U.S. patent application number 15/803597 was filed with the patent office on 2018-03-01 for gantry charged particle nozzle system - rolling floor interface apparatus and method of use thereof.
The applicant listed for this patent is Mark R. Amato, Armin Huseinovic, W. Davis Lee, Daniel J. Raymond, Jillian Reno, Lou Wainwright. Invention is credited to Mark R. Amato, Armin Huseinovic, W. Davis Lee, Daniel J. Raymond, Jillian Reno, Lou Wainwright.
Application Number | 20180056093 15/803597 |
Document ID | / |
Family ID | 61241277 |
Filed Date | 2018-03-01 |
United States Patent
Application |
20180056093 |
Kind Code |
A1 |
Reno; Jillian ; et
al. |
March 1, 2018 |
GANTRY CHARGED PARTICLE NOZZLE SYSTEM - ROLLING FLOOR INTERFACE
APPARATUS AND METHOD OF USE THEREOF
Abstract
The invention comprises a segmented rolling floor apparatus and
method of use thereof, such as for use in a charged particle cancer
therapy system. The segmented rolling floor comprises a first spool
and a second spool, attached to opposite ends of the rolling floor,
which cooperatively wind and unwind the rolling floor. The
segmented rolling floor circumferentially surrounds a nozzle system
penetrating through an aperture in the segmented rolling floor,
where the nozzle system is used to deliver charged particles, from
an accelerator, to a tumor of a patient. The rolling floor and
nozzle systems move at respective rates maintaining the nozzle
system in the aperture allowing for a safe/walkable floor while
allowing treatment of the tumor as a gantry rotates the nozzle
system and delivers protons to the tumor from positions above and
below the floor.
Inventors: |
Reno; Jillian; (Beverly,
MA) ; Huseinovic; Armin; (Winchester, MA) ;
Amato; Mark R.; (South Hamilton, MA) ; Raymond;
Daniel J.; (Windham, NH) ; Lee; W. Davis;
(Newburyport, MA) ; Wainwright; Lou; (Lynnfield,
MA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Reno; Jillian
Huseinovic; Armin
Amato; Mark R.
Raymond; Daniel J.
Lee; W. Davis
Wainwright; Lou |
Beverly
Winchester
South Hamilton
Windham
Newburyport
Lynnfield |
MA
MA
MA
NH
MA
MA |
US
US
US
US
US
US |
|
|
Family ID: |
61241277 |
Appl. No.: |
15/803597 |
Filed: |
November 3, 2017 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
15467840 |
Mar 23, 2017 |
|
|
|
15803597 |
|
|
|
|
15402739 |
Jan 10, 2017 |
|
|
|
15467840 |
|
|
|
|
15348625 |
Nov 10, 2016 |
9855444 |
|
|
15402739 |
|
|
|
|
15167617 |
May 27, 2016 |
9737733 |
|
|
15348625 |
|
|
|
|
62561148 |
Sep 20, 2017 |
|
|
|
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61N 2005/1087 20130101;
G21K 5/10 20130101; A61N 2005/1095 20130101; A61N 5/1069 20130101;
A61N 2005/1061 20130101; A61B 6/4085 20130101; A61N 5/107 20130101;
A61N 5/1043 20130101; A61N 5/1037 20130101; A61N 2005/105 20130101;
A61N 2005/1051 20130101; A61B 6/4266 20130101; A61N 5/1067
20130101; A61N 5/1082 20130101; G21K 5/04 20130101; A61B 6/4435
20130101; A61N 5/1077 20130101; A61B 6/4258 20130101; A61B 6/4208
20130101; A61N 5/1039 20130101; A61B 6/032 20130101; A61N 2005/1054
20130101; A61N 2005/1097 20130101; A61N 5/1049 20130101; A61B
6/5205 20130101 |
International
Class: |
A61N 5/10 20060101
A61N005/10; A61B 6/03 20060101 A61B006/03 |
Claims
1. An apparatus, comprising: a first rolling floor spooler system;
a segmented rolling floor comprising a first end attached to said
rolling floor spooler system, said rolling floor spooler system
configured to wind up a section of said segmented rolling floor
during use.
2. The apparatus of claim 1, further comprising: a nozzle system
penetrating through an aperture in said segmented rolling
floor.
3. The apparatus of claim 2, further comprising: a beam path from
an accelerator, along a beam transport line, though a rotatable
section of said beam transport line, and through said nozzle
system.
4. The apparatus of claim 3, further comprising: a gantry attached
to said rotatable section of said beam transport line; and a
mechanical connection forcing movement of said segmented rolling
floor with rotation of said gantry.
5. The apparatus of claim 3, further comprising: a second rolling
floor spool attached to a second end of said segmented rolling
floor.
6. The apparatus of claim 5, said first rolling floor spooler
system positioned above a plane of a floor coplanar with a walkable
plane surface section of said segmented rolling floor, said second
rolling floor spool positioned below the plane of the floor.
7. The apparatus of claim 3, said segmented rolling floor further
comprising: an upper section directly above a patient position,
said patient position in said beam path.
8. The apparatus of claim 7, said segmented rolling floor further
comprising: a vertical section at least five feet in length.
9. The apparatus of claim 8, said segmented rolling floor further
comprising: a curved rolling wall section.
10. The apparatus of claim 7, further comprising: an X-ray imaging
system penetrating through said segmented rolling floor.
11. A method, comprising the steps of: providing a segmented
rolling floor; and spooling said segmented rolling floor onto a
first rolling floor spool, said first rolling floor spool attached
to a first end of said segmented rolling floor.
12. The method of claim 11, further comprising the step of:
unwinding said segmented rolling floor from a second rolling floor
spool, attached to a second end of said segmented rolling floor,
during said step of spooling.
13. The method of claim 12, further comprising the step of:
positioning a nozzle end of a nozzle system through an aperture in
said segmented rolling floor.
14. The method of claim 13, further comprising the step of:
co-moving said nozzle system and said segmented rolling floor.
15. The method of claim 14, further comprising the step of:
sequentially transporting positively charged particles from an
accelerator, along a rotatable beam transport line, and through
said nozzle system.
16. The method of claim 15, further comprising the step of: a
gantry rotating said rotatable beam transport line at a rate of
said step of spooling said segment rolling floor.
17. The method of claim 16, further comprising the step of: imaging
a tumor of a patient, using a stationary imaging source and an
imaging detection panel, simultaneous with said step of said gantry
rotating said rotatable beam transport line.
18. The method of claim 15, further comprising the step of:
horizontally extending at least one proton tomography detection
panel to an opposite side of a patient position from said nozzle
system.
19. The method of claim 18, further comprising the step of:
maintaining said proton tomography detection panel on the opposite
side of the patient position from said nozzle system during
movement of said segmented rolling floor.
Description
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] This application:
[0002] is a continuation-in-part of U.S. patent application Ser.
No. 15/467,840 filed Mar. 23, 2017, which is a continuation-in-part
of U.S. patent application Ser. No. 15/402,739 filed Jan. 10, 2017,
which is a continuation-in-part of U.S. patent application Ser. No.
15/348,625 filed Nov. 10, 2016, which is a continuation-in-part of
U.S. patent application Ser. No. 15/167,617 filed May 27, 2016; and
claims benefit of U.S. provisional patent application No.
62/561,148 filed Sep. 20, 2017.
BACKGROUND OF THE INVENTION
Field of the Invention
[0003] The invention relates generally a gantry for controlling an
ion beam, such as for imaging and treating a tumor.
Discussion of the Prior Art
[0004] Cancer Treatment
[0005] Proton therapy works by aiming energetic ionizing particles,
such as protons accelerated with a particle accelerator, onto a
target tumor. These particles damage the DNA of cells, ultimately
causing their death. Cancerous cells, because of their high rate of
division and their reduced ability to repair damaged DNA, are
particularly vulnerable to attack on their DNA.
[0006] Patents related to the current invention are summarized
here.
[0007] Proton Beam Therapy System
[0008] F. Cole, et. al. of Loma Linda University Medical Center
"Multi-Station Proton Beam Therapy System", U.S. Pat. No. 4,870,287
(Sep. 26, 1989) describe a proton beam therapy system for
selectively generating and transporting proton beams from a single
proton source and accelerator to a selected treatment room of a
plurality of patient treatment rooms.
[0009] Problem
[0010] There exists in the art of charged particle cancer therapy a
need for safe, accurate, precise, and rapid imaging of a patient
and/or treatment of a tumor using charged particles.
SUMMARY OF THE INVENTION
[0011] The invention relates generally to safely controlling an ion
beam, such as for imaging and treating a tumor.
DESCRIPTION OF THE FIGURES
[0012] A more complete understanding of the present invention is
derived by referring to the detailed description and claims when
considered in connection with the Figures, wherein like reference
numbers refer to similar items throughout the Figures.
[0013] FIG. 1A illustrate component connections of a charged
particle beam therapy system, FIG. 1B illustrates a charged
particle therapy system;
[0014] FIG. 2 illustrates a tomography system;
[0015] FIG. 3 illustrates a beam path identification system;
[0016] FIG. 4A illustrates a beam path identification system
coupled to a beam transport system and a tomography scintillation
detector; FIG. 4B illustrates an x-axis ionization strip detector;
FIG. 4C illustrates a y-axis ionization strip detector; FIG. 4D
illustrates a kinetic energy dissipation chamber; FIG. 4E
illustrates ionization strips integrated with the kinetic energy
dissipation chamber;
[0017] FIG. 4F illustrates an alternating kinetic energy
dissipation chamber--targeting chamber; FIG. 4G illustrates a beam
mapping chamber; FIG. 4H illustrates beam direction compensating
chambers; and FIG. 4I illustrates the scintillation detector
rotating with the patient and gantry nozzle;
[0018] FIG. 5 illustrates a treatment delivery control system;
[0019] FIG. 6A illustrates a two-dimensional--two-dimensional
imaging system relative to a cancer treatment beam, FIG. 6B
illustrates multiple gantry supported imaging systems, and FIG. 6C
illustrates a rotatable cone beam;
[0020] FIG. 7A illustrates a process of determining position of
treatment room objects and FIG. 7B illustrates an iterative
position tracking, imaging, and treatment system;
[0021] FIG. 8 illustrates a fiducial marker enhanced tomography
imaging system;
[0022] FIG. 9 illustrates a fiducial marker enhanced treatment
system;
[0023] FIGS. 10(A-C) illustrate isocenterless cancer treatment
systems;
[0024] FIG. 11 illustrates a gantry counterweight system;
[0025] FIG. 12 illustrates a counterweighted gantry system;
[0026] FIG. 13A illustrates a rolling floor system with a movable
nozzle, FIG. 13B, a patient positioning system, FIG. 13C, and a
nozzle extension track guidance system, FIG. 13D;
[0027] FIG. 14 illustrates a hybrid cancer-treatment imaging
system;
[0028] FIG. 15 illustrates a combined patient positioning
system--imaging system;
[0029] FIG. 16 illustrates a combined gantry-rolling floor
system;
[0030] FIG. 17 illustrates a wall mounted gantry system;
[0031] FIG. 18 illustrates a floor mounted gantry system;
[0032] FIG. 19 illustrates a gantry superstructure system;
[0033] FIG. 20 illustrates a transformable axis system for tumor
treatment;
[0034] FIG. 21 illustrates a semi-automated cancer therapy
imaging/treatment system;
[0035] FIG. 22 illustrates a system of automated generation of a
radiation treatment plan;
[0036] FIG. 23 illustrates a system of automatically updating a
cancer radiation treatment plan during treatment; and
[0037] FIG. 24 illustrates an automated radiation treatment plan
development and implementation system.
[0038] Elements and steps in the figures are illustrated for
simplicity and clarity and have not necessarily been rendered
according to any particular sequence. For example, steps that are
performed concurrently or in different order are illustrated in the
figures to help improve understanding of embodiments of the present
invention.
DETAILED DESCRIPTION OF THE INVENTION
[0039] The invention comprises a segmented rolling floor apparatus
and method of use thereof, such as for use in a charged particle
cancer therapy system. The segmented rolling floor comprises a
first spool and a second spool, attached to opposite ends of the
rolling floor, which cooperatively wind and unwind the rolling
floor. The segmented rolling floor optionally and preferably
circumferentially surrounds a nozzle system penetrating through an
aperture in the segmented rolling floor, where the rolling floor
system moves at a rate maintaining the nozzle system in the
aperture as a gantry rotates the nozzle system and a rotatable
section of a positively charged particle beam transport line about
a cancer patient. Thus, the rolling floor forms a section of a
floor system and provides a safe/walkable floor while allowing
treatment of a tumor with the positively charged particles as the
nozzle system is rotated through positions above and below the
floor by the gantry.
[0040] The above described embodiment is optionally used in
combination with a proton therapy cancer treatment system and/or a
proton tomography imaging system. Generally, one or more detectors
imaging photons emitted from the coated layers, also referred to as
imaging sheets or layers, are used to determine one or more point
positions of the charged particle beam at a given time. Combining
the point positions yields localized vectors pinpointing the
charged particle beam position, such as entering a patient. The
resulting charged particle state determination system using one or
more coated layers is used in conjunction with a scintillation
detector or a tomographic imaging system at time of tumor and
surrounding tissue sample mapping and/or at time of tumor treatment
where common synchrotron, beam transport, and/or nozzle elements
are used for both proton imaging and cancer treatment.
[0041] The above described embodiment is optionally used in
combination with a set of fiducial marker detectors configured to
detect photons emitted from and/or reflected off of a set of
fiducial markers positioned on one or more objects in a treatment
room and resultant determined distances and/or calculated angles
are used to determine relative positions of multiple objects or
elements in the treatment room. Generally, in an iterative process,
at a first time objects, such as a treatment beamline output
nozzle, a specific portion of a patient relative to a tumor, a
scintillation detection material, an X-ray system element, and/or a
detection element, are mapped and relative positions and/or angles
therebetween are determined. At a second time, the position of the
mapped objects is used in: (1) imaging, such as X-ray, positron
emission tomography, and/or proton beam imaging and/or (2) beam
targeting and treatment, such as positively charged particle based
cancer treatment. As relative positions of objects in the treatment
room are dynamically determined using the fiducial marking system,
engineering and/or mathematical constraints of a treatment beamline
isocenter is removed.
[0042] In combination, a method and apparatus is described for
determining a position of a tumor in a patient for treatment of the
tumor using positively charged particles in a treatment room. More
particularly, the method and apparatus use a set of fiducial
markers and fiducial detectors to mark/determine relative position
of static and/or moveable objects in a treatment room using photons
passing from the markers to the detectors. Further, position and
orientation of at least one of the objects is calibrated to a
reference line, such as a zero-offset beam treatment line passing
through an exit nozzle, which yields a relative position of each
fiducially marked object in the treatment room. Treatment
calculations are subsequently determined using the reference line
and/or points thereon. The inventor notes that the treatment
calculations are optionally and preferably performed without use of
an isocenter point, such as a central point about which a treatment
room gantry rotates, which eliminates mechanical errors associated
with the isocenter point being an isocenter volume in practice.
[0043] In combination, a method and apparatus for imaging a tumor
of a patient using positively charged particles and X-rays,
comprises the steps of: (1) transporting the positively charged
particles from an accelerator to a patient position using a beam
transport line, where the beam transport line comprises a
positively charged particle beam path and an X-ray beam path; (2)
detecting scintillation induced by the positively charged particles
using a scintillation detector system; (3) detecting X-rays using
an X-ray detector system; (4) positioning a mounting rail through
linear extension/retraction to: at a first time and at a first
extension position of the mounting rail, position the scintillation
detector system opposite the patient position from the exit nozzle
and at a second time and at a second extension position of the
mounting rail, position the X-ray detector system opposite the
patient position from the exit nozzle; (5) generating an image of
the tumor using output of the scintillation detector system and the
X-ray detector system; and (6) alternating between the step of
detecting scintillation and treating the tumor via irradiation of
the tumor using the positively charged particles.
[0044] In combination, a tomography system is optionally used in
combination with a charged particle cancer therapy system. The
tomography system uses tomography or tomographic imaging, which
refers to imaging by sections or sectioning through the use of a
penetrating wave, such as a positively charge particle from an
injector and/or accelerator. Optionally and preferably, a common
injector, accelerator, and beam transport system is used for both
charged particle based tomographic imaging and charged particle
cancer therapy. In one case, an output nozzle of the beam transport
system is positioned with a gantry system while the gantry system
and/or a patient support maintains a scintillation plate of the
tomography system on the opposite side of the patient from the
output nozzle.
[0045] In another example, a charged particle state determination
system, of a cancer therapy system or tomographic imaging system,
uses one or more coated layers in conjunction with a scintillation
material, scintillation detector and/or a tomographic imaging
system at time of tumor and surrounding tissue sample mapping
and/or at time of tumor treatment, such as to determine an input
vector of the charged particle beam into a patient and/or an output
vector of the charged particle beam from the patient.
[0046] In another example, the charged particle tomography
apparatus is used in combination with a charged particle cancer
therapy system. For example, tomographic imaging of a cancerous
tumor is performed using charged particles generated with an
injector, accelerated with an accelerator, and guided with a
delivery system. The cancer therapy system uses the same injector,
accelerator, and guided delivery system in delivering charged
particles to the cancerous tumor. For example, the tomography
apparatus and cancer therapy system use a common raster beam method
and apparatus for treatment of solid cancers. More particularly,
the invention comprises a multi-axis and/or multi-field raster beam
charged particle accelerator used in: (1) tomography and (2) cancer
therapy. Optionally, the system independently controls patient
translation position, patient rotation position, two-dimensional
beam trajectory, delivered radiation beam energy, delivered
radiation beam intensity, beam velocity, timing of charged particle
delivery, and/or distribution of radiation striking healthy
tissue.
[0047] The system operates in conjunction with a negative ion beam
source, synchrotron, patient positioning, imaging, and/or targeting
method and apparatus to deliver an effective and uniform dose of
radiation to a tumor while distributing radiation striking healthy
tissue.
[0048] For clarity of presentation and without loss of generality,
throughout this document, treatment systems and imaging systems are
described relative to a tumor of a patient. However, more generally
any sample is imaged with any of the imaging systems described
herein and/or any element of the sample is treated with the
positively charged particle beam(s) described herein.
[0049] Charged Particle Beam Therapy
[0050] Throughout this document, a charged particle beam therapy
system, such as a proton beam, hydrogen ion beam, or carbon ion
beam, is described. Herein, the charged particle beam therapy
system is described using a proton beam.
[0051] However, the aspects taught and described in terms of a
proton beam are not intended to be limiting to that of a proton
beam and are illustrative of a charged particle beam system, a
positively charged beam system, and/or a multiply charged particle
beam system, such as C.sup.4+ or C.sup.6+. Any of the techniques
described herein are equally applicable to any charged particle
beam system.
[0052] Referring now to FIG. 1A, a charged particle beam system 100
is illustrated. The charged particle beam preferably comprises a
number of subsystems including any of: a main controller 110; an
injection system 120; a synchrotron 130 that typically includes:
(1) an accelerator system 131 and (2) an internal or connected
extraction system 134; a radio-frequency cavity system 180; a beam
transport system 135; a scanning/targeting/delivery system 140; a
nozzle system 146; a patient interface module 150; a display system
160; and/or an imaging system 170.
[0053] An exemplary method of use of the charged particle beam
system 100 is provided. The main controller 110 controls one or
more of the subsystems to accurately and precisely deliver protons
to a tumor of a patient. For example, the main controller 110
obtains an image, such as a portion of a body and/or of a tumor,
from the imaging system 170. The main controller 110 also obtains
position and/or timing information from the patient interface
module 150. The main controller 110 optionally controls the
injection system 120 to inject a proton into a synchrotron 130. The
synchrotron typically contains at least an accelerator system 131
and an extraction system 134. The main controller 110 preferably
controls the proton beam within the accelerator system, such as by
controlling speed, trajectory, and timing of the proton beam. The
main controller then controls extraction of a proton beam from the
accelerator through the extraction system 134. For example, the
controller controls timing, energy, and/or intensity of the
extracted beam. The controller 110 also preferably controls
targeting of the proton beam through the
scanning/targeting/delivery system 140 to the patient interface
module 150 or a patient with a patient positioning system. One or
more components of the patient interface module 150, such as
translational and rotational position of the patient, are
preferably controlled by the main controller 110. Further, display
elements of the display system 160 are preferably controlled via
the main controller 110. Displays, such as display screens, are
typically provided to one or more operators and/or to one or more
patients. In one embodiment, the main controller 110 times the
delivery of the proton beam from all systems, such that protons are
delivered in an optimal therapeutic manner to the tumor of the
patient.
[0054] Herein, the main controller 110 refers to a single system
controlling the charged particle beam system 100, to a single
controller controlling a plurality of subsystems controlling the
charged particle beam system 100, or to a plurality of individual
controllers controlling one or more sub-systems of the charged
particle beam system 100.
