US20070003010A1 - Radiation systems with imaging capability - Google Patents

Abstract

A radiation system includes a radiation source capable of generating a radiation beam having an energy suitable for treating tissue, an imager operatively associated with the radiation source, and a PET imager located adjacent to the imager. A radiation system includes a first ring, a radiation source coupled to the first ring, an imager operatively associated with the radiation source, a second ring located adjacent to the first ring, and a PET imager coupled to the second ring. A radiation system includes a structure having a first side, a second side, a first opening located on the first side, a second opening located on the second side, and a bore extending between the first opening and the second opening, a radiation source located outside the bore, and a PET imager located within or adjacent to the bore.

Description

RELATED APPLICATION DATA
• This application claims the benefit of U.S. Provisional Patent Application No. 60/676,138, filed on Apr. 29, 2005, the entire disclosure of which is expressly incorporated by reference herein.
• This application is related to U.S. patent application Ser. No. ______, entitled “Radiation systems” having Attorney Docket No. 7045512001, U.S. patent application Ser, No. ______, entitled “Patient support systems” having Attorney Docket No. 7045512003, and U.S. patent application Ser. No. ______, entitled “Systems and methods for treating patients using radiation” having Attorney Docket No. 7045512004.
FIELD
• This application relates generally to radiation systems, and more particularly, to radiation systems having imaging capability.
BACKGROUND
• Positron emission tomography (PET) detects photons generated through positron-electron annihilation of positrons from a radioactive tracer placed in the object, e.g., patient, to be imaged, and analyzes the photon energy and trajectory to generate tomographic images of the patient. PET images may be used to identify areas where a tumor is actively growing. However, due to attenuation effect in PET procedures, PET images tend to be blurry. As such, it may be desirable to obtain information about an anatomy, such as a density of tissue, that is being imaged, and use such information to correct attenuation effect in PET imaging.
• Computed tomography (CT) imaging may be used to obtain density information, and therefore, may be used to correct attenuation effect in PET images. In a typical CT process, a radiation source emits a thin X-ray beam while rotating around a patient. X-ray image detector positioned at the opposite side of the patient from the radiation source picks up and records data regarding absorption of the X-ray beam by various tissues and bones in the patient. A computer processes the data and generates images that assimilate multiple X-ray images into a two-dimensional cross sectional image.
• In existing PET-CT procedures, the patient is generally placed on a first patient support when the PET device is used to obtain PET images of the patient. After the PET imaging session, the patient may be moved to a second patient support where the patient can be imaged using a CT device that is configured for providing only imaging function. The CT image data obtained using the CT device may then be used to perform attenuation correction for the PET images obtained using the PET device. As a result of moving the patient to different supports, the position and/or the shape of the target tissue within the patient may change.
• In some cases, a PET device and a CT device may be placed in a same room, and a single patient support may be used to position a patient between the PET device and the CT device. However, the PET and CT devices may not be positioned in close proximity relative to each other. As a result, the patient support may need to be moved over a substantial distance from a first operative position associated with the PET device to a second operative position associated with the CT device. This increases a duration of the PET-CT procedure, and increases the chance that the patient may move while transporting between the PET and CT devices. In some cases, the PET and CT devices may be combined in a single machine. However, in such systems, the machine can only perform low energy imaging of the patient, and is not capable of providing treatment to the patient.
• Another problem associated with existing PET-CT procedures is that PET photons have an energy of approximately 511 keV, and undergo significant Compton scattering, while attenuation of x-rays of typical diagnostic sources generally are dominated by the photoelectric effect. Since CT imaging using typical diagnostic sources provides attenuation that is not dominated by Compton scattering, traditional diagnostic sources may not be the most desirable tool for correcting attenuation effect for PET imaging.
SUMMARY
• In accordance with some embodiments, a radiation system includes a radiation source capable of generating a radiation beam having an energy suitable for treating tissue, an imager operatively associated with the radiation source, and a PET imager located adjacent to the imager.
• In accordance with other embodiments, a radiation system includes a first ring, a radiation source coupled to the first ring, an imager operatively-associated with the radiation source, a second ring located adjacent to the first ring, and a PET imager coupled to the second ring.
• In accordance with other embodiments, a radiation system includes a structure having a first side, a second side, a first opening located on the first side, a second opening located on the second side, and a bore extending between the first opening and the second opening, a radiation source located outside the bore, and a PET imager located within or adjacent to the bore.
• Other aspects and features will be evident from reading the following detailed description of the embodiments.
BRIEF DESCRIPTION OF THE DRAWINGS
• The drawings illustrate the design and utility of preferred embodiments, in which similar elements are referred to by common reference numerals. In order to better appreciate how advantages and objects of the embodiments are obtained, a more particular description of the embodiments will be illustrated in the accompanying drawings.
• FIG. 1A illustrates an isometric view of a radiation system in accordance with some embodiments;
• FIG. 1B illustrates an isometric view of a radiation system having imaging capability in accordance with some embodiments;
• FIG. 1C illustrates an isometric view of a radiation system in accordance with other embodiments;
• FIG. 1D illustrates an isometric view of a radiation system in accordance with other embodiments;
• FIG. 1E illustrates a top view of the radiation system ofFIG. 1C in accordance with some embodiments;
• FIG. 1F illustrates an isometric view of a radiation system in accordance with other embodiments;
• FIG. 2 illustrates an isometric view of a radiation system that includes, or is used with, a computed tomography device, in accordance with some embodiments;
• FIG. 3 illustrates an isometric view of a radiation system that includes, or is used with, a device having a C-arm configuration, in accordance with some embodiments;
• FIG. 4A illustrates an isometric view of a radiation system having a docking system for allowing a device to be docked adjacent to the radiation system in accordance with some embodiments;
• FIGS. 4B and 4C illustrate a method of docking a device adjacent to the radiation system ofFIG. 4A in accordance with some embodiments;
• FIG. 5A illustrates an isometric view of a radiation system having a docking system for allowing the radiation system to be docked adjacent to a device in accordance with some embodiments;
• FIGS. 5B and 5C illustrate a method of docking the radiation system ofFIG. 5A adjacent to a device in accordance with some embodiments;
• FIG. 6A illustrates a side view of a patient support system in accordance with some embodiments, showing the patient support system placed on one side of the radiation system ofFIG. 1A;
• FIG. 6B illustrates a side view of a patient support system in accordance with other embodiments, showing the patient support system placed on another side of the radiation system ofFIG. 1A;
• FIG. 7 illustrates a side view of the patient support system ofFIG. 6A, showing a patient support of the patient support system being placed at a first operative position;
• FIG. 8 illustrates a side view of the patient support system ofFIG. 6A, showing a patient support of the patient support system being placed at a second operative position;
• FIG. 9 illustrates a side view of a patient support system in accordance with some embodiments;
• FIG. 10A illustrates a side view of a patient support system in accordance with other embodiments;
• FIG. 10B illustrates a top view of a docking system for allowing a patient support system to be docked adjacent to a radiation system in accordance with some embodiments;
• FIG. 10C illustrates a top view of the patient support system ofFIG. 10A docked adjacent to the radiation system ofFIG. 1A in a first configuration in accordance with some embodiments;
• FIG. 10D illustrates a top view of the patient support system ofFIG. 10A docked adjacent to the radiation system ofFIG. 1A in a second configuration in accordance with other embodiments;
• FIG. 10E illustrates a top view of the patient support system ofFIG. 10A docked adjacent to the radiation system ofFIG. 1A in a third configuration in accordance with other embodiments;
• FIG. 10F illustrates a top view of the patient support system ofFIG. 10A docked adjacent to the radiation system ofFIG. 1A in a fourth configuration in accordance with other embodiments;
• FIG. 10G illustrates a top view of a docking system in accordance with other embodiments;
• FIG. 10H illustrates a top view of a docking system in accordance with other embodiments;
• FIG. 11A illustrates a side view of a patient support system placed between a radiation system and a device in accordance with some embodiments, showing a patient support of the patient support system placed at a first operative position;
• FIG. 11B illustrates a side view of the patient support system ofFIG. 11A, showing the patient support of the patient support system placed at a second operative position;
• FIG. 12A illustrates a side view of a patient support system having a first positioner, a second positioner, and a patient support in accordance with some embodiments, wherein the patient support is shown coupled to the first positioner;
• FIG. 12B illustrates a side view of the patient support system ofFIG. 12A, showing the patient support being coupled to both the first and the second positioners;
• FIG. 12C illustrates a side view of the patient support system ofFIG. 12A, showing the patient support being coupled to the second positioner;
• FIG. 13A illustrates a patient support system in accordance with other embodiments;
• FIG. 13B illustrates a patient support system in accordance with other embodiments;
• FIG. 13C illustrates a method of using the patient support ofFIG. 13A in accordance with some embodiments;
• FIG. 13D illustrates an isometric view of a patient support in accordance with other embodiments;
• FIG. 13E illustrates an isometric view of a patient support in accordance with other embodiments;
• FIG. 14A illustrates an isometric view of a radiation system that includes a patient position sensing system in accordance with some embodiments;
• FIG. 14B illustrates a side view of a radiation system that includes a patient position sensing system in accordance with other embodiments;
• FIG. 14C illustrates a side view of a radiation system that includes a patient position sensing system in accordance with other embodiments;
• FIG. 15 illustrates an isometric view of a radiation system that includes compensating coils in accordance with some embodiments;
• FIG. 16A illustrates an isometric view of a radiation system that includes a protective shield in accordance with some embodiments;
• FIG. 16B illustrates a side cross-sectional view of the radiation system ofFIG. 16A;
• FIG. 16C illustrates an isometric view of a radiation system that includes a protective shield in accordance with other embodiments;
• FIGS. 17A-17E illustrate radiation systems in accordance with other embodiments;
• FIG. 18 illustrates a radiation beam generator having a permanent magnet for altering a trajectory of a beam in accordance with some embodiments; and
• FIG. 19 illustrates a block diagram of a computer system that can be used to control an operation of a radiation system, a device, and/or a patient support system in accordance with some embodiments.
DETAILED DESCRIPTION OF THE EMBODIMENTS
• Various embodiments are described hereinafter with reference to the figures. It should be noted that the figures are not drawn to scale and elements of similar structures or functions are represented by like reference numerals throughout the figures. It should also be noted that the figures are only intended to facilitate the description of specific embodiments. They are not intended as an exhaustive description of the invention or as a limitation on the scope of the invention. In addition, an aspect described in conjunction with a particular embodiment is not necessarily limited to that embodiment and can be practiced in any other embodiments. Moreover, alternative configurations, components, methods, etc. discussed in conjunction with one embodiment can be used in any other embodiment even if such other embodiment does not discuss such alternatives or discusses different alternatives.
• FIG. 1A illustrates aradiation system10 in accordance with some embodiments. Theradiation system10 includes astructure12 having afirst side14, asecond side16, afirst opening18 located on thefirst side14, asecond opening20 located on thesecond side16, and abore22 extending between the first-andsecond openings18,20. In the illustrated embodiments, theopenings18,20 are circular in shape and are sized for accommodating at least a part of a patient. In other embodiments, theopenings18,20 can have other shapes. The through bore22 of thestructure12 provides a passage for allowing at least a portion of a patient to be transported from one side of thestructure12 to an opposite side of thestructure12. In some embodiments, a diagnostic procedure (e.g., an imaging procedure) is performed on the patient on one side of the structure12 (e.g., for the purpose of obtaining information, such as a position of a target region, of the patient), and the patient is then transported through thebore22 to the opposite side of thestructure12 for a treatment procedure. In other embodiments, the patient is treated on one side of thestructure12, and is then transported through thebore22 to the opposite side of thestructure12 for further procedure(s), such as a diagnostic procedure (e.g., to evaluate a treatment procedure, or to verify location, orientation, and/or shape of a target tissue,) or a treatment procedure.
• It should be noted that the shape and configuration of thestructure12 should not be limited to the examples discussed previously, and that thestructure12 can have other configurations in other embodiments. For example, in other embodiments, thestructure12 can have a curvilinear shape, or other shapes. Also, in some embodiments, thestructure12 can have a size and shape such that the structure can house mechanical and electrical components associated with an operation of theradiation system10 as desired.
• Theradiation system10 also includes afirst radiation source40 located adjacent to thefirst side14 for delivering aradiation beam42. Theradiation beam42 can be a pencil beam, a fan beam, a cone beam, or other types of beams having different configurations. As used in this specification, the term “radiation source” refers to an emission point/region of a radiation beam (e.g., radiation beam42), and may or may not include components, such as a particle generator, an accelerator, a cooling system, a shielding, etc., that are used to generate theradiation beam42. As shown in the figure, theradiation system10 includes anarm30 secured to thestructure12, and thefirst radiation source40 is-secured to thearm30. Some or all of the components used to generate theradiation beam42 can be housed within thearm30, thestructure12, a separate housing (not shown), or combination thereof. For example, in some embodiments, theaccelerator31 associated with theradiation source40 may be housed within thearm30. In such cases, one or more magnets (electromagnet(s) or permanent magnet(s)) may be provided within thearm30 for changing a characteristic (e.g., a trajectory) of an electron beam created by theaccelerator31. If permanent magnet(s) is used, its associated magnetic field can be trimmed electromagnetically (e.g., using one or more electromagnetic coil(s)) or mechanically (e.g., using one or more permanent magnet(s)). Also, in some embodiments, the mechanical trimming can be performed using a magnetic shunt. Magnetic field trimming will be described with reference toFIG. 18.
• As shown in the figure, thearm30 is secured to amechanical linkage44, such as a ring, that is rotatable relative to thestructure12, thereby allowing thefirst radiation source40 to rotate about anaxis46 of thebore22. Thearm30 of theradiation system10 is advantageous in that it allows radiation be delivered to a portion of a patient that is placed outside thebore22. In particular, since the patient is not confined by thebore22, the patient can be oriented at different angles relative to theaxis46 outside thebore22. For example, the patient can be positioned at least partially outside thebore22 and oriented at an angle relative to theaxis46. In some embodiments, thearm30 is also advantageous in that it can be used to house at least some of the components, such as an accelerator, associated with theradiation source40, thereby eliminating the need to cramp the components within thebore22.
• In other embodiments, or any of the embodiments described herein, theradiation system10 may not include the arm30 (FIG. 1F). In such cases, the first radiation-source40 may be rotatably secured to thestructure12. For example, theradiation source40 may be secured to a ring (which may be a full ring or a partial ring) that is rotatable relative to thestructure12 in a slip-ring configuration. In such cases, at least some of the components withinarm30 may be disposed within thestructure12. It should be noted that any one or a combination of any of the features described herein may be incorporated and implemented with theradiation system10 ofFIG. 1F, and that a configuration where a radiation source such assource40 is within a ring can be incorporated and implemented in any embodiments such as those illustrated or described herein.
• In the illustrated embodiments, thefirst radiation source40 is a treatment radiation source for providing treatment energy. In such cases, theradiation system10 further includes one or more collimators (not shown) for controlling a delivery of the radiation beam42 (e.g., changing a shape of the beam42). A collimator can be, for example, a multi-leaf collimator, which is known in the art. Alternatively, thefirst radiation source40 can be a diagnostic radiation source for providing diagnostic energy. In some embodiments, the treatment energy is generally those energies of 160 keV or greater, and more typically 1 MeV or greater, and diagnostic energy is generally those energies below the high energy range, and more typically below 160 keV. In other embodiments, the treatment energy and the diagnostic energy can have other energy levels, and refer to energies that are used for treatment and diagnostic purposes, respectively. For example, a radiation beam having an energy level that is typically used for treatment purpose may be considered as having a diagnostic energy level if the radiation beam is used for diagnostic purpose (e.g., for imaging). As such, the term “treatment energy” and the term “diagnostic energy” should not be limited to energy levels having certain magnitudes. In further embodiments, thefirst radiation source40 is a multi-energy x-ray source that is capable of providing radiation energy at different energy levels. By way of example, thefirst radiation source40 is able to generate X-ray radiation at a plurality of photon energy levels within a range anywhere between approximately 10 kilo-electron-volts (keV) and approximately 20 mega-electron-volts (MeV). Radiation sources capable of generating X-ray radiation at different energy levels are described in U.S. patent application Ser. No. 10/033,327, entitled “RADIOTHERAPY APPARATUS EQUIPPED WITH AN ARTICULABLE GANTRY FOR POSITIONING AN IMAGING UNIT,” filed on Nov. 2, 2001, and U.S. patent application Ser. No. 10/687,573, entitled “MULTI-ENERGY X-RAY SOURCE,” filed on Oct. 15, 2003, both of which are expressly incorporated by reference in their entirety.
