに備え、前記第2のコントローラは、前記第1の伝送機要素と通信し、前記第1の複数の信号は、前記第2のコントローラからの放射線源コマンドを備える、請求項18に記載のシステム。
- 25前記治療放射線源の前に配置されているマルチリーフコリメータをさらに備え、前記第1の複数の信号は、前記第2のコントローラからのマルチリーフコリメータコマンドを備える、請求項24に記載のシステム。
- 26前記第1の複数の信号は、前記第2のコントローラからのガントリ回転コマンドを備える、請求項24に記載のシステム。
- 27前記第1の通信インターフェースおよび前記第2の通信インターフェースは、誘導信号転送方法を使用して信号を伝送する、請求項18に記載のシステム。
- 28前記第1の通信インターフェースおよび前記第2の通信インターフェースは、容量信号転送方法を使用して信号を伝送する、請求項18に記載のシステム。
- 29前記回転可能リングに搭載されており、かつ、前記第1の受信機要素と通信する第1の位置センサと、前記固定フレームに搭載されており、かつ、前記第2の受信機要素と通信する第2の位置センサとをさらに備える、請求項18に記載のシステム。
- 30前記回転可能リングは、前記リングの円周の周囲に位置し、かつ、前記第2の位置センサによって検出可能である複数のインデックスマーカを備え、前記固定フレームは、前記フレームの円周の周囲に位置し、かつ、前記第1の位置センサによって検出可能である複数のインデックスマーカを備える、請求項29に記載のシステム。
- 31前記第1の複数の信号は、前記第1の位置センサからのインデックスマーカデータを備え、前記第2の複数の信号は、前記第2の位置センサからのインデックスマーカデータを備え、前記システムは、前記第1の複数の信号および前記第2の複数の信号を受信および比較することにより、前記第1の複数の信号および前記第2の複数の信号の差異を識別するように構成されているコントローラをさらに備える、請求項30に記載のシステム。
- 32前記コントローラは、前記第1の複数の信号および前記第2の複数の信号の間の差異を示すための信号を生成するように構成されている、請求項31に記載のシステム。
- 33前記第1の複数の信号は、前記第1の位置センサからの前記回転可能リングの角度位置データを備え、前記第2の複数の信号は、前記第2の位置センサからの前記回転可能リングの角度位置データを備え、前記システムは、前記第1の複数の信号および前記第2の複数の信号を受信および比較することにより、前記第1の複数の信号および前記第2の複数の信号の差異を識別するように構成されているコントローラをさらに備え、前記第1の複数の信号と第2の複数の信号との間の前記差異を識別することは、前記第1の複数の信号の導関数を経時的に計算することと、前記第2の複数の信号の導関数を経時的に計算することと、前記計算された導関数の間の差異を決定することと、前記差異が事前決定された閾値を超える場合、位置センサ故障信号を生成することとを含む、請求項29に記載のシステム。
- 34前記治療放射線源は、ビーム経路に沿って放出される放射線ビームを生成するように構成されており、前記放射線ビームは、x軸側面とy軸側面とを有する2次元投影を有し、前記システムは、前記ビーム経路内に配置されているビーム限定アセンブリをさらに備え、前記ビーム限定アセンブリは、前記放射線ビームのy軸側面を成形するように構成されている上側ジョーと、前記放射線ビームのx軸側面を成形するように構成されているマルチリーフコリメータと、前記放射線ビームのy軸側面を成形するように構成されている下側ジョーであって、前記マルチリーフコリメータは、前記上側ジョーと前記下側ジョーとの間に位置する、下側ジョーとを備える、請求項1に記載のシステム。
- 35前記上側ジョーは、前記マルチリーフコリメータおよび前記下側ジョーよりも前記治療放射線源の近くに位置し、前記下側ジョーは、前記マルチリーフコリメータおよび前記上側ジョーよりも前記治療放射線源から遠くに位置する、請求項34に記載のシステム。
- 36前記治療放射線源は、線形加速器を備える、請求項34に記載のシステム。
- 37前記上側ジョーは、垂直軸に対して第1の角度で角度を付けられている内向きの面を備え、前記下側ジョーは、前記垂直軸に対して第2の角度で角度を付けられている内向きの面を備え、前記第1の角度は、前記第2の角度よりも大きい、請求項34に記載のシステム。
- 38前記放射線ビームは、ビーム広がりと、焦線によって画定されるビーム境界とを有し、前記上側ジョーは、前記焦線に沿って整合されていない内向きの面を備え、前記下側ジョーは、前記焦線に沿って整合されている内向きの面を備える、請求項34に記載のシステム。
- 39前記上側ジョーの内向きの面は、垂直軸に対して第1の角度で角度を付けられており、前記下側ジョーの内向きの面は、前記垂直軸に対して第2の角度で角度を付けられており、前記焦線は、前記垂直軸に対して第3の角度で角度を付けられている、請求項38に記載のシステム。
- 40前記第1の角度は、前記第2の角度よりも大きい、請求項39に記載のシステム。
- 41前記治療放射線源は、線形加速器(リニアック)とマグネトロンとを備える、請求項1に記載のシステム。
- 42前記マグネトロンは、前記リニアック内で電子を加速させるためのRFエネルギーを提供するように構成されており、前記マグネトロンは、中心空洞を含む1つ以上の空洞を有するリングアノードと、前記リングアノードの中心空洞内に位置するカソードとをさらに備え、前記カソード支持体は、前記カソードを前記リングアノードに結合し、前記カソード支持体の縦軸は、前記ガントリの半径方向軸に沿って整合されている、請求項41に記載のシステム。
- 43前記回転可能リングから前記固定フレームに熱を伝達する1つ以上の熱交換器を有する温度管理システムをさらに備える、請求項1に記載のシステム。
- 44前記温度管理システムは、前記回転可能リングから前記固定フレーム上の冷却流体に熱を伝達する、請求項43に記載のシステム。
- 45前記1つ以上の熱交換器は、前記回転可能リングから生成される熱を前記固定フレームに伝達するように構成されている第1のセットの熱交換器と、前記固定フレームから外部ヒートシンクに前記熱を伝達するように構成されている第2のセットの熱交換器とを備える、請求項43に記載のシステム。
- 46前記外部ヒートシンクは、閉ループ設備液体システムである、請求項45に記載のシステム。
- 47前記回転可能リングに搭載されている第2のガントリと、前記第2のガントリ上に搭載されているkVシステムとをさらに備える、請求項1に記載のシステム。
- 48前記kVシステムは、ビーム経路に沿って放出されるビームを生成するように構成されているkV放射線源と、前記第2のガントリに搭載されており、かつ、前記kV放射線源の前記ビーム経路内に配置されているコリメータとを備え、前記コリメータは、前記ビームを遮断する第1の構成と、前記ビームを伝送する第2の構成とを有する、請求項47に記載のシステム。
- 49前記コリメータは、回転することにより、前記第1の構成と第2の構成との間で遷移する、請求項48に記載のシステム。
- 50前記コリメータは、放射線遮断材料から作製されるシリンダと、前記シリンダの縦軸を横断する開口とを備え、前記第1の構成では、前記開口は、前記ビーム経路に沿って整合されておらず、前記第2の構成では、前記開口は、前記ビーム経路に沿って整合されている、請求項49に記載のシステム。
- 51前記ガントリは、ボアを備え、前記ボアは、第1の部分と第2の部分とを備え、前記第2の部分の直径は、前記第1の部分の直径よりも大きい、請求項1に記載のシステム。
- 52少なくとも前記第2の部分の領域を照明するように構成されている画像プロジェクタをさらに備える、請求項51に記載のシステム。
- 53前記画像プロジェクタからの照明は、画像およびビデオのうちの1つ以上のものを備える、請求項52に記載のシステム。
- 54前記ボアの表面に沿って配置されているフレキシブルディスプレイをさらに備える、請求項51に記載のシステム。
- 55前記フレキシブルディスプレイは、有機発光ダイオード(OLED)ディスプレイである、請求項54に記載のシステム。
- 56前記ボア内で音を出力するように構成されているオーディオデバイスをさらに備える、請求項51に記載のシステム。
- 57前記ボアの前記第2の部分を通して空気流を指向するように構成されている空気流デバイスをさらに備える、請求項51に記載のシステム。
- 58前記ボア内の患者の眼球位置および視線のうちの1つ以上のものを検出するように構成されている光学眼球追跡装置と、前記眼球位置および前記視線を使用して、前記画像プロジェクタからの照明を変化させるように構成されているプロセッサとをさらに備える、請求項54に記載のシステム。
- 59前記1つ以上のPET検出器は、前記ドラムの長さに沿って搭載されている、請求項8に記載のシステム。
- 60放射線療法システムであって、固定フレームと、 50RPM以上かつ 70RPM以下の最大速度で回転するように構成されている回転可能リングとを備えるガントリであって、前記回転可能リングは、ドラムを備え、前記ドラムは、リング状の第1の端面と、前記第1の端面の反対側のリング状の第2の端面と、前記リング状の第1の端面と前記リング状の第2の端面との間の長さに沿って延在するリブ構造とを有し、前記回転可能リングが前記最大速度で回転するときに前記第1の端面の長さと前記第2の端面の長さとの間の長さの変化が0.5mm未満である、ガントリと、前記固定フレームと前記回転可能リングとの間に位置するスリップリングであって、前記回転可能リングが前記最大速度で回転している間に前記固定フレームと前記回転可能リングとの間で電気信号を通信するように構成されているスリップリングと、線形加速器(リニアック)とマグネトロンとを備える治療放射線源であって、前記リニアックは、第1の搭載アセンブリによって前記ドラムの長さに沿って取り付けられており、かつ、前記リニアックおよび第1の搭載アセンブリから分離している放射線遮蔽内に封入されており、前記マグネトロンは、前記マグネトロンのカソード支持体が、前記回転可能リングが前記最大速度で回転している間に生成される求心力の方向と整合されるように、前記ドラムの長さに沿って半径方向に搭載されている、治療放射線源と、前記ドラムの長さに沿って搭載されている1つ以上の陽電子消滅放出(PET)検出器とを備える、放射線療法システム。
- 61前記回転可能リングから前記固定フレーム上の冷却流体に熱を伝達する1つ以上の熱交換器を有する温度管理システムをさらに備える、請求項60に記載のシステム。
Independent claims61
135 paragraphs, as filed
CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Provisional Patent Application No. 62/422,404, filed November 15, 2016, the disclosure of which is incorporated by reference in its entirety. is incorporated herein by reference.
The present invention relates to systems, devices and methods for control of radiation therapy. The systems, devices, and methods can be used for emission-stimulated high-energy photon delivery.
Radiation therapy involves directing radiation at a tumor from one or more directions. In some radiation therapy systems, a radiation source mounted on a gantry rotates around a patient on a table or bed and directs radiation toward the patient's tumor. As the radiation source rotates around the patient, the patient table or couch may be moved in a direction that is parallel to the axis of rotation of the radiation source. In this manner, radiation is applied to a patient's tumor from different gantry angles at different patient table or couch positions based on images of the patient and tumor generated by different imaging modalities prior to the treatment session. may be
Emission-guided radiation therapy (EGRT) applies radiation based on the positron emission pathway emitted by a positron emission tomography (PET) tracer localized to the tumor during the treatment session. In addition to the radiation source for therapeutically irradiating the tumor area, the EGRT system also has an array of PET detectors for sensing positron emission pathways occurring within the tumor area, which can provide real-time location data. This may reduce the latency between tumor localization and irradiation of the tumor. The gantry of a guided-emission radiotherapy system may rotate at speeds ranging from about 10 revolutions per minute (RPM) to about 70 RPM for timely response to detection of positron emission pathways that indicate the real-time location of the tumor. . Improvements in the gantry rotation mechanism, radiation sources, and/or radiation sensors (eg, PET detectors, gamma ray or X-ray detectors, etc.) may be desirable to accommodate this increased gantry rotation speed. Conversely, an increase in temporal resolution in a PET detector may decrease the required rotational latency due to the limited spatial extent of these events coupled with the temporal resolution of PET events.
<p>Disclosed herein are radiation therapy systems and methods. The radiotherapy system may comprise a gantry comprising a stationary frame and a rotatable ring configured to rotate up to about 70 RPM. A radiotherapy system includes a therapeutic radiation source, one or more beam shaping components, and an imaging system (e.g., one or more PET detectors, kV CT imaging system) and supporting electronics mounted on a rotatable ring. These components may be mounted and arranged on the rotatable ring such that mechanical forces and/or other perturbations due to high speed ring rotation (e.g., above about 50 RPM) do not interfere with their function. good. The radiotherapy system also transfers heat generated by components on the rotatable ring (and heat generated by rotating the ring at speeds up to 70 RPM) to the facility cooling system through the stationary frame. A temperature management system may be provided, configured to: These radiation therapy systems and methods are directed emission-directed radiation, in which gamma rays from markers or tracers localized to a patient target area (e.g., tumor area) can be detected and used to direct the radiation to the target area. It may also be used for biologically guided radiation therapy such as therapy. These systems and methods also reduce radiation exposure or delivery to non-target areas such as normal or healthy tissue surrounding tumors and/or radiation sensitive structures or organs (eg, organs at risk). can help with that.</p><p>A drum may be provided having a length therebetween such that it is less than 5 mm. The system further includes a slip ring positioned between the fixed frame and the rotatable ring and configured to communicate electrical signals therebetween while the rotatable ring rotates up to about 70 RPM; A therapeutic radiation source comprising an accelerator (linac) and a magnetron, one or more PET detectors mounted along the length of the drum, and heat transfer from the rotatable ring to the cooling fluid on the stationary frame. and a temperature management system. A linac may be mounted along the length of the drum by a first mounting assembly and enclosed in a radiation shield separate from the linac and the first mounting assembly, the magnetron having a cathode support for the magnetron. , may be mounted radially along the length of the drum to align with the direction of the centripetal force generated while the rotatable ring rotates up to about 70 RPM. The radiation shield may be mounted to the gantry using a second mounting assembly separate from the first mounting assembly. For example, the second mounting assembly may not directly contact the first mounting assembly, and/or the first and second mounting assemblies may be separated by an air gap, and/or The linac and radiation shield are separated by an air gap. The radiation shield and second mounting assembly may not touch the linac. Optionally, some variations comprise an actuator coupled to the linac and the first mounting assembly using a ball screw such that the location of the linear accelerator is configured to be adjusted by the actuator. may The actuator may or may not be removable and/or may be controllable from a remote location, such as a location outside the room in which the rotatable gantry is located.</p><p>The system may also include a first controller located on the rotatable ring and a second controller on the fixed frame. A first controller may generate control commands for the therapeutic radiation source and one or more PET detectors, a second controller may generate control commands for the gantry motion system, Synchronization data between the first controller and the second controller may be transferred via the slip ring. Activation of the therapeutic radiation source and acquisition of PET data may be based on signals generated by a first controller, rotation of the ring may be based on signals generated by a second controller, and synchronization Signals may be transmitted between processors via slip rings to synchronize activation of therapeutic radiation sources, acquisition of PET data, and gantry motion. In some variations, the slip ring may comprise a data brush block and a power brush block. The system is further configured with a first receiver element mounted on the rotatable ring and transmitting the first plurality of signals to the first receiver element while the rotatable ring is moving. a first transmitter element mounted on the fixed frame, a second transmitter element mounted on the rotatable ring, and a second receiver mounted on the fixed frame and a second communication interface, comprising: A second transmitter element may be configured to transmit a second plurality of signals to a second receiver element while the rotatable ring is moving. A first plurality of signals may be transmitted across a first communication interface and a second plurality of signals (eg, gantry rotation speed data, positron emission data from one or more positron emission detectors, , radiation data from a radiation detector mounted on a rotatable ring opposite the therapeutic radiation source) may be simultaneously transmitted across the second communication interface. In some variations the system is placed in front of the radiation source. A multi-leaf collimator positioned in the multi-leaf collimator transmits position data of individual leaves of the multi-leaf collimator to a second transmitter element for transmission to a second receiver element. It may be configured as A second controller may communicate with the first transmitter element, the first plurality of signals comprising radiation source commands from the second controller. Alternatively or additionally, the first plurality of signals may comprise multi-leaf collimator commands and/or gantry rotation commands from the second controller. The first communication interface and the second communication interface may transmit signals using inductive signal transfer methods or capacitive signal transfer methods.</p><p>Some variations further include a first position sensor mounted on the rotatable ring and communicating with the first receiver element and a second position sensor mounted on the fixed frame and communicating with the second receiver element. position sensors. The rotatable ring may comprise a plurality of locators or index markers positioned around the circumference of the ring and detectable by a second position sensor, and the fixed frame positioned around the circumference of the frame. but may comprise a plurality of locators or index markers detectable by the first position sensor. The first plurality of signals may comprise index marker data from the first position sensor and the second plurality of signals may comprise index marker data from the second position sensor. The first and/or second controller may be configured to receive and compare the first and second plurality of signals and identify differences between the first and second plurality of signals. The first and/or second controller may be configured to generate a signal to indicate the difference between the first and second plurality of signals. The first plurality of signals may comprise angular position data of the rotatable ring from the first position sensor and the second plurality of signals may comprise angular position data of the rotatable ring from the second position sensor. may be provided. The system may further comprise a controller configured to receive and compare the first and second plurality of signals and identify differences between the first and second plurality of signals. One variation of a method for identifying differences between a first plurality of signals and a second plurality of signals includes the steps of calculating the derivative of the first plurality of signals over time; calculating the derivative of the second plurality of signals to , determining a difference between the calculated derivatives, and generating a position sensor failure signal if the difference exceeds a predetermined threshold. and may include</p><p>In some variations, the system may further comprise a housing defining a volume enclosing the gantry. The housing may include one or more side hatches along the length of the drum configured to allow access to the therapeutic radiation source and one or more PET detectors. The radiation therapy system also includes a plurality of rotor elements around the rotatable ring, a stator element enclosed within a stationary frame opposite the rotor elements, and ball bearings positioned adjacent to the plurality of rotor elements. and an exercise system. One or more rotor elements may comprise one or more magnetic or inductive elements and the stator elements may comprise coils.</p><p>The radiation therapy system may also comprise a therapeutic radiation source configured to produce a radiation beam emitted along the beam path, the radiation beam having an x-axis side and a y-axis side. Having a two-dimensional projection, the system further comprises a beam limiting assembly positioned within the beam path. One variation of the beam-defining assembly includes an upper jaw configured to shape the y-axis side of the radiation beam, a multi-leaf collimator configured to shape the x-axis side of the radiation beam, and a radiation beam a lower jaw configured to shape the y-axis side of the . A multi-leaf collimator may be located between the upper and lower jaws. The upper jaw may be located closer to the radiation source than the multi-leaf collimator and lower jaw, and the lower jaw may be located further from the radiation source than the multi-leaf collimator and upper jaw. The upper jaw may comprise an inwardly facing surface angled at a first angle with respect to the vertical axis and the lower jaw may comprise an inwardly facing surface angled at a second angle with respect to the vertical axis. A face may be provided and the first angle may be less than the second angle. The radiation beam may have a beam divergence and a beam boundary defined by a focal line, and the upper jaw may comprise an inwardly facing surface that is misaligned along the focal line and the lower jaw. . The inwardly facing surface of the upper jaw may be angled at a first angle with respect to the vertical axis and the inwardly facing surface of the lower jaw is angled at a second angle with respect to the vertical axis. and the focal line may be angled at a third angle with respect to the vertical axis. The first angle can be less than the second angle.</p><p>A magnetron of the radiation therapy system may be configured to provide RF energy to accelerate electrons within the linac. The magnetron may comprise a ring anode having one or more cavities, including a central cavity, and a cathode located within the central cavity of the ring anode, the cathode support having a longitudinal axis of the cathode support extending from the gantry. The cathode may be bonded to the ring anode so that it is aligned along the radial axis of the .</p><p>In some variations, the thermal management system includes a first set of heat exchangers configured to transfer heat generated from the rotating ring to the fixed frame and heat transfer from the fixed frame to an external heat sink. and a second set of heat exchangers configured to. For example, the external heat sink may be a closed loop facility liquid system.</p><p>Optionally, some variations of radiation therapy systems may comprise a second gantry mounted on a rotatable ring and a kV system mounted on the second gantry. The kV system may comprise a kV radiation source and a rotatable collimator positioned within the beam path of the kV radiation source. The rotatable collimator may have a first configuration for blocking the beam and a second configuration for transmitting the beam. Rotating the rotatable collimator may transition between a first configuration and a second configuration. The rotatable collimator may comprise a cylinder made of radiation blocking material and an aperture transverse to the longitudinal axis of the cylinder. In a first configuration the aperture may not be aligned along the beam path and in a second configuration the aperture may be aligned along the beam path.</p><p>One variation of the radiation therapy device may comprise a rotatable gantry comprising a bore and a radiation source coupled to the gantry. The bore of the rotatable gantry may comprise a first portion and a second portion, the diameter of the second portion being greater than the diameter of the first portion. In one variant, at least one region of the second portion may comprise an ellipsoid. The radiation therapy device may further comprise an image projector configured to illuminate at least one area of the second portion. Illumination may comprise one or more images and/or videos. The radiotherapy device or system may optionally include a flexible display positioned along the surface of the bore. The flexible display may be an organic light emitting diode (OLED) display. In some variations, the radiotherapy device may comprise an audio device configured to output sound within the bore. Optionally, the radiotherapy system may comprise an airflow device configured to direct airflow through the second portion of the bore. Some variations use an optical eye tracker configured to detect one or more of a patient's eye position and line of sight within the bore, and the eye position and line of sight to determine illumination. and a processor configured to change. A gantry corresponding to the first portion may be rotatable and one or more of the gantry corresponding to the second portion and the radiation source may be fixed. The first portion may comprise a first end and a second end, the first end may comprise a circular opening, the second portion may comprise a second An enclosure may be provided coupled to the ends. In some examples, the diameter of the first portion can be substantially constant and the diameter of the second portion can vary. In other examples, the diameter of the second portion can exceed the diameter of the first portion by up to about four times.</p><p>Herein, a rotatable gantry comprising a patient region and configured to receive a patient on a patient platform and output a beam from a radiation source; and a rotatable gantry configured to identify the patient in the patient region. , a patient location system, a microphone array and a speaker array positioned in a patient area, identifying patient ears using the patient location system, and noise cancellation using the microphone array and ear locations. Another variation of a radiation therapy system is described, comprising a processor configured to generate a signal. The speaker array may be configured to output noise cancellation signals. In some variations, the microphone array and speaker array may be located within the end of the gantry. Also herein, receiving location data for a patient's ear positioned within a patient treatment area of a radiation therapy system; and receiving noise generated from the radiation therapy system using a microphone array. a method of noise cancellation for a radiation therapy system, which may include using ear location data and received noise to generate a noise cancellation signal; and outputting the cancellation signal from a speaker array. explained. The method may optionally include imaging the patient to generate ear location data.</p><p>Also disclosed herein are methods of treating radiation therapy patients. One variation of such a method includes the steps of aligning a first patient's body to a first patient platform using an alignment system located within the alignment chamber; moving a first patient's body on a first patient platform into a room and docking the first patient platform to a radiation therapy system located in a radiation therapy room, the docking comprising: The steps may include moving a first patient platform into a patient treatment area of a radiation therapy system and treating the first patient using the radiation therapy system. Some methods may further include performing each of the above steps with respect to a second patient and a second patient platform after completing each step with the first patient. The method may include administering the radioisotope to the first patient in the dosing chamber and moving the first patient from the dosing chamber to the alignment chamber. These steps are performed for the second patient and the second patient platform after completing each step for the first patient, and for the third patient after completing each step for the second patient. may</p><p>Disclosed herein is one variation of a method of operating a radiation therapy system comprising a rotatable gantry and a rotatable gantry positioned in a patient area of the gantry and configured to move relative to the gantry. A radiation therapy system comprising a patient platform, a gantry-mounted collimator comprising a plurality of leaves configured to open and close from a plurality of gantry angles, and a radiation source coupled to the collimator. receiving a treatment plan for a patient comprising providing a set of open leaves and corresponding gantry angles; outputting a radiation beam from a collimator using the radiation source and the treatment plan; and Varying velocities of one or more of the patient platform and the gantry using the plan. In some variations, the method may include prioritizing collimator velocity over patient platform and gantry velocity. Prioritizing the speed of the collimator may include varying the speed of one or more of the patient platform and the gantry to maintain the speed of the collimator. In some methods, patient platform velocity may be increased in the absence of radiation beam emission. Alternatively or additionally, the gantry speed may be constant and the patient platform speed may vary, or the patient platform speed may be constant and the gantry speed may vary.</p><p>Disclosed herein is a variation of a method of identifying a patient anatomy, comprising the steps of coupling a radioactive reference to the exterior of the patient (the radioactive reference corresponds to the patient anatomy); and identifying a patient coupled to the patient platform; and using the locations of the radioactive fiducials to align the patient anatomy to the patient platform. The radioactive reference may comprise a hydrogel and/or may be a point source of approximately 500 kilovolts. In some variations, the method may include treating the patient using a radiotherapy beam in combination with a radioactive reference coupled to the patient. The method may optionally include identifying radioactive fiducials concurrently with treating and using the location data to determine movement of the patient's anatomy. In some variations, the method may include coupling a metal fiducial to the exterior of the patient, the metal fiducial corresponding to patient anatomy; and identifying the metal fiducial. . The exterior may comprise one or more of the skin, the patient's orifice, the sternum, and the buttocks. In some variations, the method may include marking the patient at a first skin location corresponding to the patient's anatomy, and the radioactive reference may be coupled to the patient at the first location. Alternatively or additionally, the radioactive reference may comprise an aperture block configured for insertion within the aperture and/or coupled to patient clothing configured to be worn on the patient. good too.</p><p>Another variation of the method for identifying patient anatomy comprises the steps of identifying an internal region of interest in the patient, embedding a radioactive fiducial into the region of interest, and identifying the patient coupled to the radioactive fiducial and patient platform. and registering the region of interest to the patient platform using the location of the radioactive fiducials. The implanted radioactive standards may include one or more of hydrogels and tracers.</p><p>Also herein, a rotatable gantry, a linear accelerator mounted to the gantry using a first mounting assembly, and a second linear accelerator disposed across the linear accelerator and separate from the first mounting assembly. Also disclosed is a variation of a radiation therapy system that is mounted to the gantry using a mounting assembly and may include a radiation shield. For example, the second mounting assembly may not directly contact the first mounting assembly and/or the first mounting assembly and the second mounting assembly are separated by an air gap. The radiation shield and the second mounting assembly may not contact the linac, for example the linac and the radiation shield may be separated by an air gap. In some variations, the gantry may comprise a housing with an exterior surface and an interior surface, the first mounting assembly may be attached to the interior surface, and the second mounting assembly may be attached to the exterior surface. may be attached to the The system may optionally comprise an actuator coupled to the first mounting assembly using a ball screw such that the actuator is coupled to the linear accelerator. The actuator may be configured to adjust the location of the linear accelerator. The actuator may be removable and/or controllable from a remote location. For example, the rotatable gantry may be located inside a room and the remote location may be outside the room.</p><p>Here, a rotatable gantry comprising a rotatable ring movably coupled to a fixed frame, a radiation source mounted on the rotatable ring, and a first receiver element mounted on the rotatable ring and a first transmitter element mounted on a fixed frame configured to transmit the first plurality of signals to the first receiver element while the rotatable ring is moving; A second communication interface comprising a first communication interface, a second transmitter element mounted on the rotatable ring, and a second receiver element mounted on the fixed frame, wherein the second and a second communication interface configured to transmit a second plurality of signals to a second receiver element while the rotatable ring is moving. A modification of is disclosed. In some variations, a first plurality of signals may be transmitted across a first communication interface and a second plurality of signals are simultaneously transmitted across a second communication interface. may Some variations may comprise a multi-leaf collimator positioned in front of the radiation source, the multi-leaf collimator separating individual leaves of the multi-leaf collimator for transmission to the second receiver element. It may be arranged to transmit the position data to the second transmitter element. The second plurality of signals may comprise gantry rotational speed data. Some variations may also comprise one or more positron emission detectors and the second plurality of signals comprise positron emission data from the one or more positron emission detectors. The system may comprise a radiation detector mounted on the rotatable ring opposite the therapeutic radiation source, the second plurality of signals comprising radiation data from the radiation detector. A controller may be located on the fixed frame and communicate with the first transmitter element, and the first plurality of signals may comprise radiation source commands from the controller. The system may comprise a multi-leaf collimator positioned in front of the radiation source, wherein the first plurality of signals are received from the controller. Equipped with a multi-leaf collimator command. The first plurality of signals may comprise gantry rotation commands from the second controller. In some variations, the first communication interface and the second communication interface may transmit signals using inductive signal transfer methods. Optionally, the system includes a first position sensor mounted on the rotatable ring and communicating with the first receiver element and a second position sensor mounted on the fixed frame and communicating with the second receiver element. and a position sensor. The rotatable ring may comprise a plurality of index markers located around the circumference of the ring and detectable by the second position sensor, the stationary frame located around the circumference of the frame, A plurality of index markers may be provided that are detectable by the first position sensor. The first plurality of signals may comprise index marker data from the first position sensor and the second plurality of signals comprise index marker data from the second position sensor. The system may further comprise a controller configured to receive and compare the first and second plurality of signals and identify differences between the first and second plurality of signals. For example, the controller may be configured to generate a signal to indicate the difference between the first and second plurality of signals. The first plurality of signals may comprise angular position data of the rotatable ring from the first position sensor and the second plurality of signals may comprise angular position data of the rotatable ring from the second position sensor. Prepare. The system may further comprise a controller configured to receive and compare the first and second plurality of signals and identify differences between the first and second plurality of signals. Identifying differences between the first plurality of signals and the second plurality of signals includes calculating the derivative of the first plurality of signals over time; calculating a derivative of the signal; determining a difference between the calculated derivative; and generating a position sensor failure signal if the difference exceeds a predetermined threshold.