Example I
Charged Particle Cancer Therapy System Control
[0055] Referring now to FIG. 1B, an illustrative exemplary
embodiment of one version of the charged particle beam system 100
is provided. The number, position, and described type of components
is illustrative and non-limiting in nature. In the illustrated
embodiment, the injection system 120 or ion source or charged
particle beam source generates protons. The injection system 120
optionally includes one or more of: a negative ion beam source, a
positive ion beam source, an ion beam focusing lens, and a tandem
accelerator. The protons are delivered into a vacuum tube that runs
into, through, and out of the synchrotron. The generated protons
are delivered along an initial path 262. Optionally, focusing
magnets 127, such as quadrupole magnets or injection quadrupole
magnets, are used to focus the proton beam path. A quadrupole
magnet is a focusing magnet. An injector bending magnet 128 bends
the proton beam toward a plane of the synchrotron 130. The focused
protons having an initial energy are introduced into an injector
magnet 129, which is preferably an injection Lambertson magnet.
Typically, the initial beam path 262 is along an axis off of, such
as above, a circulating plane of the synchrotron 130. The injector
bending magnet 128 and injector magnet 129 combine to move the
protons into the synchrotron 130. Main bending magnets, dipole
magnets, turning magnets, or circulating magnets 132 are used to
turn the protons along a circulating beam path 164. A dipole magnet
is a bending magnet. The main bending magnets 132 bend the initial
beam path 262 into a circulating beam path 164. In this example,
the main bending magnets 132 or circulating magnets are represented
as four sets of four magnets to maintain the circulating beam path
164 into a stable circulating beam path. However, any number of
magnets or sets of magnets are optionally used to move the protons
around a single orbit in the circulation process. The protons pass
through an accelerator 133. The accelerator accelerates the protons
in the circulating beam path 164. As the protons are accelerated,
the fields applied by the magnets are increased. Particularly, the
speed of the protons achieved by the accelerator 133 are
synchronized with magnetic fields of the main bending magnets 132
or circulating magnets to maintain stable circulation of the
protons about a central point or region 136 of the synchrotron. At
separate points in time the accelerator 133/main bending magnet 132
combination is used to accelerate and/or decelerate the circulating
protons while maintaining the protons in the circulating path or
orbit. An extraction element of an inflector/deflector system is
used in combination with a Lambertson extraction magnet 137 to
remove protons from their circulating beam path 164 within the
synchrotron 130.
[0056] One example of a deflector component is a Lambertson magnet.
Typically the deflector moves the protons from the circulating
plane to an axis off of the circulating plane, such as above the
circulating plane. Extracted protons are preferably directed and/or
focused using an extraction bending magnet 142 and optional
extraction focusing magnets 141, such as quadrupole magnets, and
optional bending magnets along a positively charged particle beam
transport path 268 in a beam transport system 135, such as a beam
path or proton beam path, into the scanning/targeting/delivery
system 140. Two components of a scanning system 140 or targeting
system typically include a first axis control 143, such as a
vertical control, and a second axis control 144, such as a
horizontal control. In one embodiment, the first axis control 143
allows for about 100 mm of vertical or y-axis scanning of the
proton beam 268 and the second axis control 144 allows for about
700 mm of horizontal or x-axis scanning of the proton beam 268. A
nozzle system 146 is used for directing the proton beam, for
imaging the proton beam, for defining shape of the proton beam,
and/or as a vacuum barrier between the low pressure beam path of
the synchrotron and the atmosphere.
[0057] Protons are delivered with control to the patient interface
module 150 and to a tumor of a patient. All of the above listed
elements are optional and may be used in various permutations and
combinations.
[0058] Ion Extraction from Ion Source
[0059] For clarity of presentation and without loss of generality,
examples focus on protons from the ion source. However, more
generally cations of any charge are optionally extracted from a
corresponding ion source with the techniques described herein. For
instance, C.sup.4+ or C.sup.6+ are optionally extracted using the
ion extraction methods and apparatus described herein. Further, by
reversing polarity of the system, anions are optionally extracted
from an anion source, where the anion is of any charge.
[0060] Herein, for clarity of presentation and without loss of
generality, ion extraction is coupled with tumor treatment and/or
tumor imaging. However, the ion extraction is optional used in any
method or apparatus using a stream or time discrete bunches of
ions.
[0061] Beam Transport
[0062] The beam transport system 135 is used to move the charged
particles from the accelerator to the patient, such as via a nozzle
in a gantry, described infra.
[0063] Nozzle
[0064] After extraction from the synchrotron 130 and transport of
the charged particle beam along the proton beam path 268 in the
beam transport system 135, the charged particle beam exits through
the nozzle system 146. In one example, the nozzle system includes a
nozzle foil covering an end of the nozzle system 146 or a
cross-sectional area within the nozzle system forming a vacuum
seal. The nozzle system includes a nozzle that expands in
x/y-cross-sectional area along the z-axis of the proton beam path
268 to allow the proton beam 268 to be scanned along the x-axis and
y-axis by the vertical control element and horizontal control
element, respectively. The nozzle foil is preferably mechanically
supported by the outer edges of an exit port of the nozzle or
nozzle system 146. An example of a nozzle foil is a sheet of about
0.1 inch thick aluminum foil. Generally, the nozzle foil separates
atmosphere pressures on the patient side of the nozzle foil from
the low pressure region, such as about 10.sup.-5 to 10.sup.-7 torr
region, on the synchrotron 130 side of the nozzle foil. The low
pressure region is maintained to reduce scattering of the
circulating charged particle beam in the synchrotron. Herein, the
exit foil of the nozzle is optionally the first sheet 760 of the
charged particle beam state determination system 750, described
infra.
[0065] Tomography/Beam State
[0066] In one embodiment, the charged particle tomography apparatus
is used to image a tumor in a patient. As current beam position
determination/verification is used in both tomography and cancer
therapy treatment, for clarity of presentation and without
limitation beam state determination is also addressed in this
section. However, beam state determination is optionally used
separately and without tomography.
[0067] In another example, the charged particle tomography
apparatus is used in combination with a charged particle cancer
therapy system using common elements. For example, tomographic
imaging of a cancerous tumor is performed using charged particles
generated with an injector, accelerator, and guided with a delivery
system that are part of the cancer therapy system, described
supra.
[0068] In various examples, the tomography imaging system is
optionally simultaneously operational with a charged particle
cancer therapy system using common elements, allows tomographic
imaging with rotation of the patient, is operational on a patient
in an upright, semi-upright, and/or horizontal position, is
simultaneously operational with X-ray imaging, and/or allows use of
adaptive charged particle cancer therapy. Further, the common
tomography and cancer therapy apparatus elements are optionally
operational in a multi-axis and/or multi-field raster beam
mode.
[0069] In conventional medical X-ray tomography, a sectional image
through a body is made by moving one or both of an X-ray source and
the X-ray film in relative to the patient during the exposure. By
modifying the direction and extent of the movement, operators can
select different focal planes, which contain the structures of
interest. More modern variations of tomography involve gathering
projection data from multiple directions by moving the X-ray source
and feeding the data into a tomographic reconstruction software
algorithm processed by a computer. Herein, in stark contrast to
known methods, the radiation source is a charged particle, such as
a proton ion beam or a carbon ion beam. A proton beam is used
herein to describe the tomography system, but the description
applies to a heavier ion beam, such as a carbon ion beam. Further,
in stark contrast to known techniques, herein the radiation source
is optionally stationary while the patient is rotated.
[0070] Referring now to FIG. 2, an example of a tomography
apparatus is described and an example of a beam state determination
is described. In this example, the tomography system 200 uses
elements in common with the charged particle beam system 100,
including elements of one or more of the injection system 120, the
accelerator 130, a positively charged particle beam transport path
268 within a beam transport housing 261 in the beam transport
system 135, the targeting/delivery system 140, the patient
interface module 150, the display system 160, and/or the imaging
system 170, such as the X-ray imaging system.
[0071] The scintillation material is optionally one or more
scintillation plates, such as a scintillating plastic, used to
measure energy, intensity, and/or position of the charged particle
beam. For instance, a scintillation material 210 or scintillation
plate is positioned behind the patient 230 relative to the
targeting/delivery system 140 elements, which is optionally used to
measure intensity and/or position of the charged particle beam
after transmitting through the patient. Optionally, a second
scintillation plate or a charged particle induced photon emitting
sheet, described infra, is positioned prior to the patient 230
relative to the targeting/delivery system 140 elements, which is
optionally used to measure incident intensity and/or position of
the charged particle beam prior to transmitting through the
patient. The charged particle beam system 100 as described has
proven operation at up to and including 330 MeV, which is
sufficient to send protons through the body and into contact with
the scintillation material. Particularly, 250 MeV to 330 MeV are
used to pass the beam through a standard sized patient with a
standard sized pathlength, such as through the chest. The intensity
or count of protons hitting the plate as a function of position is
used to create an image. The velocity or energy of the proton
hitting the scintillation plate is also used in creation of an
image of the tumor 220 and/or an image of the patient 230. The
patient 230 is rotated about the y-axis and a new image is
collected. Preferably, a new image is collected with about every
one degree of rotation of the patient resulting in about 360 images
that are combined into a tomogram using tomographic reconstruction
software. The tomographic reconstruction software uses overlapping
rotationally varied images in the reconstruction. Optionally, a new
image is collected at about every 2, 3, 4, 5, 10, 15, 30, or 45
degrees of rotation of the patient.
[0072] Herein, the scintillation material 210 or scintillator is
any material that emits a photon when struck by a positively
charged particle or when a positively charged particle transfers
energy to the scintillation material sufficient to cause emission
of light. Optionally, the scintillation material 210 emits the
photon after a delay, such as in fluorescence or phosphorescence.
However, preferably, the scintillator has a fast fifty percent
quench time, such as less than 0.0001, 0.001, 0.01, 0.1, 1, 10,
100, or 1,000 milliseconds, so that the light emission goes dark,
falls off, or terminates quickly. Preferred scintillation materials
include sodium iodide, potassium iodide, cesium iodide, an iodide
salt, and/or a doped iodide salt. Additional examples of the
scintillation materials include, but are not limited to: an organic
crystal, a plastic, a glass, an organic liquid, a luminophor,
and/or an inorganic material or inorganic crystal, such as barium
fluoride, BaF.sub.2; calcium fluoride, CaF.sub.2, doped calcium
fluoride, sodium iodide, NaI; doped sodium iodide, sodium iodide
doped with thallium, NaI(TI); cadmium tungstate, CdWO.sub.4;
bismuth germanate; cadmium tungstate, CdWO.sub.4; calcium
tungstate, CaWO.sub.4; cesium iodide, CsI; doped cesium iodide;
cesium iodide doped with thallium, CsI(Tl); cesium iodide doped
with sodium CsI(Na); potassium iodide, KI; doped potassium iodide,
gadolinium oxysulfide, Gd.sub.2O.sub.2S; lanthanum bromide doped
with cerium, LaBr.sub.3(Ce); lanthanum chloride, LaCl.sub.3; cesium
doped lanthanum chloride, LaCl.sub.3(Ce); lead tungstate,
PbWO.sub.4; LSO or lutetium oxyorthosilicate (Lu.sub.2SiO.sub.5);
LYSO, Lu.sub.1.8Y.sub.0.2SiO.sub.5(Ce); yttrium aluminum garnet,
YAG(Ce); zinc sulfide, ZnS(Ag); and zinc tungstate, ZnWO.sub.4.
[0073] In one embodiment, a tomogram or an individual tomogram
section image is collected at about the same time as cancer therapy
occurs using the charged particle beam system 100. For example, a
tomogram is collected and cancer therapy is subsequently performed:
without the patient moving from the positioning systems, such as in
a semi-vertical partial immobilization system, a sitting partial
immobilization system, or the a laying position. In a second
example, an individual tomogram slice is collected using a first
cycle of the accelerator 130 and using a following cycle of the
accelerator 130, the tumor 220 is irradiated, such as within about
1, 2, 5, 10, 15 or 30 seconds. In a third case, about 2, 3, 4, or 5
tomogram slices are collected using 1, 2, 3, 4, or more rotation
positions of the patient 230 within about 5, 10, 15, 30, or 60
seconds of subsequent tumor irradiation therapy.
[0074] In another embodiment, the independent control of the
tomographic imaging process and X-ray collection process allows
simultaneous single and/or multi-field collection of X-ray images
and tomographic images easing interpretation of multiple images.
Indeed, the X-ray and tomographic images are optionally overlaid
and/or integrated to from a hybrid X-ray/proton beam tomographic
image as the patient 230 is optionally in the same position for
each image.
[0075] In still another embodiment, the tomogram is collected with
the patient 230 in the about the same position as when the
patient's tumor is treated using subsequent irradiation therapy.
For some tumors, the patient being positioned in the same upright
or semi-upright position allows the tumor 220 to be separated from
surrounding organs or tissue of the patient 230 better than in a
laying position. Positioning of the scintillation material 210
behind the patient 230 allows the tomographic imaging to occur
while the patient is in the same upright or semi-upright
position.
[0076] The use of common elements in the tomographic imaging and in
the charged particle cancer therapy allows benefits of the cancer
therapy, described supra, to optionally be used with the
tomographic imaging, such as proton beam x-axis control, proton
beam y-axis control, control of proton beam energy, control of
proton beam intensity, timing control of beam delivery to the
patient, rotation control of the patient, and control of patient
translation all in a raster beam mode of proton energy delivery.
The use of a single proton or cation beamline for both imaging and
treatment eases patient setup, reduces alignment uncertainties,
reduces beam state uncertainties, and eases quality assurance.
[0077] In yet still another embodiment, initially a
three-dimensional tomographic X-ray and/or proton based reference
image is collected, such as with hundreds of individual rotation
images of the tumor 220 and patient 230. Subsequently, just prior
to proton treatment of the cancer, just a few 2-dimensional control
tomographic images of the patient are collected, such as with a
stationary patient or at just a few rotation positions, such as an
image straight on to the patient, with the patient rotated about 45
degrees each way, and/or the X-ray source and/or patient rotated
about 90 degrees each way about the y-axis. The individual control
images are compared with the 3-dimensional reference image. An
adaptive proton therapy is optionally subsequently performed where:
(1) the proton cancer therapy is not used for a given position
based on the differences between the 3-dimensional reference image
and one or more of the 2-dimensional control images and/or (2) the
proton cancer therapy is modified in real time based on the
differences between the 3-dimensional reference image and one or
more of the 2-dimensional control images.
[0078] Charged Particle State Determination/Verification/Photonic
Monitoring
[0079] Still referring to FIG. 2, the tomography system 200 is
optionally used with a charged particle beam state determination
system 250, optionally used as a charged particle verification
system. The charged particle state determination system 250
optionally measures, determines, and/or verifies one of more of:
(1) position of the charged particle beam, such as a treatment beam
269, (2) direction of the treatment beam 269, (3) intensity of the
treatment beam 269, (4) energy of the treatment beam 269, (5)
position, direction, intensity, and/or energy of the charged
particle beam, such as a residual charged particle beam 267 after
passing through a sample or the patient 230, and/or (6) a history
of the charged particle beam.
[0080] For clarity of presentation and without loss of generality,
a description of the charged particle beam state determination
system 250 is described and illustrated separately in FIG. 3 and
FIG. 4A; however, as described herein elements of the charged
particle beam state determination system 250 are optionally and
preferably integrated into the nozzle system 146 and/or the
tomography system 200 of the charged particle treatment system 100.
More particularly, any element of the charged particle beam state
determination system 250 is integrated into the nozzle system 146,
a dynamic gantry nozzle, and/or tomography system 200, such as a
surface of the scintillation material 210 or a surface of a
scintillation detector, plate, or system. The nozzle system 146 or
the dynamic gantry nozzle provides an outlet of the charged
particle beam from the vacuum tube initiating at the injection
system 120 and passing through the synchrotron 130 and beam
transport system 135. Any plate, sheet, fluorophore, or detector of
the charged particle beam state determination system is optionally
integrated into the nozzle system 146. For example, an exit foil of
the nozzle is optionally a first sheet 252 of the charged particle
beam state determination system 250 and a first coating 254 is
optionally coated onto the exit foil, as illustrated in FIG. 2.
Similarly, optionally a surface of the scintillation material 210
is a support surface for a fourth coating 292, as illustrated in
FIG. 2. The charged particle beam state determination system 250 is
further described, infra.
[0081] Referring now to FIG. 2, FIG. 3, and FIG. 4A, four sheets, a
first sheet 252, a second sheet 270, a third sheet 280, and a
fourth sheet 290 are used to illustrate detection sheets and/or
photon emitting sheets upon transmittance of a charged particle
beam. Each sheet is optionally coated with a photon emitter, such
as a fluorophore, such as the first sheet 252 is optionally coated
with a first coating 254. Without loss of generality and for
clarity of presentation, the four sheets are each illustrated as
units, where the light emitting layer is not illustrated. Thus, for
example, the second sheet 270 optionally refers to a support sheet,
a light emitting sheet, and/or a support sheet coated by a light
emitting element. The four sheets are representative of n sheets,
where n is a positive integer.
[0082] Referring now to FIG. 2 and FIG. 3, the charged particle
beam state verification system 250 is a system that allows for
monitoring of the actual charged particle beam position in
real-time without destruction of the charged particle beam. The
charged particle beam state verification system 250 preferably
includes a first position element or first beam verification layer,
which is also referred to herein as a coating, luminescent,
fluorescent, phosphorescent, radiance, or viewing layer. The first
position element optionally and preferably includes a coating or
thin layer substantially in contact with a sheet, such as an inside
surface of the nozzle foil, where the inside surface is on the
synchrotron side of the nozzle foil. Less preferably, the
verification layer or coating layer is substantially in contact
with an outer surface of the nozzle foil, where the outer surface
is on the patient treatment side of the nozzle foil. Preferably,
the nozzle foil provides a substrate surface for coating by the
coating layer. Optionally, a binding layer is located between the
coating layer and the nozzle foil, substrate, or support sheet.
Optionally, the position element is placed anywhere in the charged
particle beam path. Optionally, more than one position element on
more than one sheet, respectively, is used in the charged particle
beam path and is used to determine a state property of the charged
particle beam, as described infra.
[0083] Still referring to FIG. 2 and FIG. 3, the coating, referred
to as a fluorophore, yields a measurable spectroscopic response,
spatially viewable by a detector or camera, as a result of
transmission by the proton beam. The coating is preferably a
phosphor, but is optionally any material that is viewable or imaged
by a detector where the material changes, as viewed
spectroscopically, as a result of the charged particle beam hitting
or transmitting through the coating or coating layer. A detector or
camera views secondary photons emitted from the coating layer and
determines a position of a treatment beam 269, which is also
referred to as a current position of the charged particle beam or
final treatment vector of the charged particle beam, by the
spectroscopic differences resulting from protons and/or charged
particle beam passing through the coating layer. For example, the
camera views a surface of the coating surface as the proton beam or
positively charged cation beam is being scanned by the first axis
control 143, vertical control, and the second axis control 144,
horizontal control, beam position control elements during treatment
of the tumor 220. The camera views the current position of the
charged particle beam or treatment beam 269 as measured by
spectroscopic response. The coating layer is preferably a phosphor
or luminescent material that glows and/or emits photons for a short
period of time, such as less than 5 seconds for a 50% intensity, as
a result of excitation by the charged particle beam. The detector
observes the temperature change and/or observe photons emitted from
the charged particle beam traversed spot. Optionally, a plurality
of cameras or detectors are used, where each detector views all or
a portion of the coating layer. For example, two detectors are used
where a first detector views a first half of the coating layer and
the second detector views a second half of the coating layer.
Preferably, at least a portion of the detector is mounted into the
nozzle system to view the proton beam position after passing
through the first axis and second axis controllers 143, 144.
Preferably, the coating layer is positioned in the proton beam path
268 in a position prior to the protons striking the patient
230.
[0084] Referring now to FIG. 1 and FIG. 2, the main controller 110,
connected to the camera or detector output, optionally and
preferably compares the final proton beam position or position of
the treatment beam 269 with the planned proton beam position and/or
a calibration reference, such as a calibrated beamline, to
determine if the actual proton beam position or position of the
treatment beam 269 is within tolerance. The charged particle beam
state determination system 250 preferably is used in one or more
phases, such as a calibration phase, a mapping phase, a beam
position verification phase, a treatment phase, and a treatment
plan modification phase. The calibration phase is used to
correlate, as a function of x-, y-position of the first axis
control 143 and the second axis control 144 response the actual x-,
y-position of the proton beam at the patient interface.
[0085] During the treatment phase, the charged particle beam
position is monitored and compared to the calibration and/or
treatment plan to verify accurate proton delivery to the tumor 220
and/or as a charged particle beam shutoff safety indicator.
Referring now to FIG. 5, the position verification system 179
and/or a treatment delivery control system 112, upon determination
of a tumor shift, an unpredicted tumor distortion upon treatment,
and/or a treatment anomaly optionally generates and or provides a
recommended treatment change 1070. The treatment change 1070 is
optionally sent out while the patient 230 is still in the treatment
position, such as to a proximate physician or over the internet to
a remote physician, for physician approval 1072, receipt of which
allows continuation of the now modified and approved treatment
plan.
Example I
[0086] Referring now to FIG. 2, a first example of the charged
particle beam state determination system 250 is illustrated using
two cation induced signal generation surfaces, referred to herein
as the first sheet 252 and a third sheet 780. Each sheet is
described below.