• In some embodiments, theradiation system10 further includes acontrol system78. Thecontrol system78 includes aprocessor84, such as a computer processor, coupled to acontrol80. Thecontrol system78 may also include amonitor86 for displaying data and aninput device88, such as a keyboard or a mouse, for inputting data. In some embodiments, during an operation of theradiation system10, theradiation source40 rotates about the patient (e.g., as in an arc-therapy). The rotation and the operation of theradiation source40 are controlled by thecontrol80, which provides power and timing signals to theradiation source40 and controls a rotational speed and position of theradiation source40 based on signals received from theprocessor84. Although thecontrol80 is shown as a separate component from thestructure12 and theprocessor84, in alternative embodiments, thecontrol80 can be a part of thestructure12 or theprocessor84.
• In any of the embodiments described herein, theradiation system10 can further include animager50 located next to thefirst opening18 and opposite from the radiation source40 (FIG. 1B). In some embodiments, theimager50 includes a conversion layer made from a scintillator element, such as Cesium Iodide (Csl), and a photo detector array (e.g., a photodiode layer) coupled to the conversion layer. The conversion layer generates light photons in response to radiation, and the photo detector array, which includes a plurality of detector elements, is configured to generate electrical signal in response to the light photons from the conversion layer. Theimager50 can have a curvilinear surface (e.g., a partial circular arc). Such configuration is beneficial in that each of the imaging elements of theimager50 is located substantially the same distance from theradiation source40. In an alternative embodiment, theimager50 may have a rectilinear surface or a surface having other profiles. Theimager50 can be made from amorphous silicon, crystal and silicon wafers, crystal and silicon substrate, or flexible substrate (e.g., plastic), and may be constructed using flat panel technologies or other techniques known in the art of making imaging device. In alternative embodiments, theimager50 may use different detection schemes. For example, in alternative embodiments, instead of having the conversion layer, theimager50 may include a photoconductor, which generates electron-hole-pairs or charges in response to radiation.
• It should be noted that the configuration of theimager50 should not be limited to the examples discussed previously, and that imagers having other configurations may be used in other embodiments. By way of example, U.S. patent application Ser. No. 10/439,350, entitled “MULTI ENERGY X-RAY IMAGER” filed on May 15, 2003, discloses imaging devices capable of generating signals in response to multiple radiation energy levels, and can be used as theimager50 in accordance with some embodiments. In addition, U.S. patent application Ser. No. 10/013,199, entitled “X-RAY IMAGE ACQUISITION APPARATUS,” and filed on Nov. 2, 2001, discloses an image detecting device that is capable of detecting multiple energy level X-ray images, and can also be used as theimager50 in accordance with other embodiments. U.S. patent application Ser. No. 10/687,552, entitled “MULTI-ENERGY RADIATION DETECTOR,” and filed on Oct. 15, 2003, discloses multi-energy radiation detectors that can be used as theimager50 in different embodiments. In other embodiments, theimager50 can be implemented using flat panel technologies. Also, in further embodiments, theimager50 can be a multi-slice flat panel. Multi-slice flat panel CT has been described in U.S. patent application Ser. No. 10/687,552, entitled “MULTI-SLICE FLAT PANEL COMPUTED TOMOGRAPHY,” and filed on Oct. 15, 2003. U.S. patent application Ser. Nos. 10/439,350, 10/013,199, and 10/687,550 are expressly incorporated by reference in their entirety. In other embodiments, theimager50 may be similarly incorporated in theradiation system10 ofFIG. 1F, or in any of theradiation systems10 described herein.
• It should be noted that theradiation system10 should not be limited to the configuration discussed previously, and that theradiation system10 can have other configurations in other embodiments. For example, in some embodiments, theradiation system10 can have the configuration shown inFIG. 1C. In the illustrated embodiments, theradiation system10 includes the structure12a,which has a configuration that is similar to that discussed previously with reference to structure12 ofFIG. 1A. Theradiation system10 also includes thearm30 and theradiation source40. However, in the illustrated embodiments, thearm30 has a configuration that resembles a L-shape, and includes afirst portion54 and a second portion55. The second portion55 of thearm30 has afirst opening19, asecond opening21, and a bore56 extending between the first and thesecond openings19,21. As shown inFIG. 1E, which is a top view of the system ofFIG. 1C, thearm30 is rotatably coupled to thestructure12 via acylindrical shaft49, which circumscribe at least part of thebore22 and at least part of the bore56 in a coaxial configuration. In other embodiments, thearm30 can be rotatably coupled to thestructure12 in other configurations. The bore56 is positioned relative to thebore22 such that at least a part of a patient can move through the bore56 to thebore22, and vice versa. In other embodiments, any of the features described herein can also be included with theradiation system10 ofFIG. 1C. For example, in other embodiments, theradiation source40 can deliver diagnostic energy, and theradiation system10 ofFIG. 1C can further include an imager (e.g., the imager50) in operative position with theradiation source40 such that theradiation source40 and the imager can be used to generate image data.
• In some embodiments, any of theradiation systems10 described herein can further include a x-ray source, such as tube51 (an example of an imaging device ) and an imager52 (another example of an imaging device) secured to thesecond portion54 of the arm30 (FIG. 1D), wherein the x-ray tube51 and the imager52 are positioned to image at least a portion of the patient. The x-ray tube51 and the imager52 can be used to generate data regarding a patient while the patient is positioned in an operative position associated with theradiation source40. For example, in some embodiments, the x-ray tube51 generates a cone beam, and the imager52 generates cone beam CT data, which represent image of a portion of a patient. Alternatively, the imaging devices can be used for radiography or fluoroscopic imaging. In the embodiments ofFIG. 1A, the x-ray tube51 and the imager52 could be attached toring44. In the embodiments ofFIG. 1F, the x-ray tube51 and the imager52 could be attached to thering53.
• FIG. 2 illustrates theradiation system10 ofFIG. 1A when used with a computed tomography image acquisition device (CT device)100. TheCT device100 includes agantry102 having abore103, apatient support114 for supporting apatient116, and acontrol system108 for controlling an operation of thegantry102. In the illustrated embodiments, thegantry102 has a slip-ring configuration (donut shape). Alternatively, thegantry102 can have other configurations, such as a C-arm configuration. TheCT device100 also includes a radiation source (e.g., x-ray source)120 that projects a beam122 of radiation towards adetector124 on an opposite side of thegantry102 while thepatient116 is positioned at least partially between theradiation source120 and thedetector124. Theradiation source120 can be configured to generate a cone beam (for cone beam computed tomography—“CBCT”). In other embodiments, theradiation source120 generates beams having other configurations, such as a fan beam. Thedetector124 has a plurality of sensor elements configured for sensing radiation that passes through the patient. Each sensor element generates an electrical signal representative of an intensity of the radiation as it passes through the patient. It will be appreciated that throughout the present specification, although specific embodiments of various imaging devices may be illustrated by fan beam CT or cone beam CT, any type of CT generally can be practiced in any of the embodiments.
• Thecontrol system108 includes aprocessor134, such as a computer processor, coupled to agantry rotation control141. Thecontrol system108 may also include amonitor156 for displaying data and aninput device158, such as a keyboard or a mouse, for inputting data. During a scan to acquire x-ray projection data (i.e., CT image data), thegantry102 rotates about the patient. The rotation of thegantry102 and the operation of theradiation source120 are controlled by thegantry rotation control141, which provides power and timing signals to theradiation source120 and controls a rotational speed and position of thegantry102 based on signals received from theprocessor134. Although thecontrol141 is shown as a separate component from thegantry102 and theprocessor134, in alternative embodiments, thecontrol141 can be a part of thegantry102 or theprocessor134. In some embodiments, theprocessor134 and theprocessor84 are implemented using a same component, such as a single processor.
• During a radiation procedure using theCT device100, theradiation source120 generates and directs a x-ray beam122 towards thepatient116, while thedetector124 measures the x-ray absorption at a plurality of transmission paths defined by the x-ray beam during the process. Thedetector124 produces a voltage proportional to the intensity of incident x-rays, and the voltage is read and digitized for subsequent processing in a computer. After image data at different gantry angles have been collected, the collected data are processed for reconstruction of a matrix (CT image), which constitutes a depiction of a density function of the bodily section being examined. By considering one or more of such sections, a skilled diagnostician can often diagnose various bodily ailments. In some cases, the one or more sections can also be used to perform treatment planning.
• As shown in the figure, anaxis160 of thebore103 of theCT device100 is substantially parallel with (e.g., within 20° from) theaxis46 of thebore22 of theradiation system10. Such configuration allows thepatient116 to be transported between a first operative position (e.g., the position of thepatient116 when being operated (e.g., treated or imaged) by theradiation source40 of the radiation system10) and a second operative position (e.g., the position of thepatient116 when being operated by theradiation source120 of the CT device100). In the illustrated embodiments, thepatient116 can be transported between the first and second operative positions by positioning thepatient support114 in a linear manner along theaxis46 of the radiation-system10. Patient supports that can be used with theradiation system10 will be described in further detail later. In the illustrated embodiments, theaxis160 of thebore103 aligns with theaxis46 of thebore22. In other embodiments, theaxis160 of thebore103 may not align with theaxis46 of thebore22. For example, in some embodiments, the axis of thebore160 may be offset from theaxis46 of thebore22.
• In the illustrated embodiments ofFIG. 2, theprocessor134 used to control an operation of theCT device100 is also coupled to theradiation system10, and is configured to control an operation of theradiation system10. Alternatively, a separate control system (e.g., the system78) can be used to control an operation of theradiation system10. Also, in some embodiments, theradiation system10 includes theCT device100. In such cases, theCT device100 can be separated from theradiation system10 as that shown in the figure. Alternatively, theCT device100 can be integrated with theradiation system10 as a single unit.
• In some embodiments, theelectron accelerator31 associated with the radiation source40.may cause interference with thedevice100. In such cases, a shield (not shown) can be placed between theaccelerator31 and thedevice100 to prevent, or at least minimize the effect of, interference due to theaccelerator31. The shield can be made from Mumetal or other materials. In some embodiments, the shield can be placed around theaccelerator31. In other embodiments, the shield can be placed around thedevice100 or a component (e.g., a component that may be affected by a magnetic field from the accelerator31) of thedevice100. In other embodiments, the shield can be secured to thestructure12, such as to thesecond side16 of thestructure12.
• It should be noted that the devices that can be used/included with theradiation system10 should not be limited to theCT device100 discussed previously, and that a variety of forms of medical devices (e.g., devices with a ring gantry) can be used/included with theradiation system10 in other embodiments. For example, in some embodiments, thedevice100 used/included with theradiation system10 may be a diagnostic/treatment device having a C-arm configuration (FIG. 3). Thedevice100 is positioned relative to thebore22 such that a patient can be positioned between a first operative position associated with theradiation source40, and a second operative position associated with thedevice100. In any embodiment, thedevice100 can be any diagnostic device, such as a laminar tomography device, a MRI device, a fluoroscope, an angiography device, a PET device, a SPECT device, a PET-CT device, a tomosynthesis imaging device, a CT device, a CBCT device, etc. that can be used/included with theradiation system10. In such cases, thediagnostic device100 is positioned relative to thebore22 such that a patient can be positioned between a first operative position associated with theradiation source40, and a second operative position associated with the diagnostic device. In further embodiments, thedevice100 used/included with theradiation system10 may include a plurality of diagnostic devices (e.g., any multiple, or any combination, of the diagnostic devices described).
• In the above embodiments, theradiation system10 can further include rollers that allows theradiation system10 to be “rolled” to a desired position. After theradiation system10 is desirably positioned, the rollers may be locked to thereby prevent theradiation system10 from moving. For example, the rollers may be locked during an operation. The rollers are advantageous because it allows the flexibility to readily move the radiation system10 (e.g., before an operation, or during an operation). In other embodiments, the rollers are optional, and theradiation system10 is fixedly secured to a floor of an operation room.
• In some embodiments, theradiation system10 can further include a docking system that allows adevice100 to be docked next to thesecond opening20 in a desired relationship (either during an operation, or before an operation). Various techniques can be employed to implement the docking feature of theradiation system10.FIG. 4A illustrates theradiation system10 ofFIG. 1A that includes adocking system160 for allowing adevice166 to be docked next to thestructure12. Thedevice166 is represented as a block diagram, and can be a treatment device or a diagnostic device (such as any of thedevices100 discussed previously). In the illustrated embodiments, thedocking system160 is a rail system that includes afirst rail162 and asecond rail164 located adjacent to thesecond side16 of theradiation system10. Therails162,164 can be secured to theradiation system10, a floor at which theradiation system10 sits, or a platform (not shown) that is itself secured to theradiation system10 or the floor. Therails162,164 each have a substantially rectilinear profile, but can have a curvilinear profile in other embodiments. Also, in other embodiments, thedocking system160 can have less than two (e.g., one) rails, or more than two rails.
• FIGS. 4B and 4C illustrate a method of docking adevice166 adjacent to thesecond side16 of theradiation system10 in accordance with some embodiments. Thedevice166 is represented as a block diagram, and can be a treatment device or a diagnostic device (such as any of thedevices100 discussed previously). As shown inFIG. 4B, before thedevice166 is docked, thedevice166 is positioned such that its wheels/rollers168 are aligned with therails162,164 of thedocking system160. Thedevice166 is then advanced such that therollers168 engage with thedocking system160. Next, thedevice166 is further advanced, while guided by thedocking system160, until thedevice166 is docked next to thesecond opening20 of the radiation system10 (FIG. 4C). In some embodiments, thedocking system160 can further include a locking device (not shown), which can be used to lock thedevice166 in place when thedevice166 is desirably positioned.
• In some embodiments, the position of one or both of therails162,164 of thedocking system160 can be adjusted such that thedocking system160 can accommodatedifferent devices166 having different configurations. For example, in some embodiments, the distance between therails162,164 can be varied such thatdevices166 having different roller spacing can be docked. Also, in other embodiments, one or more rails can be removed or added to thedocking system160 for allowingdevices166 having different number of rollers to be docked. In some embodiments, thedocking system160 can further include therollers168 of thedevice166.
• It should be noted that thedocking system160 should not be limited to the example discussed previously, and that thedocking system160 can be implemented using other techniques. For example, in other embodiments, instead of, or in addition to rail(s), thestructure12 and thedevice166 can have a key-type docking mechanism, which allows a portion of thestructure12 to mate with a portion of thedevice166, or other alignment devices, including visual alignment marks, sensors, or other means, which allow thedevice166 to be positioned in a desired relationship relative to theradiation system10. In further embodiments, thedevice166 does not includerollers168. Instead, thedevice166 can be positioned using a crane, air cushion, a positioner, glide block(s), or other transportation mechanism.
• In some embodiments, instead of, or in addition to, thedocking system160, theradiation system10 can further include adocking system170 for allowing thestructure12 to be docked into a desired position. Various techniques can be employed to implement the docking feature of theradiation system10.
• FIG. 5A illustrates theradiation system10 ofFIG. 1A that includes adocking system170. In the illustrated embodiments, thedocking system170 includes a roller system having a set of first roller(s)172 and a second set of roller(s)174 located adjacent to a bottom portion of theradiation system10. In other embodiments, thedocking system170 can have less than two (e.g., one) roller, or more than sets of two rollers. In the illustrated embodiments, the roller sets172,174 are configured to mate withrails176,178 of arail system180. Therail system180 can be secured to another device, such as thedevice166, a floor at which theradiation system10 sits, or a platform that is placed against a floor or secured to thedevice166. Therails176,178 each have a substantially rectilinear profile, but can have a curvilinear profile in other embodiments. In some embodiments, thedocking system170 can further includes therail system180.