</p><p>As used herein, a radiation source configured to produce a radiation beam emitted along a beam path, the radiation beam having a two-dimensional projection having an x-axis side and a y-axis side. A variation of a radiation therapy system is described that may include a radiation source having a radiation source and a beam limiting assembly positioned within the beam path. The beam defining assembly includes an upper jaw configured to shape a y-axis side of the radiation beam, a multi-leaf collimator configured to shape an x-axis side of the radiation beam, and a y-axis side of the radiation beam. The multi-leaf collimator may comprise a lower jaw positioned between the upper and lower jaws. In some examples, the upper jaw may be located closer to the radiation source than the multi-leaf collimator and the lower jaw, and the lower jaw is located further from the radiation source than the multi-leaf collimator and the upper jaw. You may The radiation source may comprise a linear accelerator. The upper jaw may comprise an inwardly facing surface angled at a first angle with respect to the vertical axis and the lower jaw may comprise an inwardly facing surface angled at a second angle with respect to the vertical axis. A face may be provided, the first angle being less than the second angle. The radiation beam may have a beam divergence and a beam boundary defined by a focal line, and the upper jaw may comprise an inwardly facing surface that is misaligned along the focal line and the lower jaw. . The inwardly facing surface of the upper jaw may be angled at a first angle with respect to the vertical axis and the inwardly facing surface of the lower jaw is angled at a second angle with respect to the vertical axis. and the focal line may be angled at a third angle with respect to the vertical axis, the first angle being less than the second angle.</p><p>Also described herein is a rotatable gantry comprising a rotatable ring movably coupled to a stationary frame, the rotatable gantry having a radial axis and a linear gantry mounted on the rotatable ring. A variation of a radiation therapy system is also disclosed that may comprise an accelerator and a magnetron mounted on a rotatable ring configured to provide RF energy for accelerating electrons in a linear accelerator. The magnetron comprises: a ring anode having one or more cavities including a central cavity; a cathode located within the central cavity of the ring anode; a cathode support coupling the cathode to the ring anode; The longitudinal axis of may comprise the cathode support aligned along the radial axis of the gantry. Rotation of the rotatable ring may produce a directional centripetal force, and the longitudinal axis of the cathode support may be aligned along the direction of the centripetal force.</p><p>Provided herein is a gantry configured to rotate at a speed of at least 30 RPM, the gantry comprising a fixed frame and a rotatable ring coupled to the fixed frame; a first set of heat exchangers configured to transfer heat generated from the rotating ring to a stationary frame; and a first set of heat exchangers configured to transfer heat from the stationary frame to an external heat sink. A radiation therapy system is described that may comprise a temperature management system comprising a second set of heat exchangers. The external heat sink may be a closed loop facility liquid system.</p><p><u style="Single">The present invention provides, for example, the following.</u><u style="Single">(Item 1)</u><u style="Single"> A radiotherapy system comprising:</u><u style="Single"> A gantry comprising a stationary frame and a rotatable ring configured to rotate up to about 70 RPM, said rotatable ring comprising a drum, said drum comprising a first ring-shaped end surface; a second ring-shaped end face opposite said first end face; a gantry having a length between one end face and said second end face;</u><u style="Single"> located between the stationary frame and the rotatable ring and configured to communicate electrical signals between the stationary frame and the rotatable ring while the rotatable ring rotates up to about 70 RPM; a slip ring that is</u><u style="Single"> A therapeutic radiation source comprising a linear accelerator (linac) and a magnetron, the linac mounted along the length of the drum by a first mounting assembly and separate from the linac and the first mounting assembly. and the magnetron is positioned such that the cathode support of the magnetron is aligned with the direction of the centripetal force generated while the rotatable ring rotates up to about 70 RPM. a therapeutic radiation source mounted radially along the length of the drum;</u><u style="Single"> one or more PET detectors mounted along the length of the drum;</u><u style="Single"> a thermal management system that transfers heat from the rotatable ring to a cooling fluid on the stationary frame;</u><u style="Single"> A system comprising:</u><u style="Single">(Item 2)</u><u style="Single"> Further comprising a first controller located on the rotatable ring and a second controller on the stationary frame, the first controller for the therapeutic radiation source and the one or more PET detectors. wherein the second controller generates control commands for a gantry motion system, synchronization data between the first controller and the second controller for controlling the slip ring; The system of item 1, transferred via.</u><u style="Single">(Item 3)</u><u style="Single"> Activation of the therapeutic radiation source and acquisition of PET data is based on signals generated by the first controller, rotation of the ring is based on signals generated by the second controller, and synchronization signals are based on signals generated by the second controller. , is transmitted between processors via the slip ring to synchronize activation of the therapeutic radiation source, acquisition of PET data, and gantry motion.</u><u style="Single">(Item 4)</u><u style="Single"> The system of item 1, wherein the slip ring comprises a data brush block and a power brush block.</u><u style="Single">(Item 5)</u><u style="Single"> further comprising a housing defining a volume enclosing the gantry, wherein the housing is configured to allow access to the therapeutic radiation source and one or more PET detectors along the length of the drum A system according to item 1, comprising one or more side hatches along.</u><u style="Single">(Item 6)</u><u style="Single"> a plurality of rotor elements around said rotatable ring; stator elements enclosed within said stationary frame opposite said rotor elements; and ball bearings located adjacent said plurality of rotor elements. The system of item 1, further comprising an exercise system comprising:</u><u style="Single">(Item 7)</u><u style="Single"> 7. The system of item 6, wherein the one or more rotor elements comprise one or more magnetic or inductive elements and the stator elements comprise coils.</u><u style="Single">(Item 8)</u><u style="Single"> The system of item 1, wherein the radiation shield is mounted on the gantry using a second mounting assembly separate from the first mounting assembly.</u><u style="Single">(Item 9)</u><u style="Single"> 9. The system of item 8, wherein the second mounting assembly does not directly contact the first mounting assembly.</u><u style="Single">(Item 10)</u><u style="Single"> 9. The system of item 8, wherein the first mounting assembly and the second mounting assembly are separated by an air gap.</u><u style="Single">(Item 11)</u><u style="Single"> 9. The system of item 8, wherein the radiation shield and the second mounting assembly do not contact the linac.</u><u style="Single">(Item 12)</u><u style="Single"> 9. The system of item 8, wherein the linac and the radiation shield are separated by an air gap.</u><u style="Single">(Item 13)</u><u style="Single"> 9. The system of item 8, further comprising an actuator coupled to the linac and the first mounting assembly using a ball screw, wherein the location of the linac is configured to be adjusted by the actuator.</u><u style="Single">(Item 14)</u><u style="Single"> 14. The system of item 13, wherein the actuator is removable.</u><u style="Single">(Item 15)</u><u style="Single"> 14. The system of item 13, wherein the actuator is controllable from a remote location.</u><u style="Single">(Item 16)</u><u style="Single"> 16. The system of item 15, wherein the rotatable gantry is located inside a room and the remote location is outside the room.</u><u style="Single">(Item 17)</u><u style="Single"> A first receiver element mounted on the rotatable ring and configured to transmit a first plurality of signals to the first receiver element while the rotatable ring is moving. a first communication interface comprising a first transmitter element mounted on the fixed frame;</u><u style="Single"> a second communication interface comprising a second transmitter element mounted on said rotatable ring and a second receiver element mounted on said fixed frame, said second transmitter element comprising: a second communication interface configured to transmit a second plurality of signals to the second receiver element while the rotatable ring is moving;</u><u style="Single"> The system of item 1, further comprising:</u><u style="Single">(Item 18)</u><u style="Single"> 18. The method of item 17, wherein the first plurality of signals are transmitted across the first communication interface and the second plurality of signals are simultaneously transmitted across the second communication interface. system.</u><u style="Single">(Item 19)</u><u style="Single"> Further comprising a multi-leaf collimator positioned in front of the radiation source, the multi-leaf collimator transmitting position data of individual leaves of the multi-leaf collimator to the second receiver element for transmission to the second receiver element. 18. The system of item 17, configured to transmit to two transmitter elements.</u><u style="Single">(Item 20)</u><u style="Single"> 18. The system of item 17, wherein the second plurality of signals comprises gantry rotational speed data.</u><u style="Single">(Item 21)</u><u style="Single"> 18. The system of item 17, wherein the second plurality of signals comprises positron emission data from one or more positron emission detectors.</u><u style="Single">(Item 22)</u><u style="Single"> 18. The system of item 17, further comprising a radiation detector mounted on the rotatable ring opposite the therapeutic radiation source, wherein the second plurality of signals comprises radiation data from the radiation detector.</u><u style="Single">(Item 23)</u><u style="Single"> 18. The system of item 17, wherein the second controller communicates with the first transmitter element and the first plurality of signals comprises radiation source commands from the second controller.</u><u style="Single">(Item 24)</u><u style="Single"> 24. The system of item 23, further comprising a multi-leaf collimator positioned in front of the radiation source, wherein the first plurality of signals comprises multi-leaf collimator commands from the second controller.</u><u style="Single">(Item 25)</u><u style="Single"> 24. The system of item 23, wherein the first plurality of signals comprises gantry rotation commands from the second controller.</u><u style="Single">(Item 26)</u><u style="Single"> 18. The system of item 17, wherein the first communication interface and the second communication interface transmit signals using an inductive signal transfer method.</u><u style="Single">(Item 27)</u><u style="Single"> 18. The system of item 17, wherein the first communication interface and the second communication interface transmit signals using capacitive signal transfer methods.</u><u style="Single">(Item 28)</u><u style="Single"> further comprising: a first position sensor mounted on said rotatable ring and in communication with said first receiver element; and a second position sensor mounted on said fixed frame in communication with said second receiver element. 18. The system of item 17, comprising:</u><u style="Single">(Item 29)</u><u style="Single"> The rotatable ring comprises a plurality of index markers located around the circumference of the ring and detectable by the second position sensor, and the fixed frame is located around the circumference of the frame. , comprising a plurality of index markers detectable by said first position sensor.</u><u style="Single">(Item 30)</u><u style="Single"> The first plurality of signals comprises index marker data from the first position sensor and the second plurality of signals comprises index marker data from the second position sensor, the system further comprising: 30. The system of claim 29, comprising a controller configured to receive and compare said first and second plurality of signals and to identify differences between said first and second plurality of signals.</u><u style="Single">(Item 31)</u><u style="Single"> 31. The system of item 30, wherein the controller is configured to generate a signal to indicate the difference between the first and second plurality of signals.</u><u style="Single">(Item 32)</u><u style="Single"> The first plurality of signals comprises angular position data of the rotatable ring from the first position sensor and the second plurality of signals comprises angular position data of the rotatable ring from the second position sensor. position data, the system further comprising a controller configured to receive and compare the first and second plurality of signals and identify differences between the first and second plurality of signals; , identifying the difference between the first plurality of signals and the second plurality of signals;</u><u style="Single"> calculating the derivative of the first plurality of signals over time;</u><u style="Single"> calculating the derivative of the second plurality of signals over time;</u><u style="Single"> determining the difference between the calculated derivatives;</u><u style="Single"> generating a position sensor failure signal if the difference exceeds a predetermined threshold;</u><u style="Single"> 29. The system of item 28, comprising:</u><u style="Single">(Item 33)</u><u style="Single"> said therapeutic radiation source configured to produce a radiation beam emitted along a beam path, said radiation beam having a two-dimensional projection having an x-axis side and a y-axis side, said system further comprises a beam-defining assembly disposed within said beam path, said beam-defining assembly comprising:</u><u style="Single"> an upper jaw configured to shape a y-axis side of the radiation beam;</u><u style="Single"> a multi-leaf collimator configured to shape an x-axis side of the radiation beam;</u><u style="Single"> a lower jaw configured to shape a y-axis side of the radiation beam, the multi-leaf collimator being positioned between the upper and lower jaws;</u><u style="Single"> The system of item 1, comprising:</u><u style="Single">(Item 34)</u><u style="Single"> the upper jaw is located closer to the radiation source than the multi-leaf collimator and the lower jaw, and the lower jaw is located further from the radiation source than the multi-leaf collimator and the upper jaw; A system according to item 33.</u><u style="Single">(Item 35)</u><u style="Single"> 34. The system of item 33, wherein the radiation source comprises a linear accelerator.</u><u style="Single">(Item 36)</u><u style="Single"> The upper jaw comprises an inwardly facing surface angled at a first angle with respect to a vertical axis and the lower jaw has an inwardly facing surface angled at a second angle with respect to the vertical axis. 34. The system of item 33, wherein the first angle is less than the second angle.</u><u style="Single">(Item 37)</u><u style="Single"> Item 33, wherein the radiation beam has a beam divergence and a beam boundary defined by a focal line, and the upper jaw comprises an inwardly facing surface that is misaligned along the focal line and the lower jaw. The system described in .</u><u style="Single">(Item 38)</u><u style="Single"> The inward facing surface of the upper jaw is angled at a first angle with respect to the vertical axis and the inward facing surface of the lower jaw is angled at a second angle with respect to the vertical axis. 38. The system of item 37, wherein the focal line is angled at a third angle with respect to the vertical axis.</u><u style="Single">(Item 39)</u><u style="Single"> 39. The system of item 38, wherein the first angle is less than the second angle.</u><u style="Single">(Item 40)</u><u style="Single"> The magnetron is configured to provide RF energy for accelerating electrons within the linac, the magnetron further comprising:</u><u style="Single"> a ring anode having one or more cavities including a central cavity;</u><u style="Single"> a cathode located within the central cavity of said ring anode;</u><u style="Single"> wherein the cathode support couples the cathode to the ring anode, the longitudinal axis of the cathode support being aligned along the radial axis of the gantry;</u><u style="Single"> The system of item 1.</u><u style="Single">(Item 41)</u><u style="Single"> The thermal management system includes a first set of heat exchangers configured to transfer heat generated from the rotating ring to the fixed frame; and a second set of heat exchangers configured to:</u><u style="Single">(Item 42)</u><u style="Single"> 42. The system of item 41, wherein the external heat sink is a closed loop facility liquid system.</u><u style="Single">(Item 43)</u><u style="Single"> The system of item 1, further comprising a second gantry mounted on said rotatable ring and a kV system mounted on said second gantry.</u><u style="Single">(Item 44)</u><u style="Single"> The kV system comprises a kV radiation source and a rotatable collimator positioned in a beam path of the kV radiation source, the rotatable collimator having a first configuration to block the beam and a first configuration to transmit the beam. 44. The system of item 43, having a second configuration of:</u><u style="Single">(Item 45)</u><u style="Single"> 45. The system of item 44, wherein the rotatable collimator rotates to transition between the first configuration and the second configuration.</u><u style="Single">(Item 46)</u><u style="Single"> The rotatable collimator comprises a cylinder made of radiation blocking material and an aperture transverse to the longitudinal axis of the cylinder, wherein in the first configuration the aperture is aligned along the beam path. 46. The system of item 45, wherein first, in the second configuration, the aperture is aligned along the beam path.</u><u style="Single">(Item 47)</u><u style="Single"> 2. The method of claim 1, wherein the rotatable gantry comprises a bore, the bore comprising a first portion and a second portion, the diameter of the second portion being greater than the diameter of the first portion. system.</u><u style="Single">(Item 48)</u><u style="Single"> 48. The system of item 47, further comprising an image projector configured to illuminate at least an area of the second portion.</u><u style="Single">(Item 49)</u><u style="Single"> 49. The system of item 48, wherein the illumination comprises one or more of images and video.</u><u style="Single">(Item 50)</u><u style="Single"> 48. The system of item 47, further comprising a flexible display positioned along the surface of the bore.</u><u style="Single">(Item 51)</u><u style="Single"> 51. The system of item 50, wherein the flexible display is an organic light emitting diode (OLED) display.</u><u style="Single">(Item 52)</u><u style="Single"> 48. The system of item 47, further comprising an audio device configured to output sound within the bore.</u><u style="Single">(Item 53)</u><u style="Single"> 48. The system of item 47, further comprising an airflow device configured to direct airflow through a second portion of the bore.</u><u style="Single">(Item 54)</u><u style="Single"> an optical eye tracker configured to detect one or more of a patient's eye position and line of sight within said bore; and using said eye position and said line of sight to vary said illumination. 51. The system of item 50, further comprising a processor configured to:</u><u style="Single">(Item 55)</u><u style="Single"> A radiotherapy system comprising:</u><u style="Single"> a rotatable gantry, said rotatable gantry having a patient region, said rotatable gantry configured to receive a patient on a patient platform and output a beam from a radiation source;</u><u style="Single"> a patient location system configured to identify the patient within the patient area;</u><u style="Single"> a microphone array and a speaker array positioned in the patient area;</u><u style="Single"> a processor configured to identify a patient's ear using the patient location system and to generate a noise cancellation signal using the microphone array and the ear location, the speaker array comprising: is configured to output said noise cancellation signal; and</u><u style="Single"> A system comprising:</u><u style="Single">(Item 56)</u><u style="Single"> 56. The system of item 55, wherein the microphone array and speaker array are located within an end of the gantry.</u><u style="Single">(Item 57)</u><u style="Single"> A method of noise cancellation for a radiation therapy system comprising:</u><u style="Single"> receiving location data for a patient's ear positioned within a patient treatment area of a radiation therapy system;</u><u style="Single"> receiving noise generated from the radiation therapy system using a microphone array;</u><u style="Single"> generating a noise cancellation signal using the ear location data and the received noise;</u><u style="Single"> outputting the erasing signal from a speaker array;</u><u style="Single"> A method, including</u><u style="Single">(Item 58)</u><u style="Single"> 58. The method of item 57, further comprising imaging the patient to generate the ear location data.</u><u style="Single">(Item 59)</u><u style="Single"> A method of treating a radiation therapy patient, comprising:</u><u style="Single"> aligning the first patient's body to the first patient platform using an alignment system located in the alignment chamber;</u><u style="Single"> moving the first patient's body on the first patient platform from the registration room to a radiation therapy room;</u><u style="Single"> docking the first patient platform to a radiation therapy system located within the radiation therapy room, the docking moving the first patient platform into a patient treatment area of the radiation therapy system; including moving; and</u><u style="Single"> treating the first patient using the radiation therapy system;</u><u style="Single"> A method, including</u><u style="Single">(Item 60)</u><u style="Single"> A method of operating a radiation therapy system comprising:</u><u style="Single"> A radiation therapy system is provided, the radiation therapy system comprising a rotatable gantry and a patient platform disposed in a patient region of the gantry and configured to move relative to the gantry. a collimator mounted on the gantry, the collimator comprising a plurality of leaves configured to open and close from a plurality of gantry angles; and a radiation source coupled to the collimator. and</u><u style="Single"> receiving a patient treatment plan comprising a set of open leaves and corresponding gantry angles;</u><u style="Single"> outputting a radiation beam from the collimator using the radiation source and the treatment plan;</u><u style="Single"> using the treatment plan to vary the speed of one or more of the patient platform and the gantry;</u><u style="Single"> A method, including</u><u style="Single">(Item 61)</u><u style="Single"> A method of identifying patient anatomy, comprising:</u><u style="Single"> coupling a radioactive reference external to the patient, said radioactive reference corresponding to patient anatomy;</u><u style="Single"> identifying the patient coupled to the radioactive reference and patient platform;</u><u style="Single"> aligning the patient anatomy with the patient platform using the radioactive fiducial locations;</u><u style="Single"> A method, including</u><u style="Single">(Item 62)</u><u style="Single"> 62. The method of item 61, wherein the radioactive standard comprises a hydrogel.</u><u style="Single">(Item 63)</u><u style="Single"> 62. The method of item 61, wherein the radioactive reference is a point source of approximately 500 kilovolts.</u><u style="Single">(Item 64)</u><u style="Single"> A method of positioning a patient anatomy, comprising:</u><u style="Single"> identifying an internal region of interest in the patient;</u><u style="Single"> embedding a radioactive standard in the region of interest;</u><u style="Single"> identifying the radioactive reference and the patient coupled to the patient platform;</u><u style="Single"> aligning the region of interest with the patient platform using the location of the radioactive fiducials;</u><u style="Single"> A method, including</u></p>
<figref num="1A">1A-1C are illustrative depictions of variations of a guided release radiotherapy system. FIG. 1A is a perspective view of a variation of the gantry and patient platform.</figref><figref num="1B">1A-1C are illustrative depictions of variations of a guided release radiotherapy system. FIG. 1B depicts a cross-sectional view of the gantry and patient platform of FIG. 1A.</figref><figref num="1C">1A-1C are illustrative depictions of variations of a guided release radiotherapy system. FIG. 1C depicts another perspective view of the gantry and patient platform of FIG. 1A.</figref><figref num="2">FIG. 2 is an illustrative cross-sectional view of a variation of the gantry.</figref><figref num="3A">FIG. 3A is a block diagram representation of one variation of a communication interface that may be used with a radiation therapy system.</figref><figref num="3B">FIG. 3B is a cross-sectional view of a modified gantry.</figref><figref num="3C">FIG. 3C is a block diagram of the gantry.</figref><figref num="3D">FIG. 3D depicts a schematic side view of a variation of the gantry.</figref><figref num="3E">FIG. 3E depicts a front view of a slip ring for the gantry variant.</figref><figref num="3F">FIG. 3F depicts a schematic side view of a variation of the gantry.</figref><figref num="3G">FIG. 3G depicts a front view of the rotor and stator elements for one variation of the gantry.</figref><figref num="4A">4A-4B are illustrative depictions of variations of a linear accelerator (linac). FIG. 4A is a cross-sectional view of a modification of the linac.</figref><figref num="4B">4A-4B are illustrative depictions of variations of a linear accelerator (linac). FIG. 4B depicts an exploded perspective view of the linac of FIG. 4B.</figref><figref num="4C">FIG. 4C is a perspective view of one variation of the gantry with linac and mounting assembly.</figref><figref num="4D">FIG. 4D is a top view of one variation of the linac positioning assembly.</figref><figref num="4E">FIG. 4E is a side view of one variation of the linac positioning assembly.</figref><figref num="4F">FIG. 4F is a perspective view of one variation of the gantry with the MV detector, mounting assembly, and positioning assembly.</figref><figref num="4G">4G-4H depict perspective and exploded perspective views of the MV detector and positioning assembly of FIG. 4F.</figref><figref num="4H">4G-4H depict perspective and exploded perspective views of the MV detector and positioning assembly of FIG. 4F.</figref><figref num="4I">Figures 4I-4J depict various configurations of MV positioning assemblies.</figref><figref num="4J">Figures 4I-4J depict various configurations of MV positioning assemblies.</figref><figref num="5A">5A-5E are illustrative depictions of one variation of a temperature management system that may be used with a rotatable gantry. 5A-5E are illustrative depictions of one variation of a temperature management system that may be used with a rotatable gantry. FIG. 5A is a block diagram representing one variation of the heat transfer or cooling path from the rotatable ring of the gantry to the stationary frame of the gantry.</figref><figref num="5B">5A-5E are illustrative depictions . FIG. 5B is a front view of a gantry with one variation of the temperature management system.</figref><figref num="5C">5A-5E are illustrative depictions of one variation of a temperature management system that may be used with a rotatable gantry. 5A-5E are illustrative depictions of one variation of a temperature management system that may be used with a rotatable gantry. FIG. 5C is a side view of the gantry of FIG. 5B.</figref><figref num="5D">5A-5E are illustrative depictions of one variation of a temperature management system that may be used with a rotatable gantry. 5A-5E are illustrative depictions of one variation of a temperature management system that may be used with a rotatable gantry. FIG. 5D is a perspective view of the gantry of FIG. 5B.</figref><figref num="5E">5A-5E are illustrative depictions of one variation of a temperature management system that may be used with a rotatable gantry. 5A-5E are illustrative depictions of one variation of a temperature management system that may be used with a rotatable gantry. FIG. 5E is another perspective view of the gantry of FIG. 5A.</figref><figref num="6A">6A-6B are illustrative depictions of several other variations of the gantry. FIG. 6A is a cross-sectional side view of the gantry.</figref><figref num="6B">6A-6B are illustrative depictions of several other variations of the gantry. 6B is a partially cutaway perspective view of the gantry of FIG. 6A.</figref><figref num="7">FIG. 7 is an illustrative cross-sectional view of a variation of the radiotherapy system.</figref><figref num="8A">FIG. 8A is a front view of the gantry.</figref><figref num="8B">8B is a cross-sectional front view of one variation of the radiation beam path and beam shaping components mounted on the gantry of FIG. 8A.</figref><figref num="8C">FIG. 8C is a schematic cross-sectional view of the radiation beam path and beam shaping components of FIG. 8B.</figref><figref num="8D">FIG. 8D is a close-up view of the radiation beam path and beam shaping components of FIG. 8B.</figref><figref num="8E">FIG. 8E is a plot of the y-axis radiation dose or fluence profile for different upper jaw offset values.</figref><figref num="8F">FIG. 8F depicts one variation of beam shaping components mounted on curved rails.</figref><figref num="9">9A-9B are illustrative depictions of magnetron variations. FIG. 9A is a side view of the magnetron. 9B is a cross-sectional side view of the gantry and magnetron of FIG. 9A.</figref><figref num="10">FIG. 10 is an illustrative depiction of a variation of the collimator timing diagram.</figref><figref num="11">FIG. 11 is an illustrative depiction of a variation of the beam converter.</figref><figref num="12">FIG. 12 is an illustrative schematic diagram of a patient workflow variation for a radiotherapy system.</figref><figref num="13A">FIG. 13A depicts one variation of the kV CT gantry ring.</figref><figref num="13B">FIG. 13B depicts one variation of a kV radiation source collimator for a kV imaging system.</figref><figref num="13C">FIG. 13C is a perspective exploded view of the kV radiation source collimator of FIG. 13B.</figref><figref num="14">FIG. 14A is a cross-sectional view of a first configuration of a kV radiation source collimator. 14B is a cross-sectional view of a second configuration of the kV radiation source collimator of FIG. 14A.</figref><figref num="15">FIG. 15A schematically depicts forces sustained by a rotatable ring with a disc. FIG. 15B schematically depicts the force sustained by the rotatable ring with drum structure.</figref><figref num="16A">FIG. 16A depicts one variation of a rotatable gantry with a drum structure.</figref><figref num="16B">FIG. 16B depicts schematic front (left) and side (right) views of one variation of a rotatable ring with a drum structure.</figref><figref num="16C">FIG. 16C depicts a schematic front view of one variation of a rotatable gantry with a drum structure.</figref><figref num="16D">FIG. 16D depicts schematic front (left) and side (right) views of one variation of a rotatable ring with a disc.</figref><figref num="16E">FIG. 16E depicts a schematic side view of one variation of a rotatable gantry with a disk.</figref><figref num="17A">FIG. 17A depicts a rear perspective view of one variation of a radiation therapy system.</figref><figref num="17B">FIG. 17B depicts a side view of one variation of a radiotherapy system.</figref>
Generally, systems, devices, and methods for emission-stimulated high-energy photon delivery are described herein. In some variations, the present systems, devices, and methods may be used to deliver radiation doses to desired areas of a patient (eg, therapeutic doses to a patient's tumor). In general, the radiotherapy systems described herein include a gantry comprising a rotatable ring coupled to a stationary frame via a rotation mechanism such that the rotatable ring rotates at about 10 RPM to about 70 RPM; Radiation sources (e.g., MV X-ray source) and one or more PET detectors mounted on a rotatable ring. A radiation source mounted on the rotatable ring may deliver a radiation dose to the patient, and a PET detector mounted on the rotatable ring may detect PET events. The radiation source and the PET detector can be coplanar (e.g., both mounted on a rotatable ring and arranged such that the beam plane of the radiation source is coplanar with the detection plane of the PET detector). ), the PET detectors may be arranged to avoid crossing the therapeutic radiation beam path. A radiation therapy system may comprise a patient treatment area comprising a longitudinal bore or channel extending through the gantry. In some variations, the rotating ring may comprise a first communication interface and the fixed frame may comprise a second communication interface. In some of these embodiments, both the first and second communication interfaces may be configured to transmit and receive data therebetween while the ring rotates.
