An apparatus and method for coupling a fixed-aperture collimator to a variable-aperture collimator. The variable-aperture collimator may be an IRIS collimator having multiple leaves configured to open and close an aperture of the IRIS collimator within which the fixed-aperture collimator is retained.

Integrated variable-aperture collimator and fixed-aperture collimator

Treatment targets such as tumors or lesions, located within an anatomical region that undergoes motion (which may be periodic with cycle P), are dynamically tracked. A 4D mathematical model is established for the non-rigid motion and deformation of the anatomical region, from a set of CT or other 3D images. The 4D mathematical model relates the 3D locations of part(s) of the anatomical region with the targets being tracked, as a function of the position in time within P. Using fiducial-less non-rigid image registration between pre-operative DRRs and intra-operative x-ray images, the absolute position of the target and/or other part(s) of the anatomical region is determined. The cycle P is determined using motion sensors such as surface markers. The radiation beams are delivered using: 1) the results of non-rigid image registration; 2) the 4D model; and 3) the position in time within P.

Dynamic tracking of moving targets

A device and a process for performing high temporal- and spatial-resolution MR imaging of the anatomy of a patient during intensity modulated radiation therapy (IMRT) to directly measure and control the highly conformal ionizing radiation dose delivered to the patient for the treatment of diseases caused by proliferative tissue disorders. This invention combines the technologies of open MRI, multileaf-collimator or compensating filter-based IMRT delivery, and cobalt teletherapy into a single co-registered and gantry mounted system.

System for delivering conformal radiation therapy while simultaneously imaging soft tissue

A patient positioning system for use with a radiation therapy system that monitors the location of fixed and movable components and pre-plans movement of the movable components so as to inhibit movement if a collision would be indicated. The positioning system can also coordinate movement of multiple movable components for reduced overall latency in registering a patient. The positioning system includes external measurement devices which measure the location and orientation of objects, including components of the radiation therapy system, in space and can also monitor for intrusion into the active area of the therapy system by personnel or foreign objects to improve operational safety of the radiation therapy system.

Path planning and collision avoidance for movement of instruments in a radiation therapy environment

OBJECTIVE: New technology has enabled the increasing use of radiosurgery to ablate spinal lesions. The first generation of the CyberKnife (Accuray, Inc., Sunnyvale, CA) image-guided radiosurgery system required implanted radiopaque markers (fiducials) to localize spinal targets. A recently developed and now commercially available spine tracking technology called Xsight (Accuray, Inc.) tracks skeletal structures and eliminates the need for implanted fiducials. The Xsight system localizes spinal targets by direct reference to the adjacent vertebral elements. This study sought to measure the accuracy of Xsight spine tracking and provide a qualitative assessment of overall system performance. METHODS: Total system error, which is defined as the distance between the centroids of the planned and delivered dose distributions and represents all possible treatment planning and delivery errors, was measured using a realistic, anthropomorphic head-and-neck phantom. The Xsight tracking system error component of total system error was also computed by retrospectively analyzing image data obtained from eleven patients with a total of 44 implanted fiducials who underwent CyberKnife spinal radiosurgery. RESULTS: The total system error of the Xsight targeting technology was measured to be 0.61 mm. The tracking system error component was found to be 0.49 mm. CONCLUSION: The Xsight spine tracking system is practically important because it is accurate and eliminates the use of implanted fiducials. Experience has shown this technology to be robust under a wide range of clinical circumstances.

A study of the accuracy of cyberknife spinal radiosurgery using skeletal structure tracking.

Radiosurgery is defined as the delivery of high doses of ionising radiation, in mono- or hypo- fractionated treatments, to destroy tumours or focal areas of pathology The clinical requirements of designing a radiosurgical treatment system include providing: a) a highly precise beam delivery to targets located throughout the body, b) a highly conformal dose distribution, c) the ability to irradiate both small and/or large complex-shaped lesions while minimising the dose to adjacent radiosensitive tissues and d) the ability to interactively track lesion motion due to normal patient motion To accomplish this, the CyberKnife radiosurgery system has pioneered in this area by taking advantage of the inherent geometrical targeting precision of a commercial arm-based robotic system carrying a compact X-band linear accelerator and integrated with X-ray imaging and visualisation feedback systems The arm-mounted linear accelerator, equipped with patient specific anatomical models, registered to the patient in real-time with image guidance, dynamically and safely delivers conformal and homogeneous radiation for therapeutic benefit This paper details the components of the CyberKnife system and their integration in the clinical workflow of radiosurgery

Robotic Whole Body Stereotactic Radiosurgery : Clinical Advantages of the Cyberknife Integrated System

An interface is provided to a user to perform a plurality of treatment planning operations associated with the treatment plan before the treatment plan is optimized. The treatment planning operations include at least one of selecting a treatment planning parameter or inputting data corresponding to the treatment planning parameter. One or more templates containing one or more pre-defined treatment planning parameters are provided to the user to enable the user to skip performing one or more of the plurality of operations.

Wizard and template for treatment planning

An apparatus and method for optimizing a workspace of a radiation treatment delivery system. An optimized treatment plan is generated for delivering a dose of radiation to a volume of interest (“VOI”) in a patient using fewer changes to a treatment plan parameter during delivery of the dose of radiation then available to a radiation treatment delivery system. The optimized treatment plan limits a number of adjustments to the treatment plan parameter during delivery of the dose of radiation. Prior to delivery, the optimized treatment plan is analyzed to determine whether a quality of the optimized treatment plan is acceptable.

Workspace optimization for radiation treatment delivery system

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Robotic Whole Body Stereotactic Radiosurgery : Clinical Advantages of the Cyberknife Integrated System

Wizard and template for treatment planning

Workspace optimization for radiation treatment delivery system