• FIGS. 5B and 5C illustrate a method of docking theradiation system10 to a desired position, e.g., adjacent to thedevice166, in accordance with some embodiments. Thedevice166 is represented as a block diagram, and can be a treatment device or a diagnostic device (such as any of those discussed previously). As shown inFIG. 5B, before theradiation system10 is docked, theradiation system10 is positioned such that its roller sets172,174 are aligned with therails176,178. Theradiation system10 is then advanced such that the roller sets172,174 engage with therails176,178, respectively. Next, theradiation system10 is further advanced, while guided by therails176,178, until theradiation system10 is docked next to the device166 (FIG. 5C). In some embodiments, thedocking system170 can further include a locking device (not shown), such as a brake system, which can be used to lock theradiation system10 in place when theradiation system10 is desirably positioned.
• In some embodiments, the position of one or both of the roller sets172,174 of thedocking system170 can be adjusted such that theradiation system10 can be mated with rails having different configurations. For example, in some embodiments, the distance between the roller sets172,174 can be varied such that theradiation system10 can be docked with rails having different spacing. Also, in other embodiments, one or more roller sets can be removed or added to thedocking system170 for allowing theradiation system10 to dock with a rail system having different number of rails.
• It should be noted that thedocking system170 should not be limited to the example discussed previously, and that thedocking system170 can be implemented using other techniques. For example, in other embodiments, thestructure12 and thedevice166 can have a key-type docking mechanism, which allows a portion of thestructure12 to mate with a portion of thedevice166. In alternative embodiments, thedocking system170 can have a first portion (e.g., a protrusion) associated with theradiation system10, and a second portion (e.g., a component having a recess) associated with thedevice166, wherein the first portion and/or the second portion are configured to mate with each other. The first and second portions of a docking system can be implemented using any machinery, device, or system known in the art, including those described earlier in relation toFIGS. 4A-4C. In other embodiments, theradiation system10 can include other alignment devices, which allow theradiation system10 to be positioned in a desired relationship relative to thedevice166. In further embodiments, theradiation system10 does not include the roller system. Instead, theradiation system10 can be positioned using a crane, air cushion, a positioner, glide block(s), or other transportation mechanism.
• In any of the docking systems described herein, the docking system can further include one or more facilities, such as a water line, an electricity connection, an oil supply, etc., that connects to the device (such as thestructure12 or the device166) as the device is being docked (or after the device is docked). In some embodiments, the facilities can be located on, underneath a floor, or underneath a platform that is secured to the floor. Alternatively, or additionally, the docking system can allow for provision of facilities from one device, such asdevice12, to one or more others.
• Also, in any of the docking systems described herein, the docking system can further include a communication system that allows one device to communicate with thedevice166 or another device. For example, in some embodiments in which thedevice166 is being docked, thestructure12 includes a signal receiver and/or a transmitter, and thedevice166 includes a signal transmitter and/or a receiver. During use, the signal transmitter of, e.g., thedevice166 transmits signals to thestructure12 regarding a position of the device166 (e.g., relative to a prescribed coordinate system). The signal receiver of thestructure12 receives the transmitted signal, and generates an output based on the transmitted signal. In some embodiments, the output can be displayed on a user interface, such as a computer screen, which allows an operator to perform an action based on the output. In other embodiments, the devices can perform or assist in docking (including, e.g., gross positioning and/or fine positioning). For example, thedevice166 can be configured to automatically position itself based on the received output. In further embodiments, thestructure12 can include a position sensor which senses a position of thedevice166, and a transmitter that transmits steering signals to thedevice166. In such cases, thedevice166 includes a receiver, which receives the steering signals and steers itself into a desired position relative to thestructure12 based on the steering signals. Other communication techniques can also be used in other embodiments.
• FIG. 6A illustrates apatient support system200 that can be used with any of the embodiments of theradiation system10 described herein, or with any radiation system, such as a treatment device or a diagnostic device. Thepatient support system200 includes apatient support201 having afirst end202, asecond end204, and asupport surface206 that extends between the first and second ends202,204. In some embodiments, thesupport surface206 of thepatient support201 can include a plurality of envelopes that can be filled with a fluid (gas or liquid). The envelopes can be selectively filled to create a desired topography of thesupport surface206, thereby allowing a patient to be correctly placed on thesupport surface206. For example, in some embodiments, the envelopes adjacent the perimeter of thesupport surface206 can be selectively filled to create a recess in a center portion of thesupport surface206. Alternatively, small individual regions can have mechanically or thermally positionable mechanisms to provide various shapes in the support surface. The shape of thesupport surface206 can accommodate a shape of a patient or a portion thereof. The precise shape for a given patient determined, e.g., during treatment planning or a previous session, can be stored and used later such that when the patient lies on thesupport surface206, the patient will be correctly positioned relative to thesupport surface206. In other embodiments, thesupport surface206 does not include the envelopes or other positionable mechanism.
• Thepatient support system200 also includes a positioner208 (represented as a block diagram) for positioning thepatient support201. In particular, thepositioner208 is configured to position thepatient support201 at a first operative position such that radiation beam from theradiation source40 can be delivered to a portion117 (e.g., a target region) of the patient116 (FIG. 7), and a second operative position such that thedevice166 can be used to operate on theportion117 of the patient116 (FIG. 8). As shown inFIGS. 7 and 8, theportion117 of thepatient116 is positioned on (adjacent to) thefirst side14 of thestructure12 when it is being treated by theradiation source40, and is positioned on (adjacent to) thesecond side16 of the structure12 (e.g., within a gantry of the device166) when it is being imaged by thedevice166. In the illustrated embodiments ofFIGS. 6A, 7, and8, thepatient support system200 is located on thefirst side14 of thestructure12. Alternatively, the patient support system200 (or any of the patient support systems described herein) can be located on thesecond side16 of the structure12 (FIG. 6B). In such cases, thepositioner208 places thepatient support201 at the first operative position associated with theradiation source40 by translating at least a part of thepatient support201 past thedevice166.
• In some embodiments, thedevice166 is an imaging device, such as a CT device. In such cases, thepositioner208 can be used to position the patient support201 (and therefore, the patient116) at the second operative position associated with theimaging device166, thereby allowing theimaging device166 to obtain image data of an internal bodily structure of thepatient116. The obtained image data can then be used to create, or modify, a treatment plan, or to perform patient positioning. In some embodiments, the treatment plan includes parameters (such as a size and shape of a target region, an amount of radiation to be delivered to the target region, margin requirements, etc.) that can be used in a radiation treatment session to treat a portion of thepatient116. Methods of creating treatment plans using image data are known to those skilled in the art.
• In some embodiments, the obtained image data can be used to verify a position, orientation, and/or a shape, of a target region (e.g., a tissue intended to be treated with radiation). For example, the obtained image data using theimaging device166 can be compared against a previously obtained image data associated with the treatment plan to determine whether a target region has changed location, size, or shape. After a position, orientation, and/or a shape of the target region has been verified, thepositioner208 can position thepatient116 to the first operative position, at which theradiation source40 can be used to deliverradiation beam42 to treat thepatient116.
• In some embodiments, thepositioner208 does not move thepatient116 while radiation is being delivered to the patient116 from theradiation source40. In other embodiments, thepositioner208 can be used to move thepatient116 while radiation is being delivered from the radiation source.
• In some embodiments, after thepatient116 has been treated, thepositioner208 can be used to position the patient116 from a first operative position to a second operative position. While thepatient116 is at the second operative position, theimaging device166 is used to obtain image data of the treated area of thepatient116. The obtained image data can then be used to determine an effect (e.g., an effectiveness, accuracy, etc.) of the previously performed treatment procedure. In some embodiments, the obtained image data can be used to determine a next treatment plan (for a next treatment session) based on a treatment result from an earlier treatment session. For example, the obtained image data may be used to create the next treatment plan, or to modify a previously determined treatment plan, for a next treatment (e.g., next radiation segment, or next radiation session).
• It should be noted from the above embodiments that thepatient support system200 is advantageous in that it allows thepatient116 to be treated and imaged without moving the patient116 from one patient support (e.g., a patient support associated with a treatment device) to another patient support (e.g., a patient support associated with a diagnostic device). This in turn limits, or reduces the risk of, misalignment of thepatient116, and/or misalignment of a target region within thepatient116, relative to a treatment/diagnostic machine. Thepatient support system200 is also advantageous because it saves setup time.
• Also, in some embodiments, theradiation system10 may have imaging capability. For example, an imager may be placed opposite thesource40. Moreover, one or more diagnostic x-ray sources and imager(s) opposite the source(s) may be provided. In some embodiments, one or more of the diagnostic sources and one or more imagers may be disposed in the same plane as thetreatment source40. Such image data can be obtained for at least a portion (e.g., a target region) of thepatient116 while thepatient116 is at the first operative position. For example, before or after a treatment session, or in between treatment radiation delivery sessions, theradiation system10 can deliver radiation energy to image a target region of thepatient116. The obtained image data can be used to verify a position, an orientation, and/or a shape, of the target region, and/or to evaluate an effect of a treatment session. In any embodiment, image data obtained using the imaging capability ofsystem10 can be processed with image data obtained using one or more of thedevice166, and/or one or more images from a previous diagnostic or planning session, for treatment evaluation, treatment planning, and/or patient positioning.
• FIG. 9 illustrates thepatient support system200 ofFIG. 7 in accordance with some embodiments. Thepatient support system200 can be used with any of the embodiments of theradiation system10 described herein, or with any radiation system, such as a treatment device or a diagnostic device. In some embodiments, thepositioner208 includes anactuator240, acylinder242 coupled to theactuator240, and a set ofsupports244,246, wherein thepatient support201 is slidably coupled to thesupports244,246. In other embodiments, thesupports244,246 are part of thepatient support201, in which cases, thepositioner208 does not include thesupports244,246. During use, theactuator240 delivers hydraulic pressure to activate thecylinder242, which in turn, causes thepatient support201 to translate in a first direction indicated byarrow248. Theactuator240 can also remove hydraulic pressure to activate thecylinder242, which in turn, causes thepatient support201 to translate in a second direction indicated byarrow250. Thesupports244,246 provides vertical support for thepatient support201 as thepatient support201 is being positioned by theactuator240. In some embodiments, thesupports244,246 are rails, and thepatient support201 includes a set of protrusions (e.g., wheels) that mate with the respective rails. Such configuration allows thepatient support201 to be guided in a desired manner-as thepatient support201 is being positioned by theactuator240.
• It should be noted that thepatient support system200 should not be limited to the example discussed previously, and-that thepatient support system200 can have other configurations in other embodiments. For example, in other embodiments, instead of the hydraulicpressure actuating cylinder242, thepositioner208 can include a motor, such as an electric motor, a pneumatic motor, or a piezoelectric motor, for positioning thepatient support201. In some embodiments, the motor couples to a screw shaft and causes the screw shaft to turn. The screw shaft is coupled to thepatient support201, which positions thepatient support201 by rotation of the screw shaft. Also, in other embodiments, thesupports244,246 can have configurations that are different from that shown in the figure. For example, instead of the bottom side of thepatient support201, thesupports244,246 can be coupled to the top side of thepatient support201 or to side edges of thepatient support201. In other embodiments, thepositioner208 can be implemented using machineries, devices, and systems that are known in the art of positioning devices.
• In the above embodiments, thepatient support system200 is configured to translate linearly substantially along theaxis46 of theradiation system10. In other embodiments, thepatient support system200 can also have other degrees of freedom.FIG. 10A illustrates thepatient support system200 having multiple degrees of freedom in accordance with some embodiments. Thepatient support system200 can be used with any of the embodiments of theradiation system10 described herein, or with any radiation system, such as a treatment device or a diagnostic device. In the illustrated embodiments, thepositioner208 includes afirst base portion300, asecond base portion302 that is rotatably coupled to thefirst base portion300, afirst actuator304 for turning ashaft306, a second actuator308 for rotating athird actuator310, thethird actuator310, acylinder312 coupled to thethird actuator310, and a set ofsupports314,316. Thefirst actuator304 can be, for example, a motor, that rotates theshaft306, thereby causing thepatient support201 to roll or rotate about afirst axis324. The second actuator308 can be, for example, a motor, that causes rotation of thethird actuator310 about asecond axis326, thereby creating an inclined angle or pitch for thepatient support201. Thethird actuator310 is configured to actuate thecylinder312, thereby causing thepatient support201 to translate indirections248,250, as similarly discussed previously with reference toFIG. 9. In some embodiments, thepositioner208 can further include a fourth actuator (not shown) for causing thesecond base portion302 to rotate relative to thefirst base portion300 about athird axis328. Also, in other embodiments, thepositioner208 can further include an actuator for translating thepatient support201 in the directions329a,329b.In further embodiments, thepositioner208 can further include an actuator for changing an elevation of the patient support201 (e.g., moving the patient support.201 in either of the directions341,342). In some embodiments, such feature may be desirable if thebore22 of theradiation system10 is offset (e.g., higher or lower) than the bore of the adjacent device (e.g., bore160 of the device inFIG. 2). In such cases, after the patient has been treated at the first operative position associated with thestructure12, the patient will be moved to the second operative position associated with the adjacent device by translating the patient support longitudinally and raising (or lowering) the patient support. This will ensure that the patient support is located at a desired elevation relative to the second bore. The various actuators described herein can be implemented using machineries, devices, and systems that are known in the art of positioning devices. The axes described herein can be positioned in different locations than those shown herein as desired.
• Providing multiple degrees of freedom for thepatient support201 is advantageous in that it allows thepatient116 to be treated or imaged in different configurations, and allows matching of patient position and/or orientation from session to session (e.g., from a first imaging session to a second imaging session, from a first treatment session to a second treatment session, and/or from a treatment session to an imaging session, or vice versa). For example, in some embodiments, thepatient support201 can be rotated about theaxis324 to place thepatient116 in a desired orientation before theradiation source40 is used to deliver radiation to thepatient116. In other embodiments, thepatient support201 can be rotated about theaxis324 while theradiation source40 is delivering radiation to thepatient116. In some embodiments, the rotation of the.patient support201 about theaxis324 can be used to compensate for slippage of theradiation source40 relative to thestructure12. In other embodiments, thepatient support201 can be rotated about theaxis324 in accordance with a treatment plan to thereby allow a target region of thepatient116 to be treated from different angles. Providing for pitch (e.g. rotation about axis326) and/or yaw (e.g. rotation about axis328) type motions allow for providing non coplanar fields. In further embodiments, the positioning (in any or a combination of the degrees of freedom described herein) provided by any of the embodiments of thepatient positioning system200 may be used to execute and/or update a treatment plan. For example, instead of or in addition to modifying a gantry angle, a position of the patient in one or more axes may be modified based on images of the patient.
• As shown in the figure, thepatient support system200 has a cantilever configuration. To eliminate, or at least reduce, the effect of tipping due to the cantilever configuration, thepatient support system200 further includes aweight322 secured to thesecond base portion302. In other embodiments, thepatient support system200 does not include theweight322. For example, if thefirst actuator304 is made sufficiently heavy to prevent tipping of thepatient support201, then theweight322 is not needed. Also, in other embodiments, instead of the cantilever configuration shown, thepatient support system200 can have other configurations, such as a simply-supported configuration, which includes an additional support (not shown) for supporting thefirst end202 of thepatient support201. In further embodiments, thepatient support system200 is secured to a floor, a platform, or a structure, such as a rotatable platform. Rotatable platform will be described later with reference toFIGS. 13A and 13B.