In some variations, the gantry may include a thermal management system configured to dissipate any heat generated due to motion of the rotatable ring. The thermal management system may comprise two sets of heat exchangers and conduits, the first set may be configured to transfer heat from the rotating gantry to the stationary frame, and may be located on the stationary frame. A second set may be configured to transfer heat from the stationary frame to an external thermal system (eg, a closed loop facility liquid system). For example, the first set may comprise forced air heat exchangers and/or radiant heat exchangers and the second set may comprise heat exchangers coupled to the external refrigeration fluid of the external thermal system. good.
In some variations, the radiotherapy system may further comprise a radiation source mounted on a rotatable ring of the gantry. For example, the radiation source may comprise a linear accelerator (linac) and a radially mounted magnetron. The magnetron cathode support may be oriented radially with respect to the gantry. Alternatively, the radiation source may comprise a linac and a klystron. The radiation beam pulse repetition rate of a radiotherapy system is the pulse repetition rate or length of radio frequency (RF) pulses produced by a radiation source (e.g. magnetron or klystron) relative to the electron injection rate or length of an electron beam gun. can be varied by varying In some variations, the linac may be mounted to the rotatable gantry using a first mounting assembly, wherein radiation shielding disposed across the linac is separate from the first mounting assembly. It may be mounted on the gantry using two mounting assemblies. In some variations, the second mounting assembly does not directly contact the first mounting assembly and/or the first and second mounting assemblies may be separated by an air gap.
In other variations, one or more collimating elements may be positioned within the radiation beam path. For example, the radiation therapy system includes an upper jaw configured to shape a radiation beam along a first axis or dimension (eg, y-axis or width) and a second jaw orthogonal to the first axis or dimension. a multi-leaf collimator configured to shape the radiation beam along an axis or dimension (e.g., the x-axis or length) of and a first axis or dimension configured to shape the radiation beam and a lower jaw. The position of the linac relative to one or more collimating elements may be adjusted by a motor (eg, actuator), which may be remotely controlled. For example, the radiotherapy system may be in a room or bunker, and operators located in different rooms (eg, control rooms) adjust the position of the linac by controlling motors coupled to the linac. it may be possible to Optionally, the radiation therapy system includes, in addition to the therapeutic radiation source (eg, MV X-ray source), an imaging radiation source (eg, kV X-ray source), and the imaging radiation source may be configured to acquire images of the patient immediately before, during, and/or after the treatment session. The imaging radiation source and the therapeutic radiation source are located at different longitudinal locations along the length of the gantry bore (so that the radiation beam produced by the imaging radiation source is not coplanar with the therapeutic radiation source), or ( The radiation beam plane produced by the imaging radiation source may be located at the same longitudinal location such that the radiation beam plane produced by the therapeutic radiation source is coplanar. While in some variations the imaging radiation source and therapeutic radiation source may have separate linacs, radiation sources, electron injectors, and beam converter assemblies, in other variations: The imaging radiation source and therapeutic radiation source may have the same linac, radiation source, electron injector and beam converter assembly.
In some variations of the system, a radiation therapy device having a rotatable gantry includes a bore configured to reduce patient discomfort (e.g., claustrophobia) due to confinement within a small space. may In some cases, the patient may be sedated during treatment to avoid claustrophobia and to limit patient movement on the patient platform. However, sedation poses risks and may be undesirable for some patient groups, such as the elderly, patients with advanced disease, and/or patients taking medications. Radiation therapy devices as described herein facilitate patient comfort associated with confinement, may encourage patients to remain motionless for longer cycles to receive radiation therapy treatment, and may be administered with sedatives. can help reduce the use of In some variations, the bore may increase in diameter towards the end of the bore with audio/visual sensory cues simulating an expanded space to reduce patient anxiety (i.e. variable diameter bore or graduated bore). In some variations, the rotatable gantry may be enclosed within a housing. The housing may comprise a longitudinal channel or bore sized for the patient. A channel or bore may be open on one end and closed on the opposite end (eg closed bore) or open on both ends (eg open bore). Patient comfort may also be enhanced by providing airflow over the patient while the patient is within the delivery system.
The radiation therapy system disclosed herein may also be used in a tomographic procedure in which the therapeutic radiation source is rotated around the patient treatment area as the patient couch is moved through the area. This may provide a helical or spiral pattern of X-ray radiation. In some methods, the radiation directed toward the patient treatment area may be intensity modulated, eg, the intensity of the radiation beam at each gantry angle and each couch position may vary. For example, the gantry and/or patient platform may decelerate when higher levels of modulation are required by the treatment plan, and the gantry and/or patient platform increase speed when less modulation is required. You may let
I. System Gantry
In general, the systems described herein include a gantry having a stationary frame and a rotatable ring coupled to the stationary frame via a rotation mechanism, and a therapeutic radiation source (e.g., , MV X-ray source) and one or more PET detectors mounted on a rotatable ring. The radiotherapy system may also include an MV detector mounted on a rotatable ring opposite the therapeutic radiation source. The beam emitted from the therapeutic radiation source may have one or more jaws, and/or a multi-leaf collimator (e.g., a binary multi-leaf collimator), and/or any number of additional collimators or jaws, etc., as may be desired. may be shaped by the beam shaping component of The rotating mechanism may comprise a slip ring and a drive train capable of rotating the ring from about 10 RPM to about 70 RPM. The rotatable ring may rotate about the patient treatment area, which may comprise a bore or channel through the gantry. The gantry may be enclosed within a housing that may have housing bores or channels corresponding to the gantry bores or channels. A gantry housing may be a mechanical and/or visual barrier between the patient and the gantry.
The radiation therapy system may also include a patient platform configured to move the patient into and out of the patient treatment area. The position of the patient platform within the gantry bore or channel, the position of the radiation source (which may be a therapeutic radiation source) around the patient treatment area (e.g., the circumferential location of the radiation source around the gantry bore or channel), and the radiation A pulse of radiation from the source may be timed by the controller such that a desired dose is delivered to a desired area of the patient (eg, a tumor area). In some variations, the rotatable ring may be configured to continuously rotate 360 degrees in one or more directions (e.g., clockwise and/or counterclockwise), while other variations In an example, the rotatable ring rotates less than 360 degrees in one or more directions (e.g., rotates about 270 degrees clockwise and about 270 degrees counterclockwise, about 150 degrees clockwise and about 150 degrees counterclockwise from the vertical axis). clockwise about 135 degrees from the vertical axis, clockwise about 180 degrees from the vertical axis and about 150 degrees from the vertical axis, etc.).
One or more PET detectors may be mounted along at least a portion of the circumference of the rotatable ring (eg, the inner circumference, the outer circumference, or anywhere between the inner and outer circumferences). The location of the PET detector relative to the length of the bore or patient area can be the same as the location of the MV or therapeutic radiation source and the MV detector (eg, on the same "slice" of the rotating ring). That is, the radiation beam emitted by the therapeutic radiation source may be co-planar with the PET detector. The PET detector may be arranged to avoid intersecting the radiation beam path, and instead the MV detector may be located within the therapeutic radiation beam path. In some variations, the PET detector may span a subset of the circumference of the ring (eg, 180 degrees). For example, a first array of PET detectors may be mounted on a first segment or length of the rotatable ring having a length of about 25% of the circumference of the ring, and the PET detectors A second array may be mounted on a second section or length of the ring having a length of about 25% of the circumference of the ring. In this variation, the portion of the ring circumference covered by the PET detector is approximately 50% of the circumference. The first and second arrays of PET detectors may be positioned substantially opposite each other (e.g., diametrically opposite each other such that the respective centers of the PET detector arrays are about 180 degrees from each other); Or alternatively, the first arrays of PET detectors are arranged so that they are not opposite each other (e.g., the centers of each of the PET detector arrays are less than about 180 degrees from each other, e.g., about 45 degrees, about 90 degrees, or about 120 degrees, or about 150 degrees, etc.) from the second array of PET detectors. The PET detector is not coplanar or "slice" with the therapeutic radiation source of the rotating ring (i.e., the PET detector is not coplanar with the therapeutic radiation source). It may span the entire circumference (eg, 360 degrees).
Figures IA-B show a radiation therapy system comprising a gantry (102) enclosed within a housing (103), a patient treatment area (104) within a gantry bore (105), and a patient platform (106). (100) depicts a variation of (which may be a guided release radiotherapy system). The gantry (102) may be configured to rotate continuously 360 degrees clockwise or counterclockwise at about 10 RPM to about 70 RPM with respect to the stationary frame 108 (eg, continuous rotation). rotatable gantry, such as a circular gantry, comprising a rotatable ring (110). Housing (103) may have a shape that generally follows the contours of gantry (102) such that patient platform (106) may be advanced into and out of bore (105). Enclosed within the interior volume of housing (103) and depicted in FIG. 1B, radiation therapy system (100) is further positioned on rotating ring (110) at a first longitudinal location along bore (105). A therapeutic x-ray or radiation source (112) such as a linear accelerator (linac) (114) mounted and an imaging mounted on a rotating ring (110) at a second longitudinal location along the bore (105). An X-ray or radiation source (116) may be provided. In this variation, the radiation beam produced by the imaging radiation source (116) may not be coplanar with the radiation beam produced by the therapeutic radiation source (112). The length (101) of the bore (105) may be about 120 cm to about 210 cm. In some variations, the length (101) of bore (105) may be about 185 cm. The bore (105) may have a diameter of about 60 cm to about 120 cm. In some variations, the diameter of bore (105) may be about 85 cm. Patient platform (106) may be configured to extend from platform base (107) such that extension length (109) may be between about 150 cm and 250 cm. In some variations, the extended Length (109) may be about 190 cm. The housing (103) may have a height (130) of approximately 220 cm to approximately 280 cm. In some variations, housing (103) may have a height of about 250 cm. The housing (103) may have a width (132) of approximately 225cm to 325cm. In some variations, housing (103) may have a width (132) of approximately 276 cm. The housing (103) may have a length of about 120cm-230cm. In some variations, housing (103) may have a length of approximately 185 cm. The length (134) of radiation therapy system (100), including the gantry and patient platform, may be between about 400 cm and about 500 cm. In some variations, length (134) of radiation therapy system (100) may be about 439 cm. In some variations, the depth (eg, pit) may be such that the axis of bore (105) is approximately 110 cm from the bottom of system (100). In some variations, the depth may be approximately 10 cm to 60 cm. In some variations, the depth may be approximately 32 cm. The (eg, pit) may be such that the axis of bore (105) is approximately 110 cm from the bottom of system (100). In some variations, the depth may be approximately 10 cm to 60 cm. In some variations, the depth may be approximately 32 cm. The (eg, pit) may be such that the axis of bore (105) is approximately 110 cm from the bottom of system (100). In some variations, the depth may be approximately 10 cm to 60 cm. In some variations, the depth may be approximately 32 cm.
The radiation therapy system (100) may also include one or more PET detectors mounted on the rotating ring (110). For example, as depicted in FIG. 1C, the system (100) includes a first PET detector mounted along a first length (119) of the circumference (eg, inner circumference) of the rotatable ring. It may comprise an array (118) and a second array (120) of PET detectors mounted along a second length (121) of the circumference (eg inner circumference) of the rotating ring. The first array (118) may be located directly opposite (eg, 180 degrees from) the second array. The lengths of the first and second arrays can be the same or different. In the variation of FIG. 1C, the lengths of the first and second arrays may be the same, each having a length that is approximately 25% of the inner circumference of rotatable ring (110). The arc occupied by the first array (118) (and the second array (120)) may have an angular sweep of about 90 degrees, but any desired angular sweep (e.g., about 45 degrees) ~ about 180 degrees, about 60 degrees, about 75 degrees, about 120 degrees, about 135 degrees, about 140 degrees, about 150 degrees, about 155 degrees, etc.). In other variations, the PET detectors (118, 120) cover the entire circumference of the ring, except for a portion of the circumference that may be occupied by the therapeutic radiation source and the MV detector located on the opposite side of the therapeutic radiation source. may be arranged around the In some variations, one or more PET detector arrays or modules mounted on a rotatable ring can be co-planar with the radiation beam emitted by the therapeutic radiation source, respectively as they rotate. , with about 25% coverage by azimuth (e.g., 50% together) to accommodate being coplanar with the radiotherapy beamline (i.e., no PET detector arrays or modules are located within the treatment beam path). coverage) may be provided. That is, each array may cover approximately 25% of the full angular sweep of the rotatable gantry. The width of the PET detector array or module (i.e. along the length of the bore) is It may be selected, at least in part, to help facilitate acquisition and detection of PET events (eg, emission pathways). For example, the width of a PET detector array or module can be from about 4 cm to about 20 cm. In some variations, the width of the PET detector array or module may be about 5 cm.
Alternatively, the PET detector array may be located on a separate ring or gantry from the therapeutic radiation source and/or the MV detector. In some variations the PET detector ring or gantry may be non-rotatable, while in other variations the PET detector ring or gantry may be rotatable. A rotatable PET detector ring or gantry may rotate in coordination or synchronization with the therapeutic radiation source ring or gantry. For example, the PET ring or gantry may be mechanically mounted to the therapeutic radiation source ring or gantry such that rotation of one of the gantry causes rotation of the other. Alternatively, the PET ring or gantry may be rotatable separately from the therapeutic radiation source ring or gantry. For example, the motion controller may rotate two gantries or rings together or separately as may be desirable.
Optionally, in addition to the therapeutic radiation source, the radiotherapy system includes a kV X-ray source or imaging radiation source mounted on a rotatable ring and a similarly rotatable ring opposite the kV X-ray source or imaging radiation source. and an overlying kV X-ray detector. kV Radiation from an X-ray or imaging radiation source may be emitted along a first plane, while radiation from a therapeutic radiation source may be emitted along a second plane. The first plane and the second plane may not be coplanar. For example, an imaging radiation source may be mounted on the rotatable ring at a first longitudinal location in a bore or channel extending through the gantry, while a therapeutic radiation source may be mounted at a second longitudinal location in the bore or channel. It may be mounted on a rotatable ring at a location. The rotatable rings on which the imaging and therapeutic radiation sources are mounted can rotate together (eg, synchronously) or independently (eg, rotation of one gantry is separate from rotation of the other gantry). may be the same or different rotatable rings, which may be configured to The first and second planes may be substantially parallel to each other or may be at a non-zero angle to each other. In other variations, the first and second planes may be coplanar. For example, the imaging radiation source may be mounted at the same longitudinal location as the therapeutic radiation source in the bore or channel. Alternatively, or in addition, a single X-ray source or radiation that can be used to treat patient regions with radiation and to help provide data that can be used for image or dose reconstruction A source can exist. The radiotherapy system may comprise a kV or kV detector mounted on a rotatable ring opposite the imaging radiation source. Data from the kV detector may be used to align the patient within the radiotherapy system and/or generate an anatomical image of the patient. Although MV radiation sources may be described as therapeutic radiation sources, it should be understood that data acquired as a result of irradiation from MV radiation sources may be used in the calculation and generation of images and/or dose maps. The therapeutic radiation source can be any type of ionizing radiation, such as photon radiation (e.g., X-rays and gamma rays) and/or particle radiation (e.g., electrons, positrons, neutrons,
A radiation therapy system may include a controller in communication with the gantry. The controller may comprise one or more processors and one or more machine-readable memories in communication with the one or more processors. The controller may be connected to the gantry by wired or wireless communication channels. The controller may be located in the same room or bunker as the gantry, or it may be located in a different room or bunker than the gantry. In some variations, the controller may be located on the gantry, eg, mounted on a fixed frame of the gantry. The controller coordinates couch movement with gantry rotation (e.g., velocity), activates the radiation source, opens or closes the collimator leaves/jaws, detects the position of the collimator leaves/jaws, and detects the positron emission path. detect the MV radiation applied to the patient, calculate the delivered dose based on the detected MV radiation data, treat planning data, and other, including but not limited to MRI, CT, ultrasound, etc. It may be configured to store anatomical data from imaging modalities. Transfer of data and command signals between the stationary frame and the rotating ring may be facilitated by one or more communication interfaces configured to continuously transmit signals while the ring is rotating. . Real-time positron emission data and/or gantry rotation data (e.g., velocity) and/or gantry position data (e.g., gantry angle) collected by the PET detector are transmitted across one or more communication interfaces to the controller. may The controller controls the treatment by, for example, adjusting the rotational speed of the ring, opening or closing certain leaves of a multi-leaf collimator positioned over the therapeutic radiation source, and/or adjusting the timing of the therapeutic radiation pulses. Such data may be used to update plans.
rotatable ring and fixed frame
Generally, the systems described herein can help reduce the effects of vibrations and/or centripetal forces of high speed rotating rings (e.g., about 50 RPM, about 60 RPM, about 70 RPM) that can cause position shifts. , a gantry, comprising a mounting or mounting assembly. For example, a component mounted on a ring that rotates at about 60 RPM or more may experience a greater level of centripetal force than on a ring that rotates at slower speeds (eg, about 10 RPM, about 20 RPM). Radiation sources, various detectors (e.g., MV detectors, kV detectors, PET detectors), and components mounted on a rotatable ring such as multi-leaf collimators, jaws, linacs, and all support structures , may have a total weight of about 2 tons. Rotating 2 tons on a ring with a diameter of about 1.4 meters at a speed of about 60 RPM would produce a force that could cause a deflection on the ring itself and would also ensure reliable functioning of the ring-mounted components. can generate forces that can affect Various components and subsystems of the radiation therapy systems described herein may be provided with specialized mounting assemblies and/or alignments and/or orientations to help mitigate the effects of these forces. In some variations, the gantry also adjusts the position of the radiation source when it shifts or becomes misaligned with other components of the radiation therapy system (e.g., multi-leaf collimators, jaws, detectors). A motor or actuator may be provided for facilitating. Note that some radiation therapy systems may comprise all of the components described herein, but some variations may comprise a subset of these components, as may be desired. be understood.
Some radiotherapy systems may comprise a continuously rotating gantry comprising a rotatable ring and a fixed frame. The gantry may be configured to rotate 360 degrees or more in one or more directions (e.g., counterclockwise 360 degrees or more and/or clockwise 360 degrees or more). ). A continuously rotating gantry may receive its rotational power from a conventional motor and combined drive system or from an integrated rotor and stator design. For example, a continuously rotating gantry may include one or more embedded magnetic or inductive elements located on a rotatable ring. The fixed frame of the gantry may comprise embedded inductive or magnetic elements. In this arrangement, the rotatable ring may rotate relative to the stationary frame in a similar manner as the rotor rotates relative to the stator of the rotating system. To reduce latency from the time a lesion or target area is positioned for therapeutic radiation delivery, the present system rotates the therapeutic radiation source and delivery hardware at much higher speeds than conventional radiation therapy systems. may The radiation therapy system may comprise rotor and stator elements integrated into the same structure that supports the bearings, which allows the gantry to operate at up to about 70 RPM (eg, at least about 50 RPM, about 60 RPM, etc.). It can be useful to rotate (eg, 360 degrees) continuously (eg, 360 degrees) tons of hardware up to .