[0087] Still referring to FIG. 2, in the first example, the
optional first sheet 252, located in the charged particle beam path
prior to the patient 230, is coated with a first fluorophore
coating 254, wherein a cation, such as in the charged particle
beam, transmitting through the first sheet 252 excites localized
fluorophores of the first fluorophore coating 254 with resultant
emission of one or more photons. In this example, a first detector
212 images the first fluorophore coating 254 and the main
controller 110 determines a current position of the charged
particle beam using the image of the fluorophore coating 254 and
the detected photon(s). The intensity of the detected photons
emitted from the first fluorophore coating 254 is optionally used
to determine the intensity of the charged particle beam used in
treatment of the tumor 220 or detected by the tomography system 200
in generation of a tomogram and/or tomographic image of the tumor
220 of the patient 230. Thus, a first position and/or a first
intensity of the charged particle beam is determined using the
position and/or intensity of the emitted photons, respectively.
[0088] Still referring to FIG. 2, in the first example, the
optional third sheet 280, positioned posterior to the patient 230,
is optionally a cation induced photon emitting sheet as described
in the previous paragraph. However, as illustrated, the third sheet
280 is a solid state beam detection surface, such as a detector
array. For instance, the detector array is optionally a charge
coupled device, a charge induced device, CMOS, or camera detector
where elements of the detector array are read directly, as does a
commercial camera, without the secondary emission of photons.
Similar to the detection described for the first sheet, the third
sheet 280 is used to determine a position of the charged particle
beam and/or an intensity of the charged particle beam using signal
position and/or signal intensity from the detector array,
respectively.
[0089] Still referring to FIG. 2, in the first example, signals
from the first sheet 252 and third sheet 280 yield a position
before and after the patient 230 allowing a more accurate
determination of the charged particle beam through the patient 230
therebetween. Optionally, knowledge of the charged particle beam
path in the targeting/delivery system 140, such as determined via a
first magnetic field strength across the first axis control 143 or
a second magnetic field strength across the second axis control 144
is combined with signal derived from the first sheet 252 to yield a
first vector of the charged particles prior to entering the patient
230 and/or an input point of the charged particle beam into the
patient 230, which also aids in: (1) controlling, monitoring,
and/or recording tumor treatment and/or (2) tomography
development/interpretation. Optionally, signal derived from use of
the third sheet 280, posterior to the patient 230, is combined with
signal derived from tomography system 200, such as the
scintillation material 210, to yield a second vector of the charged
particles posterior to the patient 230 and/or an output point of
the charged particle beam from the patient 230, which also aids in:
(1) controlling, monitoring, deciphering, and/or (2) interpreting a
tomogram or a tomographic image.
[0090] For clarity of presentation and without loss of generality,
detection of photons emitted from sheets is used to further
describe the charged particle beam state determination system 250.
However, any of the cation induced photon emission sheets described
herein are alternatively detector arrays. Further, any number of
cation induced photon emission sheets are used prior to the patient
230 and/or posterior to the patient 230, such a 1, 2, 3, 4, 6, 8,
10, or more. Still further, any of the cation induced photon
emission sheets are place anywhere in the charged particle beam,
such as in the synchrotron 130, in the beam transport system 135,
in the targeting/delivery system 140, the nozzle system 146, in the
treatment room, and/or in the tomography system 200. Any of the
cation induced photon emission sheets are used in generation of a
beam state signal as a function of time, which is optionally
recorded, such as for an accurate history of treatment of the tumor
220 of the patient 230 and/or for aiding generation of a
tomographic image.
Example II
[0091] Referring now to FIG. 3, a second example of the charged
particle beam state determination system 250 is illustrated using
three cation induced signal generation surfaces, referred to herein
as the second sheet 270, the third sheet 280, and the fourth sheet
290. Any of the second sheet 270, the third sheet 280, and the
fourth sheet 290 contain any of the features of the sheets
described supra.
[0092] Still referring to FIG. 3, in the second example, the second
sheet 270, positioned prior to the patient 230, is optionally
integrated into the nozzle and/or the nozzle system 146, but is
illustrated as a separate sheet. Signal derived from the second
sheet 270, such as at point A, is optionally combined with signal
from the first sheet 252 and/or state of the targeting/delivery
system 140 to yield a first line or vector, v.sub.1a, from point A
to point B of the charged particle beam prior to the sample or
patient 230 at a first time, t.sub.1, and a second line or vector,
v.sub.2a, from point F to point G of the charged particle beam
prior to the sample at a second time, t.sub.2.
[0093] Still referring to FIG. 3, in the second example, the third
sheet 280 and the fourth sheet 290, positioned posterior to the
patient 230, are optionally integrated into the tomography system
200, but are illustrated as a separate sheets. Signal derived from
the third sheet 280, such as at point D, is optionally combined
with signal from the fourth sheet 290 and/or signal from the
tomography system 200 to yield a first line segment or vector,
v.sub.1b, from point C.sub.2 to point D and/or from point D to
point E of the charged particle beam posterior to the patient 230
at the first time, t.sub.1, and a second line segment or vector,
v.sub.2b, such as from point H to point I of the charged particle
beam posterior to the sample at a second time, t.sub.2. Signal
derived from the third sheet 280 and/or from the fourth sheet 290
and the corresponding first vector at the second time, t.sub.2, is
used to determine an output point, C.sub.2, which may and often
does differ from an extension of the first vector, v.sub.1a, from
point A to point B through the patient to a non-scattered beam path
of point C.sub.1. The difference between point C.sub.1 and point
C.sub.2 and/or an angle, a, between the first vector at the first
time, v.sub.1a, and the first vector at the second time, v.sub.1b,
is used to determine/map/identify, such as via tomographic
analysis, internal structure of the patient 230, sample, and/or the
tumor 220, especially when combined with scanning the charged
particle beam in the x/y-plane as a function of time, such as
illustrated by the second vector at the first time, v.sub.2a, and
the second vector at the second time, v.sub.2b, forming angle
.beta. and/or with rotation of the patient 230, such as about the
y-axis, as a function of time.
[0094] Still referring to FIG. 3, multiple detectors/detector
arrays are illustrated for detection of signals from multiple
sheets, respectively. However, a single detector/detector array is
optionally used to detect signals from multiple sheets, as further
described infra. As illustrated, a set of detectors 211 is
illustrated, including a second detector 214 imaging the second
sheet 270, a third detector 216 imaging the third sheet 280, and a
fourth detector 218 imaging the fourth sheet 290. Any of the
detectors described herein are optionally detector arrays, are
optionally coupled with any optical filter, and/or optionally use
one or more intervening optics to image any of the four sheets 252,
270, 280, 290. Further, two or more detectors optionally image a
single sheet, such as a region of the sheet, to aid optical
coupling, such as F-number optical coupling.
[0095] Still referring to FIG. 3, a vector or line segment of the
charged particle beam is determined. Particularly, in the
illustrated example, the third detector 216, determines, via
detection of secondary emitted photons, that the charged particle
beam transmitted through point D and the fourth detector 218
determines that the charged particle beam transmitted through point
E, where points D and E are used to determine the first vector or
line segment at the second time, v.sub.1b, as described supra. To
increase accuracy and precision of a determined vector of the
charged particle beam, a first determined beam position and a
second determined beam position are optionally and preferably
separated by a distance, d.sub.1, such as greater than 0.1, 0.5, 1,
2, 3, 5, 10, or more centimeters. A support element 252 is
illustrated that optionally connects any two or more elements of
the charged particle beam state determination system 250 to each
other and/or to any element of the charged particle beam system
100, such as a rotating platform 256 used to position and/or
co-rotate the patient 230 and any element of the tomography system
200.
Example III
[0096] Still referring to FIG. 4A, a third example of the charged
particle beam state determination system 250 is illustrated in an
integrated tomography-cancer therapy system 400.
[0097] Referring to FIG. 4A, multiple sheets and multiple detectors
are illustrated determining a charged particle beam state prior to
the patient 230. As illustrated, a first camera 212 spatially
images photons emitted from the first sheet 260 at point A,
resultant from energy transfer from the passing charged particle
beam, to yield a first signal and a second camera 214 spatially
images photons emitted from the second sheet 270 at point B,
resultant from energy transfer from the passing charged particle
beam, to yield a second signal. The first and second signals allow
calculation of the first vector or line segment, v.sub.1a, with a
subsequent determination of an entry point 232 of the charged
particle beam into the patient 230. Determination of the first
vector, v.sub.1a, is optionally supplemented with information
derived from states of the magnetic fields about the first axis
control 143, the vertical control, and the second axis control 144,
the horizontal axis control, as described supra.
[0098] Still referring to FIG. 4A, the charged particle beam state
determination system is illustrated with multiple resolvable
wavelengths of light emitted as a result of the charged particle
beam transmitting through more than one molecule type, light
emission center, and/or fluorophore type. For clarity of
presentation and without loss of generality a first fluorophore in
the third sheet 280 is illustrated as emitting blue light, b, and a
second fluorophore in the fourth sheet 290 is illustrated as
emitting red light, r, that are both detected by the third detector
216.
[0099] The third detector is optionally coupled with any wavelength
separation device, such as an optical filter, grating, or Fourier
transform device. For clarity of presentation, the system is
described with the red light passing through a red transmission
filter blocking blue light and the blue light passing through a
blue transmission filter blocking red light. Wavelength separation,
using any means, allows one detector to detect a position of the
charged particle beam resultant in a first secondary emission at a
first wavelength, such as at point C, and a second secondary
emission at a second wavelength, such as at point D. By extension,
with appropriate optics, one camera is optionally used to image
multiple sheets and/or sheets both prior to and posterior to the
sample. Spatial determination of origin of the red light and the
blue light allow calculation of the first vector at the second
time, v.sub.1b, and an actual exit point 236 from the patient 230
as compared to a non-scattered exit point 234 from the patient 230
as determined from the first vector at the first time,
v.sub.1a.
[0100] Ion Beam State Determination/Energy Dissipation System
[0101] Referring now to FIG. 4B-4H an ion beam state
determination/kinetic energy dissipation system is described.
Generally, a dual use chamber is described functioning at a first
time, when filled with gas, as an element in an ion beam state
determination system and functioning at a second time, when filled
with liquid, as an element of a kinetic energy dissipation system.
The dual purpose/use chamber is further described herein.
[0102] Ionization Strip Detector
[0103] Referring now to FIGS. 4(A-C), an ion beam location
determination system is described. In FIG. 4A, x/y-beam positions
are determined using a first sheet 260 and a second sheet 270, such
as where the sheets emit photons. In FIG. 4B, the first sheet 260
comprises a first axis, or x-axis, ionization strip detector 410.
In the first ionization strip detector 410, an x-axis position of
the positive ion beam is determined using vertical strips, where
interaction of the positive ion with one or more vertical strips of
the x-axis interacting strips 411 results in electron emission, the
current carried by the interacting strip and converted to an x-axis
position signal, such as with an x-axis register 412, detector,
integrator, and/or amplifier. Similarly, in the second ionization
strip detector 415, a y-axis position of the positive ion beam is
determined using horizontal strips, where interaction of the
positive ion results with one or more horizontal strips of the
y-axis ionization strips 416 results in another electron emission,
the resulting current carried by the y-axis interacting strip and
converted to a y-axis position signal, such as with a y-axis
register 417, detector, integrator, and/or amplifier.
[0104] Dual Use Ion Chamber
[0105] Referring now to FIG. 4D a dual use ionization chamber 420
is illustrated. The dual use ionization chamber 420 is optionally
positioned anywhere in an ion beam path, in a negatively charged
particle beam path, and/or in a positively charged particle beam
path, where the positively charged particle beam path is used
herein for clarity of presentation. Herein, for clarity of
presentation and without loss of generality, the dual use
ionization chamber 420 is integrated into and/or is adjacent the
nozzle system 146. The dual use ionization chamber 420 comprises
any material, but is optionally and preferably a plastic, polymer,
polycarbonate, and/or an acrylic. The dual use ionization chamber
420 comprises: a charged particle beam entrance side 423 and a
charged particle beam exit side 425. The positively charged
particle beam path optionally and preferably passes through an
entrance aperture 424 in the beam entrance side of the dual use
ionization chamber 420 and exits the dual use ionization chamber
420 through an exit aperture 426 in the charged particle beam exit
side 425. The entrance aperture 424 and/or the exit aperture 426
are optionally covered with a liquid tight and/or gas tight optic
or film, such as a window, glass, optical cell surface, film,
membrane, a polyimide film, an aluminum coated film, and/or an
aluminum coated polyimide film.
Example I
[0106] In a first example, referring now to FIG. 4D and FIG. 4E,
the entrance aperture 424 and exit aperture 426 of the charged
particle beam entrance side 423 and the charged particle beam exit
side 425, respectively, of the dual use ionization chamber 420 are
further described. More particularly, the first ionization strip
detector 410 and the second ionization strip detector 415 are
coupled with the dual use ionization chamber 420. As illustrated,
the first ionization strip detector 410 and the second ionization
strip detector 415 cover the entrance aperture 424 and optionally
and preferably form a liquid and/or gas tight seal to the entrance
side 423 of the dual use ionization chamber 420.
Example II
[0107] In a second example, referring still to FIG. 4D and FIG. 4E,
the entrance aperture 424 and exit aperture 426 of the charged
particle beam entrance side 423 and the charged particle beam exit
side 425, respectively, of the dual use ionization chamber 420 are
further described. More particularly, in this example, the first
ionization strip detector 410 and the second ionization strip
detector 415 are integrated into the exit aperture 426 of the use
ionization chamber 420. As illustrated, an aluminum coated film 421
is also integrated into the exit aperture 426.
Example III
[0108] In a third example, referring still to FIG. 4D and FIG. 4E,
the first ionization detector 410 and the second ionization
detector 415 are optionally used to: (1) cover and/or function as
an element of a seal of the entrance aperture 424 and/or the exit
aperture 426 and/or (2) function to determine a position and/or
state of the positively charged ion beam at and/or near one or both
of the entrance aperture 424 and the exit aperture 426 of the dual
use ionization chamber 420.
[0109] Referring now to FIG. 4F, two uses of the dual use
ionization chamber 420 are described. At a first time, the dual use
ionization chamber 420 is filled, at least to above a path of the
charged particle beam, with a liquid. The liquid is used to reduce
and/or dissipate the kinetic energy of the positively charged
particle beam. At a second time, the dual use ionization chamber
420 is filled, at least in a volume of the charged particle beam,
with a gas. The gas, such as helium, functions to maintain the
charged particle beam integrity, focus, state, and/or dimensions as
the helium scatters the positively charged particle beam less than
air, where the pathlength of the dual use ionization chamber 420 is
necessary to separate elements of the nozzle system, such as the
first axis control 143, the second axis control 144, the first
sheet 260, the second sheet 270, the third sheet 280, the fourth
sheet 290, and/or one or more instances of the first ionization
detector 410 and the second ionization detector 415.
[0110] Kinetic Energy Dissipater
[0111] Referring still to FIG. 4F, the kinetic energy dissipation
aspect of the dual use ionization chamber 420 is further described.
At a first time, a liquid, such as water is moved, such as with a
pump, into the dual use ionization chamber 420. The water interacts
with the proton beam to slow and/or stop the proton beam.
[0112] At a second time, the liquid is removed, such as with a pump
and/or drain, from the dual use ionization chamber 420. Through use
of more water than will fit into the dual use ionization chamber
420, the radiation level of the irradiated water per unit volume is
decreased. The decreased radiation level allows more rapid access
to the ionization chamber, which is very useful for maintenance and
even routine use of a high power proton beam cancer therapy system.
The inventor notes that immediate access to the chamber is allowed
versus a standard and mandatory five hour delay to allow radiation
dissipation using a traditional solid phase proton beam energy
reducer.
Example I
[0113] Still referring to FIG. 4F, an example of use of a liquid
movement/exchange system 430 is provided, where the liquid exchange
system 430 is used to dissipate kinetic energy and/or to disperse
radiation. Generally, the liquid exchange system moves water from
the use purpose ionization chamber 420, having a first volume 427,
using one or more water lines 436, to a liquid reservoir tank 432
having a second volume 434. Generally, any radiation build-up in
the first volume 427 is diluted by circulating water through the
water lines 436 to the second volume 434, where the second volume
is at least 0.25, 0.5, 1, 2, 3, 5, or 10 times the size of the
first volume. As illustrated, more than one drain line is attached
to the dual use ionization chamber 420, which allows the dual use
ionization chamber 420 to drain regardless of orientation of the
nozzle system 146 as the dual use ionization chamber 420 optionally
and preferably co-moves with the nozzle system 146 and/or is
integrated into the nozzle system 146. Optionally, the liquid
movement/exchange system 430 is used to remove radiation from the
treatment room 922, to reduce radiation levels of discharged fluids
to acceptable levels via dilution, and/or to move the temporarily
radioactive fluid to another area or room for later reuse in the
liquid movement/exchange system 430.
Example II
[0114] Still referring to FIG. 4F, an example of a gas
movement/exchange system 440 is provided, where the gas exchange
system 440 is used to fill/empty gas, such as helium, from the dual
use ionization chamber 420. As illustrated, helium, from a
pressurized helium tank 442 and/or a helium displacement chamber
444, is moved, such as via a regulator 446 or pump and/or via
displacement by water, to/from the dual use ionization chamber 420
using one or more gas lines. For instance, as water is pumped into
the dual use ionization chamber 420 from the liquid reservoir tank
432, the water displaces the helium forcing the helium back into
the helium displacement chamber 444. Alternatingly, the helium is
moved back into the dual use ionization chamber 420 by draining the
water, as described supra, and/or by increasing the helium
pressure, such as through use of the pressurized helium tank 442. A
desiccator is optionally used in the system.
[0115] It should be appreciated that the gas/liquid reservoirs,
movement lines, connections, and pumps are illustrative in nature
of any liquid movement system and/or any gas movement system.
Further, the water, used in the examples for clarity of
presentation, is more generally any liquid, combination of liquids,
hydrocarbon, mercury, and/or liquid bromide. Similarly, the helium,
used in the examples for clarity of presentation, is more generally
any gas, mixture of gases, neon, and/or nitrogen.
[0116] Generally, the liquid in the liquid exchange system 430,
replaces graphite, copper, or metal used as a kinetic energy
reducer in the cancer therapy system 100. Still more generally, the
liquid exchange system 420 is optionally used with any positive
particle beam type, any negative particle beam type, and/or with
any accelerator type, such as a cyclotron or a synchrotron, to
reduce kinetic energy of the ion beam while diluting and/or
removing radiation from the system.
[0117] Beam Energy Reduction
[0118] Still referring to FIG. 4F and referring now to FIG. 4H, the
kinetic energy dissipation aspect of the dual use ionization
chamber 420 is further described. A pathlength, b, between the
entrance aperture 424 and exit aperture 426, of 55 cm through water
is sufficient to block a 330 MeV proton beam, where a 330 MeV
proton beam is sufficient for proton transmission tomography
through a patient. Thus, smaller pathlengths are optionally used to
reduce the energy of the proton beam.
[0119] Still referring to FIG. 4F, in a first optional embodiment,
a series of liquid cells of differing pathlengths are optionally
moved into and out of the proton beam to reduce energy of the
proton beam and thus control a depth of penetration into the
patient 230. For example, any combination of liquid cells, such as
the dual use ionization chamber 420, having pathlengths of 1, 2, 4,
8, 16, or 32 cm or any pathlength from 0.1 to 100 cm are optionally
used. Once an energy degradation pathlength is set to establish a
main distance into the patient 230, energy controllers of the
proton beam are optionally used to scan varying depths into the
tumor.
[0120] Still referring to FIG. 4F and referring again to FIG. 4H,
in a second, preferred, optional embodiment, one or more pathlength
adjustable liquid cells, such as the dual use ionization chamber
420, are positioned in the proton beam path to use the proton beam
energy to a preferred energy to target a depth of penetration into
the patient 230. Two examples are used to further describe the
pathlength adjustable liquid cells yielding a continuous variation
of proton beam energy.
Example I
[0121] A first example of a continuously variable proton beam
energy controller 470 is illustrated in FIG. 4H. It should be
appreciated that a first triangular cross-section is used to
represent the dual use ionization chamber 420 for clarity of
presentation and without loss of generality. More generally, any
cross-section, continuous and/or discontinuous as a function of
x/y-axis position, is optionally used. Here, a continuous function,
pathlength variable with x- and/or y-axis movement first liquid
cell 428 comprises a triangular cross-section. As illustrated, at a
first time, t.sub.1, the proton beam path 268 has a first
pathlength, b.sub.1, through the first liquid cell 428. At a second
time, after translation of the first liquid cell 428 upward along
the y-axis, the proton beam path has a second pathlength, b.sub.2,
through the first liquid cell 428. Thus, by moving the first liquid
cell 428, having a non-uniform thickness, the proton beam path 268
passes through differing amounts of liquid, yielding a range of
kinetic energy dissipation. Simply, a longer pathlength, such as
the second pathlength, b.sub.2, being longer than the first
pathlength, b.sub.1, results in a greater slowing of the charged
particles in the proton beam path. Herein, an initial pathlength of
unit length one is replaced with the second pathlength that is
plus-or-minus at least 1, 2, 3, 4, 5, 10, 20, 30, 50, 100, or 200
percent of the first pathlength.