• In the illustrated embodiments, thepatient support system200 further includes a docking device317 which allows thepatient support system200 to be docked into a desired position. In some embodiments, the docking device317 includes a first set ofrollers318 on a first side of thefirst base portion300, and a second set ofrollers320 on a second side of thefirst base portion300. In other embodiments, the docking device317 can have less than two (e.g., one) set of rollers, or more than two sets of rollers. Also, in other embodiments, the docking device317 can have less than tworollers318/322 or more than tworollers318/322 per set. Alternatively, any technique or device for moving thepatient support200, including any of those described in conjunction with movingdevice166 described earlier, may be used.
• FIG. 10B illustrates a top view,of an environment in which thepatient support system200 ofFIG. 10A can be used. As shown inFIG. 10B, threesets330a-330cof rails are provided adjacent to theradiation system10. The first rail set330aincludes first andsecond rails332a,332b,the second rail set330bincludes first andsecond rails332c,332d,and the third rail set330cincludes first andsecond rails332e,332f.Therails332a,332bof thefirst set330aare configured (e.g., sized and shaped) to mate with thesets318,320 of rollers, respectively. Therails332c,332dof the second set330bare configured (e.g., sized and shaped) to mate with thesets318,320 of rollers, respectively. Therails332e,332fof the third set330care configured (e.g., sized and shaped) to mate with thesets318,320 of rollers, respectively. In other embodiments, instead of having threesets330a-330cofrails332. Less than three sets (e.g., one set), or more than three sets of rails can be provided. Also, in other embodiments, instead of having tworails332 perset330, each set330 can have less than tworails332 or more than tworails332.
• In some embodiments, the position of one or both of thesets318,320 of rollers of thepatient support system200 can be adjusted such that thepatient support system200 can be mated with rails having different configurations. For example, in some embodiments, the distance between thesets318,320 of rollers can be varied such that thepatient support system200 can be docked with rails having different spacing. Also, in other embodiments, one or more rollers can be removed or added to thepatient support system200 for allowing thepatient support system200 to dock with a rail system having different number of rails. In some embodiments, the docking system317 of thepatient support system200 can further include therails332.
• In other embodiments, the position of one or both of therails332 in each rail set330 can be adjusted such that the rail system can accommodate different patient support systems having different configurations. For example, in some embodiments, the distance between therails332 in each set330 can be varied such thatpatient support systems200 having different roller spacing can be docked. Also, in other embodiments, one or more rails can be removed or added for allowingpatient support systems200 having different number of rollers to be docked.
• It should be noted that the docking device317 of thepatient support system200 should not be limited to the examples discussed previously, and that the docking device317 can have other configurations in other embodiments. For example, in some embodiments, the docking device317 can have a first portion associated with thepatient support system200, and a second portion associated with theradiation system10, wherein the first portion and/or the second portion are configured to mate with each other. The first and second portions of the docking device317 can be implemented using any machinery, device, or system known in the art. As such, the docking device317 of thepatient support system200 may or may not include rollers, and may or may not include rails332. In further embodiments, any of the features or components described with reference toFIGS. 4 and 5 may be used to implement the docking device317.
• In one method of use, thepatient support system200 ofFIG. 10A can be docked into a desired position relative to theradiation system10 using thefirst set330aofrails332a,332b(FIG. 1C). As shown inFIG. 10C, alongitudinal axis340 of thepatient support201 is substantially parallel (e.g., within a prescribed range of angles, such as between 0° to 20°) with theaxis46 of thebore22 of theradiation system10. In such configuration, at least part of thepatient support201 can be positioned through thebore22. In another method of use, thepatient support system200 ofFIG. 10A can be docked into a desired position relative to theradiation system10 using the second set330bofrails332c,332d(FIG. 10D). When docked using the second set330bofrails332c,332d,thelongitudinal axis340 of thepatient support201 is substantially non-parallel (e.g., forming an angle that is larger than a prescribed value, such as, 5°) with theaxis46 of thebore22 of theradiation system10. Such configuration allows thepatient116 supported on thepatient support201 to be treated in a non-coplanar manner. In yet another method of use, thepatient support system200 ofFIG. 10A can be docked into a desired position relative to theradiation system10 using the third set330cofrails332e,332f(FIG. 10E). Such configuration allows thepatient116 supported on thepatient support201 to be treated in another non-coplanar manner. In yet another method of use, thepatient support system200 ofFIG. 10A can be docked next to theradiation system10 in a side-by-side manner using a fourth set330d of rails (FIG. 10F). Such configuration allows thepatient116 supported on thepatient support201 to be treated in another non-coplanar manner. In some cases, for any of the configurations ofFIGS. 1C-10E, the position and/or orientation of thepatient support201 can be further adjusted (e.g., by translating and/or rotating the patient support201) after thepatient support system200 is docked.
• In other embodiments, instead of, or in addition to, having the rail sets330 adjacent to thefirst side14 of theradiation system10, one or more rail sets can be provided adjacent to thesecond side16 of theradiation system10. Such configuration allows thepatient support system200 to be docked adjacent to thesecond side16 of theradiation system10, thereby allowing thepatient support201 to be inserted into thebore22 of theradiation system10 from thesecond side16 of theradiation system10. For example, in other embodiments, thedevice166 can be first docked next to theradiation system10. Thepatient support system200 is then docked next to thedevice166, thereby allowing thepatient support201 to be inserted into thebore22 of theradiation system10 through at least a portion of thedevice166.
• In other embodiments, instead of providing multiple sets of rails, a single set of rail(s) may be provided for allowing thepatient support system200 to be placed at different positions relative to theradiation system10.FIG. 10G illustrates aset330eof rails332g,332hthat are positioned next to theradiation system10. Each of the rails332g,332hhas an arc shape, which allows thepatient support system200 to be slid in a curvilinear manner around theradiation system10. This in turn allows thepatient support system200 to be placed at different positions relative to theradiation system10. In other embodiments, the rail set330ecan have more than two rails or less than two rails (e.g., one rail). In some embodiments, thepatient support system200 is detachably coupled to the rail set330 (e.g., thepatient support system200 can include a docking system for allowing thepatient support system200 to be docked against the rail set330).
• In further embodiments, the rail set330ecan have different configurations. For example, as shown inFIG. 10H, the rail set330ecan have an arc shape that allows thepatient support system200 to be positioned from one side of the structure12 (e.g., at the first operative position associated with the radiation source40), to another side of the structure12 (e.g., at the second operative position associated with the device166). In alternative embodiments, the rail set330ecan have a ring configuration that loops substantially around theradiation system10 and thedevice166. In the embodiment ofFIG. 10H, the patient support surface may be carried along with the other portions of thepatient support system200. Alternatively, the patient support surface may temporarily be engaged withsystem10 and/orsystem12, as will be described in more detail below, and a portion of thepatient support system200 without the support surface may travel along the rail set330eand access the support surface from either side.
• It should be noted that thepatient support system200 ofFIG. 10A should not be limited to the examples described previously, and that thepatient support system200 can have different configurations in other embodiments. In other embodiments, thepatient support201 does not have some, a combination, or all, of the degree of freedom described previously. For example, in some embodiments, thepositioner208 does not include thefirst actuator304, the second actuator308, or both. Also, in other embodiments, the relative positions of theactuators304,308,310 can be different from that shown in the figure. Further, in other embodiments, thepatient support system200 does not include the docking device317. In such cases, thepatient support system200 can be fixedly secured to a floor.
• In other embodiments, instead of using thepatient support system200 with theradiation system10 and the device166 (e.g., the device100) having the configuration shown inFIG. 6 (which shows thestructure12 and thedevice166 being in a front-to-back or front-to-front configuration), any of the embodiments of thepatient support system200 described herein can be used with theradiation system10 and thedevice166 having other configurations.FIGS. 1A and 11B illustrate theradiation system10 ofFIG. 1, and thedevice166, wherein thedevice166 is placed closer to thefirst side14 than thesecond side16 of thestructure12 in a front-to-front configuration. Thedevice166 is illustrated as the CT device, but can be any of the diagnostic/treatment devices described herein. In such cases, any of the embodiments of thepatient support system200 described herein can be placed between theradiation system10 and thedevice166. During use, thepatient support system200 positions thepatient support201 at the first operative position associated such that theradiation source40 can be used to deliver theradiation beam42 to treat the patient116 (FIG. 11A). If it is desired that thepatient116 be imaged, for example, thepatient support201 is first translated to remove thepatient support201 out of thebore22 of theradiation system10. Thesecond base portion302 of thepatient support system200 is then rotated relative to thefirst base portion300 about theaxis328, until thepatient support201 is closer to thedevice166 than theradiation system10. Thepatient support201 is then translated axially until thepatient support201 is located at the second operative position at which thepatient116 can be operated by the device166 (FIG. 11B). The above described operation of thepatient support system200 can be reversed if it is desired to move thepatient support201 from the second operative position associated with thedevice166 to the first operative position associated with theradiation source40.
• In other embodiments, instead of using thepatient support system200 in an environment in which theradiation system10 and thedevice166 are placed in a front-to-front manner (such as that shown inFIG. 11A), thepatient support system200 can be placed between theradiation system10 and thedevice166 that are placed in a back-to-back manner. Also, in other embodiments, instead of theradiation system10 and/or thedevice166 described herein, any of the embodiments of thepatient support system200 can be used with other treatment machine and/or diagnostic machine. For example, in some embodiments, thepatient support system200 can be placed between a radiation treatment machine having a configuration that is different from that shown inFIG. 1, and a diagnostic machine, such as an imaging device.
• FIGS. 12A-12C illustrate apatient support system400 in accordance with other embodiments. Thesupport system400 includes afirst positioner402, asecond positioner404, and apatient support406. Thefirst positioner402 is located adjacent to theradiation system10, and thesecond positioner404 is located adjacent to thedevice166. Thepatient support406 has afirst end407 and asecond end409.
• Thefirst positioner402 includes anactuator408, acoupler410 that is used to detachably secure thepatient support406 to thepositioner402, and asupport system412 coupled to thepatient support406 and theactuator408. Theactuator408 can be a motor, a hydraulic mechanism, or other mechanism, and is configured to position thepatient support406 along theaxis46 of thebore22. As thepatient support406 is being positioned by theactuator408, thesupport system412 provides structural support for thepatient support406. In some embodiments, thesupport system412 includes a pair of supports, such as thesupports244,246 discussed previously with reference toFIG. 9. Alternatively, thesupport system412 can have other configurations (e.g., having a platform). In the illustrated embodiments, thecoupler410 includes ajaw assembly414 having afirst jaw416 and asecond jaw418, and is configured to engage with thefirst end407 of thepatient support406. As shown inFIG. 12A, thejaw assembly414 is in a closed position, thereby detachably coupling thepatient support406 to thefirst positioner402. In other embodiments, instead of thejaw assembly414, thecoupler410 can have other configurations that allow thecoupler410 to detachably secure to a portion of thepatient support406. For example, in other embodiments, thecoupler410 can include one or more dowels or protrusions that are sized to be inserted in respective slot(s) at thepatient support406. The dowel(s) or protrusion(s) may be used to provide moment resistance resulted from thepatient116 being supported on thepatient support406. Thecoupler410 may further include a locking mechanism for securing to thepatient support406 after the dowel(s) or protrusion(s) have been inserted into respective slot(s). In further embodiments, thecoupler410 may have other types of securing mechanisms for detachably coupling to thepatient support406. Also, in alternative embodiments, instead of thefirst end407, thecoupler410 can engage with other portion(s) of thepatient support406.
• In some embodiments, thesecond positioner404 may be similar to thefirst positioner402, and includes anactuator420, acoupler424 that is used to detachably secure thepatient support406 to thesecond positioner404, and asupport system426 coupled to thepatient support406 and theactuator420. Theactuator420 can be a motor, a hydraulic mechanism, or other mechanism, and is configured to position thepatient support406 along theaxis160 of the lumen122. As thepatient support406 is being positioned by theactuator420, thesupport system426 provides structural support for thepatient support406. In some embodiments, thesupport system426 includes a pair of supports, such as thesupports244,246 discussed previously with reference toFIG. 9. Alternatively, thesupport system426 can have other configurations. Thecoupler424 includes ajaw assembly428 having afirst jaw430 and asecond jaw432, and is configured to engage with thesecond end409 of thepatient support406. In other embodiments, instead of thejaw assembly428, thecoupler424 can have other configurations that allow thecoupler424 to detachably secure to a portion of thepatient support406. Also, in alternative-embodiments, instead of thesecond end409, thecoupler424 can engage with other portion(s) of thepatient support406.
• In other embodiments, thesecond positioner404 can have a configuration that is different from thefirst positioner402. For example, in other embodiments, thesecond positioner404 can have number of degrees of freedom, and/or degrees of freedom, that are different from those of thefirst positioner402.
• Thepatient support system400 can be used-to position thepatient116 at a first operative position (e.g., the position of thepatient116/patient support406 at which thepatient116 can be treated by the radiation source40), and at a second operative position (e.g., the position of thepatient116/patient support406 at which the patient116 can be operated by the device166). For example, as shown inFIG. 12A, thecoupler410 can engage with thepatient support406 to thereby allow theactuator408 to control a position of thepatient support406. In some embodiments, theactuator408 is coupled to a processor (such as any of the processors described herein), which controls an operation of theactuator408. For example, theprocessor84/134 can provide signals to theactuator408 to cause theactuator408 to position thepatient support406 along theaxis46 during, or in between, radiation delivery sessions.
• If it is desired to place thepatient116 at the second operative position, theactuator408 then advances thepatient support406 further into thebore22 until thesecond end409 of thepatient support406 is engaged with thecoupler424 of the second positioner404 (FIG. 12B). When thecoupler424 is engaged with thesecond end409, thejaws430,432 of thejaw assembly428 are closed to grab onto thesecond end409 of thepatient support406. After thecoupler424 is engaged with thepatient support406, thecoupler410 of thefirst positioner402 is then disengaged (e.g., by opening the jaw assembly414) with thefirst side407 of the patient support406 (FIG. 12C). Thepatient support406 can then be positioned by thesecond positioner404 until thepatient support406 is at the second operative position. During use of thedevice166, thesecond positioner404 can be used to position thepatient support406 along theaxis160 associated with thedevice166.
• In other embodiments, thepatient support system400 can have configurations that are different from those described previously. For example, in other embodiments, thepatient support system400 can include other types of mechanical devices or systems that allow thepatient support406 to be passed from one positioner to another positioner. Also, in other embodiments, theradiation system10 and/or thedevice166 can have a mechanical component that temporarily engages thepatient support406 before the patient support is passed from a first positioner to a second positioner. In such cases, the first positioner may or may not engage with thepatient support406 while theradiation system10 and/or thedevice166 is engaged with thepatient support406. In some embodiments, a single positioner can be used such that after thesystem10 and/orsystem166 has engaged thepatient support406, the positioner is moved to the opposite side to engage thepatient support406 from that side.
• In further embodiments, theradiation system10 or thedevice166 can include a positioner for positioning thepatient support406. In such cases, thepatient support system400 does not include the positioner404 (or the positioner402), and the positioner402 (or the positioner404) can be used to position thepatient support406 through a first range of positions, and pass thepatient support406 to the positioner of theradiation system10 or thedevice166, which can be used to position thepatient support406 through a second range of positions. The first range of positions and the second range of positions may or may not overlap.
• In any of the embodiments of thepatient support system200/400 described herein, the positioner208 (orpositioner402 or404) can be coupled to a computer system or a processor, such as theprocessor84 ofFIG. 1A, theprocessor134 ofFIG. 2, or a separate processor. The processor can then be used to control an operation of thepositioner208. For example, the processor may be configured (e.g., programmed and/or constructed) to control an amount of movement of the patient support (e.g., rotation aboutaxis324 to thereby tilt the patient support, and/or other types of movement described herein) during a procedure. In some embodiments, the amount of movement of the patient support is prescribed by a treatment plan, which is executed by the processor during a treatment session. The treatment plan may be one that is determined during a diagnostic session, or alternatively, be one that is determined during a treatment session (for example, the treatment plan determined in a diagnostic session may be modified during a treatment session to result in a modified treatment plan).