FIG. 2 is a cross-sectional schematic view of one variation of a gantry (200) comprising a rotatable ring (202) and a stationary frame (204). The rotatable ring (202) may comprise arms (206) having one or more rotor elements, which may be embedded magnetic or inductive elements (214). The rotor element may be enclosed within the housing of the ring arm (206) or rotatable ring (202). For example, embedded magnetic or inductive elements may comprise rare earth magnets and/or electromagnets and/or coils encapsulated in steel. A plurality of rotor elements (214) arranged around the circumference of the rotatable ring (202), e.g. There may be 28, 30, 50, 64, 75, 100, 125, 128, 135, 150, 175, 200, 256 etc. In some variations, the rotor elements (214) may be evenly distributed around the rotatable ring (202). Fixed frame (204) may comprise arms (208) configured to rotatably engage ring arms (206) via ball bearing assemblies (210). The ball bearing assembly (210) may be at least partially enclosed and secured by a bearing housing or bearing plate (211). One or more stator elements or drive motors (212) are mounted on the frame arms (208) at locations in close proximity to the enclosed or embedded rotor elements (214) on the ring arms (206). Alternatively, there may be a space or gap between the drive motor and the rotor element (eg, a gap between the drive motor and the rotor element housing). Optionally, the drive motor (212) may be integrated or embedded within the bearing housing or plate (211). In some variations, the motor (212) can move about 3,400 kg from rest to about 60 RPM in about 20 seconds.<sup>*</sup>m<sup>2</sup>may be an induction motor configured to exert a motive force on the rotatable ring with an inertia of . Activation of the motor (212) in turn applies a magnetic force on the enclosed or embedded rotor element (214), creating a motive force to cause rotation of the rotatable ring (202), arm (208) the magnetic field. ). Rotation of the ring (202) relative to the fixed frame (204) may be supported by a ball bearing assembly (210). A ball bearing assembly (210) is positioned between the ring arm (206) and the frame arm (208) adjacent the interface between the rotor element (214) and the drive motor or stator element (212). You may For example, the ball bearing housing (211) may have a recess, the ring arm (206) may have a corresponding recess, and the ball bearing assembly (210) is formed by the recess. may be located within a cavity in which the In some variations, the stator element may comprise multiple individual coils arranged in a ring-shaped band (also depicted in FIG. 3G). Mechanical contact between the components of the ball bearing assembly (210), ring arm (206), and frame arm (208) is controlled by one or more lubricants and/or lubricants to reduce friction between the components. A surface modifier may be provided. Optionally, some welded joints of the ball bearing assembly (210) and/or the ball bearing housing or plate (211) and/or between the frame arm (208) and the stationary frame (204) connect the frame and the rotating gantry. It may be omitted or reduced to help reduce deflection, which may help improve bearing life while maintaining required structural support. Embedding or enclosing magnetic or inductive elements (214) within a casing or housing can help reduce the amount of stray magnetic fields that can perturb the electron beam within the linac. Increasing the number of rotor elements and/or distributing the rotor elements around the gantry will allow the rotor elements to align with the drive motor.
Rotation of masses up to several tons at high rotational speeds produces high levels of kinetic energy. Components mounted on the rotatable ring may be anchored so that they remain attached (eg, and therefore do not pose a safety threat) despite high levels of kinetic energy. System bearing tolerances are configured to reduce vibrations that can lead to fastener loosening. For example, fasteners for components on the rotatable ring may be secured using industrial techniques such as adhesive epoxies, torque wrenches, mechanical locking fasteners, controlled assembly procedures, and the like. Some variations may include one or more accelerometers mounted on a rotatable ring, and data from the accelerometers may be analyzed to detect loose fasteners or components. good. When the radiation therapy system is in use, gantry rotation can exhibit periodic accelerations resulting from vibration and motion, which may be measured using one or more accelerometers. In some variations, Fourier analysis of acceleration data from one or more on-board accelerometers while the gantry is rotating (eg, during a treatment session) can be compared to reference acceleration data. A detected difference may indicate when a component on the rotatable ring begins to relax, and a notification may be generated to the operator.
The structure of the rotatable ring may be configured to withstand forces and/or stresses generated during rotation up to about 70 RPM with a deflection of about 0.5 mm or less. Rotating a mass of about 2 tons located about 1.4 meters from the axis of rotation at about 60 RPM is recommended for slower rotating rings (e.g., about 10 RPM or less) or less mass-loaded rings (e.g., CT imaging). It is possible to generate forces (eg, deflection forces) and/or forces (eg, hoop stresses) that are several orders of magnitude greater than those of a ring). Conventional radiotherapy and CT imaging rings typically comprise a disc with bearings that are generally coplanar with the disc. Any radiation source, radiation detector, image detector, controller, etc. components may be mounted on the front or planar surface of the disk. This can cause cantilever unloading from the surface of the disk, especially during rotation at speeds above about 60 RPM, especially when the disk is loaded with heavy components (e.g., radiation shielding, linacs, etc.). May cause instability and/or deflection.
The disc deflection may be about the cube of the disc thickness. Increasing the thickness of the disk can help increase the stiffness of the disk, but components mounted on the front or flat surface of the disk still lead to instability during rotation at speeds above about 60 RPM. obtain. A rotatable ring with a drum structure can help address instability and deflection during rotation at speeds of about 60 RPM and above. The drum structure includes a first ring-shaped end face or plane, a second ring-shaped end face or plane, and along the length between the first ring-shaped end face and the second ring-shaped end face. Extending lateral support or rib structures may also be provided. The length of the lateral support structure may be about 45 cm to about 95 cm, such as about 60 cm, about 75 cm. A lateral support or rib structure extends between and attaches a plurality of support beams, and/or brackets, and/or cage structures, and/or struts to the first end face and the second end face. You may prepare. The lateral support structure may have mounting surfaces for various components of the radiation therapy system. The approximately cubed relationship of deflection to thickness (which in the case of a drum is the separation distance between the two end faces, or the length of the lateral support or rib structure) is, for example, approximately 0.0 for 10-fold separation. 001× deflection (ie 60 cm separation vs. 6 cm thick disc) may be provided. In addition to increasing the overall stiffness of the rotatable ring (thereby reducing its deflection when fully loaded and rotating at speeds of about 60 RPM or higher), the drum structure is also useful in radiotherapy systems. If the component has an inner surface (e.g., radially inwardly facing surface along the lateral support structure, an inwardly facing surface of the ring-shaped end face) and an outer surface (e.g., radially outward along the lateral support structure) of the drum facing surface, the outwardly facing surface of the ring-shaped end face). Increasing the number of places for mounting components by using a drum structure instead of a disk allows the same number of components to be mounted on a ring with a smaller outside diameter can be Reducing the overall outer diameter of the rotatable ring can reduce its overall mass and rotational inertia. Radial mounting of components on the side support structures along the length of the drum can also help facilitate inspection of components mounted on the ring. A rotatable ring whose components are mounted on the surface or plane of the disk may require removal of the entire housing or enclosure in order to access and inspect the components mounted on the disk surface. A rotatable ring with a drum structure may allow access and inspection of the radially mounted components through openings and panels (eg, hatches) located on the sides of the housing. The drum can be rotated to an access panel or hatch and components may be inspected or radially removed without requiring removal of the entire housing. Optionally, a manually actuated brake may be provided to stop the rotation of the ring or lock its position during repair or service. Mounting can also help facilitate inspection of components mounted on the ring. A rotatable ring whose components are mounted on the surface or plane of the disk may require removal of the entire housing or enclosure in order to access and inspect the components mounted on the disk surface. A rotatable ring with a drum structure may allow access and inspection of the radially mounted components through openings and panels (eg, hatches) located on the sides of the housing. The drum can be rotated to an access panel or hatch and components may be inspected or radially removed without requiring removal of the entire housing. Optionally, a manually actuated brake may be provided to stop the rotation of the ring or lock its position during repair or service. Mounting can also help facilitate inspection of components mounted on the ring. A rotatable ring whose components are mounted on the surface or plane of the disk may require removal of the entire housing or enclosure in order to access and inspect the components mounted on the disk surface. A rotatable ring with a drum structure may allow access and inspection of the radially mounted components through openings and panels (eg, hatches) located on the sides of the housing. The drum can be rotated to an access panel or hatch and components may be inspected or radially removed without requiring removal of the entire housing. Optionally, a manually actuated brake may be provided to stop the rotation of the ring or lock its position during repair or service.
Figures 15A and 15B schematically depict different forces sustained by the disk and drum structures. The deflection δ of the disk is approximately proportional to the square of the length of the drum divided by the cube of the mass times the thickness of the drum. The deflection of the disk is calculated by starting with the bending moment of the beam, as depicted in FIG. 15A.
<img file="JP7201243B2_D0001.tif" /> where E = Young's modulus m = total mass I = moment of inertia <img file="JP7201243B2_D0002.tif" /> where b = the width of the segment of flexion approximately equal to the outer diameter of the disc <img file="JP7201243B2_D0003.tif" />
In contrast, the deflection δ of the drum structure is approximately proportional to the square of the length of the drum divided by the mass times the longitudinal length of the drum (ie the distance between the two end faces or planes). This can provide stiffness versus mass advantages for drum structures versus cantilever discs. FIG. 15B depicts the force sustained by the drum structure with mass mounted thereon.
<img file="JP7201243B2_D0004.tif" /> where E = Young's modulus M = total mass I = moment of inertia <img file="JP7201243B2_D0005.tif" /> where r = inner radius of the drum structure t = "thickness" or longitudinal length of the drum structure <img file="JP7201243B2_D0006.tif" />
Figures 16A-16C depict one variation of a rotatable ring comprising a drum structure (1600). The drum structure (1600) comprises a first end face (1602), a second end face (1604) opposite the first end face, and a longitudinal distance between the first end face and the second end face or and lateral support structures (1606) disposed along the length. The first and second end surfaces may each comprise a ring-shaped plate with a central opening (1608). The drum structure (1600) may comprise multiple exterior surfaces (1610) and interior surfaces (1612) that may be suitable for mounting various components and electronics. As explained above, various components, e.g., therapeutic radiation source, and/or PET detector, and/or MV detector, and/or kV detector, and/or imaging system or radiation source, thermal An exchanger or the like may be mounted on the rotatable ring. In some variations, the larger and/or larger components may be mounted on the lateral support structures, while the smaller and/or smaller components are mounted on the first and It may be mounted along a second end face or plate. As an example, FIG. 16A shows a linac (1614) radially mounted on a side support beam (1606) and a linac (1614) mounted on the side support beam (1606) and also on first and second end plates (1614). 1602, 1604) and a radiation shield mounting assembly (1616) mounted along. A beam stop or counterweight (1618) may be mounted on the side support beam (1606) opposite the linac (1614). A beam stop (1618) may be located below the MV detector (not shown). A second end face or plate (1604) may comprise a plurality of recesses (1622) for ball bearings and rotor supports. Lateral support structures or beams are designed to circle the drum structure (1600) for mounting components and/or to provide an access path for inspecting or removing/replacing components. A plurality of cutouts or openings (1620) may be provided around the perimeter. FIG. 16B shows a front view of the gantry with a fixed frame (1630) and a rotatable ring with a drum structure (1632), and the upper part of the gantry (above the axis of rotation (1633)) and (above the axis of rotation (1633)). 1633) is a schematic depiction of a side view of the bottom portion of the gantry). The components (1634) mounted on the drum (1632) may be circumferentially arranged about the bore (1631), the drum being configured to rotate about the axis of rotation (1633). may Drum structure (1632) may be coupled to stationary frame (1630) via bearings (1636), eg, ball bearings as described above. Drum (1632) may comprise lateral support structures or beams (1638) on which components (1634) may be radially mounted. As depicted in FIG. 16C, the gantry may be enclosed in a housing or enclosure (1640). Mounting the component (1634) on the side support beams (1638) may allow radial access (eg, in the direction of arrow 1642) to the component. For example, component (1634) may be moved or disposed radially (1642) through a side access panel or hatch, which may be represented by dashed line (1641). 17A-17C depict one variation of a system comprising a gantry having a rotatable drum structure and a housing enclosing the gantry. The enclosure may include one or more side access panels or hatches. The radiotherapy system (1700) may comprise a gantry enclosed in a housing (1702) with side access panels or hatches (1704). The gantry may comprise a rotatable ring (1706) having a drum structure as described above and components (1708) radially mounted on side support beams or structures. When a component on the rotatable ring needs to be inspected or replaced, The ring may be rotated so that the component is aligned with one or more access panels or hatches. Opening a panel or hatch allows the technician to move components (e.g., along a radial (by) allowing components to be repaired or removed or replaced.
16D-16E depict one variation of a gantry with a rotatable ring with a disc. In contrast to a rotatable ring with a drum structure (as depicted in FIGS. 16A-16C), the components are mounted on the front surface of the disk and not radially mounted. FIG. 16D shows a front view of the gantry with a fixed frame (1630) and a rotatable ring with a disc (1652), and the upper part of the gantry (above the axis of rotation (1653)) and (above the axis of rotation (1653)). ) is a schematic depiction of a side view of the bottom portion of the gantry below ); Component (1654) may be mounted on the front surface of disk (1652), and the disk may be configured to rotate about axis of rotation (1653). Disk (1652) may be coupled to stationary frame (1650) via bearing (1656), eg, a ball bearing as described above. As depicted in FIG. 16E, mounting component (1654) on or on the front surface of the disc is along a direction that is perpendicular to the plane of the disc, as indicated by the direction of arrow (1642). done. That is, components (1654) may be placed or removed in a direction perpendicular to the radius of the disc. In some variations, access to components (1654) through the gantry housing may be provided through the front or back of the housing rather than from the sides of the housing. This may involve disassembling a substantial portion of the front and/or back of the housing in order to inspect, locate and/or replace components mounted on disk (1652).
communication interface
Generally, the systems described herein may include a data interface to facilitate continuous and high speed transfer of data and command signals. A data interface may be provided between the rotatable portion and the fixed portion of the gantry to transfer data between the rotatable portion and the fixed portion while the rotatable portion is rotating. A dependency communication interface may be provided. In some variations, the radiation therapy system includes one or more signal transfer or communication interfaces between components mounted on the rotatable ring and not located on the rotatable ring (e.g., in a fixed frame). on-board and/or in communication with fixed frames). The type of signals and data transferred between the rotatable and stationary parts of the radiotherapy system may be (e.g., from a controller to a linac to fire radiation pulses, or a multi-channel to open or close certain leaves). motion command signals to leaf collimators), positron emission data from PET detectors, radiation data from MV and/or kV detectors, and position data of components on the rotatable ring (e.g. rotational speed, linac location/gantry angle/launch position or index, collimator leaf positions, jaws, etc.), and system status data (eg, temperature, ambient radiation level, etc.).
In one variation, the radiotherapy system captures PET data and maintains high angular accuracy for delivering radiation, while accommodating a relatively high speed (e.g., 60 RPM) continuously rotating gantry. and a rotational/dynamic gantry communication interface. A radiotherapy system with a high speed rotatable gantry may be equipped with a slip ring based communication interface or linkage. That is, in order to properly latch the angular position to each detected PET event (or radiation delivery angle), the time delay between the detection or measurement of the PET detector position and the detection or measurement of the PET event is reduced. It should be.
In many radiotherapy systems, the inherent time delay of position information from the static readhead across slip ring-based communication links is too large for desired temporal accuracy, resulting in unacceptable treatment accuracy. can result in Contact slip rings (often used) are not recommended for high-speed rotating gantry systems (e.g., 60 RPM or higher) because high-speed rotation can promote wear and tear on contact components, compromising data connections and signal integrity. ) is not ideal for use in
Rotary and stationary encoders are used so that the PET data can be precisely linked to where it was collected, and thus activated when the linac and collimator are rotated to the desired gantry angle or firing position. , can help facilitate timely and fast transfer of system feedback to the controller. In addition, drive motor and/or controller position data feedback regarding rotational speed can help maintain a desired (constant or variable) rotational speed within a specified motion error. System status data that is consistently and rapidly transferred to the system controller helps detect any faults in the system (even single points of failure) before such faults escalate into safety hazards or substantial system damage. It can help in timely identification. Additionally, precise synchronization across fixed and rotating components can help coordinate gantry rotation with respect to linac firing.
To accommodate fast and robust transfer of data, the radiotherapy system described herein uses two or more independent communication interfaces that provide redundant feedback data for verification of gantry rotation and signal synchronization. (eg, dual feedback communication channels). This data enables the controller to quickly and accurately detect when any system component deviates from desired standards or tolerances, generate appropriate operator notifications, and/or diagnose and/or repair. Commands can be automatically generated to help correct such deviations. In some variations, feedback data from two or more communication interfaces may be continuously compared and monitored for any timing deviations exceeding specified tolerances. For example, angular alignment data transmitted across the two feedback data channels is sent at regular intervals (eg, about 500Hz to about 2,000Hz, about 1, 000 Hz) may be compared and monitored. In some variations, the two or more independent communication interfaces have separate readheads (eg, receiver elements) and separate encoders (eg, transmitter elements). In one variation, the first communication interface may comprise a first readhead mounted on a rotatable ring of the gantry, the first readhead also mounted on the rotatable ring Communicating with the first position sensor, the second communication interface may comprise a second readhead mounted on the fixed frame, the second readhead also mounted on the fixed frame Communicate with a second position sensor. The first and second position sensors may be magnetic and measure incremental position around the gantry (eg, relative position between the rotatable ring and the stationary frame). In one variation, the rotatable ring and the fixed frame may each have index marks spaced about 15 to about 18 degrees around their circumference, which are the first and second A position sensor may allow identifying the angle or rotation location of the rotatable ring with respect to the fixed frame. As the first position sensor moves across the index marker on the fixed frame (and/or as the index marker on the rotatable ring moves across the second position sensor), the first position sensor A first index signal may be output (and/or the second position sensor may output a second index signal). The absolute position of the rotatable ring may be calculated by the controller after the ring has rotated through the at least two index markers. Additionally or alternatively, the first and second position sensors may each output a signal representative of the rotational or angular position of the rotatable ring relative to the stationary frame. In one variant, the fixed frame and the rotatable ring may each comprise a plurality of locator marks and a plurality of counts located between the locator marks. Rotatable ring locator The number of counts between marks may differ from the number of counts between locator marks in fixed frames. The locator marks and counts may comprise strips of magnetic and/or metallic material that are detectable by sensors (e.g. readheads or receiver units) on the rotatable ring and/or fixed frame (e.g. , moving past the locator mark or counter may induce a current in the sensor). A plurality of locator marks distributed around the circumference of the rotatable ring or stationary frame may comprise an encoder strip. In some variations, the system may comprise a first encoder strip on the outer circumference of the slip ring rotor and a second encoder strip on the outer circumference of the slip ring stator. The encoder strip is a flat band that is built into the structure (eg, located within a recess in a rotatable ring and/or fixed frame) such that a receiver or sensor can detect information as it is swept across the encoder strip. There may be. For example, the rotatable ring may have a feedback or encoder strip with 22 locator marks and 114,400 counts, and the fixed frame has 20 locator marks and 136, A feedback or encoder strip with 000 counts may be provided. By having locator marks that are differentially or uniquely spaced by count, the location of the rotatable ring can be determined by the sensor or receiver unit of the rotatable ring and/or fixed frame. It may be identified after sweeping over the top two consecutive locator marks. Each set of counts between locator marks may be associated with a specific arc length of 360 degree rotation. In some variations, as a safety feature, the feedback strip may be uniquely patterned with different numbers of counts between locator marks to allow independent confirmation of rotatable ring location. good.
The functionality of the first and second position sensors may be monitored to help ensure that the position of the rotatable ring is accurately measured. If the accuracy or accuracy of one or both of the position sensors deviates from specified tolerances, an error or failure signal may be generated indicating to the operator that one or both of the position sensors have failed. One method of evaluating the functionality of a position sensor may include comparing derivatives of position sensor signals (eg, signals representing rotational or angular position of a rotatable ring) over time. This can help facilitate faster and more robust indications of problems or failures in one of the position sensors. Derivatives may be generated by several methods, including the use of first difference equations, digital filters, Kalman estimators, or other estimation techniques. In one embodiment, data from a position sensor indicating the rotational or angular position of the rotatable ring is transmitted to the system controller. The controller processor then computes the derivative of the rotational or angular position signal for each position sensor by any suitable method, such as using a first difference equation, digital filters, Kalman estimators, or other estimation techniques. may The calculated derivative from each position sensor may be compared, and if the difference between the calculated derivatives of the two position sensors exceeds an error threshold, the processor then controls one or both of the position sensors. may generate a signal indicating that it needs to be checked, repaired, or replaced. In some variations, the error threshold is a derived rotational speed difference between the first position sensor and the second position sensor of about 0.5 RPM and/or a calculated rotatable ring of about 0.5 degrees. It may be the difference in the resulting rotation or angular position or the derivative of the rotation or angular position signal. The data output from the position sensors may be continuously monitored and compared, and in some variations, from about 500 Hz to about 2,000 Hz, such as about 600 Hz, about 750 Hz, about 900 Hz, about 1, It may be polled and compared at frequencies of 000 Hz, about 1,400 Hz, about 1,500 Hz, and so on. The data output from the position sensor is about 12 to about 100 times per gantry rotation, for example, about 20 times per rotation, about 24 times per rotation, about 25 times per rotation, about 50 times per rotation, about 65 times per rotation. , about 75 times per revolution, about 80 times per revolution, about 90 times per revolution, about 100 times per revolution, etc. may be polled and compared.
In some variations, a synchronization check between two or more communication interfaces is performed each time the gantry rotates through a particular gantry angle (e.g., a linac location on the gantry rotates through a gantry angle of 180 or through the bottom of the gantry). may occur). Alternatively or additionally, synchronization checks may occur at specific time intervals or frequencies. For example, a rotating phase (e.g., a rotatable ring and all components mounted thereon) and a stationary phase (e.g., a fixed frame and all components mounted thereon or coupled thereto) of a radiotherapy system Synchronization between may occur approximately every 0.1 seconds, or at approximately 1 kHz. In some variations, synchronization across communication interfaces or channels may include transmitting only data that differs between channels, ie, offset data. Offset data may be used, for example, to automatically correct for differences between position sensors. In some variations, the first readhead (i.e., the rotatable readhead) is positioned at or near the circumference of the linac, or approximately 180 degrees from the linac (e.g., opposite or opposite the linac). ) and the second readhead (ie, the fixed readhead) may be positioned at the 9 o'clock position of the fixed frame when viewed from the front (bed side) of the gantry. In other variations, the first and second readheads may be located at any circumferential position along the rotatable ring and fixed frame, respectively, as may be desired.
In one variation, the rotating ring may comprise a slip ring assembly comprising multiple concentric power rings and data signal rings. For example, a slip ring assembly may comprise 6 power rings and 6 data signal rings. The power ring and data ring may be concentric and have the same axis of rotation. The power ring may comprise an inner set of rings that transfer power between the rotating ring and the stationary frame via power brush blocks (eg, two power brush blocks). The data signal ring may comprise an outer set of rings that transfer information between the rotating ring and the stationary frame via one or more databrush blocks. The brush blocks that contact the power ring and/or the data ring may have metal-graphite brush tips. Examples of data signals transmitted between the rotatable ring and the fixed frame via the databrush block may include synchronization signals and/or timing or data offset signals. Alternatively or additionally, data signals transmitted between the rotatable ring and the fixed frame may be transmitted via contactless links, including wireless communication or capacitive links. The wireless communication link is IEEE 802. one or more rotating antennas that receive (e.g., receiver or readhead) and/or transmit (e.g., transmitter elements) data signals, which may use a custom or recognized protocol such as 11b; One or more fixed antennas may be provided. A capacitive link may include two separate links, one link for transmitting signals from the fixed frame to the rotatable ring and one link for transmitting signals from the rotatable ring to the fixed frame. good. In some variations, contactless data and/or power transmission links are mounted on fixed frames and/or rotatable rings, such as one or more GIGACAP stators and one or more GIGACAP rotor platters. An integrated release structure may be provided. Examples of data signals transmitted between the rotatable ring and the fixed frame via the non-contact mechanism are image data (e.g., PET detector data, MV detector data, and/or kV detector data), and/or synchronization signals, and/or timing or data offset signals
FIG. 3A depicts a block diagram representation of one variation of a communication interface that may be used in a radiotherapy system comprising a rotatable gantry having a rotatable ring and a stationary frame. The communication interface may comprise a fixed communication link (352) located on a fixed frame and a rotatable communication link (353) located on a rotatable ring. Signals may be transferred between the fixed frame and the rotatable ring via fixed and rotatable communication links. The communication link may transmit signals wirelessly and/or through the brush blocks. The fixed frame may comprise a fixed controller (351) comprising a processor in communication with a fixed communication link (352), a fixed encoder (356), a gantry drive controller (358) and a gantry drive motor (360). . Gantry drive controller (358) may communicate with stationary controller (351), stationary encoder (356), and gantry drive motor (360). The rotatable ring may comprise a rotatable controller (362) comprising a processor and a rotatable encoder (364). A rotatable controller (362) may communicate with a rotatable communication link (354) and a rotatable encoder (364). The rotatable and stationary encoders may operate independently, and their encoder data (e.g., rotatable ring location data) is transmitted via signals transferred across communication links (352, 354) to They may be checked against each other periodically. The rotatable encoder and/or rotatable controller data may be a reference against which the fixed encoder and fixed controller are compared (e.g., the rotatable controller is the "master" while the fixed controller "slave"). In some variations, rotatable controller (362) issues commands for radiation delivery components (e.g., therapeutic radiation source commands, multi-leaf collimator commands, etc.). The rotatable controller (362) may read and timestamp data from a rotatable encoder (364) and/or a PET detector and/or CT imaging system mounted on the rotatable ring. Controller (362) may timestamp data obtained from components on the rotatable ring at a rate of about 0.5 kHz or greater (eg, about 1 kHz, about 1.5 kHz, etc.). Timing of commands for radiation delivery components and synchronization may be determined based on gantry angles derived from rotatable encoder data. In some variations, operation of the gantry drive motors (360) may be based on data from stationary encoders (356). For example, ring position and/or velocity data from stationary encoders (356) may be communicated to gantry drive controller (358). The gantry drive controller (358) may also receive commands from the stationary controller (351) and generate commands and instructions to the gantry drive motors (360). The gantry drive controller (358) may time stamp data from the stationary encoder (356) at a rate of approximately 250 Hz, and the time stamped encoder data is sent to the rotary controller (362) via the rotatable communication link (354). ), which may be compared with the time-stamped rotatable encoder data for accuracy. Optionally, the couch position encoder may also provide time-stamped couch position and/or velocity data to the rotatable controller via the rotatable communication link. 5kHz) may time-stamp the data obtained from the components on the rotatable ring. Timing of commands for radiation delivery components and synchronization may be determined based on gantry angles derived from rotatable encoder data. In some variations, operation of the gantry drive motors (360) may be based on data from stationary encoders (356). For example, ring position and/or velocity data from stationary encoders (356) may be communicated to gantry drive controller (358). The gantry drive controller (358) may also receive commands from the stationary controller (351) and generate commands and instructions to the gantry drive motors (360). The gantry drive controller (358) may time stamp data from the stationary encoder (356) at a rate of approximately 250 Hz, and the time stamped encoder data is sent to the rotary controller (362) via the rotatable communication link (354). ), which may be compared with the time-stamped rotatable encoder data for accuracy. Optionally, the couch position encoder may also provide time-stamped couch position and/or velocity data to the rotatable controller via the rotatable communication link.