Example II
[0122] A second example of a continuously variable proton beam
energy controller 470 is illustrated in FIG. 4H. As illustrated, by
increasing or decreasing the first pathlength, b.sub.1, the
resultant proton beam path 268 is possibly offset downward or
upward respectively. To correct the proton beam path 268 back to an
original vector, such as the treatment beam path 269, a second
liquid cell 429 is used. As illustrated: (1) a third pathlength,
b.sub.3, through the second liquid cell 429 is equal to the first
pathlength, b.sub.1, at the first time, t.sub.1; (2) the sign of
the entrance angle of the proton beam path 268 is reversed when
entering the second liquid cell 429 compared to entering the first
liquid cell 428; and (3) the sign of the exit angle of the proton
beam 268 exiting the second liquid cell 429 is opposite the first
liquid cell 428. Further, as the first liquid cell 428 is moved in
a first direction, such as upward along the y-axis as illustrated,
to maintain a fourth pathlength, b.sub.4, in the second liquid cell
429 matching the second pathlength, b.sub.2, through the first
liquid cell 428 at a second time, t.sub.2, the second liquid cell
429 is moved in an opposite direction, such as downward along the
y-axis. More generally, the second liquid cell 429 optionally: (1)
comprises a shape of the first liquid cell 428; (2) is rotated
one-hundred eighty degrees relative to the first liquid cell 428;
and (3) is translated in an opposite direction of translation of
the first liquid cell 428 through the proton beam path 268 as a
function of time. Generally, 1, 2, 3, 4, 5, or more liquid cells of
any combination of shapes are used to slow the proton beam to a
desired energy and direct the resultant proton beam, such as the
treatment beam 269 along a chosen vector as a function of time.
Example III
[0123] Still referring to FIG. 4F and FIG. 4H, the proton beam, is
optionally accelerated to an energy level/speed and, using the
variable pathlength dual use ionization chamber 420, the first
liquid cell 428, and/or the second liquid cell 429, the energy of
the extracted beam is reduced to varying magnitudes, which is a
form of scanning the tumor 220, as a function of time. This allows
the synchrotron 130 to accelerate the protons to one energy and
after extraction control the energy of the proton beam, which
allows a more efficient use of the synchrotron 130 as increasing or
decreasing the energy with the synchrotron 130 typically results in
a beam dump and recharge and/or requires significant time and/or
energy, which slows treatment of the cancer while increasing cost
of the cancer.
[0124] Beam State Determination
[0125] Referring now to FIG. 4G, a beam state determination system
460 is described that uses one or more of the first liquid cell
428, the second liquid cell 429, and/or the dual use ionization
chamber 420. For clarity of presentation and without loss of
generality, as illustrated, the first liquid cell 428 comprises an
orthotope shape. The beam state determination system 460 comprises
at least a beam sensing element 461 responsive to the proton beam
connected to the main controller 110. Optionally and preferably,
the beam sensing element 461 is positioned into various
x,y,z-positions inside the liquid containing orthotope as a
function of time, which allows a mapping of properties of the
proton beam, such as: intensity, depth of penetration, energy,
radial distribution about an incident vector of the proton beam,
and/or a resultant mean angle. As illustrated, the beam sensing
element 461 is positioned in the proton beam path at a first time,
t.sub.1, using a three-dimensional probe positioner, comprising: a
telescoping z-axis sensor positioner 462, a y-axis positioning rail
464, and an x-axis positioning rail and is positioned out of the
proton beam path at a second time, t.sub.2 using the
three-dimensional probe positioner. Generally, the probe positioner
is any system capable of positioning the beam sensing element 461
as a function of time.
[0126] Still again to FIG. 4A and referring now to FIG. 4I, the
integrated tomography-cancer therapy system 400 is illustrated with
an optional configuration of elements of the charged particle beam
state determination system 250 being co-rotatable with the nozzle
system 146 of the cancer therapy system 100. More particularly, in
one case sheets of the charged particle beam state determination
system 250 positioned prior to, posterior to, or on both sides of
the patient 230 co-rotate with the scintillation material 210 about
any axis, such as illustrated with rotation about the y-axis.
Further, any element of the charged particle beam state
determination system 250, such as a detector, two-dimensional
detector, multiple two-dimensional detectors, and/or light coupling
optic move as the gantry moves, such as along a common arc of
movement of the nozzle system 146 and/or at a fixed distance to the
common arc. For instance, as the gantry moves, a monitoring camera
positioned on the opposite side of the tumor 220 or patient 230
from the nozzle system 146 maintains a position on the opposite
side of the tumor 220 or patient 230. In various cases, co-rotation
is achieved by co-rotation of the gantry of the charged particle
beam system and a support of the patient, such as the rotatable
platform 253, which is also referred to herein as a movable or
dynamically positionable patient platform, patient chair, or
patient couch. Mechanical elements, such as the support element 251
affix the various elements of the charged particle beam state
determination system 250 relative to each other, relative to the
nozzle system 146, and/or relative to the patient 230. For example,
the support elements 251 maintain a second distance, d.sub.2,
between a position of the tumor 220 and the third sheet 280 and/or
maintain a third distance, d.sub.3, between a position of the third
sheet 280 and the scintillation material 210. More generally,
support elements 251 optionally dynamically position any element
about the patient 230 relative to one another or in x,y,z-space in
a patient diagnostic/treatment room, such as via computer
control.
[0127] Referring now to FIG. 4I, positioning the nozzle system 146
of a gantry 490 or gantry system on an opposite side of the patient
230 from a detection surface, such as the scintillation material
210, in a gantry movement system 450 is described. Generally, in
the gantry movement system 450, as the gantry 490 rotates about an
axis the nozzle/nozzle system 146 and/or one or more magnets of the
beam transport system 135 are repositioned. As illustrated, the
nozzle system 146 is positioned by the gantry 490 in a first
position at a first time, t.sub.1, and in a second position at a
second time, t.sub.2, where n positions are optionally possible. An
electromechanical system, such as a patient table, patient couch,
patient couch, patient rotation device, and/or a scintillation
plate holder maintains the patient 230 between the nozzle system
146 and the scintillation material 210 of the tomography system
200. Similarly, not illustrated for clarity of presentation, the
electromechanical system maintains a position of the third sheet
280 and/or a position of the fourth sheet 290 on a posterior or
opposite side of the patient 230 from the nozzle system 146 as the
gantry 490 rotates or moves the nozzle system 146. Similarly, the
electromechanical system maintains a position of the first sheet
260 or first screen and/or a position of the second sheet 270 or
second screen on a same or prior side of the patient 230 from the
nozzle system 146 as the gantry 490 rotates or moves the nozzle
system 146. As illustrated, the electromechanical system optionally
positions the first sheet 260 in the positively charged particle
path at the first time, t.sub.1, and rotates, pivots, and/or slides
the first sheet 260 out of the positively charged particle path at
the second time, t.sub.2. The electromechanical system is
optionally and preferably connected to the main controller 110
and/or the treatment delivery control system 112. The
electromechanical system optionally maintains a fixed distance
between: (1) the patient and the nozzle system 146 or the nozzle
end, (2) the patient 230 or tumor 220 and the scintillation
material 210, and/or (3) the nozzle system 146 and the
scintillation material 210 at a first treatment time with the
gantry 490 in a first position and at a second treatment time with
the gantry 490 in a second position. Use of a common charged
particle beam path for both imaging and cancer treatment and/or
maintaining known or fixed distances between beam transport/guide
elements and treatment and/or detection surface enhances precision
and/or accuracy of a resultant image and/or tumor treatment, such
as described supra.
[0128] System Integration
[0129] Any of the systems and/or elements described herein are
optionally integrated together and/or are optionally integrated
with known systems.
[0130] Treatment Delivery Control System
[0131] Referring now to FIG. 5, a centralized charged particle
treatment system 500 is illustrated. Generally, once a charged
particle therapy plan is devised, a central control system or
treatment delivery control system 112 is used to control
sub-systems while reducing and/or eliminating direct communication
between major subsystems. Generally, the treatment delivery control
system 112 is used to directly control multiple subsystems of the
cancer therapy system without direct communication between selected
subsystems, which enhances safety, simplifies quality assurance and
quality control, and facilitates programming. For example, the
treatment delivery control system 112 directly controls one or more
of: an imaging system, a positioning system, an injection system, a
radio-frequency quadrupole system, a linear accelerator, a ring
accelerator or synchrotron, an extraction system, a beam line, an
irradiation nozzle, a gantry, a display system, a targeting system,
and a verification system. Generally, the control system integrates
subsystems and/or integrates output of one or more of the above
described cancer therapy system elements with inputs of one or more
of the above described cancer therapy system elements.
[0132] Still referring to FIG. 5, an example of the centralized
charged particle treatment system 1000 is provided. Initially, a
doctor, such as an oncologist, prescribes 510 or recommends tumor
therapy using charged particles.
[0133] Subsequently, treatment planning 520 is initiated and output
of the treatment planning step 520 is sent to an oncology
information system 530 and/or is directly sent to the treatment
delivery system 112, which is an example of the main controller
110.
[0134] Still referring to FIG. 5, the treatment planning step 520
is further described.
[0135] Generally, radiation treatment planning is a process where a
team of oncologist, radiation therapists, medical physicists,
and/or medical dosimetrists plan appropriate charged particle
treatment of a cancer in a patient. Typically, one or more imaging
systems 170 are used to image the tumor and/or the patient,
described infra. Planning is optionally: (1) forward planning
and/or (2) inverse planning. Cancer therapy plans are optionally
assessed with the aid of a dose-volume histogram, which allows the
clinician to evaluate the uniformity of the dose to the tumor and
surrounding healthy structures. Typically, treatment planning is
almost entirely computer based using patient computed tomography
data sets using multimodality image matching, image
co-registration, or fusion.
[0136] Forward Planning
[0137] In forward planning, a treatment oncologist places beams
into a radiotherapy treatment planning system including: how many
radiation beams to use and which angles to deliver each of the
beams from. This type of planning is used for relatively simple
cases where the tumor has a simple shape and is not near any
critical organs.
[0138] Inverse Planning
[0139] In inverse planning, a radiation oncologist defines a
patient's critical organs and tumor and gives target doses and
importance factors for each. Subsequently, an optimization program
is run to find the treatment plan which best matches all of the
input criteria.
[0140] Oncology Information System
[0141] Still referring to FIG. 5, the oncology information system
530 is further described. Generally, the oncology information
system 530 is one or more of: (1) an oncology-specific electronic
medical record, which manages clinical, financial, and
administrative processes in medical, radiation, and surgical
oncology departments; (2) a comprehensive information and image
management system; and (3) a complete patient information
management system that centralizes patient data; and (4) a
treatment plan provided to the charged particle beam system 100,
main controller 110, and/or the treatment delivery control system
112. Generally, the oncology information system 530 interfaces with
commercial charged particle treatment systems.
[0142] Safety System/Treatment Delivery Control System
[0143] Still referring to FIG. 5, the treatment delivery control
system 112 is further described. Generally, the treatment delivery
control system 112 receives treatment input, such as a charged
particle cancer treatment plan from the treatment planning step 520
and/or from the oncology information system 530 and uses the
treatment input and/or treatment plan to control one or more
subsystems of the charged particle beam system 100. The treatment
delivery control system 112 is an example of the main controller
110, where the treatment delivery control system receives subsystem
input from a first subsystem of the charged particle beam system
100 and provides to a second subsystem of the charged particle beam
system 100: (1) the received subsystem input directly, (2) a
processed version of the received subsystem input, and/or (3) a
command, such as used to fulfill requisites of the treatment
planning step 520 or direction of the oncology information system
530. Generally, most or all of the communication between subsystems
of the charged particle beam system 100 go to and from the
treatment delivery control system 112 and not directly to another
subsystem of the charged particle beam system 100. Use of a
logically centralized treatment delivery control system has many
benefits, including: (1) a single centralized code to maintain,
debug, secure, update, and to perform checks on, such as quality
assurance and quality control checks; (2) a controlled logical flow
of information between subsystems; (3) an ability to replace a
subsystem with only one interfacing code revision; (4) room
security; (5) software access control; (6) a single centralized
control for safety monitoring; and (7) that the centralized code
results in an integrated safety system 540 encompassing a majority
or all of the subsystems of the charged particle beam system
100.
[0144] Examples of subsystems of the charged particle cancer
therapy system 100 include: a radio frequency quadrupole 550, a
radio frequency quadrupole linear accelerator, the injection system
120, the synchrotron 130, the accelerator system 131, the
extraction system 134, any controllable or monitorable element of
the beam line 268, the targeting/delivery system 140, the nozzle
system 146, a gantry 560 or an element of the gantry 560, the
patient interface module 150, a patient positioner 152, the display
system 160, the imaging system 170, a patient position verification
system 179, any element described supra, and/or any subsystem
element. A treatment change 570 at time of treatment is optionally
computer generated with or without the aid of a technician or
physician and approved while the patient is still in the treatment
room, in the treatment chair, and/or in a treatment position.
[0145] Integrated Cancer Treatment--Imaging System
[0146] One or more imaging systems 170 are optionally used in a
fixed position in a cancer treatment room and/or are moved with a
gantry system, such as a gantry system supporting: a portion of the
beam transport system 135, the targeting/delivery control system
140, and/or moving or rotating around a patient positioning system,
such as in the patient interface module. Without loss of generality
and to facilitate description of the invention, examples follow of
an integrated cancer treatment--imaging system. In each system, the
beam transport system 135 and/or the nozzle system 146 indicates a
positively charged beam path, such as from the synchrotron, for
tumor treatment and/or for tomography, as described supra.
Example I
[0147] Referring now to FIG. 6A, a first example of an integrated
cancer treatment--imaging system 600 is illustrated. In this
example, the charged particle beam system 100 is illustrated with a
treatment beam 269 directed to the tumor 220 of the patient 230
along the z-axis. Also illustrated is a set of imaging sources 610,
imaging system elements, and/or paths therefrom and a set of
detectors 620 corresponding to a respective element of the set of
imaging sources 610. Herein, the set of imaging sources 610 are
referred to as sources, but are optionally any point or element of
the beam train prior to the tumor or a center point about which the
gantry rotates. Hence, a given imaging source is optionally a
dispersion element used to form cone beam. As illustrated, a first
imaging source 612 yields a first beam path 632 and a second
imaging source 614 yields a second beam path 634, where each path
passes at least into the tumor 220 and optionally and preferably to
a first detector array 622 and a second detector array 624,
respectively, of the set of detectors 620. Herein, the first beam
path 632 and the second beam path 634 are illustrated as forming a
ninety degree angle, which yields complementary images of the tumor
220 and/or the patient 230. However, the formed angle is optionally
any angle from ten to three hundred fifty degrees. Herein, for
clarity of presentation, the first beam path 632 and the second
beam path 634 are illustrated as single lines, which optionally is
an expanding, uniform diameter, or focusing beam. Herein, the first
beam path 632 and the second beam path 634 are illustrated in
transmission mode with their respective sources and detectors on
opposite sides of the patient 230. However, a beam path from a
source to a detector is optionally a scattered path and/or a
diffuse reflectance path. Optionally, one or more detectors of the
set of detectors 620 are a single detector element, a line of
detector elements, or preferably a two-dimensional detector array.
Use of two two-dimensional detector arrays is referred to herein as
a two-dimensional-two-dimensional imaging system or a 2D-2D imaging
system.
[0148] Still referring to FIG. 6A, the first imaging source 612 and
the second imaging source 614 are illustrated at a first position
and a second position, respectively. Each of the first imaging
source 612 and the second imaging source 614 optionally: (1)
maintain a fixed position; (2) provide the first beam path(s) 632
and the second beam path(s) 634, respectively, such as to an
imaging system detector 620 or through the gantry 490, such as
through a set of one or more holes or slits; (3) provide the first
beam path 632 and the second beam path 634, respectively, off axis
to a plane of movement of the nozzle system 146; (4) move with the
gantry 490 as the gantry 490 rotates about at least a first axis;
(5) move with a secondary imaging system independent of movement of
the gantry, as described supra; and/or (6) represent a narrow
cross-diameter section of an expanding cone beam path.
[0149] Still referring to FIG. 6A, the set of detectors 620 are
illustrated as coupling with respective elements of the set of
sources 610. Each member of the set of detectors 620 optionally and
preferably co-moves/and/or co-rotates with a respective member of
the set of sources 610. Thus, if the first imaging source 612 is
statically positioned, then the first detector 622 is optionally
and preferably statically positioned. Similarly, to facilitate
imaging, if the first imaging source 612 moves along a first arc as
the gantry 490 moves, then the first detector 622 optionally and
preferably moves along the first arc or a second arc as the gantry
490 moves, where relative positions of the first imaging source 612
on the first arc, a point that the gantry 490 moves about, and
relative positions of the first detector 622 along the second arc
are constant. To facilitate the process, the detectors are
optionally mechanically linked, such as with a mechanical support
to the gantry 469 in a manner that when the gantry 490 moves, the
gantry moves both the source and the corresponding detector.
Optionally, the source moves and a series of detectors, such as
along the second arc, capture a set of images. As illustrated in
FIG. 6A, the first imaging source 612, the first detector array
622, the second imaging source 614, and the second detector array
624 are coupled to a rotatable imaging system support 462, which
optionally rotates independently of the gantry 490 as further
described infra. As illustrated in FIG. 6B, the first imaging
source 612, the first detector array 622, the second imaging source
614, and the second detector array 624 are coupled to the gantry
490, which in this case is a rotatable gantry.
[0150] Still referring to FIG. 6A, optionally and preferably,
elements of the set of sources 610 combined with elements of the
set of detectors 620 are used to collect a series of responses,
such as one source and one detector yielding a detected intensity
and rotatable imaging system support 462 preferably a set of
detected intensities to form an image. For instance, the first
imaging source 612, such as a first X-ray source or first cone beam
X-ray source, and the first detector 622, such as an X-ray film,
digital X-ray detector, or two-dimensional detector, yield a first
X-ray image of the patient at a first time and a second X-ray image
of the patient at a second time, such as to confirm a maintained
location of a tumor or after movement of the gantry and/or nozzle
system 146 or rotation of the patient 230. A set of n images using
the first imaging source 612 and the first detector 622 collected
as a function of movement of the gantry and/or the nozzle system
146 supported by the gantry and/or as a function of movement and/or
rotation of the patient 230 are optionally and preferably combined
to yield a three-dimensional image of the patient 230, such as a
three-dimensional X-ray image of the patient 230, where n is a
positive integer, such as greater than 1, 2, 3, 4, 5, 10, 15, 25,
50, or 100. The set of n images is optionally gathered as described
in combination with images gathered using the second imaging source
614, such as a second X-ray source or second cone beam X-ray
source, and the second detector 624, such as a second X-ray
detector, where the use of two, or multiple, source/detector
combinations are combined to yield images where the patient 230 has
not moved between images as the two, or the multiple, images are
optionally and preferably collected at the same time, such as with
a difference in time of less than 0.01, 0.1, 1, or 5 seconds.
Longer time differences are optionally used. Preferably the n
two-dimensional images are collected as a function of rotation of
the gantry 490 about the tumor and/or the patient and/or as a
function of rotation of the patient 230 and the two-dimensional
images of the X-ray cone beam are mathematically combined to form a
three-dimensional image of the tumor 220 and/or the patient 230.
Optionally, the first X-ray source and/or the second X-ray source
is the source of X-rays that are divergent forming a cone through
the tumor. A set of images collected as a function of rotation of
the divergent X-ray cone around the tumor with a two-dimensional
detector that detects the divergent X-rays transmitted through the
tumor is used to form a three-dimensional X-ray of the tumor and of
a portion of the patient, such as in X-ray computed tomography.
[0151] Still referring to FIG. 6A, use of two imaging sources and
two detectors set at ninety degrees to one another allows the
gantry 490 or the patient 230 to rotate through half an angle
required using only one imaging source and detector combination. A
third imaging source/detector combination allows the three imaging
source/detector combination to be set at sixty degree intervals
allowing the imaging time to be cut to that of one-third that
gantry 490 or patient 230 rotation required using a single imaging
source-detector combination. Generally, n source-detector
combinations reduces the time and/or the rotation requirements to
1/n. Further reduction is possible if the patient 230 and the
gantry 490 rotate in opposite directions. Generally, the used of
multiple source-detector combination of a given technology allow
for a gantry that need not rotate through as large of an angle,
with dramatic engineering benefits.
[0152] Still referring to FIG. 6A, the set of sources 610 and set
of detectors 620 optionally use more than one imaging technology.
For example, a first imaging technology uses X-rays, a second used
fluoroscopy, a third detects fluorescence, a fourth uses cone beam
computed tomography or cone beam CT, and a fifth uses other
electromagnetic waves. Optionally, the set of sources 610 and the
set of detectors 620 use two or more sources and/or two or more
detectors of a given imaging technology, such as described supra
with two X-ray sources to n X-ray sources.