• In some embodiments, thepatient support system200 can further include one or more position/motion sensors for sensing a position/motion of thepatient support201. The sensed position/motion is then transmitted from the sensor(s) to the processor, which determines an actual position of thepatient support201 based on the sensed position/motion received from the sensor(s). In some cases, the processor can be further configured to position thepatient support201 based on the actual position of the patient support201 (e.g., having a feedback feature).
• Also, in any of the embodiments of thepatient support system200/400 described herein, thepatient support system200/400 can further include one or more markings (not shown), which allows thepatient support201/406 to be registered with theradiation system10 and/or with thedevice166. For example, one or both of theradiation system10 and thedevice166 can include an optical sensor for sensing the marking(s) of thepatient support system200/400, thereby allowing a position of thepatient support201 to be determined. The optical sensor can be, for example, a camera or an infrared position sensor. In some embodiments, the optical sensor is coupled to the processor, which receives position signals from the optical sensor. Based on the received position signals, the processor then determines an actual position of thepatient support201.
• It should be noted that thepatient support system200/400 can have other configurations in other embodiments. For example, in other embodiments, thepatient support system200 can have the configuration shown inFIG. 13A. Thepatient support system200 ofFIG. 13A includes thepatient support201, apatient positioner208, afirst base portion300, and asecond base portion302 that is rotatably coupled to thefirst base portion300. In the illustrated embodiments, thefirst base portion300 is coupled (e.g., fixedly secured, or detachably secured) to aplatform262, which is rotatably secured to a floor (or a platform). Theplatform262 can rotate about avertical axis350 in the directions shown by the double-headed arrow360a.Thesecond base portion302 is rotatably coupled to the first base portion301 such that thesecond base portion302 is rotatable aboutvertical axis352 in the directions shown by the arrow360b.In other embodiments,first base portion300 and theplatform262 can be implemented as a single unit or structure.
• Thepositioner208 includes afirst arm366 rotatably secured to thesecond base portion302 such that thefirst arm366 is rotatable relative to thesecond base portion302 in the directions shown by the arrow360c.Thepositioner208 also includes asecond arm368 that is rotatably secured to thefirst arm366 such that thesecond arm368 is rotatable relative to thefirst arm366 in the directions shown by the arrow360d.Thepatient support201 is slidably secured to a support370, which in turn, is rotatably secured to thesecond arm368. As such, thepatient support201 is rotatable relative to thesecond arm368 in the directions shown by thearrow360e,and is slidable relative to the support370 as indicated by the arrow360f.
• During use, theplatform262 can be rotated to place thepatient support201 at a desired position relative to theradiation system10. Also, in some cases, thesecond base portion302 can be rotated relative to thefirst base portion300 to place thepatient support201 at a desired position relative to the radiation system10 (FIG. 13B). As illustrated, the combination of rotating thefirst base portion300 about theaxis350, and rotating thesecond base portion302 about the axis352 (and in some cases, further coupled with translation movement360fof the patient support201) allows thepatient support201 to be oriented at a desiredangle390 relative to theradiation system10, and be placed in an operative position associated with the radiation system10 (FIG. 13C). For example, in some cases, after thepatient support201 has been positioned such that apoint380 on thepatient support201 is located at a desired location, the movements of thebase portions300,302 (and in some cases, together with translation of the patient support201) may allow thepatient support201 to be rotated about avertical axis384 through the point380 (as indicated by the arrow382) to thereby adjust an orientation of thepatient support201 relative to thesystem10. Also, in some cases, movements of thearms366,368 allows a height (elevation) of thepatient support201 to be adjusted. Further, thepatient support201 may rotate relative to thesecond arm368 as thesecond arm368 rotates relative to thefirst arm366 to thereby remain in a horizontal configuration. Thepatient support201 may rotate relative to thesecond arm368 while thesecond arm368 remains stationary relative to thefirst arm366. In such cases, the movement of thepatient support201 allows an angle of tilt of thepatient support201 to be adjusted.
• In other embodiments, thepatient support201 of thepatient support system200 may be configured so that it does not translate relative to thearm368. Also, in further embodiments, thepatient support201 may have other degrees of freedom, such as any or combination of the degrees of freedom described with reference toFIG. 10A. For example, in other embodiments, thepatient support201 may have a roll feature in which thepatient support201 may tilt or rotate about alongitudinal axis324 of thepatient support201.
• Although thepatient support system200 ofFIGS. 13A and 13B is illustrated as being used with theradiation system10 with thearm30, in other embodiments, thepatient support system200 ofFIGS. 13A and 13B may be used with any of theradiation systems10 described herein (e.g., theradiation system10 ofFIG. 1F that does not include the arm30), with any of thedevices166 described herein, and/or with any radiation system not described herein (which may be a treatment machine or a diagnostic machine).
• In any of the embodiments of thepatient support system200/400 described herein, thepatient support201/406 can have a feature that allows a surface of thepatient support201 to be customized for different patients.FIG. 13D illustrates a variation of thepatient support201 in accordance with some embodiments. Thepatient support201 includes a plurality ofsupport portions270a-270jthat are positionable relative to each other, thereby allowing a desired support surface to be formed. In the illustrated embodiments,support portions270a-270jare adapted to support a head, left arm, right arm, upper body, mid-body, lower body, left side of a body, right side of a body, thighs, and legs, respectively, of a patient. In some cases, the support portion270dcan be rotated relative to thesupport portion270f(as indicated by arrow274d) to form a convenient position and shape for loading and unloading a patient for treatment and/or imaging. For example, to facilitate patient loading, the patient support can form into a shape of a chair onto which the patient sits. Thereafter, once the patient is in the chair (and positioned and/or immobilized if desired), the patient support forms into a position and/or moves into a location as needed for treatment and/or imaging.
• As shown in the embodiments ofFIG. 13D, support portion270amay translate relative to support portion270d(as indicated by arrow274b) to accommodate patients with different neck lengths, and may rotate relative to support portion270d(as indicated by arrow274a) to adjust an angle of tilt of a patient's head. The support portion270dmay also translate relative to support portion270e(as indicated by arrow274c) to adjust for patients with different body lengths. Thesupport portions270g,270hmay rotate (as indicated byarrows274e) and translate (as indicated by arrows274fto hold a patient's body in place and to-adjust for patients with different body widths. The support portion270imay rotate relative to thesupport portion270fto adjust an angle of tile of a patient's thighs. The support portion270jmay rotate relative to the support portion270ito adjust an angle of tile of a patient's legs. The support portions270b,270cmay rotate (as indicated by arrows274j), may locally translate (as indicated by arrows274l), and/or may globally translate (as indicated by arrows274k) to adjust for different arms positions of the patient. In other embodiments, not all of thesupport portions270 of thepatient support201 are moveable as described, and any or a subset of thesupport portions270 may be fixed relative to an adjacent support portion. Also, in further embodiments: any of thesupport portions270 may have additional degree of movement(s). For example, in other embodiments, the support portion270imay translate relative to thesupport portion270fto adjust for patients with different thigh lengths.
• In some embodiments, thepatient support201/406 can further include device(s) for knowing and setting position for each of the supported portions, such as position sensors secured to each of thesupport portions270a-270j.In such cases, a memory can be used to store position signals from the position sensors, which represent a desired support configuration of thepatient support201 for a specific user. The memory can store different sets of position signals for different users. Also, a user interface, such as a computer, or a set of buttons, can be used to allow a user to select a desired set of position signals from the memory. In some embodiments, thepositioner208 automatically adjusts thesupport portions270a-270jbased on the selected set of position signals, thereby placing thesupport portions270a-270jin a configuration that was previously selected by a user.
• In any of the embodiments described herein, thepatient support201/406 can include a matrix of support portions276 (FIG. 13E). Each of thesupport portions276 can be positioned by apositioner272 to move in the directions shown by the double headed arrow271. Such configuration allows thepatient support201 to provide different configurations of the support surface for different users. Thepositioner272 may be actuated using a motor, a hydraulic, a pneumatic device, or any of other types of mechanical linkage. In some embodiments, thepatient support201 ofFIG. 13E can further include device(s) for sensing position, such as position sensors, and a memory for storing set positions, as similarly discussed previously. The matrix ofsupport portions276 may be implemented in any of the embodiments of thepatient support201/406 described herein. For example, in some embodiments, any of thesupport portions270 inFIG. 13D may be substituted with, or may include, a matrix of thesupport portions276. In other embodiments, the matrix of thesupport portions276 may be implemented in other embodiments of thepatient support201/406, or in a patient support not described herein.
• In any of the embodiments of theradiation system10 described herein, theradiation system10 can further include a patient position sensing system440 (FIG. 14A). The patientposition sensing system440 includes anoptical device441aand amarker block442. In the illustrated embodiments, theoptical device441ais a camera, such as a CCD camera, but can be other type of optical sensor that is capable of sensing an object. Theoptical device441acan be mounted to a ceiling, to the radiation system10 (e.g., within the bore22), to thedevice166, to the patient support system200 (e.g., the patient support201) (FIG. 14C), or to a support stand (not shown). Themarker block442 includes a plurality ofmarkers444 that are so positioned such that at least some of them can be viewed/sensed by theoptical device441a.Themarkers444 can be implemented using reflective objects. In the illustrated embodiments, theoptical device441ais coupled to theprocessor134, which controls an operation of theradiation system10 based on input received from theoptical device441a.Alternatively, the optical device441 can be coupled to theprocessor84 ofFIG. 1A, or a separate processor, for processing image signals received from theoptical device441a.
• During use, themarker block442 is secured to thepatient116, and theoptical device441ais used to sense the positions of at least some of themarkers444 on themarker block442. Based on the sensed positions of at least some of themarkers444, theprocessor134 then determines a position and an orientation of themarker block442. The determined position and orientation of themarker block442 can then be used to determine whether thepatient116 has moved and/or an amount of movement undergone by thepatient116. In such cases, theprocessor134 can be configured to control an operation (e.g., a rotational speed of theradiation source40 about thepatient116, an activation of theradiation source40, a de-activation of theradiation source40, an activation period of the radiation source40 (duration of radiation delivery), etc.) of theradiation system10 based on the determined patient movement. In some embodiments, the patient movement is associated with a respiration of thepatient116. In such cases, theprocessor134 can be configured to control an operation of theradiation system10 based on phase(s) of the respiratory cycle of thepatient116. In other embodiments, theprocessor134 can be configured to control an operation of theradiation system10 based on other physiological movements of thepatient116.
• In some embodiments, theprocessor134 can be configured to gate an operation of theradiation system10 based on the determined patient movement. For example, in some embodiments, theprocessor134 is configured to activate theradiation source40 when an amplitude of the patient movement is below a prescribed threshold, and de-activate theradiation source40 when an amplitude of the patient movement is above a prescribed threshold. In another example, theprocessor134 is configured to activate theradiation source40 during a certain prescribed phase(s) of the patient movement (e.g., respiratory movement/cycle), and de-activate theradiation source40 during another prescribed phase(s) of the patient movement. As used in this specification, the term “phase” refers to a variable that is associated with a degree of completeness of a physiological cycle (e.g., a respiratory cycle). Patient position sensing systems, methods of performing medical procedures based on sensed physiological movement, and methods of gating an operation of a radiation device have been described in U.S. patent application Ser. Nos. 09/178,383, 09/893,122, 10/664,534, 10/454,754, 10/234,658, 10/305,416, 10/656,478, and 10/655,920, all of which are expressly incorporated by reference herein.
• It should be noted that the patientposition sensing system440 should not be limited by the configuration described previously, and that the patientposition sensing system440 can have other configurations in other embodiments. For example, in other embodiments, instead of a singleoptical device441 a, the patientposition sensing system440 can further include one or more additional optical device(s)441 for sensing themarker block442 when thepatient116 is located at the first operative position associated with theradiation source40. Also, in other embodiments, the patientposition sensing system440 can further include one or more marker block(s)442. In further embodiments, instead of having a cube configuration, themarker block442 can have other shapes, such as a semi-spherical shape, a cone shape, or other customized shapes.
• In other embodiments, instead of, or in addition to, having theoptical device441afor sensing patient movement when thepatient116 is being operated by theradiation source40, theradiation system10 can have a second optical device441bfor sensing patient movement when thepatient116 is being operated by the device166 (illustrated as a block diagram) (FIG. 14B). In such cases, when thepatient116 is positioned at the second operative position associated with thedevice166, the optical device441bcan be used to sense patient movement. The sensed patient movement can then be used to control an operation of thedevice166, as similarly discussed previously.
• In some embodiments, if theoptical device441ais secured to the patient support system200 (such as that shown inFIG. 14C), then the second optical device441bis not needed. In such cases, the optical device441bwill be moved with thepatient support201, and the optical device441 can be used to sense themarker block442 when the patient is positioned at the first operative position associated with theradiation source40, and at the second operative position associated with thedevice166. In other embodiments, theoptical device441amay be secured at a distance that is sufficiently far away from the first and second operative positions such that it can view both positions in a single field of view. In further embodiments, theoptical device441 a may be moveable (e.g., pivotable and/or translatable). For example, if thedevice166 is positioned next to thestructure12 in a side-by-side configuration, theoptical device441amay be rotated towards a first direction associated with thestructure12 when the patient is being operated in the first operative position, and may be rotated towards a second direction associated with thedevice166 when the patient is being operated in the second operative position. Devices placed in a side-by-side configuration will be described inFIG. 17E.
• In some embodiments, thedevice166 is a CT device. In such cases, the second optical device441bis used to determine phases of a physiological cycle as the CT device is used to generate a plurality of images at the plurality of phases of a physiological cycle, wherein each of the images provides an indication of a location of a target region. Theprocessor134 then creates a treatment plan based at least in part on the plurality of images collected at the plurality of phases in the cycle. After the treatment plan has been created, thepatient116 is then positioned from the second operative position associated with thedevice166 to the first operative position associated with the radiation source40 (e.g., by being translated at least partially through thebore22 of the structure12). Theradiation source40 is then used to treat thepatient116 in accordance with the created treatment plan. In some embodiments, the created treatment plan prescribes the phases of a physiological cycle at which radiation is to be delivered to thepatient116, and the amount of radiation to be delivered at the prescribed phases. In such cases, the firstoptical device441acan be used to determine patient movement when thepatient116 is at the first operative position, and theradiation source40 is used to deliver radiation to thepatient116 based on the determined patient movement in conformance with the treatment plan.
• In any of the embodiments described herein, instead of using the optical device441 to sense marker(s) on themarker block442, the optical device441 may be used to sense a marker on a patient. For example, the marker may be a print made on a skin of the patient. Alternatively, the marker may be a part of an anatomy of the patient, such as a skin mark on the patient, or a topography/shape of a portion of a patient.