FIG. 3B depicts a schematic cross-sectional view of one variation of a communication interface or slip ring linkage that may be used in a radiation therapy system with a rotatable gantry. The rotatable gantry (300) may be a circular gantry comprising a rotatable ring (302) and a stationary frame (304). Rotatable ring (302) may be coupled to frame (304) via gantry bearings (306) and may be configured to rotate about an axis of rotation represented by dashed line (301). A first communication interface (310) includes a rotating receiver element (312) mounted on a rotatable ring (302) and a rotatable component mounted on a fixed frame (304) from a non-rotating motion controller (330). and a static transmitter element (314) configured to transfer command signals to. For example, command signals representing controller instructions for linac launch and multi-leaf collimator operation (e.g., opening and/or closing certain leaves) can be sent from a stationary controller, static transmitter elements (314), rotating receiver elements ( 310). A second communication interface (320) comprises a rotating transmitter element (322) mounted on a rotatable ring (302) and a static receiver element (324) mounted on a fixed frame (304). good too. The rotating transmitter element (322) may be configured to transfer data signals from the rotatable component to the non-rotating controller (330). Data signals representing, for example, linac position information, collimator leaf position information, measured rotational speed data of rotatable rings, PET detector data, MV detector data and/or kV detector data, etc. (302) may be transferred to the fixed motion controller (330) and/or the fixed controller. Some of this data is used to generate commands for gantry rotation and collimator leaf actuation to detect any system deviations or deviations (e.g. position drift of any of these components). lift) and the timing of firing radiation pulses may be transmitted to a controller on a rotatable ring that coordinates the linac location with the collimator leaf configuration. The transmitter and receiver elements of the first and second communication interfaces may communicate commands and/or data using inductive and/or capacitive signal transfer methods.
FIG. 3C is a functional block diagram depicting the flow of data between fixed or static components of the gantry and rotatable or dynamic components of the gantry. Static feedback is precise low-latency position data on the fixed side. Fixed high bandwidth data within this subsystem, such as the position and/or velocity of the rotatable ring, is detected by a fixed readhead (324) or fixed encoder and transmitted to a fixed motor controller (330) and motor (332). may Operation of the motor controller and motor may not rely on data signals transmitted across the slip rings. Rotational high bandwidth data within the subsystem, such as the position and/or velocity of the rotatable ring, is detected by a rotating readhead (312) or rotatable encoder, radiation delivery module (340), PET detector (340). , and other electronics (344) may be transmitted to other modules on the rotatable ring. Signals transmitted across the slip ring may include relatively low latency signals such as synchronization signals, data from the rotatable PET detector (342) and the MV detector (not shown). . These signals may be transmitted across the slip rings to a motion controller (330), which may help better coordinate the control of the motor (332) that drives the rotatable ring (302). Multileaf collimator and linac firing commands, generated by a system controller (not shown) (e.g., based on treatment planning and/or feedback data from PET detectors and/or MV detectors), are rotated from the system controller. It may be transmitted to the collimator and linac. The angular locations of the linac, collimator, and PET detector may be tracked by the system controller. The latency between detection of a positron emission event and application of a therapeutic radiation pulse contributes to treatment inaccuracy, as a delay of several seconds can interfere with the system's ability to apply radiation therapy prior to tumor migration. obtain. PE
3D-3F depict one variation of the communication interface across slip rings between the fixed frame and the rotatable ring. A fixed frame (370) may comprise a fixed receiver unit (372), a fixed transmitter unit (374), and a stator ring (376). The stator ring (376) may comprise a plurality of locator marks (378) and counts (379) between the locator marks (378). The rotatable ring (380) may comprise a rotatable receiver unit (382), a rotatable transmitter unit (384) and a rotor ring (386). The rotor ring (386) may comprise a plurality of locator marks (388) and counts (389) between the locator marks (388). The number of counts between the locator marks of the stator ring may differ from the number of counts between the locator marks of the rotor ring. The stator ring and rotor ring may each have about 10 to about 50 locator marks, with about 100,000 to about 200,000 counts. For example, the stator ring may have 20 locator marks and 136,000 counts, and the rotor ring may have 22 locator marks and 114,000 counts. 400 counts. The receiver unit may comprise capacitive or inductive sensors configured to detect the locator marks and counts as the receiver unit moves over the locator marks and counts. The rotatable receiver unit (382) may comprise an encoder, and as the rotatable receiver unit sweeps across the stator locator marks (378) and counts (379) on the stator ring (376), The position and/or velocity of the rotatable ring (380) are used to control the motion of therapeutic radiation sources, multileaf collimators, MV detectors, PET detectors, and other components on the rotatable ring. good too. The fixed receiver unit (372) may comprise an encoder and is rotatable as the fixed receiver unit sweeps across the rotor locator marks (388) and counts (389) on the rotor ring (386). The position and/or velocity of ring (380) may be used to control the operation of a gantry drive controller and/or a gantry drive motor. Time-stamped fixed receiver or encoder data is transmitted to the controller on the rotatable ring via a fixed transmitter unit (374) and time-stamped to ascertain/check the position and/or velocity of the rotatable ring. It may be compared with a rotatable receiver or encoder data with. Time-stamped fixed receiver or encoder data may optionally be transmitted via the databrush block. In some variations, data from the GIGACAP rotor/stator and/or data from the encoder may be transmitted via the transmitter unit and 10BaseT data transmitted across the brush blocks. good too. The rotatable ring (380) may also comprise one or more brush blocks (381) positioned at various circumferential locations for data or power transmission. For example, the rotatable ring (380) may be traversed by a fixed power source (as shown). There may also be two power brush blocks (381) that can be transmitted from (without) to the rotatable ring. The rotatable ring may also comprise a databrush block (383) across which synchronization and/or offset data signals containing 10BaseT data may be transferred.
FIG. 3F illustrates the communication interface between the rotatable ring and the fixed frame, and the rotor and rotator mechanically driving the rotation of the ring, the cooling system, and the various components and modules mounted on the rotatable ring. 1 depicts a schematic side cross-sectional view of a stator; A fixed frame (390) includes a fixed receiver unit (392), a fixed transmitter unit (394), a stator coil (396), fixed feedback or locator marks (398), and a motion controller (391). You may prepare. A rotatable ring (303) includes a rotatable receiver unit (305), a rotatable transmitter unit (307), a rotor magnet (309), a slip ring (311), and a radiation delivery assembly (313). , PET detection system (315), electronic circuits and components (317), KV A CT system (319) and a cooling system (321) may be provided. The rotatable ring may also include a plurality of locator marks (397) as previously described. FIG. 3G depicts a front view of the stator coils (396) and rotor magnets (309). The stator coil may comprise multiple coils arranged in a ring-shaped band. The motion controller (391) may generate current through the stator coils (396) that may induce a magnetic flux that provides the motive force for the rotor magnets (309) causing rotation of the ring. The gantry bearings (393) on the stationary frame (390) guide the movement of the ring when subjected to the motive force generated by the rotor/stator interaction as described above and depicted in FIG. can help you do that. In some variations, the ball bearing assembly and stator (e.g., stator coil) can help generate sufficient motive force to rotate the ring with several tons of components mounted thereon. , may be retained by the same structure or housing. A cooling system (321) may be located adjacent to the slip ring (311) to facilitate transfer of heat generated at the slip ring interface to the cooling system. For example, a cooling system may be configured to facilitate heat transfer between a component at approximately 40°C and a heat sink at approximately 20°C. Optionally, the heat conductor connects the cooling system (321), the radiation delivery assembly (313), and/or the PET detection system (315), and/or the electronics (317), and/or the KV CT system (319). may be combined. Additional discussion of cooling system variations is provided below.
Although these communication interfaces and/or slip-ring-based communication links are described in the context of a continuously rotating gantry driven by a rotary drive motor, such communication interfaces and/or links may include static motors, It should be understood that it may be included in any type of rotatable gantry, including a rotatable gantry using a drivetrain mechanism with a static motion controller.
with radiation shield
In radiation therapy, it is desirable that the therapeutic radiation beam be well controlled and characterized. For a therapeutic radiation source or linac mounted on a rotatable gantry, adjusting the radiation beam while the gantry is rotating at different velocities and/or when the radiation beam may be projected from different gantry angles. , in particular, can be difficult. A typical approach to address this problem is to place the linac on the gantry using a rigid mounting mechanism such that the emitted radiation beam deviates as little as possible under different conditions (velocity, angle). Tight mounting may be included. Optional beam generating components and beam limiting devices may also be mounted on the gantry to reduce excursions during these different conditions. Additionally, it may be desirable to provide radiation shielding around the body of the linac to help reduce any stray radiation that may be unwantedly emitted from anywhere except through the desired opening. Typically, the shield is heavy (in some systems it can be about 400-500 pounds) and can significantly pull the structures that hold it around the linac. Currently, radiation therapy systems include heavy/massive structures that hold linacs, beam-defining devices, and radiation shielding, which may be acceptable for relatively slow-rotating gantrys (e.g., rotational speeds less than about 10 RPM). . However, due to high gantry rotation speeds of about 50 RPM to about 70 RPM or more (e.g., 60 RPM or more), the centripetal force acting on this heavy mounting structure can lead to linac excursion and/or structural failure of the gantry. can cause stress.
The radiation therapy system disclosed herein comprises a linac (e.g., therapeutic radiation source), a radiation shield disposed across the linac without contacting the linac, and a radiation shield for mounting the linac to a rotatable ring of a rotatable gantry. and a second mounting assembly separate from the first mounting assembly for mounting the radiation shield to the rotatable ring. A second mounting assembly may comprise a shelf or bridge structure for securely attaching the radiation shield to the rotatable ring of the gantry. The first mounting assembly and the second mounting assembly may be separated by an air gap and/or may not be in direct contact with each other. Mounting the linac and radiation shield with separate mounting assemblies can help isolate any structural deflections or mechanical forces that may be generated by rotating the radiation shield from the linac and beam-defining device. Isolating these mechanical forces can help facilitate stability and/or accuracy of delivered radiation under different operating configurations while still having radiation shielding.
FIG. 4A depicts one variation of the linac, radiation shielding, and corresponding mounting assembly for the rotatable gantry, and FIG. 4B depicts an exploded view of the linac, radiation shielding, and corresponding mounting assembly of FIG. 4A. do. Referring to FIG. 4A, the gantry rotatable ring (400) may comprise a chassis or support structure (401) on which the linac (402) and linac radiation shield (406) are mounted. The support structure (401) may comprise a first interior side (420) and a second exterior side (422), and further includes a mounting bracket (403) located on the first interior side (420). ) may be provided. Mounting bracket (403) may comprise one or more beams or plates. The linac (402) is mounted on a rotatable ring by a first mounting assembly (404), which may have two panels (424a, 424b) connected to a top plate (426), as depicted in Figure 4B. (400) may be mounted on. In some variations, the panels (424a, 424b) and top plate (426) may be welded together and into the gantry support structure (401). The linac (402) may be positioned across an opening in the top plate (426) and fixedly attached to the top plate (426). The top plate (426) may lie flush with the exterior side (422) of the gantry support structure (401) or may be mounted slightly from the exterior side (422). The panels (424a, 424b) extend toward the interior side (420) of the support structure (401) and may be attached to mounting brackets (403). An optional beam limiting or shaping device (408) may optionally be attached to the first mounting assembly (404). This can help maintain the relative positioning between the linac and the beam defining or shaping device. In the variation depicted in FIGS. 4A and 4B, radiation shielding (406) extends across linac (402). It may be mounted on the rotatable ring (400) by a second mounting assembly (410), which may have a bridge shape with two sloping panels arranged in parallel and extending from the upper generally horizontal panel. That is, the upper portion of the second mounting assembly (410) has a curve, shape, or surface along the length of the circumference of the gantry ring, e.g., tangentially following the curvature of the ring, and curved from the upper portion. Or it may have two side portions that bend and follow the curvature of the ring. More generally, the radiation shielding mounting assembly can help anchor the gantry shielding by increasing the contact surface area and attachment points between the mounting assembly and the gantry, gantry curvature and/or gantry curvature. It may have a shape corresponding to the surface contour. For example, a mounting assembly that approximately follows the curve of the gantry distributes forces along the gantry's support structure and/or provides more surface area for welded, soldered, threaded, and other mechanical attachments. can help enable A second mounting assembly (410) may be attached to the exterior side (422) of the support structure (401) and separated from the first mounting assembly (404) by an air gap (412). For example, the first mounting assembly (404) and the second mounting assembly (410) may be attached to different support structures or beams of the rotatable ring. The linac (402) and radiation shielding (406) may also be separated by a gap. It may have a shape that corresponds to the curvature of the gantry and/or the surface contour of the gantry, which can help secure the gantry shield by increasing the contact surface area and attachment points between the gantry and the gantry. For example, a mounting assembly that approximately follows the curve of the gantry distributes forces along the gantry's support structure and/or provides more surface area for welded, soldered, threaded, and other mechanical attachments. can help enable A second mounting assembly (410) may be attached to the exterior side (422) of the support structure (401) and separated from the first mounting assembly (404) by an air gap (412). For example, the first mounting assembly (404) and the second mounting assembly (410) may be attached to different support structures or beams of the rotatable ring. The linac (402) and radiation shielding (406) may also be separated by a gap. It may have a shape that corresponds to the curvature of the gantry and/or the surface contour of the gantry, which can help secure the gantry shield by increasing the contact surface area and attachment points between the gantry and the gantry. For example, a mounting assembly that approximately follows the curve of the gantry distributes forces along the gantry's support structure and/or provides more surface area for welded, soldered, threaded, and other mechanical attachments. can help enable A second mounting assembly (410) may be attached to the exterior side (422) of the support structure (401) and separated from the first mounting assembly (404) by an air gap (412). For example, the first mounting assembly (404) and the second mounting assembly (410) may be attached to different support structures or beams of the rotatable ring. The linac (402) and radiation shielding (406) may also be separated by a gap.
Linac matching
A radiation beam or spot emitted by a linac may be precisely aligned with a beam-defining or shaping device (e.g., a multi-leaf collimator) to obtain and maintain precise and/or accurate therapeutic beam performance. can help. In some variations, the alignment between the linac radiation beam or spot and the collimator may be within a predetermined tolerance threshold of about 200 microns or less. Alignment of the linac spot to the collimator is checked in at least three situations: in the factory, upon delivery of the system to the outpatient clinic, and when the linac or beam converter is inspected in the field. may Alignment may include launching a pulse from the linac through a collimator and measuring the incidence of the pulse on a detector (eg, MV detector) located on the opposite side of the linac. Based on the known configuration of the collimator (e.g. some leaves open and some others closed) and data from the detectors, the controller determines whether the linac alignment is within predetermined tolerances. may be determined. If the radiation beam or spot is not aligned with the collimator within predetermined tolerances, the location of the linac may be adjusted. Such adjustments are typically performed manually, and often these steps can be repeated several times before the desired alignment is achieved, thus opening the bunker doors and linacs. It is considered cumbersome to move, close the bunker door, fire the linac pulse, and measure the linac location and beam spot relative to the collimator.
The radiation therapy system described herein optionally includes an intermediate adjuster plate on which the linac is mounted, an alignment actuator, and once alignment between the linac and the collimator is obtained, adjusts the position of the intermediate adjuster plate. and a locking lockdown mechanism. In some variations, the alignment actuator may be removable such that the actuator may be removed after the linac has been aligned, which reduces exposure of the actuator to radiation produced by the system during a treatment session. It can help to limit A linac (optionally a beam converter and/or a beam-limiting component associated with the beam converter) may be mounted on an adjuster plate, and the plate may be moved relative to the collimator by an actuator. In one variation, the adjuster plate may be coupled to the actuator via a screw, and the motor of the actuator may rotate the screw and move the adjuster plate. In some variations, the adjuster plate may be coupled to one or more actuators via two screws, with rotation of the first screw along a first axis (e.g., the x-axis). Moving the plate, rotation of the second screw moves the plate along a second axis (eg, the y-axis) that may be orthogonal to the first axis.
The alignment actuators may be remotely controlled by an operator located in a room separate from the radiotherapy treatment room. For example, alignment actuators may optionally communicate with a wireless transceiver that may receive remote operator commands. Alternatively or additionally, the alignment actuator may be connected by one or more wires to a controller in another room. This may allow the linac radiation spot to be aligned with the collimator by an operator located outside the bunker, and when the desired alignment is obtained, the operator locks the linac and plate in the desired location. optionally, the alignment actuator may be removed prior to the treatment session. A radiation therapy system comprising a kV or imaging radiation source may optionally comprise the same mechanism for adjusting the alignment of the kV or imaging radiation source to the kV detector. A radiotherapy system with MV detectors may include an angle adjustment mechanism having an anchor on one end and an adjustment screw on the other end for aligning the MV detector array with the jaw plane. good.
4C-4E depict one variation of the radiation source (linac) adjustment mechanism. FIG. 4C shows a rotatable gantry ring (430) and a linac (432) mounted on the gantry (430), an X-axis adjustment assembly (434), and a Y-axis adjustment assembly (434) with the linac beam path along the Z-axis. 436) is a perspective component diagram. The linac (432) may be mounted on a moveable adjuster plate to which an X-axis adjustment assembly (434) and a Y-axis adjustment assembly (436) may be attached. The adjustment assembly may also be attached to the linac baseplate (440), which is fixedly mounted on the gantry ring (430), eg, mounted to the primary collimator. FIG. 4D depicts a top view of linac (432) mounted on adjuster plate (438). Adjuster plate (438) includes one or more mounting holes (439a) for X-axis adjustment assembly (434) and one or more mounting holes (439b) for Y-axis adjustment assembly (436). , may include a plate adjuster mount (437). The adjustment assembly uses one or more screws that engage within mounting holes on the adjuster plates (439a, 439b) and one or more holes (441a, 441b) on the linac base plate to attach the adjuster plate and linac plate. It may be attached to plate (440). The adjustment assembly may be coupled to the adjuster plate and plate by one or more screws, although it should be understood that the assembly may be attached by welding, brazing, adhesives, or the like. Adjuster plate (438) may be moved relative to base plate (440) based on actuation by adjustment assemblies (434, 436).
FIG. 4E depicts a close-up side view of one variation of an adjustment assembly for positioning a linac. The adjustment assembly may be used as either an X-axis adjustment assembly or a Y-axis adjustment assembly, and may be used to adjust the position of any radiation source and/or detector as appropriate. The adjustment assembly (450) includes a first mount (452) configured to attach to the adjuster plate (438), a second mount (454) configured to attach to the base plate (440), A screw (456) connecting the first and second mounts together and rotating the screw (456) to adjust the distance between the first mount (452) and the second mount (454) , and a stepper motor (458). A stepper motor (458) may be coupled to the screw (456) via a drive belt between the motor and the screw. For example, the screw (456) may have a first pulley (455) located at one end of the screw, and the stepper motor (458) has a second pulley (458) coupled to the rotating shaft of the motor. 459) and a second pulley (459) such that rotation of the second pulley (459) causes rotation of the first pulley (455), thereby rotating the screw (456) and moving the adjuster plate relative to the base plate. and a belt spanning both the first and second pulleys. Some variations of the stepper motor may include a gearbox that adjusts the torque produced to a level suitable for moving the adjuster plate and the linac mounted thereon. Adjustment assembly (450) may also include a dial indicator (460) that provides a mechanical reference for the operator to track movement within the adjustment plane. In some variations, the alignment assembly may include a wireless transceiver that communicates with a remote controller or processor so that motor activation and linac movement can be controlled from another room. alternatively or additionally , the alignment assembly may be connected by one or more wires to a controller or processor in another room. The first mount (452) may be coupled to the adjuster plate (438) via screws, pegs or protrusions corresponding to mounting holes (439) in the adjuster plate and the second mount (454). may be coupled to the baseplate via screws, pegs or protrusions corresponding to mounting holes (441) in the baseplate. An adjustment assembly (450) may be used to adjust the position of the linac along the X and Y axes. The adjustment assembly (450) uses a stepper motor that rotates a screw to move the linac adjuster plate, although other variations include other mechanisms for moving the linac adjuster plate, such as a rack and pinion mechanism, Electromagnetic actuator mechanisms and the like may also be used.
In some variations, the MV detector located across from the linac may also be adjusted to help ensure consistent alignment with the linac. For example, the linac and MV detector positions may be adjusted together, and/or the linac or MV detector positions may be adjusted so that they are aligned (e.g., the center of the MV detector is across from the center of the linac beam). may be checked when the position of the MV detector or linac is adjusted to ensure that the FIG. 4F depicts the gantry ring and the MV detector (470) mounted thereon. The linac may be mounted directly across from the MV detector (470), eg, across an opening across from the MV detector, using the mounting and positioning mechanisms described above. The MV detector mounting mechanism mounts to the gantry ring using flanges to control the MV detector position along the X, Y, and Z axes (where the linac applies radiation along the Z axis) A series of gantry mounting flanges and alignment or adjuster plates may be provided. The gantry mounting flanges may be configured to pivot or tilt the MV detector with respect to the isocenter, e.g., establish nominal Y-axis and Z-axis positions with respect to the MV beam source (e.g., linac). may be used for A co-mounted alignment plate may be configured to rotatably adjust the MV detector along the z-axis to properly align with the plane established by the MV beam source. Optionally, alignment or adjuster plates optionally add adjustability for discrete y-axis positions offset from the nominal plane in both positive and negative directions (eg, during a test or calibration session). good too.
FIG. 4G depicts a perspective view of the MV detector (470) and its mounting and positioning assembly. The mounting and adjustment assembly may comprise an alignment or adjuster plate (474) movably attached to the gantry mount assembly (472). A mounting plate (472) may be fixedly attached to the gantry ring. FIG. 4H depicts an exploded view of the MV detector (470), alignment plate (474), and gantry mount assembly (472). The gantry mount assembly (472) may comprise an MV support plate (482) and a support block (480) attached to the bottom surface of the MV support plate (482). The MV detector (470) may be mounted directly on the alignment plate (474). The MV support plate and support block may be fixedly attached to the gantry ring via bolts and/or alignment pins. The alignment plate (474) is coupled to a mechanism (such as the mechanism described above with respect to the linac mounting and positioning assembly) configured to translate the MV detector along one axis (eg, the Y axis). and/or may be coupled to a pivotable or rotatable mechanism configured to rotate the MV detector about one axis (eg, the Z axis). The mounting and alignment assembly may also include mounting flanges (476, 478) coupled to support block (480) and support plate (482). FIG. 4I depicts two possible translation positions offset from the nominally aligned position shown in FIG. 4J (the top view of FIG. 4I shows the adjustment assembly in the fully extended configuration). 4I depicts the adjustment assembly in the fully retracted configuration). Figure 4J depicts the nominally aligned position of the MV detector assembly along with one possible rotation or pivoting state (the top view of Figure 4J depicts the adjustment assembly in the nominal configuration). , the bottom view of Figure 4J depicts the adjustment assembly when rotated or pivoted.