[0153] Still referring to FIG. 6A, use of one or more of the set of
sources 610 and use of one or more of the set of detectors 620 is
optionally coupled with use of the positively charged particle
tomography system described supra. As illustrated in FIG. 6A, the
positively charged particle tomography system uses a second
mechanical support 643 to co-rotate the scintillation material 210
with the gantry 490, as well as to co-rotate an optional sheet,
such as the first sheet 260 and/or the fourth sheet 290.
Example II
[0154] Referring now to FIG. 6B, a second example of the integrated
cancer treatment--imaging system 600 is illustrated using greater
than three imagers.
[0155] Still referring to FIG. 6B, two pairs of imaging systems are
illustrated. Particularly, the first and second imaging source 612,
614 coupled to the first and second detectors 622, 624 are as
described supra. For clarity of presentation and without loss of
generality, the first and second imaging systems are referred to as
a first X-ray imaging system and a second X-ray imaging system. The
second pair of imaging systems uses a third imaging source 616
coupled to a third detector 626 and a fourth imaging source 618
coupled to a fourth detector 628 in a manner similar to the first
and second imaging systems described in the previous example. Here,
the second pair of imaging systems optionally and preferably uses a
second imaging technology, such as fluoroscopy. Optionally, the
second pair of imaging systems is a single unit, such as the third
imaging source 616 coupled to the third detector 626, and not a
pair of units. Optionally, one or more of the set of imaging
sources 610 are statically positioned while one of more of the set
of imaging sources 610 co-rotate with the gantry 490. Pairs of
imaging sources/detector optionally have common and distinct
distances, such as a first distance, d.sub.1, such as for a first
source-detector pair and a second distance, d.sub.2, such as for a
second source-detector or second source-detector pair. As
illustrated, the tomography detector or the scintillation material
210 is at a third distance, d.sub.3. The distinct differences allow
the source-detector elements to rotate on a separate rotation
system at a rate different from rotation of the gantry 490, which
allows collection of a full three-dimensional image while tumor
treatment is proceeding with the positively charged particles.
Example III
[0156] For clarity of presentation, referring now to FIG. 6C, any
of the beams or beam paths described herein is optionally a cone
beam 690 as illustrated. The patient support 152 is an mechanical
and/or electromechanical device used to position, rotate, and/or
constrain any portion of the tumor 220 and/or the patient 230
relative to any axis.
[0157] Tomography Detector System
[0158] A tomography system optically couples the scintillation
material to a detector. As described, supra, the tomography system
optionally and preferably uses one or more detection sheets, beam
tracking elements, and/or tracking detectors to determine/monitor
the charged particle beam position, shape, and/or direction in the
beam path prior to and/or posterior to the sample, imaged element,
patient, or tumor. Herein, without loss of generality, the detector
is described as a detector array or two-dimensional detector array
positioned next to the scintillation material; however, the
detector array is optionally optically coupled to the scintillation
material using one or more optics. Optionally and preferably, the
detector array is a component of an imaging system that images the
scintillation material 210, where the imaging system resolves an
origin volume or origin position on a viewing plane of the
secondary photon emitted resultant from passage of the residual
charged particle beam 267. As described, infra, more than one
detector array is optionally used to image the scintillation
material 210 from more than one direction, which aids in a
three-dimensional reconstruction of the photonic point(s) of
origin, positively charged particle beam path, and/or tomographic
image.
[0159] Imaging
[0160] Generally, medical imaging is performed using an imaging
apparatus to generate a visual and/or a symbolic representation of
an interior constituent of the body for diagnosis, treatment,
and/or as a record of state of the body. Typically, one or more
imaging systems are used to image the tumor and/or the patient. For
example, the X-ray imaging system and/or the positively charged
particle imaging system, described supra, are optionally used
individually, together, and/or with any additional imaging system,
such as use of X-ray radiography, magnetic resonance imaging,
medical ultrasonography, thermography, medical photography,
positron emission tomography (PET) system, single-photon emission
computed tomography (SPECT), and/or another nuclear/charged
particle imaging technique.
[0161] Fiducial Marker
[0162] Fiducial markers and fiducial detectors are optionally used
to locate, target, track, avoid, and/or adjust for objects in a
treatment room that move relative to the nozzle or nozzle system
146 of the charged particle beam system 100 and/or relative to each
other. Herein, for clarity of presentation and without loss of
generality, fiducial markers and fiducial detectors are illustrated
in terms of a movable or statically positioned treatment nozzle and
a movable or static patient position. However, generally, the
fiducial markers and fiducial detectors are used to mark and
identify position, or relative position, of any object in a
treatment room, such as a cancer therapy treatment room 922.
Herein, a fiducial indicator refers to either a fiducial marker or
a fiducial detector. Herein, photons travel from a fiducial marker
to a fiducial detector.
[0163] Herein, fiducial refers to a fixed basis of comparison, such
as a point or a line. A fiducial marker or fiducial is an object
placed in the field of view of an imaging system, which optionally
appears in a generated image or digital representation of a scene,
area, or volume produced for use as a point of reference or as a
measure. Herein, a fiducial marker is an object placed on, but not
into, a treatment room object or patient. Particularly, herein, a
fiducial marker is not an implanted device in a patient. In
physics, fiducials are reference points: fixed points or lines
within a scene to which other objects can be related or against
which objects can be measured. Fiducial markers are observed using
a sighting device for determining directions or measuring angles,
such as an alidade or in the modern era a digital detection system.
Two examples of modern position determination systems are the
Passive Polaris Spectra System and the Polaris Vicra System (NDI,
Ontario, Canada).
[0164] Referring now to FIG. 7A, use of a fiducial marker system
700 is described. Generally, a fiducial marker is placed 710 on an
object, light from the fiducial marker is detected 730, relative
object positions are determined 740, and a subsequent task is
performed, such as treating a tumor 770. For clarity of
presentation and without loss of generality, non-limiting examples
of uses of fiducial markers in combination with X-ray and/or
positively charged particle tomographic imaging and/or treatment
using positively charged particles are provided, infra.
Example I
[0165] Referring now to FIG. 8, a fiducial marker aided tomography
system 800 is illustrated and described. Generally, a set of
fiducial marker detectors 820 detects photons emitted from and/or
reflected off of a set of fiducial markers 810 and resultant
determined distances and calculated angles are used to determine
relative positions of multiple objects or elements, such as in the
treatment room 922.
[0166] Still referring to FIG. 8, initially, a set of fiducial
markers 810 are placed on one or more elements. As illustrated, a
first fiducial marker 811, a second fiducial marker 812, and a
third fiducial marker 813 are positioned on a first, preferably
rigid, support element 852. As illustrated, the first support
element 852 supports a scintillation material 210. As each of the
first, second, and third fiducial markers 811, 812, 813 and the
scintillation material 210 are affixed or statically positioned
onto the first support element 852, the relative position of the
scintillation material 210 is known, based on degrees of freedom of
movement of the first support element, if the positions of the
first fiducial marker 811, the second fiducial marker 812, and/or
the third fiducial marker 813 is known. In this case, one or more
distances between the first support element 852 and a third support
element 856 are determined, as further described infra.
[0167] Still referring to FIG. 8, a set of fiducial detectors 820
are used to detect light emitted from and/or reflected off one or
more fiducial markers of the set of fiducial markers 810. As
illustrated, ambient photons 821 and/or photons from an
illumination source reflect off of the first fiducial marker 811,
travel along a first fiducial path 831, and are detected by a first
fiducial detector 821 of the set of fiducial detectors 820. In this
case, a first signal from the first fiducial detector 821 is used
to determine a first distance to the first fiducial marker 811. If
the first support element 852 supporting the scintillation material
210 only translates, relative to the nozzle system 146, along the
z-axis, the first distance is sufficient information to determine a
location of the scintillation material 210, relative to the nozzle
system 146. Similarly, photons emitted, such as from a light
emitting diode embedded into the second fiducial marker 812 travel
along a second fiducial path 832 and generate a second signal when
detected by a second fiducial detector 822, of the set of fiducial
detectors 820. The second signal is optionally used to confirm
position of the first support element 852, reduce error of a
determined position of the first support element 852, and/or is
used to determine extent of a second axis movement of the first
support element 852, such as tilt of the first support element 852.
Similarly, photons passing from the third fiducial marker 813
travel along a third fiducial path 833 and generate a third signal
when detected by a third fiducial detector 823, of the set of
fiducial detectors 820. The third signal is optionally used to
confirm position of the first support element 852, reduce error of
a determined position of the first support element 852, and/or is
used to determine extent of a second or third axis movement of the
first support element 852, such as rotation of the first support
element 852.
[0168] If all of the movable elements within the treatment room 922
move together, then determination of a position of one, two, or
three fiducial markers, dependent on degrees of freedom of the
movable elements, is sufficient to determine a position of all of
the co-movable movable elements. However, optionally two or more
objects in the treatment room 922 move independently or
semi-independently from one another. For instance, a first movable
object optionally translates, tilts, and/or rotates relative to a
second movable object. One or more additional fiducial markers of
the set of fiducial markers 810 placed on each movable object
allows relative positions of each of the movable objects to be
determined.
[0169] Still referring to FIG. 8, a position of the patient 230 is
determined relative to a position of the scintillation material
210. As illustrated, a second support element 854 positioning the
patient 230 optionally translates, tilts, and/or rotates relative
to the first support element 852 positioning the scintillation
material 210. In this case, a fourth fiducial marker 814, attached
to the second support element 854 allows determination of a current
position of the patient 230. As illustrated, a position of a single
fiducial element, the fourth fiducial marker 814, is determined by
the first fiducial detector 821 determining a first distance to the
fourth fiducial marker 814 and the second fiducial detector 822
determining a second distance to the fourth fiducial marker 814,
where a first arc of the first distance from the first fiducial
detector 821 and a second arc of the second distance from the
second fiducial detector 822 overlap at a point of the fourth
fiducial marker 834 marking the position of the second support
element 852 and the supported position of the patient 230. Combined
with the above described system of determining location of the
scintillation material 210, the relative position of the
scintillation material 210 to the patient 230, and thus the tumor
220, is determined.
[0170] Still referring to FIG. 8, one fiducial marker and/or one
fiducial detector is optionally and preferably used to determine
more than one distance or angle to one or more objects. In a first
case, as illustrated, light from the fourth fiducial marker 814 is
detected by both the first fiducial detector 821 and the second
fiducial detector 822. In a second case, as illustrated, light
detected by the first fiducial detector 821, passes from the first
fiducial marker 811 and the fourth fiducial marker 814. Thus, (1)
one fiducial marker and two fiducial detectors are used to
determine a position of an object, (2) two fiducial markers on two
elements and one fiducial detector is used to determine relative
distances of the two elements to the single detector, and/or as
illustrated and described below in relation to FIG. 10A, and/or (3)
positions of two or more fiducial markers on a single object are
detected using a single fiducial detector, where the distance and
orientation of the single object is determined from the resultant
signals. Generally, use of multiple fiducial markers and multiple
fiducial detectors are used to determine or overdetermine positions
of multiple objects, especially when the objects are rigid, such as
a support element, or semi-rigid, such as a person, head, torso, or
limb.
[0171] Still referring to FIG. 8, the fiducial marker aided
tomography system 800 is further described. As illustrated, the set
of fiducial detectors 820 are mounted onto the third support
element 856, which has a known position and orientation relative to
the nozzle system 146. Thus, position and orientation of the nozzle
system 146 is known relative to the tumor 220, the patient 230, and
the scintillation material 210 through use of the set of fiducial
markers 810, as described supra. Optionally, the main controller
110 uses inputs from the set of fiducial detectors 820 to: (1)
dictate movement of the patient 230 or operator; (2) control,
adjust, and/or dynamically adjust position of any element with a
mounted fiducial marker and/or fiducial detector, and/or (3)
control operation of the charged particle beam, such as for imaging
and/or treating or performing a safety stop of the positively
charged particle beam. Further, based on past movements, such as
the operator moving across the treatment room 922 or relative
movement of two objects, the main controller is optionally and
preferably used to prognosticate or predict a future conflict
between the treatment beam 269 and the moving object, in this case
the operator, and take appropriate action or to prevent collision
of the two objects.
Example II
[0172] Referring now to FIG. 9, a fiducial marker aided treatment
system 3400 is described. To clarify the invention and without loss
of generality, this example uses positively charged particles to
treat a tumor. However, the methods and apparatus described herein
apply to imaging a sample, such as described supra.
[0173] Still referring to FIG. 9, four additional cases of fiducial
marker--fiducial detector combinations are illustrated. In a first
case, photons from the first fiducial marker 811 are detected using
the first fiducial detector 821, as described in the previous
example. However, photons from a fifth fiducial marker 815 are
blocked and prevented from reaching the first fiducial detector 821
as a sixth fiducial path 836 is blocked, in this case by the
patient 230. The inventor notes that the absence of an expected
signal, disappearance of a previously observed signal with the
passage of time, and/or the emergence of a new signal each add
information on existence and/or movement of an object. In a second
case, photons from the fifth fiducial marker 815 passing along a
seventh fiducial path 837 are detected by the second fiducial
detector 822, which illustrates one fiducial marker yielding a
blocked and unblocked signal usable for finding an edge of a
flexible element or an element with many degrees of freedom, such
as a patient's hand, arm, or leg. In a third case, photons from the
fifth fiducial marker 815 and a sixth fiducial marker 816, along
the seventh fiducial path 837 and an eighth fiducial path 838
respectively, are detected by the second fiducial detector 822,
which illustrates that one fiducial detector optionally detects
signals from multiple fiducial markers. In this case, photons from
the multiple fiducial sources are optionally of different
wavelengths, occur at separate times, occur for different
overlapping periods of time, and/or are phase modulated. In a
fourth case, a seventh fiducial marker 817 is affixed to the same
element as a fiducial detector, in this case the front surface
plane of the third support element 856. Also, in the fourth case, a
fourth fiducial detector 824, observing photons along a ninth
fiducial path 839, is mounted to a fourth support element 858,
where the fourth support element 858 positions the patient 230 and
tumor 220 thereof and/or is attached to one or more fiducial source
elements.
[0174] Still referring to FIG. 9 the fiducial marker aided
treatment system 900 is further described. As described, supra, the
set of fiducial markers 810 and the set of fiducial detectors 820
are used to determine relative locations of objects in the
treatment room 922, which are the third support element 856, the
fourth support element 858, the patient 230, and the tumor 220 as
illustrated. Further, as illustrated, the third support element 856
comprises a known physical position and orientation relative to the
nozzle system 146. Hence, using signals from the set of fiducial
detectors 820, representative of positions of the fiducial markers
810 and room elements, the main controller 110 controls the
treatment beam 269 to target the tumor 220 as a function of time,
movement of the nozzle system 146, and/or movement of the patient
230.
Example III
[0175] Referring now to FIG. 10A, a fiducial marker aided treatment
room system 1000 is described. Without loss of generality and for
clarity of presentation, a zero vector 1001 is a vector or line
emerging from the nozzle system 146 when the first axis control
143, such as a vertical control, and the second axis control 144,
such as a horizontal control, of the scanning system 140 is turned
off. Without loss of generality and for clarity of presentation, a
zero point 1002 is a point on the zero vector 1001 at a plane of an
exit face the nozzle system 146.
[0176] Generally, a defined point and/or a defined line are used as
a reference position and/or a reference direction and fiducial
markers are defined in space relative to the point and/or line.
[0177] Six additional cases of fiducial marker--fiducial detector
combinations are illustrated to further describe the fiducial
marker aided treatment room system 1000. In a first case, the
patient 230 position is determined. Herein, a first fiducial marker
811 marks a position of a patient positioning system 1350 and a
second fiducial marker 812 marks a position of a portion of skin of
the patient 230, such as a limb, joint, and/or a specific position
relative to the tumor 220. In a second case, multiple fiducial
markers of the set of fiducial markers 810 and multiple fiducial
detectors of said set of fiducial detectors 820 are used to
determine a position/relative position of a single object, where
the process is optionally and preferably repeated for each object
in the treatment room 922. As illustrated, the patient 230 is
marked with the second fiducial marker 812 and a third fiducial
marker 813, which are monitored using a first fiducial detector 821
and a second fiducial detector 822. In a third case, a fourth
fiducial marker 814 marks the scintillation material 210 and a
sixth fiducial path 836 illustrates another example of a blocked
fiducial path. In a fourth case, a fifth fiducial marker 815 marks
an object not always present in the treatment room, such as a
wheelchair 1040, walker, or cart. In a sixth case, a sixth fiducial
marker 816 is used to mark an operator 1050, who is mobile and must
be protected from an unwanted irradiation from the nozzle system
146.
[0178] Still referring to FIG. 10A, clear field treatment vectors
and obstructed field treatment vectors are described. A clear field
treatment vector comprises a path of the treatment beam 269 that
does not intersect a non-standard object, where a standard object
includes all elements in a path of the treatment beam 269 used to
measure a property of the treatment beam 269, such as the first
sheet 260, the second sheet 270, the third sheet 280, and the
fourth sheet 290. Examples of non-standard objects or interfering
objects include an arm of the patient couch, a back of the patient
couch, and/or a supporting bar, such a robot arm. Use of fiducial
indicators, such as a fiducial marker, on any potential interfering
object allows the main controller 110 to only treat the tumor 220
of the patient 230 in the case of a clear field treatment vector.
For example, fiducial markers are optionally placed along the edges
or corners of the patient couch or patient positioning system or
indeed anywhere on the patient couch. Combined with a-priori
knowledge of geometry of the non-standard object, the main
controller can deduce/calculate presence of the non-standard object
in a current or future clear field treatment vector, forming a
obstructed field treatment vector, and perform any of: increasing
energy of the treatment beam 269 to compensate, moving the
interfering non-standard object, and/or moving the patient 230
and/or the nozzle system 146 to a new position to yield a clear
field treatment vector. Similarly, for a given determined clear
filed treatment vector, a total treatable area, using scanning of
the proton beam, for a given nozzle-patient couch position is
optionally and preferably determined. Further, the clear field
vectors are optionally and preferably predetermined and used in
development of a radiation treatment plan.
[0179] Referring again to FIG. 7A, FIG. 8, FIG. 9, and FIG. 10A,
generally, one or more fiducial markers and/or one or more fiducial
detectors are attached to any movable and/or statically positioned
object/element in the treatment room 922, which allows
determination of relative positions and orientation between any set
of objects in the treatment room 922.
[0180] Sound emitters and detectors, radar systems, and/or any
range and/or directional finding system is optionally used in place
of the source-photon-detector systems described herein.
[0181] 2D-2D X-Ray Imaging
[0182] Still referring to FIG. 10A, for clarity of presentation and
without loss of generality, a two-dimensional-two-dimensional
(2D-2D) X-ray imaging system 1060 is illustrated, which is
representative of any source-sample-detector transmission based
imaging system. As illustrated, the 2D-2D imaging system 1060
includes a 2D-2D source end 1062 on a first side of the patient 230
and a 2D-2D detector end 1064 on a second side, an opposite side,
of the patient 230. The 2D-2D source end 1062 holds, positions,
and/or aligns source imaging elements, such as: (1) one or more
imaging sources; (2) the first imaging source 612 and the second
imaging source 622; and/or (3) a first cone beam X-ray source and a
second cone beam X-ray source; while, the 2D-2D detector end 1064,
respectively, holds, positions, and/or aligns: (1) one or more
imaging detectors 1066; (2) a first imaging detector and a second
imaging detector; and/or (3) a first cone beam X-ray detector and a
second cone beam X-ray detector.
[0183] In practice, optionally and preferably, the 2D-2D imaging
system 1060 as a unit rotates about a first axis around the
patient, such as an axis of the treatment beam 269, as illustrated
at the second time, t.sub.2. For instance, at the second time,
t.sub.2, the 2D-2D source end 1062 moves up and out of the
illustrated plane while the 2D-2D detector end 1064 moves down and
out of the illustrated plane. Thus, the 2D-2D imaging system may
operate at one or more positions through rotation about the first
axis while the treatment beam 269 is in operation without
interfering with a path of the treatment beam 269.
[0184] Optionally and preferably, the 2D-2D imaging system 1060
does not physically obstruct the treatment beam 269 or associated
residual energy imaging beam from the nozzle system 146. Through
relative movement of the nozzle system 146 and the 2D-2D imaging
system 1060, a mean path of the treatment beam 269 and a mean path
of X-rays from an X-ray source of the 2D-2D imaging system 1060
form an angle from 0 to 90 degrees and more preferably an angle of
greater than 10, 20, 30, or 40 degrees and less than 80, 70, or 60
degrees. Still referring to FIG. 10A, as illustrated at the second
time, t.sub.2, the angle between the mean treatment beam and the
mean X-ray beam is 45 degrees.
[0185] The 2D-2D imaging system 1060 optionally rotates about a
second axis, such as an axis perpendicular to FIG. 10A and passing
through the patient and/or passing through the first axis. Thus, as
illustrated, as the exit port of the output nozzle system 146 moves
along an arc and the treatment beam 269 enters the patient 230 from
another angle, rotation of the 2D-2D imaging system 1060 about the
second axis perpendicular to FIG. 10A, the first axis of the 2D-2D
imaging system 1060 continues to rotate about the first axis, where
the first axis is the axis of the treatment beam 269 or the
residual charged particle beam 267 in the case of imaging with
protons.