• Although the patientposition sensing system440 has been described as having the optical device441 and themarker block442, in other embodiments, other position/movement sensing devices can be used as the patientposition sensing system440. As such, the patientposition sensing system440 may or may not include the optical device441 and themarker block442. For example, in other embodiments, the patientposition sensing system440 includes one or more infrared position sensors for sensing at least a part of thepatient116. In other embodiments, the patientposition sensing system440 includes one or more magnetic field sensors. In such cases, one or more magnetic devices, such as coils, may be placed within, or secured on, thepatient116. An external electromagnetic coil then provides electromagnetic pulses to interact with the coil(s) within/on thepatient116. Based on the interaction, the position and/or the orientation of thepatient116 can be determined. In alternative embodiments, the patientposition sensing system440 includes one or more sensors, such as RF transponder, ultrasound sensors, or microwave energy sensors (which utilizes technologies that are similar to those used in radar systems), for sensing at least a part of thepatient116. In other embodiments, the patientposition sensing system440 includes one or more ultrasound energy sensors for sensing at least a part of thepatient116. In further embodiments, other devices, such as a strain gauge, or other mechanical/electrical devices, can be used to sense a position/movement of thepatient116.
• In further embodiments, the patientposition sensing system440 may be an imaging device. The imaging device may be, for example, a CT device, a laminar tomography device, a MRI device, a fluoroscope, an angiography device, a PET device, a PET-CT device, a SPECT device, or a tomosynthesis imaging device. In such cases, the imaging device may be used to obtain an image of a portion of the patient, and a processor then processes the image to determine a position of a target tissue. For example, the processor may process the image to identify one or more markers implanted at or near a target tissue. Alternatively, the processor may process the image to identify a part of an anatomy of the patient. In some embodiments, thedevice166 may be the imaging device that is a part of the patientposition sensing system440.
• It should be noted that the method of using the patientposition sensing system440 should not be limited to the examples discussed previously, and that the patientposition sensing system440 can be used to assist determining treatment plans and/or to assist gating of medical procedures in other manners in other embodiments. For example, in other embodiments, the patient movement sensed by the firstoptical device441acan be used in a predictive physiological gating procedure, in which-the operation of theradiation source40 is predictively gated based at least in part on the patient movement. Predictive gating of a medical procedure has been described in U.S. patent application Ser. No. 09/893,122.
• Further, in some embodiments, theposition sensing system440 can be used to determine a position of thepatient support201. For example, the marker block442 (or another marker block) can be secured to the patient support, and the optical device441 is then used to sense the markers on the marker block. Based on the sensed markers, theprocessor134 then determines a position and an orientation of the marker block442 (and therefore, the position and orientation of the patient support201). In other embodiments, instead of using a marker block, thepatient support201 can include a detectable marker secured to a portion of thesupport201.
• In the above embodiments, theposition sensing system440 has been described as having themarker block442. However, in other embodiments, themarker block442 is not needed, and theposition sensing system440 does not include themarker block442. For example, in some embodiments, the optical device441 can be used to sense a portion of a patient, wherein the portion is used as a marker (e.g., a physiological marker). In such cases, a processor (such as theprocessor84/134) can be configured to receive image signal from the optical device441, and process the signal to identify the physiological marker. In some embodiments, the processor can be configured to identify and analyze a topography of a patient surface, and determine a characteristic of the patient, such as an amplitude and/or a phase of a breathing cycle of the patient based on a result of the analysis.
• In any of the embodiments of theradiation system10 described herein, theradiation system10 can further include one or more compensating coils450 that are electrically coupled to a generator452 (FIG. 15). In the illustrated embodiments, theradiation system10 includes a pair of coils450a,450bthat are parallel to a x-axis of theradiation system10, a pair ofcoils450c,450dthat are parallel to a y-axis of theradiation system10, and four coils450e-450hthat are parallel to a z-axis of theradiation system10. In other embodiments, the number of coils450 can be different from that shown. For example, in other embodiments, theradiation system10 can include one coil (e.g., coil450a) that is parallel to the x-axis, one coil (e.g., coil450c) that is parallel to the y-axis, and one coil (e.g.,coil450e) that is parallel to the z-axis. Also, in alternative embodiments, theradiation system10 can include fewer or more than three sets of coils450, which each set having one or more coils450. In further embodiments, the orientation and position of the coils450 can be different from that shown. For example, in other embodiments, theradiation system10 can include coils450 that are not orthogonal relative to each other. In the illustrated embodiments, the coils450 are illustrated as being located within thestructure12. In other embodiments, instead of placing the coils450 inside thestructure12, some or all of the coils450 can be secured within thearm30 of theradiation system10, thepatient support system200, thedevice166, or a separate structure (not shown) that is adjacent to theradiation system10.
• One or more generator, such asgenerator452 is configured to selectively provide electrical energy to one or more of the coils450 to create a desired electromagnetic field having a certain magnitude during an operation of theradiation system10. In some embodiments, thedevice166 may include an electron accelerator that may remain on while theradiation source40 is used to deliver radiation to thepatient116. In such cases, the electromagnetic field created by the coil(s)450 is used to compensate (e.g., reduce) interference associated with a magnetic field of the accelerator in thedevice166. In other embodiments, a magnetic field of an accelerator in theradiation system10 may interfere with an operation of the device166 (especially if thedevice166 includes a radiation source). In such cases, the electromagnetic field created by the coil(s)450 is used to compensate (e.g., reduce) interference resulted from a magnetic field of the accelerator in theradiation system10. In other embodiments, the magnetic field created by the coil(s)450 can be used to compensate interference effects due to other components, such as a positioner of a patient support system.
• In some embodiments, thegenerator452 is coupled to a processor, such as theprocessor84 ofFIG. 1A, which controls an operation of thegenerator452. In other embodiments, instead of using theprocessor84, thegenerator452 can be coupled to theprocessor134, or a separate processor, which controls an operation of thegenerator452. Theprocessor84/134 can be configured (e.g., programmed) to provide activation signals to thegenerator452 to cause thegenerator452 to activate certain coil(s)450 during an operation of theradiation system10. In other embodiments, instead of, or in addition to, providing activation signals, theprocessor84/134 can be configured to determine an amount of current to be delivered to each of the coil(s)450 to be activated. In some embodiments, the magnetic field resulted from theaccelerator31 can be calculated based on operational parameters of the accelerator31 (such as a position of theaccelerator31, an orientation of theaccelerator31, an/or an amount of current to be delivered to the accelerator31), and the processor then determines which of the coils450 to activate to eliminate, or at least reduce the effect of, the magnetic field associated with theaccelerator31. In other embodiments, instead of calculating the magnetic field associated with theaccelerator31, one or more magnetic field sensors can be placed adjacent to the accelerator31 (such as on or next to the device166). In such cases, the processor receives signals from the magnetic field sensor(s), and determines which of the coils450 to activate to eliminate, or at least reduce the effect of, the magnetic field associated with theaccelerator31.
• In the above embodiments, the compensating magnetic field is described as being provided by one or more coils450. Alternatively, instead of, or in addition to, using electromagnetic coils450, theradiation system10 can include one or more permanent magnets that provides a magnetic field for compensating (at least-in part) magnetic interference.
• In any of the embodiments described herein, instead of, or in addition to, including compensating coil(s) and/or magnet(s), theradiation system10 can further include a shield to prevent, or at least minimize the effect of, interference due to theaccelerator31. For example, a shield (not shown) can be placed between theaccelerator31 and thedevice166 to prevent, or at least minimize the effect of, interference due to theaccelerator31. The shield can be made from Mumetal, or other materials. In some embodiments, the shield can be placed around theaccelerator31. In other embodiments, the shield can be placed around thedevice166 or a component (e.g., a component that may be affected by a magnetic field from the accelerator31) of thedevice166. In other embodiments, the shield can be secured to thestructure12, such as to thesecond side16 of thestructure12. In any embodiment, the coils and/or shield may be used to shield other devices from the a magnetic field such as that generated by the accelerator, such as a MRI device, or a magnetic based sensing device.
• In any of the embodiments of theradiation system10 described herein, theradiation system10 can further include aprotective guard500 for protecting the patient116 (FIG. 16A). Theguard500 can be made from any material, such as carbon fiber, as long as it allows at least some of the radiation from theradiation source40 to be transmitted therethrough. In the illustrated embodiments, theguard500 has a circular cylindrical shape, but can have other cylindrical shapes in other embodiments. Also, in other embodiments, theguard500 can be a partial cylinder (e.g., have an arc shape cross section) (FIG. 16B).
• During use, theguard500 is placed between the patient116 and the radiation source40 (FIG. 16C). Theguard500 protects the patient116 from being collided with theradiation source40 or thearm30 of theradiation system10 as theradiation source40 is rotating about thepatient116. Theguard500 also allows the arm30 (and therefore, the radiation source40) to be rotated about thepatient116 at a faster speed without the risk of injuring thepatient116.
• In some embodiments, theguard500 is detachably coupled to theradiation system10. In such cases, when theguard500 is not used, theguard500 can be detached from theradiation system10. In other embodiments, theguard500 is detachably coupled to thepatient support system200. In such cases, when theguard500 is not used, theguard500 can be detached from thepatient support system200. In other embodiments, theguard500 is rotatably secured (e.g., via one or more hinges) to theradiation system10, which allows theguard500 to be opened or closed relative to theradiation system10 between uses. In further embodiments, theguard500 is slidably secured to theradiation system10. For example, in some embodiments, theguard500 can be slid along theaxis46 of thebore22 to thereby exposed thepatient support201 such that apatient116 can be placed on thepatient support201. After thepatient116 is placed on thepatient support201, theguard500 can then be slid to a closed position, such as that shown inFIG. 16C. In further embodiments, theguard500 can be coupled (e.g., slidably secured, rotatably secured, or detachably secured) to thepatient support201, which allows theguard500 to be positioned in conjunction with thepatient support201. In such cases, if thepatient support201 is translated along theaxis46 of thebore22, theguard500 will move with thepatient support201. In some embodiments, if thepatient support201 is positioned between the first operative position associated with theradiation source40, and the second operative position associated with thedevice166, theguard500 that is coupled to thepatient support201 will move with thepatient support201. In the case in which thedevice166 includes a moving part, such as a rotating gantry, theguard500 can also protect the patient116 from being collided with the moving component of thedevice166.
• In some embodiments, if theguard500 is coupled to thepatient support201, theguard500 can be made sufficiently small such that it can fit within thebore22 of theradiation system10 in different orientations. Such allows thepatient116 to be treated in different non-coplanar manners. In other embodiments, if theguard500 is coupled to theradiation system10, the cross sectional size of the guard500 (and the bore22) can be made sufficiently large to allow thepatient support201 to be oriented in a non-coplanar manner within theguard500. In further embodiments, when treating thepatient116 in a non-coplanar manner, theguard500 is decoupled (or retracted) from theradiation system10 and/or thepatient support201, and is not used.
• It should be noted that theprotective guard500 is not limited to being used with the radiation system10 (e.g., any of theradiation systems10 inFIGS. 1A-1F). In other embodiments, theguard500 can be used with other treatment devices or imaging devices. For examples, in other embodiments, theguard500 can be included or used with a conventional CT machine.
• In any of the embodiments of theradiation system10 described herein, theradiation system10 can further include a guard that covers at least a portion of thearm30. For example, the guard can be a cylindrical structure that is placed around thearm30 and in a coaxial relationship with thebore22. The guard prevents, or at least reduce the risk of, a collision by the arm against a person, such as an operator of theradiation system10.
• In any of the embodiments of theradiation system10 described herein, theradiation system10 can further include a PET device secured next to theradiation source40.FIG. 17A illustrates a variation of theradiation system10 that includes twoPET imagers600a,600b.ThePET imagers600a,600bare located next to theradiation source40, and opposite from each other across theopening19. The positions of thePET imagers600a,600bcan be adjusted using themechanical linkages604. In the illustrated embodiments, theradiation system10 also includes animager606, which is similar to theimager50 discussed previously with reference toFIG. 1B. Theimager606 is located opposite from theradiation source40 across the opening19 (at an operative position in association with the radiation source40). The configuration of theradiation system10 should not be limited to the examples discussed previously, and that theradiation system10 can have other configurations in other embodiments. For example, in other embodiments, instead of having thearm30, theradiation system10 can have a ring gantry with a slip-ring configuration (e.g., such as that described with reference toFIG. 1F). In such cases, thestructure12 of theradiation system10 can further include a PET device secured next to the ring gantry. For example, the PET device may compriseimagers600aand600battached to a ring. Theradiation source40 and theimager606 may also be secured to the same ring. Alternatively, the PET device may include a PET imager having a ring configuration formed as part of thesystem10, e.g, within the bore ofsystem10.
• During use, theradiation source40 can be used to deliver treatment radiation to treat a patient while the patient is positioned at the first operative position associated with theradiation source40. Theradiation source40 can also be used to deliver low dose radiation to obtain an image (e.g., using the imager606) of a portion of the patient while the patient is at the first operative position. In such cases, the collimator next to theradiation source40 may be opened to provide an imaging window for allowing the imaging radiation to pass therethrough. ThePET imagers600a,600bcan be used to obtain PET image data of a portion of the patient while the patient is at-the first operative position. Such feature is advantageous in that it allows PET image data from thePET imagers600a,600b,and image data from theimager606, to be collected without moving the patient support. Theimagers600aand600bcan be rotated to obtain data at a plurality of angular positions, to provide more data for volumetric reconstruction.
• In some embodiments, theradiation system10 ofFIG. 17A can be used with thedevice166, as similarly discussed with reference toFIG. 2. During use, the patient can be placed at the operative position associated with thedevice166, and thedevice166 can be used to create a treatment plan for the patient. At least a portion of the patient is then transferred from the operative position associated with thedevice166, through thebore22 and the bore56, to the operative position associated with theradiation source40, where the patient can be treated and/or imaged by theradiation source40 and/or theimagers600a,600b,or by the imaging devices51 and52 ofFIG. 1D.
• In other embodiments, instead of the configuration shown inFIG. 17A, theradiation system10 does not include thePET imagers600a,600b(FIG. 17B). Instead, theradiation system10 is used with, or includes, thedevice166, which includes PET imager(s) (for example, thedevice166 may include two PET imagers (or multiple sets of two imagers) secured to a ring and positioned opposite from each other, or alternatively, thedevice166 may include a PET imager having a stationary ring configuration. In such cases, the patient is positioned at the second operative position associated with thedevice166, and the PET imager(s) are used to obtain PET image data of a portion of the patient. The portion of the patient is then positioned through thebore22 of thestructure12 and through the bore56 of thearm30 until it is at the first operative position associated with theradiation source40. Theradiation source40 then delivers low dose radiation beam to obtain image data (e.g., using the imager606) of the portion of the patient. In other embodiments, the image data can be obtained before the PET image data. The configuration of theradiation system10 should not be limited to the examples discussed previously, and that theradiation system10 can have other configurations in other embodiments. For example, in other embodiments, instead of having thearm30, theradiation system10 can have a ring gantry with a slip-ring configuration. Also, in other embodiments, instead of, or in addition to, PET imagers, thedevice166 can include one or more SPECT imagers. Similarly, in other embodiments,imagers600a,600band/or606 may be SPECT imagers.
• In any of the embodiments described herein, image data obtained using theimager606 can be used to perform attenuation correction for the PET image data (to correct attenuation effect in PET). This is advantageous because PET photons, having an energy of approximately 511 keV, undergo significant Compton scattering, while attenuation of x-rays of typical diagnostic sources generally are dominated by the photoelectric effect. Photons from the treatment beam are typically in the MeV range, and like the PET photons, the attenuation is dominated by Compton scattering. Thus, the attenuation data from the treatment beam may provide a better measure of attenuation. In addition, since a PET image may not provide a desired image resolution, the image data obtained using theimager606 can be used to correct certain features of the PET image data. In some embodiments, the image data (whether fromimager606 or other imaging device) and the PET image data are combined to form a composite image, which may be used for treatment planning and/or for treatment evaluation. The composite image may be used during a treatment process. For example, the composite image may be used to verify a location of a target tissue region and/or to show the areas where a tumor is actively growing. As a further exemplary alternative, the imaging devices51 and52 may be used to obtain data for attenuation correction, and/or for use in forming a composite image.