Temperature control
Generally, the systems described herein may comprise a radiation therapy system comprising a thermal management system to help maintain system temperature within an operable range. A continuously rotating gantry for radiation therapy poses a difficult temperature or heat management problem. A gantry capable of rotating at speeds of about 10 RPM to about 70 RPM may generate more heat than a gantry rotating at a slower speed. For example, a continuous rotating radiation therapy system can generate over 70 kW of heat. Many of the sensors in radiation therapy systems are sensitive to changes in temperature, and elevated temperatures can also adversely affect patient comfort. Large bore continuous rotating fluid unions used in radiotherapy systems with low speed gantry (eg, less than about 10 RPM) are suitable for use with high speed gantry (eg, about 20 RPM to about 70 RPM, about 60 RPM and above). may not be. In addition to removing heat from the gantry itself, the thermal management system may also need to remove heat from the gantry enclosure and treatment bunker. Temperature control may be managed at many levels by several methods. The method for temperature control is such that sensor data is used to measure fan operation (e.g., speed control), hot and cold liquid mixing rates on the rotatable ring and/or between the rotatable ring and the stationary frame, and/or the rotatable A feedback loop with temperature and airflow sensors may be included that may be used to adjust the control of liquid flow over the ring. In some variations, the thermal management system for transferring heat across the rotatable ring and/or to a fixed frame and/or to an outpatient clinic or facility heat sink includes multiple heat sinks on the rotatable ring. Liquid branches or conduits, and/or fluid pumps or other regulators, and/or rotatable ring heat exchangers, and/or stationary heat exchangers, and/or heating liquid from rotatable rings to cooling liquids on stationary frames may include the step of contacting or mixing with stomach. FIG. 5A is a block diagram representing one variation of heat transfer from the rotatable ring to the fixed frame. Heat generated by components on the rotatable ring may be transferred to a cooling fluid, which may be circulated throughout the ring. Heat transferred to the cooling fluid is via one or more forced air heat exchangers (e.g., via air conduits with or without the assistance of one or more fans) between the rotatable ring and stationary frame. It may be transmitted to the air circulated between them. Heated air from the rotating ring (and heat from components on the stationary frame) may be directed to the facility cooling fluid. Alternatively, the heated air from the rotatable ring may be transferred directly to the facility cooling fluid without using a forced air heat exchanger. In the variation depicted in FIG. 5A, the thermal management system (520) controls the temperature of the components (523) (eg, linac, magnetron, collimator, jaws, PET detector array, MV detector, etc.) on the rotatable gantry. There may be one or more fluid conduits (522) and one or more heat exchangers (524) that circulate fluid therebetween. Fluid conduits (522) may form loops that transport heated fluid from the components to heat exchangers (524), where the fluid is cooled by one or more fans (526). The cooling fluid is then circulated back to component (523). In some variations, a fluid flow controller (525) may be located on the rotatable ring to adjust the fluid rate in response to data from temperature sensors on the rotatable ring. Heat from the fluid is transferred to the air via the fan (526), which is then channeled to one or more stationary heat exchangers (530). Optionally, the heated air flow rate between the rotatable ring and the stationary frame may be facilitated by a second set of fans (528) adjacent to the stationary heat exchanger. A stationary heat exchanger (530) may transfer heat from the air to the facility cooling system (532). The facility cooling system, for example, circulates cooling air that mixes with heated air in a stationary heat exchanger (530), or
A variation of a temperature management system for a radiation therapy system with a high speed gantry may comprise two sets of heat exchangers and conduits. For example, a heat exchanger may comprise a copper substrate with a high surface area to volume ratio and a liquid conduit thermally coupled to the surface of the substrate. Heat from the rotating gantry is obtained by raising the temperature of the air surrounding the gantry, which heat is transferred to the exchanger substrate, for example, via airflow provided by a fan or via radiative conduction. may Heat from the substrate may then be transferred to the cooling liquid in the conduit, which then transfers heat away from the gantry to the liquid reservoir. The cooling liquid may, for example, be water and may be circulated locally (e.g., in or in close proximity to the room or bunker where the treatment system is located) and/or traverse the treatment facility. may be cycled through. A first set of heat exchangers and conduits may be configured to transfer heat generated from the rotating ring to the stationary frame of the gantry, and a second set of heat exchangers and conduits may transfer heat from the stationary frame. It may be configured to transfer heat to the closed loop facility liquid system. In this configuration, heat from components mounted on the rotating ring may be removed using a rotatable closed-loop water system. The rotatable water system may be configured to transfer heat to conduits within the stationary frame using either a forced air heat exchanger or a radiant heat exchanger. For example, the heat may then be transferred to the refrigeration fluid (eg, provided by the facility) via conduits within the fixed frame that may be coupled to the forced air system. The forced air system may be ducted through a second set of heat exchangers that may be coupled to the refrigeration fluid. A portion of this refrigerated forced air may be directed under the gantry enclosure to maintain a constant ambient air temperature. A variable speed fan or variable refrigeration fluid flow may be used to maintain the temperature of the stationary heat exchange system.
One variation of the temperature management system is depicted in FIGS. 5B-5E. FIG. 5B depicts a gantry (500) enclosed within a housing (501). Gantry (500) may comprise a rotatable ring (502) and a stationary frame (not depicted). The thermal management assembly comprises one or more exhaust components (504) mounted on a rotatable ring (502) and a fixed duct (506) located within the enclosure of the housing (501). of heat exchange interfaces. Rotatable ring (502) may be coupled or mounted to a fixed frame. The evacuation component (504) may be at one or more locations along the circumference of the rotatable ring (502). Any number of emission components (504), e.g., 1 emission component, 2 or more emission components, 3 or more, 4 or more, 5 or more, or 10 or more emission components may be mounted on the rotatable ring. Additional exhaust components may be located near components with high heat output. In some variants, kV The CT head may include complementary ejection components. The exhaust component or forced air heat exchanger may comprise one or more fans oriented such that the airflow direction is radial (ie perpendicular to the axis of rotation). Airflow that is parallel to the axis of rotation may not direct air as efficiently as radial airflow that is perpendicular to the axis of rotation. This can be particularly noticeable when the gantry is rotating at speeds of about 50 RPM or higher (eg, about 60 RPM). For example, the first heat exchange interface depicted in Figure 5B comprises five exhaust components (504). The exhaust component (504) may transfer heat generated by components on the rotatable ring (502) to the stationary duct (506) depicted in Figures 5D-5E. The fixed duct has a shape similar to that of the rotatable ring (502) so that heat can be transferred from the exhaust component (504) to the fixed duct (506) while the ring (502) is rotating. may have. For example, as depicted in FIG. 5E, stationary duct (506) may have a circular shape corresponding to the shape of rotatable ring (502). The heat generated by the components on the rotatable ring (502) can raise the temperature of the surrounding air, which heated air is captured by the exhaust component (504) and travels towards the stationary duct (506). may be The thermal management system may further comprise a second heat exchange interface comprising a fixed duct (506) and an air portal (508). Air portals (508) may be configured for unidirectional and/or bidirectional airflow and exchange, and may be connected to a facility reservoir of cooling air or fluid. In the example depicted in Figures 5C-5E, the air portal (508) transports cooling air from the equipment reservoir into the enclosure of the housing (501) and out of the rotatable ring (502) to the exhaust component (504). ) may be provided with a fan (510) to transport the heated air out. Optionally, some components on the rotatable ring are dedicated heat transfer or cooling paths (ie, a dedicated cooling fluid flow system and/or a forced air heat exchanger or exhaust to transfer heat to the stationary frame). For example, a magnetron may have a dedicated cooling path.
gantry bore
In some variations of the system, a radiation therapy device having a rotatable gantry includes a bore configured to reduce patient discomfort (e.g., claustrophobia) due to confinement within a small space. may In some variations, the gantry may provide a comfortable patient environment to reduce patient anxiety and increase patient compliance with radiation therapy treatment. For example, in some variations, the bore of the rotatable gantry increases in diameter toward the end of the bore (i.e., a variable diameter bore or a graduated bore), resulting in a perception of claustrophobia and confinement (e.g., procedural patient lying stationary in), thereby allowing the patient to remain stationary on the patient platform for a longer period of time.
In some variations the bore may be open on both ends (e.g. open bore gantry), while in other variations the bore is open on one end and (eg closed bore gantry). One of the ends of the bore may be open to receive a patient on the patient platform for radiation therapy treatment. As explained in detail below, the bore may be enclosed at one end while maintaining the perception of an enlarged space within the bore. 6A-6B show a closed bore gantry (604) in which the closed end (second portion (608)) of the bore (604) has a diameter greater than the diameter of the open end (first portion (606)) of the bore (604). 602), representing an exemplary radiation therapy device (600). In some variations, the gantry (602) may comprise a first portion (606) and a second portion (608). As depicted in FIG. 6A, a patient (622) positioned on the patient platform (620) passes through a circular opening in the first end of the first portion (606) and into the bore (604). may be advanced. A second end of the first portion (606) may be coupled to the enclosure of the second portion (608). The patient (622) may be advanced so that its head is positioned within the enclosure of the second portion (608). By increasing the diameter of the bore (604) in which the patient's head is positioned during treatment, the patient's perception of entrapment can be reduced without increasing the diameter along the entire length of the bore (604). , claustrophobia can be alleviated.
In some variations, the diameter (609) of the second portion (608) of the bore (604) is up to four times greater than the diameter (607) of the first portion (606) of the bore (604). obtain. In some embodiments, the diameter (609) of the second portion (608) of bore (604) is approximately three times greater than the diameter (607) of the first portion (606) of bore (604). obtain. In other variations, diameter (609) of second portion (608) of bore (604) may vary, while diameter (607) of first portion (606) of bore (604) is substantially can be substantially constant. As shown in FIGS. 6A-6B, the second portion of bore (604) may have an ellipsoidal shape (eg, a hemispherical shape) and is illuminated as described in further detail below. may The second portion (608) may comprise any shape configured to simulate an expanded space. For example, the second portion (608) may comprise a cuboid shape, such as an open box shape. Additionally, the second portion may enclose the patient (622) within the patient's field of view. For example, the bore (604) of the second portion (608) is positioned from approximately below the patient's eye level with respect to the patient platform (620) because the patient (622) cannot see below that point. may be opened.
As shown in FIG. 6A, the first portion (606) extends axially through the plane of the radiation beam (614) with the second portion (608) formed just beyond the radiation plane. You may In this manner, the patient (622) may receive the radiation beam (614) from the rotating first portion (606) while the expansion space within the second portion (608) is maximized. may be made In Figures 6A-6B, the first portion (606) may be rotatable while the second portion (608) may be stationary. In these variations, a gap may be formed between the first portion (606) and the second portion (608). It should be appreciated that both the first portion (606) and the second portion (608) may be rotatable.
The gantry (602) may further comprise a multi-leaf collimator (612), which may be provided on the opposite side of the detector (616). Gantry (602) may be coupled to radiation source (610). In some variations, the radiation source (610) may be mounted on the gantry (602) such that it rotates with the rotation of the gantry (602) about the patient (622). Radiation source (610) and collimator (612) may be configured to emit radiation beam (614) in a plane perpendicular to the longitudinal axis of patient platform (620).
In some variations, such as with an open-bore rotatable gantry, the radiation source (610) is a magnetron mounted on a rotatable ring (not shown) of the first portion (606) of the gantry (602). may be provided. In other variations, such as those with a closed-bore rotatable gantry, the radiation source (610) may comprise a klystron not mounted on a rotatable ring of the first portion (606) of the gantry (602). . The klystron A stationary klystron can provide higher energy, higher power, and better reliability compared to a magnetron mounted on a rotatable ring.
In some variations, one or more of visual, audio, and tactile sensory input may be provided to the patient (622) to simulate an expanded space within the bore (604). . In some variations, radiation therapy device (600) may provide sensory outputs (eg, visual, auditory, tactile) configured to create the illusion of expanded space. For example, a display of an outdoor setting may be projected in the patient's field of view on the walls of the bore in combination with natural sound audio output and airflow over the patient's face. In some examples, the displayed image may change based on where the patient's eyes are looking using the optical eye tracker. Sensory output may be modified using optical eye tracker data. Such sensory output may also cause patients in open-bore systems to experience claustrophobic discomfort due to the length of the bore (i.e., the patient's head is generally in the diagnostic or therapeutic It does not exit the bore during the session), so it may be used in open-bore and closed-bore systems.
In some variations, the gantry (602) is positioned within the bore (604) of the gantry (602) such that the inner surface of the second portion (608) of the bore (604) (e.g., One or more image projectors (630) configured to illuminate (631) the ceiling (e.g., provide illumination, images, video). For example, FIG. 6B depicts an outdoor waterfall scene illuminated (631) on the interior surface of the second portion (608). The image displayed on the hemisphere of the second portion (608) may create the illusion of expanded space sufficient to alleviate claustrophobia in the patient (622). In some variations, a second portion corresponding to the patient's (622) peripheral vision, such that a lower resolution and/or out-of-focus image assists the user in maintaining their head in a fixed position. It may be displayed on the area of (608). Similarly, the amount of illumination (eg, lumens) may be maximized for the patient's central vision and gradually reduced radially outward from this position (eg, toward the peripheral vision). In some variations, the position of the image displayed on the inner surface of the second portion (608) of the bore (604) changes as the patient platform (620) translates and/or rotates through the bore (604). , may vary with the position of the patient (622). Additionally or alternatively, the interior surface of second portion (608) of bore (604) may include one or more displays (eg, LED, OLED, LCD, CRT, etc.).
In some variations, the audio device (632) outputs audio to the patient (622), e.g. may be placed anywhere in the For example, the audio device (632) may be mounted to a fixed portion of the gantry (602) inside one or more of the first portion (606) and the second portion (608). Audio device (632) may include one or more speakers. The audio output by the audio device (632) may correspond and/or be synchronized with the lighting output by the image projector (630). For example, the waterfall image displayed to the user in FIG. 6B may be accompanied by a corresponding waterfall noise that may add white noise and reduce the perception of noise from gantry (602) motion. As another example, the audio output may further comprise echoes to simulate an expanded space. Additionally, the speaker may also output a noise cancellation signal, as discussed in more detail below.
In some variations, airflow device (636) is positioned within bore (604) to direct airflow from a predetermined direction over a desired portion of patient (622), such as the patient's face. may be placed. In some variations, the airflow device (636) may comprise one or more fans positioned within the second portion (608). The fan may draw air from within the bore (604) or externally to the gantry (602). In some examples, the airflow device (636) may be coupled to the air conditioning system to provide cooling air to the patient (622). Air flow device (636) may provide positive or negative pressure.
In some variations, optical eye tracker (634) may be placed anywhere within bore (604) with a clear line of sight to the patient's eye. The optical eye tracker (634) includes a non-contact optical sensor configured to determine line of sight and/or eye position using one or more of corneal reflection, infrared, pupil tracking, etc. You may prepare. In some variations, the image projected by the image projector (630) may be repositioned based on the detected line of sight and/or eye position from the optical eye tracker (634). In this way, the patient (622) may be able to comfortably view the images without moving their head.
In one variation, the radiation therapy system may include one or more visual displays located within the bore. The image presented on the display may be moved along the bore as the patient is moved (by the couch) during the treatment session. The detected line of sight and/or eye position from the optical eye tracker optionally moves the image along the bore such that the image is always within the patient's field of view without requiring patient head movement. may be used for In some variations, the display may be a flexible display that can be mounted along the inner surface of the bore to follow the curvature of the bore. For example, the display may be an organic light emitting diode (OLED) display. FIG. 6C depicts a cross-section of one variation of a radiotherapy system with one or more displays within the bore. A radiotherapy system (640) comprises a rotatable gantry (644) with a longitudinal bore (642) extending through the gantry, a linac (646), a kV radiation source (648) and an upper couch (655). and a plurality of displays (650a, 650b, 650c) mounted along the length of bore (642). A linac (646) may produce a therapeutic treatment beam (647) and a kV radiation source (648) produces an imaging beam (649) at a different longitudinal location along the bore than the therapeutic treatment beam. may The displays (650a, 650b, 650c) may be flexible displays, such as OLED displays, that are bendable to follow the curvature of the bore (642). A display (650) may be mounted along the length of the bore, except for the area of the bore that is within the therapeutic treatment beam path or the imaging beam path. Avoiding the radiation beam path can help extend the life of the display (650). FIG. 6D depicts an end view of the system of FIG. 6C wherein, as depicted, the flexible display (650) extends the patient's field of view and corresponding circular Arcs may be crossed and straddled. The display (650) may span across about 25% of the bore circumference to about 50% of the bore circumference, such as about 30% of the bore circumference. Figures 6E and 6F depict one variation of a system comprising a flexible display (650) positioned within a bore (642) with one or more images on the display tracking the position of the patient's eye. For example, when the patient is moved from a more superficial location (FIG. 6E) to a deeper location within the bore (FIG. 6F), the image (652) on the display (650) while the patient is in the more superficial location ) may be replaced with another image (652') on the display (650) as the patient is moved to greater depth. A sequence of images from the first image (652) to the second image (652') may be generated to create the illusion that the images are moving from one location to another. The location of the image on the display may be determined by couch position and/or optical eye tracker data, as described above.
audio system
Various components of a radiation therapy system, such as the rotating gantry, collimator leaf movement, temperature control system, and other high voltage components, can produce significant levels of mechanical noise. This machine noise can be amplified within the constraining boundaries of the gantry bore where the patient is placed. For example, gantry motion is consistent background noise, along with intermittent mechanical and electrical noise associated with activation of one or more subsystems, such as mechanical noise associated with MLC leaf movement activated during therapy beam delivery. can generate Elevated auditory noise levels can impair patient comfort, increase patient anxiety, and can lead to patient movement (eg, fidgeting, body repositioning, increased respiratory rate, etc.). Reducing hearing discomfort can therefore improve patient comfort and compliance. Noise-cancelling headphones and other wearable solutions for noise management can interfere with and/or be damaged by the treatment beam. In some variations, the radiotherapy system may include an audio system mounted on the gantry outside the treatment and/or imaging radiation beam path. The audio system uses the patient position data and microphones and speakers configured to produce noise canceling audio at the patient's ear as the patient moves through the bore of the gantry and/or receives a radiation therapy treatment. An array may be provided. A controller in communication with the microphone and speaker array maps mechanical noise, calculates a noise-canceling signal based on patient location data, and projects the appropriate amplitude and phase of the noise-canceling signal from the speaker array to the phased array. A method based on theory may be used. In general, the processor may be configured to receive ambient sound, generate a waveform signal that is the exact opposite of the ambient sound, and mix it with any desired audio signal to be output to the patient. For example, the noise cancellation signal is 180° out of phase with equal amplitude as the noise received by the patient's ear.
FIG. 7 depicts one variation of an auditory noise management system that can be used with any of the radiation therapy systems described herein. In particular, radiation therapy system (700) comprises a gantry (710), illustrated in FIG. 7, comprising a radiation source (730) coupled to a multi-leaf collimator (732). A detector (736) may be provided opposite the multi-leaf collimator (732) to receive the radiation beam (734) output from the collimator (732) and the radiation source (730). Gantry (710) may comprise a patient area with a bore of gantry (710) configured to receive a patient (722) on patient platform (720). The gantry (710) may further include a speaker array (712) and a microphone array (714) within the patient area and positioned on a fixed frame (not shown) of the gantry (710). As depicted in FIG. 7, speaker arrays (712) and microphone arrays (714) may be positioned within one or more ends of the gantry (710). In some variations, one or more of the speaker array (712) and the microphone array (714) are positioned on the inner radial surface of the stationary frame within the bore of the gantry (710) near the patient's ears. may be placed in Additionally or alternatively, one or more of the speaker array (712) and the microphone array (714) are located on the gantry (710), eg, on the outer surface of the gantry (710) opposite the inner radial surface. ) may be located outside the bore of
In variations in which the microphone array (714) is located away from the patient's ear, the noise-canceling signal generated based on the sound received at the microphone array (714) is detected where the patient (722) is located. can be out of phase so that the ambient noise picked up is not effectively canceled. Thus, the processor may generate a noise-canceling signal that also compensates for location differences between the patient's ear, the speaker array, and the microphone array. For example, the gantry (710) receives patient location data from a patient location system and uses the audio and patient location data received by the microphone array (714) to generate noise cancellation signals. A controller may be provided having (716). The processor (716) may use the patient location data when generating the noise cancellation signal to compensate for differences between the microphone locations and the patient's ear locations. The speaker array (712) may be configured to output noise cancellation signals.
Thus, system (700) may further comprise a localization system configured to locate the patient (and its ears) within the patient area. In some variations, the localization system may use patient registration data (eg, from PET imaging, kV CT imaging) to determine the patient's ear location. In other variations, the patient (722) may be positioned along the patient platform (720) at predetermined positions such that the ear locations are known. For example, patient 722 may be coupled to a fixed location on patient platform 720, such as by a head fixation device. Once the patient's ears are identified, the processor (716) may generate noise-canceling signals that compensate for any differences between the patient, the speaker array (712), and the microphone array (714).
Additionally or alternatively, the speaker array (712) is used to output audio within the bore of the gantry (710) for the patient (722) to increase patient comfort and reduce anxiety. may For example, processor (716) and speaker array (712) may be configured to output voice audio (eg, live operator voice, pre-recorded voice) that provides therapy status and/or other information. good. Providing audio to the patient (722) may draw the patient's attention during the radiotherapy procedure and may be useful during long treatment sessions (eg, 20, 30, 60 minutes). In other embodiments, the processor (716) and speaker array (712) output one or more of music, white noise, nature sounds, and other sounds to produce machine sounds produced by the radiotherapy system. Perception of noise may be reduced.
collimator system
As explained above, the radiation therapy system is A multi-leaf collimator positioned in the beam path of the x-ray or therapeutic radiation source may be provided. In some variations, the multi-leaf collimator is described in U.S. Patent Application Serial No. 15/179, filed June 10, 2016 823, which is incorporated herein by reference in its entirety. In one variation, the multi-leaf collimator may comprise multiple leaves and a corresponding number of pneumatic leaf actuation mechanisms. Each leaf actuation mechanism may be configured to move its corresponding leaf independently, and a source of compressed air may be coupled to one or more of the pneumatic leaf actuation mechanisms. Each pneumatic leaf actuation mechanism may comprise a barrel with a longitudinal lumen, a first side opening, a second side opening, and a piston extending within the longitudinal lumen of the barrel. good. The piston may comprise a shaft and a piston seal coupled to the shaft within the barrel, wherein movement of the piston within the barrel translates the collimator leaves between the first location and the second location. . The first and second openings may be fluidly connected to a source of compressed air. The pneumatic mechanism may further comprise a first valve between the first opening and the fluid source and a second valve between the second opening and the compressed air source. The first and second valves may selectively regulate fluid flow into and out of the barrel lumen. Compressed air may be distributed to each of the leaf pneumatic mechanism barrels (one per leaf) via a grid or array of air conduits, each valve of each pneumatic leaf actuation mechanism into each barrel. may be individually controlled to regulate the airflow of the Compressed air supplied to each pneumatic leaf actuation mechanism is provided by an air supply grid with separate and independently controlled valves (i.e., the first and second valves of the multiple pneumatic leaf actuation mechanisms). be done. Compressed air in the air supply grid may be provided by a compressor or compressed air source mounted on a rotatable ring of the gantry. A compressed air source mounted on a rotatable gantry, such as a fast continuously rotating gantry, is subject to elevated levels of vibration compared to an air source mounted on a non-rotating (or slow) gantry. obtain. A high speed gantry may comprise scroll or screw compressors, which may be less susceptible to vibration and sound than piston compressors. In some variations, the scroll or screw compressor may be mounted on vibration isolation feet on a rotatable ring and pressurized air having a pressure of about 10 ATM to ambient air having a pressure of about 1 ATM. may be configured to convert to Some variations of internal compressor systems may include accumulator tanks, filters, dryers, and aftercoolers. Equipped with an optional kV radiation source for imaging and/or patient alignment, the system has a pneumatic leaf actuation mechanism that can be driven by the same or different compressed air system as the MV X-ray source or therapeutic radiation source; A multi-leaf collimator may be provided.
Generally, a therapeutic radiation beam may be generated by a linac and shaped by one or more beam shaping components. In some variations, the one or more beam shaping components are one or more of the following: primary collimator, secondary collimator, multi-leaf collimator, first jaw, and/or second collimator. of jaws. The primary collimator and/or secondary collimator may be a fixed beam-shaping aperture (e.g., the shape and/or size of the aperture is constrained to a predetermined shape or size) or a variable beam-shaping aperture (e.g., the shape and size of the aperture). /or size may be varied as desired before and/or during and/or after treatment). In some variations, the primary collimator may comprise a tungsten substrate or base with trapezoidal slots that may define the general shape of the radiation beam. Similarly, the first jaw and/or the second jaw may comprise fixed beam shaping apertures or variable beam shaping apertures. The collimator and/or jaws may shape the beam along two axes (e.g., x-axis and y-axis), or shape the beam along one axis (e.g., x-axis only, or y-axis only). may be molded. A multi-leaf collimator may be configured to shape the beam along two axes (eg, x-axis and y-axis) and/or one axis (eg, x-axis only, or y-axis only). may be configured to shape the beam along The X-ray beam emitted by the linac can result from accelerating electrons into a target (such as a tungsten target), which converts the energy from electron target collision into an X-ray beam. For systems comprising a linac mounted on a rotatable ring (eg, a continuously rotatable ring), an electron source (eg, electron gun), a microwave source (eg, magnetron), a pulsed power supply, and an RF circulator are , may be provided on a rotatable ring of the gantry. Radiation therapy system (800) is It may also comprise a target transducer comprising a target and a primary collimator, a dose chamber, an upper jaw, a multi-leaf collimator (eg binary MLC) and a lower jaw. A primary collimator, upper jaw, binary MLC, and lower jaw may shape the radiation beam emitted by the linac. The upper and lower jaws may move on curved rails that loosely converge to a virtual point spot on the target transducer.
Figure 8A shows a rotatable gantry (802), a linac (804) configured to emit a therapeutic radiation beam, a pulsed power supply (806), an electron gun (808), and a magnetron (810). , an RF circulator, wherein the linac, pulsed power supply, electron gun, magnetron, and RF circulator are mounted on a rotatable ring of the gantry. A pulsed power source (806) is connected to an electron gun (808) that can generate pulses of electrons corresponding to the temporal characteristics (eg, frequency, duty cycle, etc.) of the power pulses from the source (806). may Microwaves generated by the magnetron (810) and RF circulator accelerate electrons from the gun (808) within the waveguide of the linac (804).