[0186] Optionally and preferably, one or more elements of the 2D-2D
X-ray imaging system 1060 are marked with one or more fiducial
elements, as described supra. As illustrated, the 2D-2D detector
end 1064 is configured with a seventh fiducial marker 817 and an
eighth fiducial marker 818 while the 2D-2D source end 1062 is
configured with a ninth fiducial marker 819, where any number of
fiducial markers are used.
[0187] In many cases, movement of one fiducial indicator
necessitates movement of a second fiducial indicator as the two
fiducial indicators are physically linked. Thus, the second
fiducial indicator is not strictly needed, given complex code that
computes the relative positions of fiducial markers that are often
being rotated around the patient 230, translated past the patient
230, and/or moved relative to one or more additional fiducial
markers. The code is further complicated by movement of
non-mechanically linked and/or independently moveable obstructions,
such as a first obstruction object moving along a first concentric
path and a second obstruction object moving along a second
concentric path. The inventor notes that the complex position
determination code is greatly simplified if the treatment beam path
269 to the patient 230 is determined to be clear of obstructions,
through use of the fiducial indicators, prior to treatment of at
least one of and preferably every voxel of the tumor 220. Thus,
multiple fiducial markers placed on potentially obstructing objects
simplifies the code and reduces treatment related errors.
Typically, treatment zones or treatment cones are determined where
a treatment cone from the output nozzle system 146 to the patient
230 does not pass through any obstructions based on the current
position of all potentially obstructing objects, such as a support
element of the patient couch. As treatment cones overlap, the path
of the treatment beam 269 and/or a path of the residual charged
particle beam 267 is optionally moved from treatment cone to
treatment cone without use of the imaging/treatment beam
continuously as moved along an arc about the patient 230. A
transform of the standard tomography algorithm thus allows physical
obstructions to the imaging/treatment beam to be avoided.
[0188] Isocenterless System
[0189] The inventor notes that a fiducial marker aided imaging
system, the fiducial marker aided tomography system 800, and/or the
fiducial marker aided treatment system 900 are applicable in a
treatment room 922 not having a treatment beam isocenter, not
having a tumor isocenter, and/or is not reliant upon calculations
using and/or reliant upon an isocenter. Further, the inventor notes
that all positively charged particle beam treatment centers in the
public view are based upon mathematical systems using an isocenter
for calculations of beam position and/or treatment position and
that the fiducial marker aided imaging and treatment systems
described herein do not need an isocenter and are not necessarily
based upon mathematics using an isocenter, as is further described
infra. In stark contrast, a defined point and/or a defined line are
used as a reference position and/or a reference direction and
fiducial markers are defined in space relative to the point and/or
line.
[0190] Traditionally, the isocenter 263 of a gantry based charged
particle cancer therapy system is a point in space about which an
output nozzle rotates. In theory, the isocenter 263 is an
infinitely small point in space. However, traditional gantry and
nozzle systems are large and extremely heavy devices with
mechanical errors associated with each element. In real life, the
gantry and nozzle rotate around a central volume, not a point, and
at any given position of the gantry-nozzle system, a mean or
unaltered path of the treatment beam 269 passes through a portion
of the central volume, but not necessarily the single point of the
isocenter 263. Thus, to distinguish theory and real-life, the
central volume is referred to herein as a mechanically defined
isocenter volume, where under best engineering practice the
isocenter has a geometric center, the isocenter 263. Further, in
theory, as the gantry-nozzle system rotates around the patient, the
mean or unaltered lines of the treatment beam 269 at a first and
second time, preferably all times, intersect at a point, the point
being the isocenter 263, which is an unknown position. However, in
practice the lines pass through the mechanically identified
isocenter volume 1012. The inventor notes that in all gantry
supported movable nozzle systems, calculations of applied beam
state, such as energy, intensity, and direction of the charged
particle beam, are calculated using a mathematical assumption of
the point of the isocenter 263. The inventor further notes, that as
in practice the treatment beam 269 passes through the mechanically
defined isocenter volume but misses the isocenter 263, an error
exists between the actual treatment volume and the calculated
treatment volume of the tumor 220 of the patient 230 at each point
in time. The inventor still further notes that the error results in
the treatment beam 269: (1) not striking a given volume of the
tumor 220 with the prescribed energy and/or (2) striking tissue
outside of the tumor. Mechanically, this error cannot be
eliminated, only reduced. However, use of the fiducial markers and
fiducial detectors, as described supra, removes the constraint of
using an unknown position of the isocenter 263 to determine where
the treatment beam 269 is striking to fulfill a doctor provided
treatment prescription as the actual position of the patient
positioning system, tumor 220, and/or patient 230 is determined
using the fiducial markers and output of the fiducial detectors
with no use of the isocenter 263, no assumption of an isocenter
263, and/or no spatial treatment calculation based on the isocenter
263. Rather, a physically defined point and/or line, such as the
zero point 1002 and/or the zero vector 1001, in conjunction with
the fiducials are used to: (1) determine position and/or
orientation of objects relative to the point and/or line and/or (2)
perform calculations, such as a radiation treatment plan.
[0191] Referring again to FIG. 7A and referring again to FIG. 10A,
optionally and preferably, the task of determining the relative
object positions 740 uses a fiducial element, such as an optical
tracker, mounted in the treatment room 922, such as on the gantry
or nozzle system, and calibrated to a "zero" vector 1001 of the
treatment beam 269, which is defined as the path of the treatment
beam when electromagnetic and/or electrostatic steering of one or
more final magnets in the beam transport system 135 and/or an
output nozzle system 146 attached to a terminus thereof is/are
turned off. The zero vector 1001 is a path of the treatment beam
269 when the first axis control 143, such as a vertical control,
and the second axis control 144, such as a horizontal control, of
the scanning system 140 is turned off. A zero point 1002 is any
point, such as a point on the zero vector 1001. Herein, without
loss of generality and for clarity of presentation, the zero point
1002 is a point on the zero vector 1001 crossing a plane defined by
a terminus of the nozzle of the nozzle system 146. Ultimately, the
use of a zero vector 1001 and/or the zero point 1002 is a method of
directly and optionally actively relating the coordinates of
objects, such as moving objects and/or the patient 230 and tumor
220 thereof, in the treatment room 922 to one another; not
passively relating them to an imaginary point in space such as a
theoretical isocenter than cannot mechanically be implemented in
practice as a point in space, but rather always as an a isocenter
volume, such as an isocenter volume including the isocenter point
in a well-engineered system. Examples further distinguish the
isocenter based and fiducial marker based targeting system.
Example I
[0192] Referring now to FIG. 10B, an isocenterless system 1005 of
the fiducial marker aided treatment room system 1000 of FIG. 10A is
described. As illustrated, the nozzle/nozzle system 146 is
positioned relative to a reference element, such as the third
support element 856. The reference element is optionally a
reference fiducial marker and/or a reference fiducial detector
affixed to any portion of the nozzle system 146 and/or a rigid,
positionally known mechanical element affixed thereto. A position
of the tumor 220 of the patient 230 is also determined using
fiducial markers and fiducial detectors, as described supra. As
illustrated, at a first time, t.sub.1, a first mean path of the
treatment beam 269 passes through the isocenter 263. At a second
time, t.sub.2, resultant from inherent mechanical errors associated
with moving the nozzle system 146, a second mean path of the
treatment beam 269 does not pass through the isocenter 263. In a
traditional system, this would result in a treatment volume error.
However, using the fiducial marker based system, the actual
position of the nozzle system 146 and the patient 230 is known at
the second time, t.sub.2, which allows the main controller to
direct the treatment beam 269 to the targeted and prescription
dictated tumor volume using the first axis control 143, such as a
vertical control, and the second axis control 144, such as a
horizontal control, of the scanning system 140. Again, since the
actual position at the time of treatment is known using the
fiducial marker system, mechanical errors of moving the nozzle
system 146 are removed and the x/y-axes adjustments of the
treatment beam 269 are made using the actual and known position of
the nozzle system 146 and the tumor 220, in direct contrast to the
x/y-axes adjustments made in traditional systems, which assume that
the treatment beam 269 passes through the isocenter 263. In
essence: (1) the x/y-axes adjustments of the traditional targeting
systems are in error as the unmodified treatment beam 269 is not
passing through the assumed isocenter and (2) the x/y-axes
adjustments of the fiducial marker based system know the actual
position of the treatment beam 269 relative to the patient 230 and
the tumor 220 thereof, which allows different x/y-axes adjustments
that adjust the treatment beam 269 to treat the prescribed tumor
volume with the prescribed dosage.
Example II
[0193] Referring now to FIG. 10C an example is provided that
illustrates errors in an isocenter 263 with a fixed beamline
position and a moving patient positioning system. As illustrated,
at a first time, t.sub.1, the mean/unaltered treatment beam path
269 passes through the tumor 220, but misses the isocenter 263. As
described, supra, traditional treatment systems assume that the
mean/unaltered treatment beam path 269 passes through the isocenter
263 and adjust the treatment beam to a prescribed volume of the
tumor 220 for treatment, where both the assumed path through the
isocenter and the adjusted path based on the isocenter are in
error. In stark contrast, the fiducial marker system: (1)
determines that the actual mean/unaltered treatment beam path 269
does not pass through the isocenter 263, (2) determines the actual
path of the mean/unaltered treatment beam 269 relative to the tumor
220, and (3) adjusts, using a reference system such as the zero
line 1001 and/or the zero point 1002, the actual mean/unaltered
treatment beam 269 to strike the prescribed tissue volume using the
first axis control 143, such as a vertical control, and the second
axis control 144, such as a horizontal control, of the scanning
system 140. As illustrated, at a second time, t.sub.2, the
mean/unaltered treatment beam path 269 again misses the isocenter
263 resulting in treatment errors in the traditional isocenter
based targeting systems, but as described, the steps of: (1)
determining the relative position of: (a) the mean/unaltered
treatment beam 269 and (b) the patient 230 and tumor 220 thereof
and (2) adjusting the determined and actual mean/unaltered
treatment beam 269, relative to the tumor 220, to strike the
prescribed tissue volume using the first axis control 143, the
second axis control 144, and energy of the treatment beam 269 are
repeated for the second time, t.sub.2, and again through the
n.sup.th treatment time, where n is a positive integer of at least
5, 10, 50, 100, or 500.
[0194] Referring again to FIG. 8 and FIG. 9, generally at a first
time, objects, such as the patient 230, the scintillation material
210, an X-ray system, and the nozzle system 146 are mapped and
relative positions are determined. At a second time, the position
of the mapped objects is used in imaging, such as X-ray and/or
proton beam imaging, and/or treatment, such as cancer treatment.
Further, an isocenter is optionally used or is not used. Still
further, the treatment room 922 is, due to removal of the beam
isocenter knowledge constraint, optionally designed with a static
or movable nozzle system 146 in conjunction with any patient
positioning system along any set of axes as long as the fiducial
marking system is utilized.
[0195] Referring now to FIG. 7B, optional uses of the fiducial
marker system 700 are described. After the initial step of placing
the fiducial markers 710, the fiducial markers are optionally
illuminated 720, such as with the ambient light or external light
as described above. Light from the fiducial markers is detected 730
and used to determine relative positions of objects 740, as
described above. Thereafter, the object positions are optionally
adjusted 750, such as under control of the main controller 110 and
the step of illuminating the fiducial markers 720 and/or the step
of detecting light from the fiducial markers 730 along with the
step of determining relative object positions 740 is iteratively
repeated until the objects are correctly positioned. Simultaneously
or independently, fiducial detectors positions are adjusted 780
until the objects are correctly placed, such as for treatment of a
particular tumor voxel. Using any of the above steps: (1) one or
more images are optionally aligned 760, such as a collected X-ray
image and a collected proton tomography image using the determined
positions; (2) the tumor 220 is treated 770; and/or (3) changes of
the tumor 220 are tracked 790 for dynamic treatment changes and/or
the treatment session is recorded for subsequent analysis.
[0196] Gantry
[0197] Referring now to FIGS. 11-19, a gantry system is
described.
[0198] Counterweighted Gantry System
[0199] Referring now to FIG. 11, a counterweighted gantry system
1100 is described. In the counterweighted gantry system 1100, the
gantry 490 comprises a counterweight 1120 positioned opposite a
gantry rotation axis 1411 from the nozzle system 146. Ideally, the
counterweight results in no net moment of the gantry-counterweight
system about the axis of rotation of the gantry. In practice, the
counterweight mass and distance forces, herein all elements on one
side of the axis or rotation of the gantry, is within 10, 5, 2, 1,
0.1, or 0.01 percent of the mass and distance forces of the section
of the gantry on the opposite side of the axis of rotation of the
gantry. Hence, as illustrated at a first time, t.sub.1, a first
downward force, F.sub.1, resultant from all elements of the gantry
490 on a first side of the gantry rotation axis 1411 and/or
isocenter 263 balances, counters, and/or equals a second downward
force, F.sub.2, on a second, opposite, side of the gantry rotation
axis 1411 and/or isocenter 263. Stated another way, the moment of
inertia, a quantity expressing a body's tendency to resist angular
acceleration, of a product of masses and the square of distances of
objects on a first side of the gantry rotation axis 1411 resists
acceleration of a product of masses and the square of distances of
objects on a second, opposite, side of the gantry rotation axis
1411. As illustrated at a second time, t.sub.2, despite rotation of
the gantry to a second position, a third downward force, F.sub.3,
and a fourth downward force, F.sub.4, on opposite sides of the
gantry rotation axis 1411 are still balanced. Thus, the system has
no net moment of inertia. The inventor notes that the balanced
system greatly reduces drive motor requirements and/or greatly
enhances movement precision resultant from the smaller net forces
and/or applied forces for movement of the gantry 490. Optionally,
gear backlash is compensated for separately on opposite sides of a
meridian position, such as where the beam path through the nozzle
system 146 is aligned with gravity and/or a last movement of the
rotatable beamline section 138 is against gravity, which results in
a reproducible gantry position in the presence of gear
slop/backlash versus gravity.
Example I
[0200] Referring now to FIG. 12, for clarity of presentation and
without loss of generality, an example of the counterweighted
gantry system 1100 is illustrated. As illustrated, first downward,
inertial, rotational, and/or gravitational forces on a first side,
top side as illustrated, of the gantry rotational axis 1411
counters second downward, inertial, rotational, and/or
gravitational forces on a second side, bottom side as illustrated,
of the gantry rotational axis 1411. To achieve the balanced forces,
counterweights 1120 are added to the gantry 490, such as a first
counterweight 1122, a second counterweight 1124, and/or a
counterweight connector 1126 attached to a rotatable gantry support
1210. The counterweights are optionally and preferably elements of
a modular installation, as further described infra.
[0201] Rotation
[0202] Still referring to FIG. 12, rotation of the gantry 490 is
described. Generally, the rotatable gantry support 1210 is mounted
to a support structure, not illustrated for clarity of
presentation, such as with a set of bearings and/or radial ball
bearings. As illustrated, a first bearing 1211, a second bearing
1212, and a third bearing 1213, guide and support movement of the
gantry 490. Optionally and preferably, the set of bearings include
multiple bearing elements about the rotatable gantry support 1210
on a first end of a rotatable beamline section 138 of a rotatable
beamline support arm 498 of the gantry 490 and a bearing on a
second end of the gantry support arm 498.
[0203] Installation
[0204] Still referring to FIG. 12, the gantry 490 is optionally and
preferably a free-standing system. Without a requirement of wall
mounting, further described infra, the gantry 490 is optionally and
preferably assembled in sections, such as modular sections, such as
allowing each component to fit into an elevator shaft.
Example I
[0205] In a first example, as illustrated, a section of the gantry
490 supporting the rotational beamline section 138 and the nozzle
system 146 is optionally and preferably assembled from multiple
sub-units, such as a first gantry support section 491, a second
gantry support section 492, a third gantry support section 493, a
fourth gantry support section 494, and a fifth gantry support
section 495.
[0206] Several of the sections are further described. The first
gantry section 491 couples to the rotatable gantry support 1210
using a gantry connector section 1130. The third gantry section
493, combined with the fourth gantry section 494 and the fifth
gantry section 495, provides an aperture through which the
rotational beamline section 138 passes and/or contains the nozzle
system 146.
Example II
[0207] In a second example, the rotatable gantry support 1210 is
optionally and preferably assembled from multiple sub-units, such
as a first rotatable gantry support element 1215, a second
rotatable gantry support element 1216, and a third rotatable gantry
support element 1217.
Example III
[0208] In a third example, the counterweighted gantry system 1100
is readily installed into an existing facility. As further
described using FIGS. 17-19 below, the counterweighted gantry
system 1100 is free standing, so the structure is optionally and
preferably a bolt together assembly 1250, which allows installation
of the unit into an existing structure.
[0209] Gantry Rotation
[0210] Referring still to FIG. 12 and referring now to FIGS.
13(A-D), rotation of the gantry 490 relative to a rolling floor
system 1300, also referred to as a segmented floor, is described,
where the segmented sections allow for the floor system to contour
to a curved surface, change direction around a roller, and/or spool
as further described infra.
[0211] Referring still to FIG. 12, as the rotatable beamline
support arm 498 of the gantry 490 rotates around the gantry
rotation axis 1411, the rotatable beamline section 138 of the beam
transport system 135 is moved around the gantry rotation axis 1411
and the nozzle system 146, illustrated in FIG. 13 for clarity of
presentation, extending from the aperture through the third gantry
section 493 rotates around the tumor 220, the patient 230, the
gantry rotation axis 1411, and/or the isocenter 263. Referring now
to FIG. 13A, the nozzle system 146, extending from the aperture
through the third gantry section 493, illustrated in FIG. 12, is
illustrated in a first position, a horizontal position, through a
movable floor, described infra. Referring now to FIG. 13B, for
clarity of presentation, the nozzle system 146 is rotated from the
first position illustrated in FIG. 13A at a first time, t.sub.1, to
a second position illustrated in FIG. 12 at a second time, t.sub.2,
using the gantry 490 Referring still to FIG. 13A and FIG. 13B, the
gantry 490, optionally and preferably, rotates the nozzle system
146 from a position under the patient 230 through a floor 1310, as
described infra, along a curved wall, as described infra, and
through a ceiling area, as described infra.
[0212] Rolling Floor
[0213] Referring still to FIG. 13A, the rolling floor system 1300,
also referred to as a rolling wall-floor system, is further
described. The rolling floor system 1300 comprises a rolling floor
1320, such as a segmented floor. As illustrated, the rolling floor
1320 comprises sections moving along/past a flat floor section
1322, such as inset into the floor 1310; a wall section 1324, such
as along/inset into a curved wall section 1340 of a wall; an upper
spooler section 1326, such as into/around/wound around an upper
spooler 1332 or upper spool; and a lower spooling section 1328,
such as into/around a lower spooler 1334 or lower spool. Herein, a
spooler is a device, such as a cylinder, on which an object, such
as the segmented floor is wound. A floor movement system 1330
optionally includes one or more spoolers, such as the upper spooler
1332, the lower spooler 1334, one or more rollers 1336, and/or one
or more spools 1338.
[0214] Referring still to FIG. 13A and now to FIG. 13C, the rolling
floor system 1300 is described relative to a patient positioning
system 1350. Generally, the patient positioning system 1350
comprises multiple degrees of freedom for positioning the patient
230 in an x, y, z position with yaw, tilt, and/or roll, and/or as a
function of patient rotation and time. The floor section 1322 of
the rolling floor system 1300, through which the nozzle system 146
penetrates, passes underneath the tumor 220 of the patient 230 when
the patient 230, positioned by the patient positioning system 1350,
is in a treatment position, such as in the treatment beam path 269.
Similarly, the gantry 490 rotates the nozzle system 146 around the
patient 230, such as along a concave or curved wall section 1340 of
the wall and rotates the nozzle system 146 in an arc above the
patient 230 with continued rotation of the gantry 490 and spooling
of the linked/physically clocked rolling floor system 1300.
[0215] The inventor notes that existing gantries, to allow movement
of the gantry under the patient, position the patient in space,
such as along a plank into a middle of an open chamber ten feet or
more off of the floor, which is distressful to the patient and
prevents an operator from approaching the patient during treatment.
In stark contrast, referring now to FIG. 13A and FIG. 13D, the
rolling floor system 1300 allows presence of the floor 1310 without
a gap and/or hole in the floor through which a person could fall
and still allows the gantry 490 to rotate under the patient 230.