• Various techniques may be employed for collecting the image data from theimager606 and the PET image data from thePET imagers600a,600b.For example, in some embodiments, theradiation source40 and theimager606 may be rotated around the patient to collect a plurality of image data at a plurality of gantry angles. Afterwards, thePET imagers600a,600bare then used to collect PET image data. In some cases, thePET imagers600a,600bmay be rotated around the patient to collect a desired set of PET image data. If a ring-shape PET imager is used (instead of the set ofPET imagers600a,600b), then the ring-shape PET imager needs not be rotated. In other embodiments, instead of collecting the image data before the PET image data, the PET image data may be collected first, followed by the image data from theimager606. In further embodiments, a set of image data from theimager606 and PET image data from thePET imagers600a,600bmay be collected at a first gantry angle. The gantry is then rotated to thereby collect another set of image data from theimager606 and PET image data from thePET imagers600a,600bat a second gantry angle. The rotation of the gantry, and the collection of image and PET image data are continued, until a desired amount of image data and/or PET image data is collected. The collected image data and PET image data are transmitted to a processor, such as theprocessor84, which processes the image data and the PET image data. In some embodiments, the processor uses the image data to perform attenuation correction for the PET image data, as discussed herein. In other embodiments, the processor may use the image data and the PET image data to construct a composite image, as also discussed herein.
• FIG. 17C illustrates aradiation system10 in accordance with other embodiments. Theradiation system10 includes thestructure12, which has thefirst side14, the second side, thefirst opening18 located on thefirst side14, thesecond opening20 located on the second side, and thebore22 extending between theopenings18,20. In the illustrated embodiments, theradiation system10 further includes afirst ring630a,and a second ring630b.Each of therings630a,630bmay be a complete ring or a partial ring (e.g., an arc). Therings630a,630bare independently rotatable relative to thestructure12, thereby allowing therings630a,630bto rotate at different speeds. Each of the rings630 can be used to carry different devices. In the illustrated embodiments, thefirst ring630amay be used to carry a treatment radiation source (such as an embodiment of theradiation source40 described herein), and the second ring630bmay be used to carry an x-ray tube640 and an imager642 (which for example, may be components of a CT device). Thefirst ring630ais also used to carry theimager50, such that image data can be obtained using thetreatment radiation source40 and theimager50. In any embodiment, thefirst ring630acan have one or more diagnostic sources, and one or more imagers. During use, thefirst ring630acan rotate at a first speed to treat a patient and/or to generate image data using the radiation source and the imager, and the second ring630bcan rotate at a second speed to generate CT image data using the x-ray tube640 and theimager642, wherein the first and the second speeds are different. In some embodiments, the CT device on the second ring630bcan be used to obtain an image of a portion of a patient while the patient is being treated using theradiation source40 on thefirst ring630a.
• It should be noted that the devices that can be attached to therings630a,630bare not limited to the examples discussed previously. For example, in other embodiments, a diagnostic device, such as a PET device (e.g., PET imager(s)), can be secured to the second ring630b.In such cases, the image data obtained from the imager on thefirst ring630amay be used to perform attenuation correction for PET image obtained using the PET device on the second ring630b,or may be used with the PET image data to form a composite image. The first and thesecond rings630a,630bcan be configured to rotate at the same speed or different speeds to obtain a desired result. Also, in some embodiments, thefirst ring630acan be configured to rotate by a first range of gantry angle to perform a first procedure, and the second ring630bcan be configured to rotate by a second range of gantry angle to perform a second procedure. The first and the second range may be the same or different, and may or may not overlap each other.
• In further embodiments, the PET device may include a ring-shape PET imager. In such cases, theradiation system10 ofFIG. 17C includes onering630a,and does not include a second rotatable ring. For example, the second ring630bmay be fixedly secured to thestructure12 such that the second ring630bis not rotatable relative to thestructure12, and may be used as a support to which the ring-shape PET imager is mounted. The ring-shape PET imager is secured within thebore22 next to thefirst ring630a.During use, image data are obtained using theradiation source40 and theimager50 mounted on thefirst ring630a,and the image data may be used to correct attenuation effect in PET image data obtained using the ring-shape PET imager.
• In further embodiments, the second ring630bmay carry a component, such as an imager, that is a part of an imaging device. By means of non-limiting examples, the imaging device may be a laminar tomography device, a MRI device, a fluoroscope, an angiography device, a SPECT device, or a tomosynthesis imaging device. Also, in further embodiments, instead of or in addition to having multiple rings such asrings630a,630bin thesame structure12, theradiation system10 can have a first structure (e.g., structure12) that carries thefirst ring630a,and a second structure that carries the second ring630b.The first and second structures may be dockable relative to one another, using for example, the embodiments described previously. In general, in any embodiment, each ring may carry one or more devices, each structure may carry one or more rings, and each structure may be dockable
• FIG. 17D illustrates a top view of aradiation system10 in accordance with other embodiments. Theradiation system10 includes afirst device700 and asecond device702 that is oriented at900 relative to the first device700 (e.g., axis704 associated with thefirst device700 forms a 90° relative toaxis706 associated with the second device702). In some embodiments, thefirst device700 may be any of the embodiments of the radiation systems10 (e.g., any of the devices ofFIGS. 1A-1F) described herein. In other embodiments, thefirst device700 may be a treatment machine or a diagnostic machine having other configurations. For example, thefirst device700 may be a radiation treatment machine that does not have the throughbore22. Also, in some embodiments, thesecond device702 may be any of the embodiments of the devices166 (or device100) described herein, or any treatment or diagnostic device not described herein. By means of non-limiting examples, thesecond device702 may be a CT device (e.g., a CBCT device), a laminar tomography device, a MRI device, a fluoroscope, an angiography device, a PET device, a SPECT device, a PET-CT device, or a tomosynthesis imaging device. During use, thepatient positioning system200 places a patient in a first operative position associated with thefirst device700 to allow a first procedure, such as a treatment procedure, be performed on at least a portion of the patient. Thepatient positioning system200 then places the patient in a second operative position associated with thesecond device702 to allow a second procedure, such as an imaging procedure, be performed on at least a portion of the patient. As illustrated in the embodiments, orienting thedevices700,702900 relative to each other is advantageous in that it allows a patient to be transported between two devices in a relatively short distance. Also, such placement of the first andsecond devices700,702 may allow them to be placed in a room having limited dimensions.
• Theradiation system10 ofFIG. 17D is not limited to the configuration shown. In further embodiments, the axis704 of thefirst device700 may form an angle with theaxis706 of thesecond device702 that is less than 90°. For example, as shown inFIG. 17E, thefirst device700 and thesecond device702 may be positioned in a side-by-side configuration, wherein the axis704 forms a 0° relative to theaxis706. During use, thepatient positioning system200 places a patient in a first operative position associated with thefirst device700 to allow a first procedure, such as a treatment procedure, be performed on at least a portion of the patient. Thepatient positioning system200 then places the patient in a second operative position associated with thesecond device702 to allow a second procedure, such as an imaging procedure, be performed on at least a portion of the patient. In some embodiments, thepatient positioning system200 ofFIG. 13A may be used with theradiation system10 ofFIG. 17E. As illustrated in the embodiments, orienting thedevices700,702900 or less relative to each other is advantageous in that it allows a patient to be transported between two devices in a relatively short distance. Also, such placement of the first andsecond devices700,702 may allow them to be placed in a room having limited dimensions.
• In further embodiments, the axis704 of thefirst device700 may form an angle with theaxis706 of thesecond device702 that is more than 90°, e.g., between 90° and 180°. Such configuration may be desirable to accommodate thedevices700,702 in an operating room having certain size and shape.
• FIG. 18 illustrates a schematic block diagram of aradiation beam generator750 for providing theradiation beam42 in accordance with some embodiments. Theradiation beam generator750 may be implemented in any of the embodiments of theradiation system10 described herein. Theradiation beam generator750 includes a particle source752 (e.g., an electron generator) for generating particles (e.g., electrons), theaccelerator31 for accelerating the particles, and apermanent magnet system754 for altering a trajectory of the particles. Thepermanent magnet system754 includes one or more permanent magnet(s). In the illustrated embodiments, thepermanent magnet system754 changes a direction of the beam by approximately 270°. Use of apermanent magnet system754 to change the trajectory of the beam is advantageous because it allows the overall size of theradiation beam generator750 be reduced (as compared to use of an electromagnetic system, which would increase the size of the generator750).
• In some embodiments, theradiation beam generator750 may further include one or more electromagnet(s) to alter a characteristic of the magnetic field provided by thepermanent magnet system754. In such cases, the electromagnetic coils may magnetically couple with the permanent magnetic to make changes (e.g., 30% or less) in the magnetic field that is used to bend the beam. For example, the electromagnet(s) may be configured (e.g., sized, shaped, and positioned relative to the permanent magnet754) to provide a magnetic field to change a magnitude and/or a direction of the magnetic field provided by thepermanent magnet system754, thereby allowing the generated beam to be “bent” in a desired manner. The electromagnet(s) may be positioned adjacent to thepermanent magnet system754, or connected to thepermanent magnet system754. In other embodiments, instead of using electromagnet(s), theradiation beam generator750 may include one or more additional permanent magnet(s) for adjusting a magnetic field provided by thepermanent magnet system754. For example, the additional permanent magnet may be secured to a positioner that moves the additional permanent magnet relative to thepermanent magnet system754, thereby changing a magnitude and/or a direction of the magnetic field provided by thepermanent magnet system754. In other embodiments, other techniques known in the art may be used to vary the magnetic coupling of a magnetic material or magnet in the magnetic circuit to thereby provide the magnetic trimming functionality.
• Computer System Architecture
• FIG. 19 is a block diagram illustrating an embodiment of acomputer system800 that can be used to implement various embodiments of the method described herein.Computer system800 includes abus802 or other communication mechanism for communicating information, and aprocessor804 coupled with thebus802 for processing information. Theprocessor804 may be an example of theprocessor84/134, or alternatively, an example of a component of theprocessor84/134. Thecomputer system800 also includes amain memory806, such as a random access memory (RAM) or other dynamic storage device, coupled to thebus802 for storing information and instructions to be executed by theprocessor804. Themain memory806 also may be used for storing temporary variables or other intermediate information during execution of instructions to be executed by theprocessor804. Thecomputer system800 further includes a read only memory (ROM)808 or other static storage device coupled to thebus802 for storing static information and instructions for theprocessor804. Adata storage device810, such as a magnetic disk or optical disk, is provided and coupled to thebus802 for storing information and instructions.
• Thecomputer system800 may be coupled via thebus802 to a display87, such as a cathode ray tube (CRT), or a flat panel display, for displaying information to a user. Aninput device814, including alphanumeric and other keys, is coupled to thebus802 for communicating information and command selections toprocessor804. Another type of user input device iscursor control816, such as a mouse, a trackball, or cursor direction keys for communicating direction information and command selections toprocessor804 and for controlling cursor movement on display87. This input device typically has two degrees of freedom in two axes, a first axis (e.g., x) and a second axis (e.g., y), that allows the device to specify positions in a plane.
• In some embodiments, thecomputer system800 can be used to perform various functions described herein. According to some embodiments of the invention, such use is provided bycomputer system800 in response toprocessor804 executing one or more sequences of one or more instructions contained in themain memory806. Those skilled in the art will know how to prepare such instructions based on the functions and methods described herein. Such instructions may be read into themain memory806 from another computer-readable medium, such asstorage device810. Execution of the sequences of instructions contained in themain memory806 causes theprocessor804 to perform the process steps described herein. One or more processors in a multi-processing arrangement may also be employed to execute the sequences of instructions contained in themain memory806. In alternative embodiments, hard-wired circuitry may be used in place of or in combination with software instructions to implement the invention. Thus, embodiments of the invention are not limited to any specific combination of hardware circuitry and software.
• The term “computer-readable medium” as used herein refers to any medium that participates in providing instructions to theprocessor804 for execution. Such a medium may take many forms, including but not limited to, non-volatile media, volatile media, and transmission media. Non-volatile media includes, for example, optical or magnetic disks, such as thestorage device810. Volatile media includes dynamic memory, such as themain memory806. Transmission media includes coaxial cables, copper wire and fiber optics, including the wires that comprise thebus802. Transmission media can also take the form of acoustic or light waves, such as those generated during radio wave and infrared data communications.
• Common forms of computer-readable media include, for example, a floppy disk, a flexible disk, hard disk, magnetic tape, or any other magnetic medium, a CD-ROM, any other optical medium, punch cards, paper tape, any other physical medium with patterns of holes, a RAM, a PROM, and EPROM, a FLASH-EPROM, any other memory chip or cartridge, a carrier wave as described hereinafter, or any other medium from which a computer can read.
• Various forms of computer-readable media may be involved in carrying one or more sequences of one or more instructions to theprocessor804 for execution. For example, the instructions may initially be carried on a magnetic disk of a remote computer. The remote computer can load the instructions into its dynamic memory and send the instructions over a telephone line using a modem. A modem local to thecomputer system800 can receive the data on the telephone line and use an infrared transmitter to convert the data to an infrared signal. An infrared detector coupled to thebus802 can receive the data carried in the infrared signal and place the data on thebus802. Thebus802 carries the data to themain memory806, from which theprocessor804 retrieves and executes the instructions. The instructions received by themain memory806 may optionally be stored on thestorage device810 either before or after execution by theprocessor804.
• Thecomputer system800 also includes acommunication interface818 coupled to thebus802. Thecommunication interface818 provides a two-way data communication coupling to anetwork link820 that is connected to alocal network822. For example, thecommunication interface818 may be an integrated services digital network (ISDN) card or a modem to provide a data communication connection to a corresponding type of telephone line. As another example, thecommunication interface818 may be a local area network (LAN) card to provide a data communication connection to a compatible LAN. Wireless links may also be implemented. In any such implementation, thecommunication interface818 sends and receives electrical, electromagnetic or optical signals that carry data streams representing various types of information.
• Thenetwork link820 typically provides data communication through one or more networks to other devices. For example, thenetwork link820 may provide a connection throughlocal network822 to ahost computer824 or toequipment826, such as any of the devices herein (e.g.,device166,system10,patient support system200, etc.), or a switch operatively coupled to any of the devices described herein. The data streams transported over thenetwork link820 can comprise electrical, electromagnetic or optical signals. The signals through the various networks and the signals on thenetwork link820 and through thecommunication interface818, which carry data to and from thecomputer system800, are exemplary forms of carrier waves transporting the information. Thecomputer system800 can send messages and receive data, including program code, through the network(s), thenetwork link820, and thecommunication interface818.
• Although particular embodiments of the present inventions have been shown and described, it will be understood that it is not intended to limit the present inventions, and it will be obvious to those skilled in the art that various changes and modifications may be made without departing from the spirit and scope of the present inventions. For example, the term “image” or “image data” as used in this specification includes image data that may be stored in a circuitry or a computer-readable medium, and should not be limited to image data that is displayed visually. Also, it should be noted that in other embodiments, theradiation system10 may not include one or more of the components described herein. Further, in other embodiments, theradiation system10 may include any of the components described herein, even if the components are described as separate elements from theradiation system10. The specification and drawings are, accordingly, to be regarded in an illustrative rather than restrictive sense. The present inventions are intended to cover alternatives, modifications, and equivalents, which may be included within the spirit and scope of the present inventions as defined by the claims.