FIG. 8B depicts one variation of the radiation beam path. Accelerated electrons from the linac (804) collide with the target (822) (eg, made of tungsten) of the beam converter (820), which converts the energy from the collision into an X-ray radiation beam. good. The radiation beam is first shaped by a primary collimator (824), passes through a dose chamber (826), and then along a first axis (eg, y-axis) by an upper beam limiting block or jaw (828). shaped by the leaves of the binary MLC (830) along a second axis (e.g., x-axis) and finally along the first axis (e.g., x-axis) before the radiation beam enters the patient treatment area. y-axis) by the lower beam limiting block or jaws (832). The primary collimator (824) may be mounted directly on the rotatable ring and aligned with the isocenter of the radiotherapy system. FIG. 8D depicts a close-up view of a beam-defining component within the radiation beam path. More generally, the size and shape of the openings or slots in one set of collimators or jaws may define the radiation beam within one axis (e.g., the x-axis), while the collimators or The size and shape of openings or slots in another set of jaws may define beams along another axis (eg, the y-axis). One aspect of these beam-defining devices is the extent to which they create a gradient from a full radiation beam to a fully attenuated radiation beam, where total attenuation can be a function of material thickness and the radiation blocking ability of the material ( Half value layer attenuation) may be referred to as penumbra. In some embodiments, the penumbra may be defined as the distance along this gradient from 80% to 20% radiation level, and in some other embodiments, the penumbra is from 90% to It may be defined as the distance of 10% radiation level. A smaller penumbra has sharper beam edges so that most of the beam has a uniform fluence (e.g., a flatter beam profile) compared to a beam with a larger penumbra. can enable Improving beam homogeneity can help increase treatment accuracy. Since the beam shaping components for the x-axis and y-axis components are not in the same plane, at the cost of enlarging the penumbra within the y-axis (or x-axis) edge, the x-axis (or y-axis ) There may be a trade-off to improve the penumbra within the border. A typical approach is to choose the edge (either the x-axis or the y-axis) where the penumbra should be minimal, and then place the beam shaping component at the bottom (i.e., furthest from the linac). , closest to the patient).
One method for balancing penumbra quality in both the x-axis and y-axis dimensions is to place the first portion of the y-axis beam-defining component above the x-axis beam-defining component and the y-axis Splitting the y-axis beam-defining component such that a second portion of the beam-defining component is below the x-axis beam-defining component. One variation of the jaw assembly in a split jaw configuration is depicted in FIG. 8B. As depicted there, the beam-defining components for the y-axis dimension (i.e., upper jaw (828) and lower jaw (832)) are aligned with the beam-defining components for the x-axis dimension (i.e., multi-leaf Located above and below the leaves (831) of the collimator (830). This functionally "splits" the y-axis beam-defining component so that one portion is above the x-axis beam-defining component and the other portion is below. Opposing portions of the upper and lower jaws may be adjusted independently such that openings or slots in the jaws may have different widths. In the variation of FIG. 8B, the upper jaw (828) and lower jaw (832) are split such that the upper portion is above the binary MLC and the lower portion is below the binary MLC (830). can be thought of as a single jaw. This produces a smaller penumbra than if the y-axis beam-limiting component were positioned entirely above the x-axis beam-limiting component, or if the x-axis beam-limiting component was positioned above the y-axis beam-limiting component. It can be provided in both the x-axis and y-axis dimensions. As depicted in FIG. 8C, the inward facing surface (825) of the upper jaw (828) and the inward facing surface (827) of the lower jaw (832) each have a vertical plane parallel to the radiation beam path (801). It may be oriented at an angle (840, 842) with respect to the axis. Angle (840) of face (825) of upper jaw (828) may be greater than angle (842) of face (827) of lower jaw (832). For example, the angle (840) is about 0.0 for IEC Y-field sizes ranging from 1 cm to 5 cm. Angle (842) may range from about 0.8 degrees to about 8 degrees with IEC Y field sizes ranging from 1 cm to 5 cm, while it may range from 3 degrees to about 2 degrees. The angles (840, 842) are at least partially aligned with the desired field size (e.g. , about 1 cm to about 5 cm), and/or the thickness of the upper and lower jaws (835, 837), and/or the opening or slot of the primary collimator (824), and/or the radiation source or beam energy, and/or or based on the size (eg, width) and shape of other beam-producing or beam-shaping components. In some variations, the angle (840) of the inward facing surface (825) of the upper jaw may be approximately the same as the angle (841) of the focal line (833) with respect to the vertical axis. A radiation beam focal line (833) may represent the boundary of the radiation beam spread from the linac (which may be approximated as a point or virtual source (819)). The angles (840, 842) of the inward facing surfaces of the upper and lower jaws can be the same as or different from the angle of the focal line (841). For example, the inward facing surface angle (840) may be greater than the focal angle (841), while the angle (842) may be the same as the focal angle (841). In some variations, the angle of the inward facing surfaces of the jaws (840, 842) may be adjustable. It may range from 8 degrees to about 8 degrees. The angles (840, 842) are at least partially aligned with the desired field size (e.g. , about 1 cm to about 5 cm), and/or the thickness of the upper and lower jaws (835, 837), and/or the opening or slot of the primary collimator (824), and/or the radiation source or beam energy, and/or or based on the size (eg, width) and shape of other beam-producing or beam-shaping components. In some variations, the angle (840) of the inward facing surface (825) of the upper jaw may be approximately the same as the angle (841) of the focal line (833) with respect to the vertical axis. A radiation beam focal line (833) may represent the boundary of the radiation beam spread from the linac (which may be approximated as a point or virtual source (819)). The angles (840, 842) of the inward facing surfaces of the upper and lower jaws can be the same as or different from the angle of the focal line (841). For example, the inward facing surface angle (840) may be greater than the focal angle (841), while the angle (842) may be the same as the focal angle (841). In some variations, the angle of the inward facing surfaces of the jaws (840, 842) may be adjustable. It may range from 8 degrees to about 8 degrees. The angles (840, 842) are at least partially aligned with the desired field size (e.g. , about 1 cm to about 5 cm), and/or the thickness of the upper and lower jaws (835, 837), and/or the opening or slot of the primary collimator (824), and/or the radiation source or beam energy, and/or or based on the size (eg, width) and shape of other beam-producing or beam-shaping components. In some variations, the angle (840) of the inward facing surface (825) of the upper jaw may be approximately the same as the angle (841) of the focal line (833) with respect to the vertical axis. A radiation beam focal line (833) may represent the boundary of the radiation beam spread from the linac (which may be approximated as a point or virtual source (819)). The angles (840, 842) of the inward facing surfaces of the upper and lower jaws can be the same as or different from the angle of the focal line (841). For example, the inward facing surface angle (840) may be greater than the focal angle (841), while the angle (842) may be the same as the focal angle (841). In some variations, the angle of the inward facing surfaces of the jaws (840, 842) may be adjustable. Angle (842) may be the same as focal angle (841), while it may be greater. In some variations, the angle of the inward facing surfaces of the jaws (840, 842) may be adjustable. Angle (842) may be the same as focal angle (841), while it may be greater. In some variations, the angle of the inward facing surfaces of the jaws (840, 842) may be adjustable.
In some variations, the inward facing surface (825) of the upper jaw (828) may be offset from the focal line (833). That is, the inward facing surface (825) of the upper jaw (828) may be set back from the focal line (833) by an offset value (829). As depicted in FIG. 8C, the inward facing surface (827) of the lower jaw (832) may be aligned along the focal line (833), i.e., with an offset value of 0. . The inward facing surface (825) of the upper jaw (828) is positioned at a distance from the focal line (833) with an offset value (829) of, for example, about 0.5 mm to about 2 mm, such as about 1 mm. may be (i.e. offset). In some variations, the inward facing surfaces of the upper and lower jaws are not aligned with each other (ie, have different offset values). FIG. 8E is a simulated plot of the energy fluence along the y-axis penumbra as a function of the upper jaw offset (the lower jaw offset is 0, i.e., the inward facing surface of the lower jaw is in focus). line). Beam profiles with an upper jaw offset of 0.5 mm or greater are represented by line (850) and beam profiles with an upper jaw offset of 0 are represented by line (852). The 90% penumbra of a beam whose upper jaw has an offset greater than about 0.5 mm (eg, about 1 mm) is less than the 90% penumbra of a beam whose upper jaw has no offset. That is, the beam has no offset in the upper jaw, or 0.5 mm when the upper jaw has an offset of 0.5 mm or more. Gain 90% fluence more quickly (ie, sharper slopes or edges) than when having an offset of less than 5 mm. This indicates a smaller 90%-10% penumbra, calculated as the difference between the beam half-widths at the 10% and 90% levels, respectively. A rectangular beam profile with sharper beam edges may improve the dosimetric properties of the beam because the central portion of the beam (eg, about 80% of the beam profile) is flatter or more uniform. When there is a non-zero offset of the upper jaw (828) from the focal line (833), the angles (840) and distances of all points on the surface (825) are their offsets ( 829) and due to the larger angle (840), the upper jaw (828) may be calculated to project into a slightly larger field size instead of the machine isocenter. For example, when the lower jaw projects to 2 cm in the isocenter plane and the upper jaw has a 1 mm offset from the focal line, the upper jaw may then project to a field size of about 2.8 cm. The plot in Figure 8E is simulation results for an upper jaw having a thickness (835) of approximately 55mm and a lower jaw having a thickness (837) of approximately 55mm. In some variations, the thickness of the upper jaw (835) may be greater than the thickness of the lower jaw (837), while in other variations the thicknesses (835, 837) are the same. In any case, it may be about 30 mm to about 70 mm, for example about 40 mm, about 55 mm. The offset of the inward facing surfaces of the upper and/or lower jaws depends on several factors, such as, at least in part, the energy level of the radiation beam, the thickness, location, and composition of the target, and/or the upper and/or lower jaw. It may be determined by the thickness of the lower jaw and/or the distance between the upper and/or lower jaws from the target or virtual source and/or the thickness of the multi-leaf collimator. May project to 8 cm field size. The plot in Figure 8E is simulation results for an upper jaw having a thickness (835) of approximately 55mm and a lower jaw having a thickness (837) of approximately 55mm. In some variations, the thickness of the upper jaw (835) may be greater than the thickness of the lower jaw (837), while in other variations the thicknesses (835, 837) are the same. In any case, it may be about 30 mm to about 70 mm, for example about 40 mm, about 55 mm. The offset of the inward facing surfaces of the upper and/or lower jaws depends on several factors, such as, at least in part, the energy level of the radiation beam, the thickness, location, and composition of the target, and/or the upper and/or lower jaw. It may be determined by the thickness of the lower jaw and/or the distance between the upper and/or lower jaws from the target or virtual source and/or the thickness of the multi-leaf collimator.
In some variations, one or more of the beam shaping components (eg, primary collimator, upper jaw, binary MLC, and lower jaw) may be mounted on curved rails. FIG. 8F is a schematic depiction of one variation of a beam shaping module comprising split jaws (850) and MLCs (852). Dynamic MLC (852) may be a binary MLC. The split jaws (850) include an upper jaw (854) positioned between a therapeutic radiation source (858) (eg, linac) and the MLC (852) and a lower jaw (856) positioned below the MLC (852). ). Upper jaw (854) and lower jaw (856) may be coupled together by one or more plates (860) or frames. The jaws may be mounted on one or more curved rails. For example, split jaw (850) may be slidably mounted on one or more curved rails (862). One or more plates or frames of the split jaw are sized and shaped to be larger than the cross-sectional size of the rail so that the slot can slide over the rail (as indicated by arrow (864)). , may have one or more slots. Optionally, there may be additional rails orthogonal to rail (862) to provide additional support to the jaws. Although rails (862) are curved in this example, they may not be curved in other variations (ie, they may be straight without any curvature). The jaws may be coupled to an actuator or motor that moves the position of the jaws along the curved rail. Movement of the jaws along the rails can result in a corresponding displacement of the treatment plane along the IEC-Y axis (ie, parallel to the axis of motion of the patient platform). In other variations, the jaws may instead be mounted to the gantry via one or more movable or rotatable attachment mechanisms, such as one or more hinges or pivots. Jaws move about 1 cm to about 4 cm (end to end). ), it may be possible to move about 0.5 cm to about 2 cm to the right or left of the isocenter. This may correspond to a similar shift of the treatment plane, which may shift along the longitudinal axis of the patient platform with a full range of movement of about 1 cm to about 4 cm. It should be appreciated that the total range of movement along the longitudinal axis (eg, IEC-Y) of the patient platform can be from about 1 cm to about 12 cm, eg, about 1 cm, about 2 cm, about 3 cm, etc. In some variations, the binary MLC comprises 64 leaves defining an axial plane (e.g., IEC-XZ), each 0.6 cm wide at isocenter, leading to a field of view (FOV) of approximately 40 cm. good too. The jaw actuator may be configured to move the jaws at a speed of about 0.25 cm/sec to about 2 cm/sec, such as about 0.5 cm/sec, about 1 cm/sec. The jaw actuators may, for example, comprise electromagnetic actuators. In some variations, the jaw velocity may exceed the patient platform velocity. The beam shaping modules depicted and described in FIG. Jaws and MLCs are provided, but in other variations the jaws and MLC may be movably mounted relative to each other (ie, the jaws and MLC move or shift together in unison). It may be possible to move 5 cm to about 2 cm. This may correspond to a similar shift of the treatment plane, which may shift along the longitudinal axis of the patient platform with a full range of movement of about 1 cm to about 4 cm. It should be appreciated that the total range of movement along the longitudinal axis (eg, IEC-Y) of the patient platform can be from about 1 cm to about 12 cm, eg, about 1 cm, about 2 cm, about 3 cm, etc. In some variations, the binary MLC comprises 64 leaves defining an axial plane (e.g., IEC-XZ), each 0.6 cm wide at isocenter, leading to a field of view (FOV) of approximately 40 cm. good too. The jaw actuator may be configured to move the jaws at a speed of about 0.25 cm/sec to about 2 cm/sec, such as about 0.5 cm/sec, about 1 cm/sec. The jaw actuators may, for example, comprise electromagnetic actuators. In some variations, the jaw velocity may exceed the patient platform velocity. The beam shaping modules depicted and described in FIG. Jaws and MLCs are provided, but in other variations the jaws and MLC may be movably mounted relative to each other (ie, the jaws and MLC move or shift together in unison). It may be possible to move 5 cm to about 2 cm. This may correspond to a similar shift of the treatment plane, which may shift along the longitudinal axis of the patient platform with a full range of movement of about 1 cm to about 4 cm. It should be appreciated that the total range of movement along the longitudinal axis (eg, IEC-Y) of the patient platform can be from about 1 cm to about 12 cm, eg, about 1 cm, about 2 cm, about 3 cm, etc. In some variations, the binary MLC comprises 64 leaves defining an axial plane (e.g., IEC-XZ), each 0.6 cm wide at isocenter, leading to a field of view (FOV) of approximately 40 cm. good too. The jaw actuator may be configured to move the jaws at a speed of about 0.25 cm/sec to about 2 cm/sec, such as about 0.5 cm/sec, about 1 cm/sec. The jaw actuators may, for example, comprise electromagnetic actuators. In some variations, the jaw velocity may exceed the patient platform velocity. The beam shaping modules depicted and described in FIG. Jaws and MLCs are provided, but in other variations the jaws and MLC may be movably mounted relative to each other (ie, the jaws and MLC move or shift together in unison). It may be configured to move the jaws at a speed of 5 cm/sec, about 1 cm/sec, etc. The jaw actuators may, for example, comprise electromagnetic actuators. In some variations, the jaw velocity may exceed the patient platform velocity. The beam shaping modules depicted and described in FIG. Jaws and MLCs are provided, but in other variations the jaws and MLC may be movably mounted relative to each other (ie, the jaws and MLC move or shift together in unison). It may be configured to move the jaws at a speed of 5 cm/sec, about 1 cm/sec, etc. The jaw actuators may, for example, comprise electromagnetic actuators. In some variations, the jaw velocity may exceed the patient platform velocity. The beam shaping modules depicted and described in FIG. Jaws and MLCs are provided, but in other variations the jaws and MLC may be movably mounted relative to each other (ie, the jaws and MLC move or shift together in unison).
magnetron
A magnetron is a source device that converts high voltage DC power into high frequency electromagnetic force. As explained above, the magnetron may be mounted on a rotatable ring of the gantry. High speed rotation of the gantry can cause magnetron instability due to increased levels of centripetal force compared to a stationary gantry (or a gantry rotating at a slower speed). The magnetron may include a ring anode (900) featuring a hollow structure (902) and a central cathode (904) with a gap (903) therebetween, as depicted in Figure 9A. The cathode (904) must be supported without interfering with the magnetic field structure, so the cathode may be weakly supported by the axle or bracket (906) and/or the rotational force from the rotating ring (e.g. , centripetal and/or centrifugal) and sinusoidal gravitational forces, resulting in undesirable movement of the cathode relative to the magnetron. Cathode migration can affect the magnetic field structure within the magnetron and adversely affect its ability to generate RF fields. FIG. 9B shows the magnetrons (910) mounted radially such that the cathode support (906) is aligned with the centripetal direction (912) (e.g., radially toward the center of the ring). A variation is depicted. As shown there, the cathode support or axle (906) may be oriented generally radially with respect to the rotatable ring (914) of the gantry. In this arrangement, the centripetal force may be relatively constant and the cathode support (906) may only need withstand sinusoidal gravity to support the cathode (904). Alternatively, some radiation therapy systems may include klystrons mounted on rotatable rings instead of magnetrons.
beam converter
A magnetron may accelerate electrons from an electron source (eg, an electron gun) to create an electron beam. The electron beam may be directed through the linac cavity to a beam converter comprising a high-Z material such as tungsten or tantalum. Collisions of electrons in the beam converter result in the emission of high energy photons (eg, X-ray beams). One variation of a beam converter assembly (1100) coupled to a linac (1120) is depicted in FIG. As depicted therein, the beam converter assembly (1100) may comprise a beam converter (1102) mounted within a recess of a substrate (1104). An electron beam (1101) traveling within the vacuum cavity (1122) may pass through the linac window (1124) and may be directed at one side of the beam converter (1102). Interaction of the electron beam with the beam converter may produce an X-ray beam (1103) emitted from the other side of the beam converter. The substrate (1104) may be made from a conductive material such as copper. The substrate (1104) may comprise one or more heat removal channels (1106) within the body of the substrate. In some variations, the heat removal channel (1106) may be located adjacent to the beam converter and a cooling fluid (eg, gas or liquid) may be circulated through the channel (1106). Heat generated by the incidence of electrons on the beam converter (1102) may be transferred to the conductive substrate (1104), which in turn transfers the heat to the cooling fluid within the channels (1106). The systems described herein may comprise the beam converter assembly of FIG. 11, but other beam converter assemblies (eg, other substrate geometries, heat removal channel configurations, and beam converter materials). ) can also be used.
CT system
In some radiation therapy systems, kV radiation sources and corresponding detectors may be provided for imaging purposes (eg, CT imaging). The kV radiation source and detector may be located on the rotating ring of the gantry, but different from the MV or therapeutic radiation source such that the fan beam produced by the kV radiation source is in a different plane than the MV radiation source. It may be located in a vertical location. As with MV or therapeutic radiation sources, alignment of imaging radiation sources (eg, imaging linacs) can also be motorized. The acquired imaging data may be used to register the position of the patient with respect to the gantry and therapeutic radiation source. Accurate patient alignment with the radiation therapy system facilitates accurate delivery of radiation therapy. It may be desirable to align the patient quickly and accurately. Images and/or data from kV radiation sources can also help identify the location of target volumes and sensitive structures to be avoided.
In some variations, the kV system comprises a kV radiation source, a kV detector, and a series of static and dynamic collimator elements for controlling the shape of the radiation beam emitted from the kV radiation source. good too. For example, a series of two static collimators define an aperture profile along two axes (e.g., X, Y) whose geometry can be defined by the isocenter and their relative location to the kV detector. You may Additionally, the kV system may comprise a rotatable collimation mechanism configured to control the irradiation of the beam onto the patient and kV detector. The rotatable collimation mechanism may comprise an electrical actuator, a rotatable collimator comprising a beam limiting element, and a position sensing circuit. The rotatable mechanism may be configured to rapidly adjust the position of its beam limiting element via an electrical actuator and position sensing circuitry.
FIG. 13A shows one variation of a kV imaging gantry (1300) that may comprise a kV radiation source (1302), a kV detector (1304), a kV support structure (not depicted), and a collimation assembly (1308). describe. A kV imaging gantry (1300) may be mounted on a rotatable ring to which a therapeutic radiation source, MV detector, and PET detector are mounted. The kV imaging gantry may be attached to the rotatable ring using multiple bolts and/or weld points. FIG. 13B depicts one variation of the kV radiation source support (1306) and collimation assembly (1308). The collimation assembly (1308) may comprise a radiation shield (1310). FIG. 13C depicts an exploded view of the collimation assembly (1308), kV radiation source support (1306), and radiation shield (1310) of FIG. 13B. Referring to Figure 13C, the collimation assembly may comprise a support structure (1306) on which an X-axis mounting stage (1314) and a radiation shield (1310) are mounted. It may further comprise an alignment plate (1316) and a Y-axis mounted stage (1318) mounted below the X-axis mounted stage (1314). An initial beam defining or shaping device (1320) may be mounted on the Y-axis mounting stage (1318). This can help maintain relative positioning between the kV radiation source, the kV detector, and any additional beam shaping devices.
A radiation shield (1310) may be placed over the kV radiation source and may have a shape corresponding to an expanding kV radiation source beam. Wall portions (eg, sidewall portions) of the shield may provide support for a rotatable collimator (1322), a beam shaping filter (1324), and a final beam limiting or shaping device (1326). For example, there may be two side openings (1309) on the sidewall portion of the shield (1310) that may be configured to rotatably retain two axles (1311). The axle (1311) may be cylindrical and connected to the two ends of the rotatable collimator (1322) and serve as the axis of rotation for the collimator. For example, rotatable collimator (1322) may comprise dowels or cylinders made from a radiation blocking material such as tungsten or lead. The dowel or cylinder may have a longitudinal axis and a central opening (1323). The central opening (1323) may extend laterally through the cylinder (eg, perpendicular to its longitudinal axis) and/or have a longitudinal axis length that may correspond with the desired beam width. good too. For example, the central opening may extend through the entire diameter or thickness of the collimator and may have a length approximating the length of the collimator. The aperture may be configured to shape the beam along two axes (eg, the X and Y axes) and/or shape the beam along one axis (eg, the X axis). It may be configured as The two axles or shafts (1311) may be connected to either end of the dowel or cylinder such that rotation of the axle (1311) also rotates the rotatable collimator (1322). A rotatable collimator may have two configurations, and rotation of the collimator may transition between these two configurations. In a first configuration, depicted in FIG. 14A, aperture (1323) is aligned with the radiation beam from the kV radiation source and allows the kV radiation beam to pass through. Depending on the angle of rotation (say, about 90 degrees), the collimation The data may be transitioned to a second configuration depicted in FIG. 14B. In this configuration, aperture (1323) is not aligned with the radiation beam, and wall portions of the cylinder or dowel made from radiation blocking material may obstruct or block the kV radiation beam.
A kV radiation beam collimator can help obtain and maintain precise and/or accurate imaging beam performance. In some variations, the alignment between the kV radiation beam and the collimator may be within a predetermined tolerance threshold of about 10 microns or less. Alignment of the kV radiation beam to the collimator is required in several situations, e.g., in factories, upon delivery of the system to outpatient clinics or customers, and when kV radiation sources or kV detectors are serviced or repaired. may be checked in some cases.
II. Method
Also described herein are methods for emission-stimulated high-energy photon delivery using the systems and devices described above. In some variations, the method may be used to deliver radiation doses to desired areas of the patient. Generally, the methods described herein include aligning a patient loaded onto a patient platform and treating the patient using a radiation therapy system. Increasing the efficiency of patient registration and treatment can help increase the number of patients that can be treated by a single radiation therapy system over a period of time (eg, a day).
In some variations, a method of processing a radiation therapy patient may include registering the patient to a patient platform using a registration system in a registration room. The patient may then be moved to a different room with a radiotherapy system where the patient is treated by the radiotherapy system. By performing registration and radiation therapy in separate rooms, a patient may receive a radiation dose while another patient is registered in a different room. Thus, preparation of a patient for treatment may occur in parallel with another patient treatment session while maintaining privacy and without compromising treatment quality. In some examples, a workflow may begin in a dosing chamber where a patient is administered a radioisotope (eg, a PET tracer). The patient may wait in the dosing room until a room with the alignment system becomes available.
In some variations, patient registration may optionally include applying an external radioactive reference to the patient. External radioactive references can help improve the accuracy and/or precision of patient registration for some therapies (eg, EGRT, SBRT, IMRT). In some embodiments, a radioactive reference may be used to provide an initial rough registration useful in reducing the patient dose received from subsequent kV imaging. Radioactive fiducials may be inserted into the body and/or combined with other fiducials (eg, radiopaque tattoos on the patient's skin). In other examples, the radioactive reference may remain integrated with the patient during radiation therapy, allowing detection of patient motion during therapy.