More particularly, a nozzle extension 1380 integrated into the
nozzle system 146 comprises a set of guides 1382 and a set of
rollers 1384, where the rollers are in a track 1372 that
transitions from a curved section corresponding to the curved wall
to a flat section corresponding to the flat floor 1310. When the
gantry 490 positions the nozzle system 146 and the corresponding
co-rotating/clocked floor system 1300 along the curved wall 1340,
the rollers 1384 are at a first track position and a first guide
position, such as illustrated at a first time, t.sub.1. As the
gantry 490 rotates past a plane of the floor 1310 toward a bottom
position at a third time, t.sub.3, the rollers remain in the track,
but slide up the guides 1382 to a floor position 1386. Thus, the
patient 230 and/or the operator have a continuous floor 1310 when
the nozzle system 146 penetrates through the floor with rotation of
the gantry 490 under a plane of the floor as the flat section 1322
of the rolling floor continuously fills floor space vacated by the
moving nozzle system 146 and opens up floor space for the rotating
nozzle system 146 moving with the rotatable beamline support arm
498 of the gantry 490. Optionally, the nozzle system 146 continues
rotation around the patient 220, such as back up through the floor
1310 along an upward curved path 497 with a corresponding upward
curved track section 1376. Similarly, optionally the nozzle system
146 rotates 360 degrees around the patient 230 during use.
[0216] Patient Positioning/Imaging
[0217] Referring now to FIG. 13A, FIG. 14, and FIG. 15, patient
imaging is further described.
[0218] Referring now to FIG. 13A, a hybrid cancer treatment-imaging
system 1400 is illustrated, where the imaging system rotates on an
optionally and preferably independently rotatable mount from the
second bearing 1212 and/or the rotatable gantry support 1210.
Referring now to FIG. 14, an example of the hybrid cancer
treatment-imaging system 1400 is illustrated. Generally, the gantry
490, which optionally and preferably supports the nozzle system
146, rotates around the tumor 220 and/or an isocenter 263. As
illustrated, the gantry 490 rotates about a gantry rotation axis
1411, such as using the rotatable gantry support 1210. In one case,
the gantry 490 is supported on a first end by a first buttress,
wall, or support and on a second end by a second buttress, wall, or
support.
[0219] However, as further described, infra, preferably the gantry
490 is supported using floor based mounts. A fourth optional
rotation track 1214 or bearing and a fifth optional rotation track
1218 or bearing coupling the rotatable gantry support and the
gantry 490 are illustrated, where the rotation tracks are any
mechanical connection. Referring again to FIG. 12, for clarity of
presentation, only a portion of the gantry 490 is illustrated to
provide visualization of a supported rotational beamline section
138 of the beam transport system 135 or a section of the beamline
between the synchrotron 130 and the patient 230. To further
clarify, the gantry 490 is illustrated, at one moment in time,
supporting the nozzle system 146 of the beam transport system 135
in an orientation resulting in a vertical and downward vector of
the treatment beam 269. As the rotatable gantry support 1210
rotates, the gantry 490, the rotational beamline section 138 of the
beam transport line 135, the nozzle system 146 and the treatment
beam 269 rotate about the gantry rotation axis 1411, forming a set
of treatment beam vectors originating at circumferential positions
about tumor 220 or isocentre 263 and passing through the tumor 220.
Optionally, an X-ray beam path, from an X-ray source, runs through
and moves with the nozzle system 146 parallel to the treatment beam
269. Prior to, concurrently with, intermittently with, and/or after
the tumor 220 is treated with the set of treatment beam vectors,
one or more elements of the imaging system 170 image the tumor 220
of the patient 230.
[0220] Referring again to FIG. 14, the hybrid cancer
treatment-imaging system 1400 is illustrated with an optional set
of rails 1420 and an optional rotatable imaging system support 1412
that rotates the set of rails 1420, where the set of rails 1420
optionally includes n rails where n is a positive integer. Elements
of the set of rails 1420 support elements of the imaging system
170, the patient 230, and/or a patient positioning system. The
rotatable imaging system support 1412 is optionally concentric with
the rotatable gantry support 1210. The rotatable gantry support
1210 and the rotatable imaging system support 1412 optionally:
co-rotate, rotate at the same rotation rate, rotate at different
rates, or rotate independently. A reference point 1415 is used to
illustrate the case of the rotatable gantry support 1210 remaining
in a fixed position, such as a treatment position at a third time,
t.sub.3, and a fourth time, t.sub.4, while the rotatable imaging
system support 1412 rotates the set of rails 1420.
[0221] Still referring to FIG. 14, any rail of the set of rails
optionally rotates circumferentially around the x-axis, as further
described infra. For instance, the first rail 1422 is optionally
rotated as a function of time with the gantry 490, such as on an
opposite side of the nozzle system 146 relative to the tumor 220 of
the patient 230.
[0222] Still referring to FIG. 14, a first rail of the set of rails
1420 is optionally retracted at a first time, t.sub.1, and extended
at a second time, t.sub.2, as is any of the set of rails. Further,
any of the set of rails 1420 is optionally used to position a
source or a detector at any given extension/retraction point. A
second rail 1424 and a third rail 1426 of the set of rails 1420 are
illustrated. Generally, the second rail 1424 and the third rail
1426 are positioned on opposite sides of the patient 230, such as a
sinister side and a dexter side of the patient 230. Generally, the
second rail 1424, also referred to as a source side rail, positions
an imaging source system element and the third rail 1426, also
referred to as a detector side rail, positions an imaging detector
system element on opposite sides of the patient 230.
[0223] Optionally and preferably, the second rail 1424 and the
third rail 1426 extend and retract together, which keeps a source
element mounted, directly or indirectly, on the second rail 1424
opposite the patient 230 from a detector element mounted, directly
or indirectly, on the third rail 1426. Optionally, the second rail
1424 and the third rail 1426 position positron emission detectors
for monitoring emissions from the tumor 220 and/or the patient 230,
as further described infra.
[0224] Still referring to FIG. 14, a rotational imaging system 1440
is described. For example, the second rail 1424 is illustrated
with: (1) a first source system element 1441 of a first imaging
system, or first imaging system type, at a first extension position
of the second rail 1424, which is optically coupled with a first
detector system element 1451 of the first imaging system on the
third rail 1426 and (2) a second source system element 1443 of a
second imaging system, or second imaging system type, at a second
extension position of the second rail 1424, which is optically
coupled with a second detector system element 1453 of the second
imaging system on the third rail 1426, which allows the first
imaging system to image the patient 230 in a treatment position
and, after translation of the first rail 1424 and the second rail
1426, the second imaging system to image the patient 230 in the
patient's treatment position. Optionally the first imaging system
or primary imaging system and the second imaging system or
secondary imaging system are supplemented with a tertiary imaging
system, which uses any imaging technology. Optionally, first
signals from the first imaging system are fused with second signals
from the second imaging system to: (1) form a hybrid image; (2)
correct an image; and/or (3) form a first image using the first
signals and modified using the second signals or vise-versa.
[0225] Still referring to FIG. 14, the second rail 1424 and third
rail 1426 are optionally alternately translated inward and outward
relative to the patient, such as away from the first buttress and
toward the first buttress, as described infra. In a first case, the
second rail 1424 and the third rail 1426 extend outward on either
side of the patient, as illustrated in FIG. 14. Further, in the
first case the patient 230 is optionally maintained in a treatment
position, such as in a constrained laying position that is not
changed between imaging and treatment with the treatment beam 269.
In a second case, the patient 230 is relatively translated between
the second rail 1424 and the third rail 1426. In the second case,
the patient is optionally imaged out of the treatment beam path
269. Further, in the second case the patient 230 is optionally
maintained in a treatment orientation, such as in a constrained
laying position that is not changed until after the patient is
translated back into a treatment position and treated. In a third
case, the second rail 1424 and the third rail 1426 are translated
away from the rotatable gantry support 1210 and/or the patient 230
is translated toward the rotatable gantry support 1210 to yield
movement of the patient 230 relative to one or more elements of the
first imaging system type or second imaging system type.
Optionally, images using at least one imaging system type, such as
the first imaging system type, are collected as a function of the
described relative movement of the patient 230, such as along the
x-axis and/or as a function of rotation of the first imaging system
type and the second imaging system type around the x-axis, where
the first imaging type and second imaging system type use differing
types of sources, use differing types of detectors, are generally
thought of as distinct by those skilled in the art, and/or have
differing units of measure. Optionally, the source is emissions
from the body, such as a radioactive emission, decay, and/or gamma
ray emission, and the second rail 1424 and the third rail 1426
position and/or translate one or more emission detectors, such as a
first positron emission detector on a first side of the tumor 220
and a second positron emission detector on an opposite side of the
tumor 220.
Example I
[0226] Still referring to FIG. 14, an example of the hybrid cancer
treatment--rotational imaging system is illustrated. In one example
of the hybrid cancer treatment--rotational imaging system, the
second rail 1424 and third rail 1426 are optionally
circumferentially rotated around the patient 230, such as after
relative translation of the second rail 1424 and third rail 1426 to
opposite sides of the patient 230. As illustrated, the second rail
1424 and third rail 1426 are affixed to the rotatable imaging
system support 1412, which optionally rotates independently of the
rotatable gantry support 1210. As illustrated, the first source
system element 1441 of the first imaging system, such as a
two-dimensional X-ray imaging system, affixed to the second rail
1424 and the first detector system element 1451 collect a series of
preferably digital images, preferably two-dimensional images, as a
function of co-rotation of the second rail 1424 and the third rail
1426 around the tumor 220 of the patient 230, which is positioned
along the gantry rotation axis 1411 and/or about the isocenter 263
of the charged particle beam line in a treatment room. As a
function of rotation of the rotatable imaging system support 1412
about the gantry rotation axis 1411, two-dimensional images are
generated, which are combined to form a three-dimensional image,
such as in tomographic imaging. Optionally, collection of the
two-dimensional images for subsequent tomographic reconstruction
are collected: (1) with the patient in a constrained treatment
position, (2) while the charged particle beam system 100 is
treating the tumor 220 of the patient 230 with the treatment beam
269, (3) during positive charged particle beam tomographic imaging,
and/or (4) along an imaging set of angles rotationally offset from
a set of treatment angles during rotation of the gantry 490 and/or
rotation of the patient 230, such as on a patient positioning
element of a patient positioning system.
[0227] Optionally, one or more of the imaging systems described
herein monitor treatment of the tumor 220 and/or are used as
feedback to control the treatment of the tumor 220 by the treatment
beam 269.
[0228] Referring to FIG. 15, a combined patient positioning
system--imaging system 1500 is described. Generally, the combined
patient positioning system--imaging system 1500 comprises a joint
imaging/patient positioning system 1510 and a translation/rotation
imaging system 1520. The joint imaging/patient positioning system
1510 co-moves or jointly moves the translation/rotation imaging
system 1520 and the patient 230 as both a patient support 1514 and
the translation/rotation imaging system 1520 are attached to an end
of a robotic arm used to position the patient relative to a proton
treatment beam, as further described infra.
[0229] Still referring to FIG. 15, the joint imaging/patient
positioning system 1500 is further described. The joint
imaging/patient positioning system 1510 allows movement of the
patient 230 along one or more of: an x-axis, a y-axis, and a
z-axis. Further, the patient positioning system 1510 allows yaw,
tilt, and roll of the patient as well as rotation of the patient
230 relative to a point in space, such as one or more rotation axes
passing through the joint imaging/patient positioning system 1510
and/or an isocenter point 263 of a treatment room. For clarity of
presentation and without loss of generality, all permutations and
combinations of patient movement relative to a treatment proton
beam line are illustrated with a base unit 1512, such as affixed to
a floor or wall of the treatment room; an attachment unit 1516, of
the translation/rotation imaging system 1520; and a multi-element
robotic arm section 1518 connecting the base unit 1512 and the
attachment unit 1516.
[0230] Still referring to FIG. 15, the translation aspect of the
translation/rotation imaging system 1520 is further described. The
translation/rotation imaging system 1520 comprises a ring or a
source-detector rotational positioning unit 1522, an imaging system
source support 1524, a first imaging source 612, an imaging system
detector support 1526, and a first detector array 622. The imaging
system source support 1524 is used to move a source, such as the
first imaging source 612, of the translation/rotation imaging
system 1520 and the detector support 1526 is used to move a
detector, such as the first detector array 622, of the
translation/rotation imaging system 1520. For clarity of
presentation and without loss of generality, the first imaging
source 612 is used to represent any one or more of the imaging
sources described herein and the first detector array 622 is used
to represent one or more of the imaging detectors described herein.
As illustrated, in a first case, the imaging source 612, such as an
X-ray source, moves past the patient 230 on the imaging system
source support 1524, such as under control of the main controller
110 directing a motor or drive to move the imaging source 612 along
a guide, drive system, or rail. In the illustrated case, the
source-detector rotational positioning unit 1522 is connected to an
element, such as the patient support 1514, that is positioned
relative to the nozzle system 146 and/or treatment beam path 269.
However, the source-detector rotational positioning unit 1522 is
optionally connected to the attachment element 1516 or the
rotatable imaging system support 1412. Optionally, the patient
support 1514 uses a first electromechanical interface 1532 that
moves the translation/rotation imaging system 1520 relative to the
patient support 1514 and hence the patient 230. Optionally, the
first electromechanical interface 1532 is a solid/connected element
and a second electromechanical interface 1534 and a third
electromechanical interface 1536 are used to move the imaging
system source support 1524 and the imaging system detector support
1526, respectively, relative to the patient support 1514 and hence
the patient 230.
[0231] Referring again to FIG. 14 and still referring to FIG. 15,
generally, any mechanical/electromechanical system is used to
connect the source-detector rotational positioning unit 1522 to the
attachment unit 1516 and/or an intervening connector, such as the
patient support 1514 or a secondary attachment unit 1540, as
further described infra. Notably, the patient support 1514 and/or
patient 230 optionally pass into and/or through an aperture through
the source-detector rotational positioning unit 1522. In practice,
any of the first through third electromechanical connectors 1532,
1534, 1536 function to move a first element relative to a second
element, such as along a track/rail and/or any mechanically guiding
system, such as driven by a belt, gear, motor, and/or any motion
driving source/system.
[0232] Still referring to FIG. 15, optionally, the imaging system
source support 1524 extends/retracts away/toward the attachment
unit, which results in translation of the X-ray source past the
patient 230. Similarly, as illustrated, the first detector array
622, such as an two-dimensional X-ray detector panel, moves past
the patient on the imaging system detector support 1526, such as
under control of the main controller directing a motor or drive to
move the first detector array 622, such as an X-ray detector panel,
along a guide, drive system, or rail. Optionally, the imaging
system detector support 1526 extends/retracts away/toward the
source-detector rotational positioning unit 1522, which results in
translation of the X-ray detector past the patient 230.
[0233] Referring again to FIG. 15, the interface of the
translation/rotation imaging system 1520 and the patient support
1514 to the joint imaging/patient positioning system 1510 is
described. Essentially, as the attachment unit 1516 of the joint
imaging/patient positioning system 1510 is directly
connected/physically static relative to both the
translation/rotation imaging system 1520 and the patient support
1514, as the imaging/patient positioning system 1510 moves the
patient support 1514 the entire translation/rotation imaging system
1520 moves with the patient support. Thus, no net difference in
position between the translation/rotation imaging system 1520 and
the patient 230 or patient support 1514 results as the joint
imaging/patient positioning system 1510 positions the patient 230
relative to the positively charged particle tumor treatment beam
269 and/or nozzle system 146. However, individual elements of the
translation/rotation imaging system 1520 are allowed to move
relative to the patient 230, such as in the translation movements
described above and the rotation movements described below.
[0234] Referring still to FIG. 15, the imaging source 612 and the
first detector array 622 rotate around the patient in and out of
the page. More precisely, both: (1) the first imaging source 612
and the imaging system source support 1524 and (2) the first
detector array 622 and the imaging system detector support 1526,
while connected to the source-detector positioning unit, rotate
about patient support 1514 and the patient 230. Just as illustrated
in FIG. 14, all of: (1) the first imaging source 612, (2) the
imaging system source support 1524, (3) the first detector array
622, and (4) the imaging system detector support 1526, optionally
and preferably rotate around the patient 230 independent of
movement of the patient, relative to a current position of the
positively charged particle treatment beam passing through the
nozzle system 146, using the imaging/patient positioning system
1510. Generally, the first imaging source 612 and the first
detector array 622 are positioned at any position from 0 to 360
degrees around the patient 230 and/or the first imaging source 612
and the first detector array 622 are positioned at any translation
position relative to a longitudinal axis of the patient 230, such
as from head to toe.
[0235] Integrated Gantry, Patient Positioning, Imaging, and Rolling
Floor System
[0236] Referring now to FIG. 16, a gantry superstructure 1600 is
illustrated. In this example, the counterweighted gantry system
1100 and the rolling floor system 1300 are illustrated relative to
one another. In this example, the patient positioning system 1350
is illustrated using the hybrid cancer treatment-imaging system
1400 described, supra, where a patient platform/support 1356 is
mounted onto/inside the second bearing 1212, such as on a
nonrotating or minimally rotating element of the rotatable imaging
system support 1412, where the patient platform 1356 is extendable
over the flat section 1322 of the rolling floor system 1300.
Further, an optional single element counterweight extension 1126 is
illustrated, such as optionally affixed to the first counterweight
1122.
[0237] Floor Force Directed Gantry System
[0238] Referring now to FIG. 17, a wall mounted gantry system 1700
is illustrated, where a wall mounted gantry 499 is bolted to a
first wall 1710, such as a first buttress, with a first set of
bolts 1714, optionally using a first mounting element 1712, and
mounted to a second wall 1720, such as a second buttress 1720, such
a through a second mounting element 1722, with a second set of
bolts 1714. The inventor notes that in this design, forces, such as
a first force, F.sub.1, and a second force, F.sub.2, are directed
outward into the first wall 1710 and the second wall 1720,
respectively, where at least twenty percent of resolved force is
along the x-axis as illustrated. Thus, the wall mounted gantry
system 499 must be designed to overcome tensile stress on the
bolts, greatly increasing mounting costs of the wall mounted gantry
system 499. Further, the wall mounted gantry 499 design thus
requires that the walls of the building are specially designed to
withstand the multi-ton horizontal forces resultant from the wall
mounted gantry 499. Further, as the wall mounted gantry 1700 must
rotate about an axis of rotation to function, the wall mounted
gantry 1700 cannot be connected to front and back walls, but rather
can only be mounted to side walls, such as the first wall 1710 and
the second wall 1720 as illustrated. Thus, when the wall mounted
gantry 499 rotates, the center of mass of the wall mounted gantry
499 necessarily moves into a position that is not between the end
mounting points, such as the first mounting element 1712 and the
second mounting element 1722. With movement of the center of mass
of the wall mounted gantry 499 outside of the supports, the gantry
must be configured with additional systems to prevent the wall
mounted gantry system 499 from tipping over. In stark contrast,
referring now to FIG. 18, in a floor mounted gantry system 1800 the
gantry 490 is optionally and preferably designed to rest directly
onto a support, such as the floor 1310, with no requirement of a
wall mounted system. As illustrated, the mass of the gantry 490
results in only downward forces, such as a third force, F.sub.3,
into ground or a first pier 1810 and as a fourth force, F.sub.4,
into ground and/or a second pier 1820. Generally, in the floor
mounted gantry system, the center of mass of the gantry 490 is
inside a footprint of the piers, such as the first pier 1810 and
the second pier 1820 and maintains a footprint inside the piers
even as the gantry rotates due to use of additional piers into or
out of FIG. 18 and/or due to use of the counter mass in the
counterweighted gantry system 1100.
[0239] Referring now to FIG. 19, an example of the gantry
superstructure 1600 is illustrated incorporating the gantry 490,
the gantry support arm 498, the counterweight system 1120, the
rotatable beamline section 138, and the rolling floor system 1300.
The rotatable gantry support 1210 is illustrated with the optional
hybrid cancer treatment-imaging system 1400. Further, the first
pier 1810 and the second pier 1820 of the floor mounted gantry
system 1800 are illustrated, which are representative of any number
of underfloor gantry support elements designed to support the
gantry 490, where the underfloor gantry support elements are out of
a rotation path of the gantry support arm 498 and the rotatable
beamline section 138.
[0240] Referenced Charged Particle Path
[0241] Referring now to FIG. 20, a charged particle reference beam
path system 2000 is described, which starkly contrasts to an
isocenter reference point of a gantry system, as described supra.
The charged particle reference beam path system 2000 defines voxels
in the treatment room 922, the patient 230, and/or the tumor 220
relative to a reference path of the positively charged particles
and/or a transform thereof. The reference path of the positively
charged particles comprises one or more of: a zero vector, an
unredirected beamline, an unsteered beamline, a nominal path of the
beamline, and/or, such as, in the case of a rotatable gantry and/or
moveable nozzle, a translatable and/or a rotatable position of the
zero vectors. For clarity of presentation and without loss of
generality, the terminology of a reference beam path is used herein
to refer to an axis system defined by the charged particle beam
under a known set of controls, such as a known position of entry
into the treatment room 922, a known vector into the treatment room
922, a first known field applied in the first axis control 143,
and/or a second known field applied in the second axis control 144.