Claims (37)

1. A radiation system, comprising:

a radiation source capable of generating a radiation beam having an energy suitable for treating tissue;

an imager operatively associated with the radiation source; and

a PET imager located adjacent to the imager.

2. The radiation system ofclaim 1, wherein the PET imager has a ring configuration.

3. The radiation system ofclaim 1, further comprising an additional PET imager located adjacent to the imager.

4. The radiation system ofclaim 1, wherein the radiation source, the imager, and the PET imager are mounted to a ring.

5. The radiation system ofclaim 1, wherein the radiation source and the imager are mounted to a first ring, and the PET imager is mounted to a second ring.

6. The radiation system ofclaim 5, wherein the first ring rotates at a first speed, and the second ring rotates at a second speed that is different from the first speed.

7. The radiation system ofclaim 1, further comprising a processor coupled to the imager and the PET imager, the processor configured to receive data from the imager, and PET data from the PET imager.

8. The radiation system ofclaim 7, wherein the processor is configured to perform attenuation correction on the PET data using the imaging data.

9. The radiation system ofclaim 7, wherein the processor is configured to create a composite image using the data and the PET data.

10. The radiation system ofclaim 1, further comprising a structure to which the radiation source and the imager is secured, the structure having a first side, a second side, a first opening located on the first side, a second opening located on the second side, and a bore extending between the first opening and the second opening.

11. The radiation system ofclaim 1, wherein the energy is at least 1 MeV.

12. The radiation system ofclaim 1, further comprising a collimator located next to the radiation source.

13. The radiation system ofclaim 1, wherein the radiation source is coupled to a first structure, the PET imager is coupled to a second structure, and the first and second structures are located adjacent to each other.

14. The radiation system ofclaim 13, wherein the first structure has a first axis, the second structure has a second axis, and the first axis and the second axis are offset from each other.

15. The radiation system ofclaim 13, wherein the second structure is located behind the first structure.

16. The radiation system ofclaim 13, wherein the first structure is located next to the second structure in a side-by-side configuration.

17. The radiation system ofclaim 13, wherein the first structure is oriented at 90° or less relative to the second structure.

18. The radiation system ofclaim 1, wherein the PET imager is located behind the imager.

19. A radiation system, comprising:

a first ring;

a radiation source coupled to the first ring;

an imager operatively associated with the radiation source;

a second ring located adjacent to the first ring; and

a PET imager coupled to the second ring.

20. The radiation system ofclaim 19, wherein the PET imager has an arc or ring configuration.

21. The radiation system ofclaim 19, further comprising an additional PET imager located next to the imager.

22. The radiation system ofclaim 19, wherein the first ring rotates at a first speed, and the second ring rotates at a second speed that is different from the first speed.

23. The radiation system ofclaim 19, further comprising a processor coupled to the imager and the PET imager, the processor configured to receive data from the imager and PET data from the PET imager.

24. The radiation system ofclaim 23, wherein the processor is configured to perform attenuation correction on the PET data using the imaging data.

25. The radiation system ofclaim 23, wherein the processor is configured to create a composite image using the data and the PET data.

26. The radiation system ofclaim 19, further comprising a structure to which the first and the second rings are rotatably mounted, the structure having a first side, a second side, a first opening located on the first side, a second opening located on the second side, and a bore extending between the first opening and the second opening.

27. The radiation system ofclaim 19, wherein the radiation source is capable of delivering radiation suitable for treating a patient, and the radiation system further comprises a collimator located next to the radiation source.

28. The radiation system ofclaim 19, wherein the first ring has a first axis, and the second ring has a second axis, and the first axis and the second axis align with each other.

29. A radiation system, comprising:

a structure having a first side, a second side, a first opening located on the first side, a second opening located on the second side, and a bore extending between the first opening and the second opening;

a radiation source located outside the bore; and

a PET imager located within or adjacent to the bore.

30. The radiation system ofclaim 29, wherein the PET imager has a ring configuration.

31. The radiation system ofclaim 29, further comprising a processor for receiving data generated using the radiation source, and PET data from the PET imager.

32. The radiation system ofclaim 31, wherein the processor is configured to perform attenuation correction on the PET data using the imaging data.

33. The radiation system ofclaim 31, wherein the processor is configured to create a composite image using the data and the PET data.

34. The radiation system ofclaim 29, wherein radiation source is configured to deliver treatment radiation energy.

35. The radiation system ofclaim 29, further comprising a collimator located next to the radiation source.

36. The radiation system ofclaim 29, wherein the PET imager is mounted to an additional structure located adjacent to the structure.

37. The radiation system ofclaim 29, wherein the PET imager is mounted within the bore.

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