In some variations, the speed of movement of one or more of the gantry, collimator, and patient platform is adjusted in real time according to the radiation beam intensity modulation prescribed in the treatment plan to reduce radiation treatment procedure time. may be adaptively adjusted. For example, the speed of movement of the rotating gantry and patient platform may be reduced for radiation beam delivery to tumors that require higher levels of modulation (eg, tumors with irregular shapes). In another example, the patient platform velocity may be increased when the radiation beam is off and moving between different tumors. In this manner, the speed of one or more of the gantry, collimator, and patient platform may be increased while operating the radiation therapy system within mechanical limits without violating treatment goals. In some variations, the patient platform is moved to a predetermined location, stopped at the predetermined location while therapeutic radiation is being applied to the patient, and then moved to another predetermined location. May be moved (eg, step-and-shoot motion). Applying therapeutic radiation in such a manner alleviates dose delivery imperfections and/or magnetron arcs that are often encountered when radiation is delivered to a continuously moving patient platform. can help.
In some variations, the radiation therapy system is configured to output a noise cancellation signal to a patient undergoing a procedure within the bore of the gantry to reduce perceived mechanical noise generated by the system during operation. may be Reducing perceived noise can increase patient comfort and, as a result, reduce patient movement (eg, patient excursion) on the patient platform, thereby improving patient compliance. In some embodiments, patient ear location data may be used to generate the noise cancellation signal. The radiation therapy system may comprise an audio system having one or more microphones for receiving noise to be canceled and a speaker for outputting noise cancellation signals.
Radiation therapy workflow
Radiation therapy systems are a high cost expense that can only treat a limited number of patients during the course of a day. Bunker time is expensive, and it is therefore desirable to reduce the amount of banker time spent on therapeutic tasks that do not require the use of a radiotherapy system. For example, IMRT and SBRT procedures typically deliver radiation doses over several fractions. Some IMRT procedures may deliver about 60 Gy to about 80 Gy over about 30 to about 40 fractions (eg, 2 Gy per fraction). Delivery of each IMRT fraction can take about 15 to about 20 minutes, with about 10 minutes devoted to patient setting. Some SBRT procedures may deliver about 40-80 Gy over about 3-5 fractions. Delivery of each SBRT fraction can take from about 40 minutes to about 90 minutes, with a patient setting of about 15 minutes to about 40 minutes, depending on the number and location of lesions. Patient-setting differences between IMRT and SBRT are generally due to the fact that the IMRT fraction is delivered for a single lesion, while the SBRT fraction can be delivered for one or more lesions. obtain. Under these patient workflow constraints, radiotherapy systems may deliver about 30 to about 40 IMRT fractions per day and about 6 to about 10 SBRT fractions per day. The patient workflow process, detailed below, can improve enabling the radiotherapy system to deliver up to about 60 IMRT fractions per day and up to about 12 SBRT fractions per day.
A radiotherapy system as described herein may treat patients in different rooms in parallel, thereby maintaining privacy and increasing bunker utilization efficiency and patient throughput. For example, patient uptake of radioisotopes may be performed in a first room, while patient imaging and registration may be performed in a second room. The patient may then be moved into a third room with a radiation therapy system to receive radiation therapy treatment. Therefore, patients do not occupy the third room until they are ready to undergo radiotherapy treatment. The workflow can be improved by performing tasks in parallel, thus allowing 3 patients (at different stages of treatment) in the workflow at the same time. Figure 12 shows a first room (1202), a second room (1204), a third room (1206), a control room (1208), and a corridor (1209) connecting each of the rooms. 12 is a schematic depiction of a patient workflow for a radiation therapy facility (1200) comprising; A first chamber (1202) may be configured for radioisotope administration and uptake. For example, the first room (202) may be configured to be a quiet and comfortable space for the patient to wait while biological uptake occurs. For example, uptake of a PET tracer such as FDG can take about 60 minutes. A second chamber (1204) may contain an alignment system and be configured for patient alignment of the patient to the patient platform. For example, the second room (1204) may contain an imaging system (eg, kV CT, MR, PET/CT) configured to image a patient and align with the patient platform. Various types of patient platforms, such as RADIATION THERAPY PATIENT PLATFORM", i.e., Attorney Docket No. RFXN-009/01US326517-2019, filed November 15, 2017, herein incorporated by reference in its entirety. The patient platform described and depicted in ) may be used. The patient registration process can generally take about 10 minutes. A third room (1206) may contain a radiation therapy system and may be configured to treat patients. Treatment times in the third room (1206) may vary based on the type of treatment being performed, the type of lesion, and the number of lesions. For example, radiation dose delivery for a simple IMRT lesion may be performed in about 5 minutes, while radiation dose delivery for a complex multi-lesion patient may be performed in about 60 minutes. In some variations, technicians (1211, 1213, 1215) (eg, medical professionals) may be assigned to individual patients (1210, 1212, 1214). In some variations, the control room (1208) includes an operator console (1224) and controls for patient alignment and radiation therapy in the second room (1204) and the third room (1206). and an operator (1216). In other variations, the second room (1204) and the third room (1206) may each contain an operator. In some variations, technicians (1211, 1213, 1215) (eg, medical professionals) may be assigned to individual patients (1210, 1212, 1214). In some variations, the control room (1208) includes an operator console (1224) and controls for patient alignment and radiation therapy in the second room (1204) and the third room (1206). and an operator (1216). In other variations, the second room (1204) and the third room (1206) may each contain an operator. In some variations, technicians (1211, 1213, 1215) (eg, medical professionals) may be assigned to individual patients (1210, 1212, 1214). In some variations, the control room (1208) includes an operator console (1224) and controls for patient alignment and radiation therapy in the second room (1204) and the third room (1206). and an operator (1216). In other variations, the second room (1204) and the third room (1206) may each contain an operator.
In some variations of the methods described herein, the radiotherapy patient process includes administering a radioisotope to a first patient (1210) in a first chamber (1202); and moving the first patient (1210) from one room (1202) into a second room (1204). Once in the second room (1204), the first patient (1210) may be loaded onto the first patient platform. The loaded first patient platform may then be moved into a registration area of the registration system, and first patient body location data may be generated using the registration system. good. For example, diagnostic images of a first patient (1210) and a first patient platform may be generated and used to register the first patient's body to the first patient platform. A first patient (1210) coupled to a first patient platform may then be moved out of a second room (1204) and into a third room (1206) through a corridor (1209). good. The patient should have limited movement on the first patient platform after alignment until treatment is complete.
In some variations the patient platform may comprise a set of wheels for locomotion, while in other variations the patient platform incorporates the alignment system of the second chamber (1204) into a third. It may be coupled to the rail system of the facility (1200), which connects to the radiation therapy system of the second room (1206). For example, a rail system may be placed on the floor to guide the patient platform from the second room (1204) to the third room (1206). The patient platform may be manually moved and/or driven by a motor. The first patient platform, with the first patient registered, may then be docked to the radiotherapy system. In some variations, a patient platform including a portable base may be moved from room to room as the base docks with each system. In other variations, the patient platform may be transported to different bases within each room. For example, the patient platform may be transported on a first base and then transferred to a fixed base that is fixed to the gantry of the radiotherapy system. Docking the first patient platform to the radiation therapy system registers the patient's position with the radiation therapy system. Patient alignment should remain unchanged as the patient is moved from room to room and may be monitored using a sensor system. The aligned first patient platform may then be moved into the treatment area of the radiotherapy system, and the first patient may be treated using the radiotherapy system. Each of the above steps may be performed with respect to the second patient and the second patient platform after each step is completed by the first patient. In other words, once the first patient has vacated the room, another patient may enter the room and create a continuous pipeline of patients. Similarly, each of the above steps is followed by a third patient after completing the step by a second patient. patients and a third patient platform. It should be appreciated that a single radiation source (eg, accelerator) can be coupled to multiple radiation therapy systems (eg, a fourth room with a second radiation therapy system). In some variations, imaging and therapy may occur in the same room on separate imaging and therapy systems.
patient alignment
Patient registration to the radiation therapy system is critical to the accuracy of volume delivery and constitutes a significant amount of time in patient procedures. Intensity-modulated radiation therapy (IMRT) procedures commonly utilize external references for initial patient registration. These are often in the form of small tattoos on the skin. These tattoos may be visually aligned with the laser in the treatment room, which is aligned with the radiotherapy system. The resulting conformance is generally to within 5 mm of internal body structures. However, tattoo registration can be manual intensive and time consuming. In some variations, the patient may be registered to both the radiation therapy system and the imaging machine using external references. The external reference can be, for example, a small radioactive point source (approximately 500 kV) attached to the patient. Multiple PET detectors within the radiotherapy system may detect external fiducials and align the patient. In some examples, the external reference may remain attached to the patient throughout the procedure, while in other situations, the point source may be attached to the patient as needed and permanently attached to the skin. Or may be matched to a semi-permanent tattoo.
External PET fiducials can be useful in patient registration for EGRT, SBRT, and IMRT systems. The EGRT system's PET detector is used to quickly register the patient to the system with reasonable accuracy for patients who have or have not had a PET tracer injection by using an external PET reference. may be For example, a PET detector system may provide coarse patient registration, while an integrated kV imaging system may provide fine patient registration. Coarse PET registration may improve patient registration by reducing subsequent kV imaging coverage, dose, and time.
In variations in which the patient anatomy is identified using an external radioactive reference, as described in detail herein, the radioactive reference may be coupled external to the patient. The exterior may be one or more of the skin, the patient's orifice, the sternum, and the buttocks. Diagnostic images may be produced by a PET/CT diagnostic system using a radioactive point source coupled to the skin. External criteria may be left on throughout the procedure and/or used to identify permanent or semi-permanent tattoos. A radioactive standard may be placed within the patch and placed across the patient's sternum and/or hips. In some variations, the radioactive reference may comprise a compact, rigid, high-energy photon transmission well with an adhesive backing that bonds to the patient. Therefore, the radioactive reference corresponds to the patient's anatomy. In some examples, the patient may be marked at a first skin location corresponding to the patient's anatomy (e.g., by permanent/semi-permanent tattoos on the sternum and buttocks), and the radioactive reference is at the first may be connected to the patient at the location of A patient coupled to the radioactive reference and patient platform may then be identified using, for example, PET/CT diagnostic imaging. The patient anatomy may be registered to the patient platform using the locations of the radioactive fiducials. The criteria may remain applied to the patient during radiotherapy treatment. In some embodiments, the external radioactive fiducial may align the patient to less than 5 mm. For IMRT procedures in which the patient does not receive PET tracer injections, this registration may be appropriate. For EGRT procedures in which the patient receives PET tracer injections, further registration of tumor volume and sensitive structures can be performed using internal PET signals to increase registration accuracy. A radioactive reference (eg, a PET reference) can be any source (eg, a 500 kilovolt point source) that produces about a 500 kV event localized to a point under PET imaging. For example, the radioactive standard is Na
In some variations, a patient may be treated using a combination of a radioactive reference and a radiation therapy beam coupled to the patient. It should be appreciated that the radioactive reference may be specified in parallel with the treatment steps being performed, as this may allow determination of movement of the patient's anatomy during treatment. In other variations, the diagnostic image may be a kV CT image, and the external reference coupled to the patient is a small, dense metal bead configured to show contrast on the kV image. good too. In some variations, a metal reference may be bonded externally to the patient. Similar to the radioactive fiducial, the metal fiducial may correspond to the patient anatomy on which it is placed. Metal fiducials may be identified by imaging. The metal reference may then be removed prior to the radiotherapy treatment or left attached during the radiotherapy treatment.
The radioactive reference may comprise an aperture blocker configured for insertion within the aperture. In some embodiments, the orifice blocker may comprise a bite blocker for three-dimensionally identifying the patient's bony anatomy. For example, it may comprise a bite blocker, a head fixation device that further allows alignment of the patient's anatomy in three dimensions. Additionally or alternatively, the radioactive reference may be coupled to patient clothing configured to be worn on the patient.
In some variations, an external radioactive standard may be coupled with an optically dense enclosure or well that exhibits contrast in the kV image using a PET detector system integrated with the kV imaging system. Then, the image may be captured. The optically dense housing may be bonded to the patient using, for example, an adhesive. For kV CT diagnostic scans, the housing may be coupled to the patient without a radioactive source. Dense material under kV CT imaging may be easily resolved and aligned. For PET/CT imaging, the high density enclosure may contain radioactive sources such that high density material can be resolved by kV CT and radioactive sources can be resolved by PET. PET sensing may provide global matching to within about 5 mm so that kV imaging coverage can be reduced. Reducing kV imaging reduces registration time and x-ray dose to the patient.
In a variation where patient anatomy is identified using internal radioactive fiducials, as described in detail herein, an internal region of interest in the patient may be identified, and the radioactive fiducial is It may be embedded in the region. A radioactive source may be implanted internally using a surgical procedure or a large needle. A radioactive source may be a point source. In some variations, the radioactive source may have a resolution below that of PET systems (eg, a point source with a diameter of about 4 mm). Patients coupled to radioactive standards and patient platforms may be identified using, for example, kV imaging. The region of interest may be registered to the patient platform using the locations of the radioactive fiducials. In some variations, an implanted radioactive reference may include one or more of a hydrogel and a tracer. Implanted fiducials may allow precise tracking of regions of interest and/or sensitive structures so that dose delivery limits may be reduced. This may spare healthy tissue from unnecessary dose and allow treatment of more lesions and/or at higher doses and/or more maintenance sessions.
Adjustable platform and gantry speed
Spiral tomotherapy is a type of intensity-modulated radiation therapy (IMRT). The IMRT system may comprise a radiation beam source that rotates about the longitudinal axis of the gantry, a collimator comprising multiple leaves that shape the radiation beam, and a patient platform that moves relative to the gantry. The patient receives a helical or spiral radiation dose during simultaneous motion of the rotatable gantry, collimator, and patient platform (e.g., the gantry rotates about its longitudinal axis and the patient platform translates longitudinally). You may In helical radiation therapy, intensity modulation may be achieved by varying the intensity of the radiation beam at each gantry angle and each patient platform while the gantry and patient platform are moving simultaneously. In order for the intensity-modulated dose to be delivered very accurately during helical tomotherapy, the collimator leaves (e.g., multi-leaf collimator (MLC)) are positioned at precise times corresponding to precise gantry angular position and patient platform position. must open up. Helical radiation beam intensity modulation is therefore dependent on the accuracy of the timing of MLC transitions (between open and closed positions), gantry and patient platform velocities.
When the gantry rotates relatively slowly, such as in the range of 1 RPM to 10 RPM, and when there is a relatively large angular difference between gantry firing positions, such as 7 degrees, radiation therapy treatments generally have a high level of fidelity and accuracy. There is sufficient time for the leaves to close or open between gantry positions so that the treatment plan can be followed at . Some conventional tomotherapy systems may have 51 gantry firing positions (7 degree intervals between each firing position) and a gantry rotation speed in the patient treatment range of about 1 RPM to about 5 RPM. However, when the gantry speed is much higher than about 10 RPM, especially for the EGRT system, which can reach a gantry speed of about 60 RPM using 100 launch angles (3.6 degree intervals between each launch position), the MLC transition should be much faster to provide accurate doses. As the gantry speed increases and the angular difference between gantry firing positions is reduced, the MLC transition times reach their mechanical and electronic limits, thus increasing the speed for a given gantry rotation speed and/or patient platform speed. may impose limits on the level of intensity modulation achievable for . Radiation therapy treatment quality can be compromised when the MLC, gantry, and patient platform are operated at velocities near the mechanical limits of the system, especially when treatment plans call for high levels of modulation. For example, an increase in gantry velocity while keeping the angular separation of the launch positions fixed will increase the impact on either the planned treatment volume (PTV) and/or the organ at risk (OAR) volume. It may require the treatment plan to be recalculated, potentially sacrificing dose prescription constraints.
The radiotherapy systems described herein may provide variable and real-time gantry and/or patient platform velocities to increase or decrease modulation during radiation beam delivery. The system may comprise a rotatable gantry, a patient platform positioned in a patient region of the gantry, a collimator mounted on the gantry and comprising a plurality of leaves, and a radiation source coupled to the collimator. The patient platform may move relative to the gantry (eg, longitudinally through the gantry bore) and the collimator leaves may open and close from multiple gantry angles. For example, when less modulation (eg, lower MLC transition rate) is required (per treatment plan), the gantry and/or patient platform may accelerate, and when more modulation is required, the gantry and/or the patient platform may slow down. In another example, the speed of the gantry and/or patient platform may be varied when the radiation beam is off, such as when moving between different tumors at different locations in the body (e.g., the speed of the patient platform may be varied). increase speed and decrease gantry speed). Alternatively or additionally, the platform speed may be adjusted based on data acquired by the PET detector during the treatment session. In this manner, treatment goals may be achieved while reducing treatment time.
Tumors with irregular shapes may require more modulation to deliver a dose with the proper shape. For example, the prostate axial view has a horseshoe shape that is concave around the rectum. Increased modulation may be desirable as the shape of the tumor becomes more irregular. Thus, the gantry rotation and/or patient platform velocity may be reduced when the collimated fan beam illuminates the target with a high degree of irregularity. In some variations, data acquired by the PET detector may be used to adjust platform speed. For example, areas with elevated levels of PET emission may be irradiated for a longer period of time than areas with lower levels of PET emission. Thus, the platform speed may be reduced to increase the residence time of regions with elevated levels of PET emissions in the fan beam, and the platform speed increases the residence time of regions with lower levels of PET emissions in the fan beam. It may be increased to decrease the time.
In some variations, a method of operating a radiation therapy system as described herein to reduce treatment time comprises a patient treatment plan comprising a set of open leaves and corresponding gantry angles. may include the step of receiving The beamlet firing position given by the treatment plan open leaf and gantry angle corresponds to the intensity modulation. A radiation beam may be output from the collimator using the radiation source and treatment plan, while the velocity of one or more of the patient platform and the gantry may be varied using the treatment plan. good. Accordingly, any level of intensity modulation may be reserved as prescribed by the treatment plan by adaptively adjusting one or more of the gantry velocity and patient platform velocity.
In some variations, collimator speed may be prioritized over patient platform and gantry speeds in response to the level of modulation required by the system to the treatment plan. For example, the speed of the collimator may be maintained and/or set as desired, while the speed of one or more of the patient platform and gantry is varied. When the MLC transition time cannot accommodate a particular combination of gantry velocity and/or number of gantry firing positions and/or patient platform velocity, the gantry velocity and/or couch velocity are reduced to keep the dose rate constant. may Thus, when less modulation is required, the gantry and/or patient platform is moved faster, and when more modulation is required, the gantry and/or patient platform achieves the desired level of intensity modulation. to do so, is moved slower. In some examples, the gantry velocity may be held constant while the patient platform velocity is varied. Conversely, the patient platform velocity may be held constant while the gantry velocity is varied.
A radiation therapy procedure for some patients may involve treating multiple distinct tumors. In addition to varying gantry rotation and/or patient platform velocity in response to tumor modulation levels, patient platform velocity may be varied between tumors. For example, patient platform velocity may be increased in the absence of radiation beam emission. With no dose delivered between tumors, the patient platform speed may be set to a first speed between tumors (e.g., set to maximum speed) to reduce overall treatment time. . In some variations, the first velocity of the patient platform and/or gantry may be any desired velocity when there is no beam emission, but once the patient platform reaches the boundary of the tumor, the patient platform and/or the gantry may accelerate/decelerate to reach the motion speed prescribed by the treatment plan. For example, borders (eg, 0.5 cm, 1 cm, 1.5 cm, 2 cm) may be provided around the tumor to allow the patient platform to decelerate for higher modulations in the tumor.
dose rate
There are situations in radiation therapy delivery where it is desirable to vary or gate the dose rate. In some variations, the linac may utilize injected electron beam pulses from an injector gun and RF pulses from an RF source (eg, magnetron). The injector beam pulse and RF pulse may typically be aligned (ie, the electron beam pulse and RF pulse are in phase). Either or both of the pulses can be misaligned (ie, phased to be out of phase) or shortened to vary or gate the dose rate. For systems that use a magnetron for the RF source, it may be desirable to leave the RF pulse unchanged. In these systems, the RF pulses from the magnetron can be consistent, but the radiation beam pulse repetition rate can be varied by changing the injector (eg, electron gun) pulse repetition rate.
Radiation therapy systems with binary multi-leaf collimators may output multiple linac pulses per projection. One example is depicted in FIG. Here a projection is a section of rotation that includes a binary MLC leaf transition time and a window for delivering radiation. The firing algorithm may be suitable for ring gantrys that are rotating fast enough to accommodate normal patient movements such as breathing. For example, a ring gantry rotating at 60 RPM, divided into 100 projections, leaves 10 ms per projection. A leaf transition time of 5 ms then leaves 5 ms per projection for radiation delivery. A linac pulse repetition rate of 300 Hz (3.3 ms apart) would allow only two pulses within a 5 ms window. On the other hand, the 400Hz pulse repetition rate (2. 5 ms apart) would allow 3 pulses within a 5 ms window (1 at the start of the window, 1 at the center of the window, and 1 at the end of the window). For a radiation therapy system where the linac fires at a constant rate as the ring gantry system rotates, leaf opening and transitioning are delivered by grouping projections for which no leaf is required to transition, linac triggering. It may be timed to maximize the number. In these methods, the number of linac triggers that are not delivered due to the presence of transitioning leaves is minimized. In variations where there is more than one pulse per firing window, the dose rate may be modulated by varying the number of pulses fired per firing window. For example, at 400 Hz, it is possible to fire up to 3 pulses within a 5 millisecond window. This is in contrast to typical linac systems that operate at a consistent repetition rate, where the time delay between all pulses is the same. Varying the time delay between pulses while the radiation generating system remains below the thermal average threshold of some of the radiation generating components such as the RF source, linac, RF window, and target transducer. , may allow compressing the same number of pulses into the firing window.
noise cancellation
In some variations, the radiation therapy system includes an audio system useful for reducing auditory discomfort from mechanical noise generated by the system, which can reduce patient comfort and increase patient anxiety. may In some variations, a noise cancellation method for a radiation therapy system may include receiving location data for a patient's ear positioned within a patient treatment area of the radiation therapy system. For example, ear location data may be determined using patient registration data (e.g., from PET imaging, kV CT imaging), or the patient may be preselected so that ear locations can be known. It may be positioned at a determined location. Noise generated from the radiation therapy system may be received using a microphone. A noise cancellation signal may be generated using the ear location data and the received noise. The blanking signal may then be output from the speaker. Ambient noise mixed with the cancellation signal at the patient's ear will cancel each other out (eg, destructive interference), reducing the perceptible noise volume to the patient.
Although the foregoing variations have been described in some detail by way of illustration and example for purposes of clarity and understanding, certain changes and modifications may be practiced and are intended to fall within the scope of the appended claims. It should be clear that you are. Additionally, it should be understood that the components and features of the systems and devices described herein may be used in any combination. The description of certain elements or specializations in relation to specific figures is not intended to be limiting and to imply that the elements cannot be used in combination with any of the other illustrated elements nor should it be construed as For all of the variations described above, the method steps may not be performed sequentially. Some steps are optional such that not all steps of the method may be performed.
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| EP3541281A1 | European Patent Office (EPO) | A1 | |
| JP2019534111A | Japan | A | |
| US10695586B2 | United States of America | B2 | |
| EP3541281A4 | European Patent Office (EPO) | A4 | |
| US2020368557A1 | United States of America | A1 | |
| EP3541281B1 | European Patent Office (EPO) | B1 | |
| JP2022040234A | Japan | A | |
| EP3988017A1 | European Patent Office (EPO) | A1 | |
| JP2022159434A | Japan | A | |
| JP7201243B2This record | Japan | B2 | |
| CN110234275B | China | B | |
| CN117339120A | China | A | |
| JP7421234B2 | Japan | B2 | |
| US11975220B2 | United States of America | B2 | |
| US2024350832A1 | United States of America | A1 | |
| JP2024159809A | Japan | A |
12 legal events, as the office reported them to INPADOC
Over the term
Point at a mark for the eventEvents
| Event | Code | |
|---|---|---|
| Receipt of annual feesJAPANESE INTERMEDIATE CODE: R250R250 | R250 | |
| Certificate of patent or registration of utility modelJAPANESE INTERMEDIATE CODE: R150R150 | R150 | |
| First payment of annual fees (during grant procedure)JAPANESE INTERMEDIATE CODE: A61A61 | A61 | |
| Written decision to grant a patent or to grant a registration (utility model)JAPANESE INTERMEDIATE CODE: A01A01 | A01 | |
| Decision of grant or rejection writtenTRDD | TRDD | |
| Request for written amendment filedJAPANESE INTERMEDIATE CODE: A523A521 | A521 | |
| Notification of reasons for refusalJAPANESE INTERMEDIATE CODE: A131A131 | A131 | |
| Request for written amendment filedJAPANESE INTERMEDIATE CODE: A523A521 | A521 | |
| Notification of reasons for refusalJAPANESE INTERMEDIATE CODE: A131A131 | A131 | |
| Report on retrievalJAPANESE INTERMEDIATE CODE: A971007A977 | A977 | |
| Request for written amendment filedJAPANESE INTERMEDIATE CODE: A523A521 | A521 | |
| Written request for application examinationJAPANESE INTERMEDIATE CODE: A621A621 | A621 |
Numbers
- Publication
- 7201243
- Application
- 2019525857
Titles2
- Japanese
- 放出誘導型高エネルギー光子送達のためのシステム
- English
- System for Stimulated Emission High-Energy Photon Delivery
Classification
- CPC, 19
- A61N5/10
- A61N5/1081
- A61N5/1001
- A61N5/103
- A61N5/1039
- A61N5/1045
- A61N5/1064
- G10K11/1785
- A61N2005/1019
- A61N2005/1074
- A61N2005/1092
- A61N2005/1097
- G10K2210/10
- A61N5/1049
- A61N2005/005
- A61N2005/1052
- A61N2005/1091
- A61N2005/1094
- G21K1/046
- IPC, 2
- A61N5 10
- A61N5 01