Further, as described, supra, a reference zero point or zero point
1002 is a point on the reference beam path. More generally, the
reference beam path and the reference zero point optionally refer
to a mathematical transform of a calibrated reference beam path and
a calibrated reference zero point of the beam path, such as a
charged particle beam path defined axis system. The calibrated
reference zero point is any point; however, preferably the
reference zero point is on the calibrated reference beam path and
as used herein, for clarity of presentation and without loss of
generality, is a point on the calibrated reference beam path
crossing a plane defined by a terminus of the nozzle of the nozzle
system 146. Optionally and preferably, the reference beam path is
calibrated, in a prior calibration step, against one or more system
position markers as a function of one or more applied fields of the
first known field and the second known field and optionally energy
and/or flux/intensity of the charged particle beam, such as along
the treatment beam path 269. The reference beam path is optionally
and preferably implemented with a fiducial marker system and is
further described infra.
Example I
[0242] In a first example, referring still to FIG. 20, the charged
particle reference beam path system 2000 is further described using
a radiation treatment plan developed using a traditional isocenter
axis system 2022. A medical doctor approved radiation treatment
plan 2010, such as a radiation treatment plan developed using the
traditional isocenter axis system 2022, is converted to a radiation
treatment plan using the reference beam path--reference zero point
treatment plan. The conversion step, when coupled to a calibrated
reference beam path, uses an ideal isocenter point; hence,
subsequent treatment using the calibrated reference beam and
fiducial indicators 2040 removes the isocenter volume error. For
instance, prior to tumor treatment 2070, fiducial indicators 2040
are used to determine position of the patient 230 and/or to
determine a clear treatment path to the patient 230. For instance,
the reference beam path and/or treatment beam path 269 derived
therefrom is projected in software to determine if the treatment
beam path 269 is unobstructed by equipment in the treatment room
using known geometries of treatment room objects and fiducial
indicators 2040 indicating position and/or orientation of one or
more and preferably all movable treatment room objects. The
software is optionally implemented in a virtual treatment system.
Preferably, the software system verifies a clear treatment path,
relative to the actual physical obstacles marked with the fiducial
indicators 2040, in the less than 5, 4, 3, 2, 1, and/or 0.1 seconds
prior to each use of the treatment beam path 269 and/or in the less
than 5, 4, 3, 2, 1, and/or 0.1 seconds following movement of the
patient positioning system, patient 230, and/or operator.
Example II
[0243] In a second example, referring again to FIG. 20, the charged
particle reference beam path system 2000 is further described.
[0244] Generally, a radiation treatment plan is developed 2020. In
a first case, an isocenter axis system 2022 is used to develop the
radiation treatment plan 2020. In a second case, a system using the
reference beam path of the charged particles 2024 is used to
develop the radiation treatment plan. In a third case, the
radiation treatment plan developed using the reference beam path
2020 is converted to an isocenter axis system 2022, to conform with
traditional formats presented to the medical doctor, prior to
medical doctor approval of the radiation treatment plan 2010, where
the transformation uses an actual isocenter point and not a
mechanically defined isocenter volume and errors associated with
the size of the volume, as detailed supra. In any case, the
radiation treatment plan is tested, in software and/or in a dry run
absent tumor treatment, using the fiducial indicators 2040. The dry
run allows a real-life error check to ensure that no mechanical
element crosses the treatment beam in the proposed or developed
radiation treatment plan 2020. Optionally, a physical dummy placed
in a patient treatment position is used in the dry run.
[0245] After medical doctor approval of the radiation treatment
plan 2010, tumor treatment 2070 commences, optionally and
preferably with an intervening step of verifying a clear treatment
path 2052 using the fiducial indicators 2040. In the event that the
main controller 110 determines, using the reference beam path and
the fiducial indicators 1140, that the treatment beam 269 would
intersect an object or operator in the treatment room 922, multiple
options exist. In a first case, the main controller 110, upon
determination of a blocked and/or obscured treatment path of the
treatment beam 269, temporarily or permanently stops the radiation
treatment protocol. In a second case, optionally after interrupting
the radiation treatment protocol, a modified treatment plan is
developed 2054 for subsequent medical doctor approval of the
modified radiation treatment plan 2010. In a third case, optionally
after interrupting the radiation treatment protocol, a physical
transformation of a delivery axis system is performed 2030, such as
by moving the nozzle system 146, rotating and/or translating the
nozzle position 2034, and/or switching to another beamline 2036.
Subsequently, tumor treatment 2070 is resumed and/or a modified
treatment plan is presented to the medical doctor for approval of
the radiation treatment plan.
[0246] Automated Cancer Therapy Imaging/Treatment System
[0247] Cancer treatment using positively charged particles involves
multi-dimensional imaging, multi-axes tumor irradiation treatment
planning, multi-axes beam particle beam control, multi-axes patient
movement during treatment, and intermittently intervening objects
between the patient and/or the treatment nozzle system. Automation
of subsets of the overall cancer therapy treatment system using
robust code simplifies working with the intermixed variables, which
aids oversight by medical professionals. Herein, an automated
system is optionally semi-automated, such as overseen by a medical
professional.
Example I
[0248] In a first example, referring still to FIG. 20 and referring
now to FIG. 21, a first example of a semi-automated cancer therapy
treatment system 2100 is described and the charged particle
reference beam path system 2000 is further described. The charged
particle reference beam path system 2000 is optionally and
preferably used to automatically or semi-automatically: (1)
identify an upcoming treatment beam path; (2) determine presence of
an object in the upcoming treatment beam path; and/or (3) redirect
a path of the charged particle beam to yield an alternative
upcoming treatment beam path. Further, the main controller 110
optionally and preferably contains a prescribed tumor irradiation
plan, such as provided by a prescribing doctor. In this example,
the main controller 110 is used to determine an alternative
treatment plan to achieve the same objective as the prescribed
treatment plan. For instance, the main controller 110, upon
determination of the presence of an intervening object in an
upcoming treatment beam path or imminent treatment path directs
and/or controls: movement of the intervening object; movement of
the patient positioning system; and/or position of the nozzle
system 146 to achieve identical or substantially identical
treatment of the tumor 220 in terms of radiation dosage per voxel
and/or tumor collapse direction, where substantially identical is a
dosage and/or direction within 90, 95, 97, 98, 99, or 99.5 percent
of the prescription. Herein, an imminent treatment path is the next
treatment path of the charged particle beam to the tumor in a
current version of a radiation treatment plan and/or a treatment
beam path/vector that is scheduled for use within the next 1, 5,
10, 30, or 60 seconds. In a first case, the revised tumor treatment
protocol is sent to a doctor, such as a doctor in a neighboring
control room and/or a doctor in a remote facility or outside
building, for approval. In a second case, the doctor, present or
remote, oversees an automated or semi-automated revision of the
tumor treatment protocol, such as generated using the main
controller. Optionally, the doctor halts treatment, suspends
treatment pending an analysis of the revised tumor treatment
protocol, slows the treatment procedure, or allows the main
controller to continue along the computer suggested revised tumor
treatment plan. Optionally and preferably, imaging data and/or
imaging information, such as described supra, is input to the main
controller 110 and/or is provided to the overseeing doctor or the
doctor authorizing a revised tumor treatment irradiation plan.
Example II
[0249] Referring now to FIG. 21, a second example of the
semi-automated cancer therapy treatment system 2100 is described.
Initially, a medical doctor, such as an oncologist, provides an
approved radiation treatment plan 2110, which is implemented in a
treatment step of delivering charged particles 2128 to the tumor
220 of the patient 230. Concurrent with implementation of the
treatment step, additional data is gathered, such as via an
updated/new image from an imaging system and/or via the fiducial
indicators 2040. Subsequently, the main controller 110 optionally,
in an automated process or semi-automated process, adjusts the
provided doctor approved radiation treatment plan 2110 to form a
current radiation treatment plan. In a first case, cancer
treatments halts until the doctor approves the proposed/adjusted
treatment plan and continues using the now, doctor approved,
current radiation treatment plan. In a second case, the computer
generated radiation treatment plan continues in an automated
fashion as the current treatment plan. In a third case, the
computer generated treatment plan is sent for approval, but cancer
treatment proceeds at a reduced rate to allow the doctor time to
monitor the changed plan. The reduced rate is optionally less than
100, 90, 80, 70, 60, or 50 percent of the original treatment rate
and/or is greater than 0, 10, 20, 30, 40, or 50 percent of the
original treatment rate. At any time, the overseeing doctor,
medical professional, or staff may increase or decrease the rate of
treatment.
Example III
[0250] Referring still to FIG. 21, a third example of the
semi-automated cancer therapy treatment system 2100 is described.
In this example, a process of semi-autonomous cancer treatment 2120
is implemented. In stark contrast with the previous example where a
doctor provides the original cancer treatment plan 2110, in this
example the cancer therapy system 110 auto-generates a radiation
treatment plan 2126. Subsequently, the auto-generated treatment
plan, now the current radiation treatment plan, is implemented,
such as via the treatment step of delivering charged particles 2128
to the tumor 220 of the patient 230.
[0251] Optionally and preferably, the auto-generated radiation
treatment plan 2126 is reviewed in an intervening and/or concurrent
doctor oversight step 2130, where the auto-generated radiation
treatment plan 2126 is approved as the current treatment plan 2132
or approved as an alternative treatment plan 2134; once approved
referred to as the current treatment plan.
[0252] Generally, the original doctor approved treatment plan 2110,
the auto generated radiation treatment plan 2126, or the altered
treatment plan 2134, when being implemented is referred to as the
current radiation treatment plan.
Example IV
[0253] Referring still to FIG. 21, a fourth example of the
semi-automated cancer therapy treatment system 2100 is described.
In this example, the current radiation treatment plan, prior to
implementation of a particular set of voxels of the tumor 220 of
the patient 230, is analyzed in terms of clear path analysis, as
described supra. More particularly, fiducial indicators 2040 are
used in determination of a clear treatment path prior to treatment
along an imminent beam treatment path to one or more voxels of the
tumor 220 of the patient. Upon implementation, the imminent
treatment vector is the treatment vector in the deliver charged
particles step 2128.
Example V
[0254] Referring still to FIG. 21, a fifth example of the
semi-automated cancer therapy treatment system 2100 is described.
In this example, a cancer treatment plan is generated
semi-autonomously or autonomously using the main controller 110 and
the process of semi-autonomous cancer treatment system. More
particularly, the process of semi-autonomous cancer treatment 2120
uses input from: (1) a semi-autonomously patient positioning step
2122; (2) a semi-autonomous tumor imaging step 2124, and/or for the
fiducial indicators 2040; and/or (3) a software coded set of
radiation treatment directives with optional weighting parameters.
For example, the treatment directives comprise a set of criteria
to: (1) treat the tumor 220; (2) while reducing energy delivery of
the charged particle beam outside of the tumor 220; minimizing or
greatly reducing passage of the charged particle beam into a high
value element, such as an eye, nerve center, or organ, the process
of semi-autonomous cancer treatment 2120 optionally auto-generates
the original radiation treatment plan 2126. The auto-generated
original radiation treatment plan 2126 is optionally
auto-implemented, such as via the deliver charged particles step
2126, and/or is optionally reviewed by a doctor, such as in the
doctor oversight 2130 process, described supra.
[0255] Optionally and preferably, the semi-autonomous imaging step
2124 generates and/or uses data from: (1) one or more proton scans
from an imaging system using protons to image the tumor 220; (2)
one or more X-ray images using one or more X-ray imaging systems;
(3) a positron emission system; (4) a computed tomography system;
and/or (5) any imaging technique or system described herein.
[0256] The inventor notes that traditionally days pass between
imaging the tumor and treating the tumor while a team of
oncologists develop a radiation plan. In stark contrast, using the
autonomous imaging and treatment steps described herein, such as
implemented by the main controller 110, the patient optionally
remains in the treatment room and/or in a treatment position in a
patient positioning system from the time of imaging, through the
time of developing a radiation plan, and through at least a first
tumor treatment session.
Example VI
[0257] Referring still to FIG. 21, a sixth example of the
semi-automated cancer therapy treatment system 2100 is described.
In this example, the deliver charged particle step 2128, using a
current radiation treatment plan, is adjusted autonomously or
semi-autonomously using concurrent and/or interspersed images from
the semi-autonomously imaging system 2124 as interpreted, such as
via the process of semi-automated cancer treatment 2120 and input
from the fiducial indicators 2040 and/or the semi-automated patient
position system 2122.
[0258] Referring now to FIG. 22, a system for developing a
radiation treatment plan 2210 using positively charged particles is
described. More particularly, a semi-automated radiation treatment
plan development system 2200 is described, where the semi-automated
system is optionally fully automated or contains fully automated
sub-processes.
[0259] The computer implemented algorithm, such as implemented
using the main controller 110, in the automated radiation treatment
plan development system 2200 generates a score, sub-score, and/or
output to rank a set of auto-generated potential radiation
treatment plans, where the score is used in determination of a best
radiation treatment plan, a proposed radiation treatment plan,
and/or an auto-implemented radiation treatment plan.
[0260] Still referring to FIG. 22, the semi-automated or automated
radiation treatment plan development system 2200 optionally and
preferably provides a set of inputs, guidelines, and/or weights to
a radiation treatment development code that processes the inputs to
generate an optimal radiation treatment plan and/or a preferred
radiation treatment plan based upon the inputs, guidelines, and/or
weights. An input is a goal specification, but not an absolute
fixed requirement. Input goals are optionally and preferably
weighted and/or are associated with a hard limit. Generally, the
radiation treatment development code uses an algorithm, an
optimization protocol, an intelligent system, computer learning,
supervised, and/or unsupervised algorithmic approach to generating
a proposed and/or immediately implemented radiation treatment plan,
which are compared via the score described above. Inputs to the
semi-automated radiation treatment plan development system 2200
include images of the tumor 220 of the patient 230, treatment
goals, treatment restrictions, associated weights to each input,
and/or associated limits of each input. To facilitate description
and understanding of the invention, without loss of generality,
optional inputs are illustrated in FIG. 22 and further described
herein by way of a set of examples.
Example I
[0261] Still referring to FIG. 22, a first input to the
semi-automated radiation treatment plan development system 2200,
used to generate the radiation treatment plan 2210, is a
requirement of dose distribution 2220. Herein, dose distribution
comprises one or more parameters, such as a prescribed dosage 2221
to be delivered; an evenness or uniformity of radiation dosage
distribution 2222; a goal of reduced overall dosage 2223 delivered
to the patient 230; a specification related to minimization or
reduction of dosage delivered to critical voxels 2224 of the
patient 230, such as to a portion of an eye, brain, nervous system,
and/or heart of the patient 230; and/or an extent of, outside a
perimeter of the tumor, dosage distribution 2225. The automated
radiation treatment plan development system 2200 calculates and/or
iterates a best radiation treatment plan using the inputs, such as
via a computer implemented algorithm.
[0262] Each parameter provided to the automated radiation treatment
plan development system 2200, optionally and preferably contains a
weight or importance. For clarity of presentation and without loss
of generality, two cases illustrate.
[0263] In a first case, a requirement/goal of reduction of dosage
or even complete elimination of radiation dosage to the optic nerve
of the eye, provided in the minimized dosage to critical voxels
2224 input is given a higher weight than a requirement/goal to
minimize dosage to an outer area of the eye, such as the rectus
muscle, or an inner volume of the eye, such as the vitreous humor
of the eye. This first case is exemplary of one input providing
more than one sub-input where each sub-input optionally includes
different weighting functions.
[0264] In a second case, a first weight and/or first sub-weight of
a first input is compared with a second weight and/or a second
sub-weight of a second input. For instance, a distribution
function, probability, or precision of the even radiation dosage
distribution 2222 input optionally comprises a lower associated
weight than a weight provided for the reduce overall dosage 2223
input to prevent the computer algorithm from increasing radiation
dosage in an attempt to yield an entirely uniform dose
distribution.
[0265] Each parameter and/or sub-parameter provided to the
automated radiation treatment plan development system 2200,
optionally and preferably contains a limit, such as a hard limit,
an upper limit, a lower limit, a probability limit, and/or a
distribution limit. The limit requirement is optionally used, by
the computer algorithm generating the radiation treatment plan
2210, with or without the weighting parameters, described
supra.
Example II
[0266] Still referring to FIG. 22, a second input to the
semi-automated radiation treatment plan development system 2200, is
a patient motion 2230 input. The patient motion 2230 input
comprises: a move the patient in one direction 2232 input, a move
the patient at a uniform speed 2233 input, a total patient rotation
2234 input, a patient rotation rate 2235 input, and/or a patient
tilt 2236 input. For clarity of presentation and without loss of
generality, the patient motion inputs are further described, supra,
in several cases.
[0267] Still referring to FIG. 22, in a first case the automated
radiation treatment plan development system 2200, provides a
guidance input, such as the move the patient in one direction 2232
input, but a further associated directive is if other goals require
it or if a better overall score of the radiation treatment plan
2210 is achieved, the guidance input is optionally automatically
relaxed. Similarly, the move the patient at a uniform rate 2233
input is also provided with a guidance input, such as a low
associated weight that is further relaxable to yield a high score,
of the radiation treatment plan 2210, but is only relaxed or
implemented an associated fixed or hard limit number of times.
[0268] Still referring to FIG. 22, in a second case the computer
implemented algorithm, in the automated radiation treatment plan
development system 2200, optionally generates a sub-score. For
instance, a patient comfort score optionally comprises a score
combining a metric related to two or more of: the move the patient
in one direction 2232 input, the move the patient at a uniform rate
2233 input, the total patient rotation 2234 input, the patient
rotation rate 2235 input, and/or the reduce patient tilt 2236
input. The sub-score, which optionally has a preset limit, allows
flexibility, in the computer implemented algorithm, to yield on
patient movement parameters as a whole, again to result in patient
comfort.
[0269] Still referring to FIG. 22, in a third case the automated
radiation treatment plan development system 2200 optionally
contains an input used for more than one sub-function. For example,
a reduce treatment time 2231 input is optionally used as a patient
comfort parameter and also links into the dose distribution 2220
input.
Example III
[0270] Still referring to FIG. 22, a third input to the automated
radiation treatment plan development system 2200 comprises output
of an imaging system, such as any of the imaging systems described
herein.
Example IV
[0271] Still referring to FIG. 22, a fourth optional input to the
automated radiation treatment plan development system 2200 is
structural and/or physical elements present in the treatment room
922. Again, for clarity of presentation and without loss of
generality, two cases illustrate treatment room object information
as an input to the automated development of the radiation treatment
plan 2210.
[0272] Still referring to FIG. 22, in a first case the automated
radiation treatment plan development system 2200 is optionally
provided with a pre-scan of potentially intervening support
structures 2282 input, such as a patient support device, a patient
couch, and/or a patient support element, where the pre-scan is an
image/density/redirection impact of the support structure on the
positively charged particle treatment beam. Preferably, the
pre-scan is an actual image or tomogram of the support structure
using the actual facility synchrotron, a remotely generated actual
image, and/or a calculated impact of the intervening structure on
the positively charge particle beam. Determination of impact of the
support structure on the charged particle beam is further
described, infra.
[0273] Still referring to FIG. 22, in a second case the automated
radiation treatment plan development system 2200 is optionally
provided with a reduce treatment through a support structure 2244
input. As described supra, an associated weight, guidance, and/or
limit is optionally provided with the reduce treatment through the
support structure 2244 input and, also as described supra, the
support structure input is optionally compromised relative to a
more critical parameter, such as the deliver prescribed dosage 2221
input or the minimize dosage to critical voxels 2224 of the patient
230 input.
Example V
[0274] Still referring to FIG. 22, a fifth optional input to the
automated radiation treatment plan development system 2200 is a
doctor input 2136, such as provided only prior to the auto
generation of the radiation treatment plan. Separately, doctor
oversight 2130 is optionally provided to the automated radiation
treatment plan development system 2200 as plans are being
developed, such as an intervention to restrict an action, an
intervention to force an action, and/or an intervention to change
one of the inputs to the automated radiation treatment plan
development system 2200 for a radiation plan for a particular
individual.
Example VI
[0275] Still referring to FIG. 22, a sixth input to the automated
radiation treatment plan development system 2200 comprises
information related to collapse and/or shifting of the tumor 220 of
the patient 230 during treatment. For instance, the radiation
treatment plan 2210 is automatically updated, using the automated
radiation treatment plan development system 2200, during treatment
using an input of images of the tumor 220 of the patient 230
collected concurrently with treatment using the positively charged
particles. For instance, as the tumor 220 reduces in size with
treatment, the tumor 220 collapses inward and/or shifts. The
auto-updated radiation treatment plan is optionally
auto-implemented, such as without the patient moving from a
treatment position. Optionally, the automated radiation treatment
plan development system 2200 tracks dosage of untreated voxels of
the tumor 220 and/or tracks partially irradiated, relative to the
prescribed dosage 2221, voxels and dynamically and/or automatically
adjusts the radiation treatment plan 2210 to provide the full
prescribed dosage to each voxel despite movement of the tumor 220.
Similarly, the automated radiation treatment plan development
system 2200 tracks dosage of treated voxels of the tumor 220 and
adjusts the automatically updated tumor treatment plan to reduce
and/or minimize further radiation delivery to the fully treated and
shifted tumor voxels while continuing treatment of the partially
treated and/or untreated shifted voxels of the tumor 220.
[0276] Automated Adaptive Treatment
[0277] Referring now to FIG. 23, a system for automatically
updating the radiation treatment plan 2300 and preferably
automatically updating and implementing the radiation treatment
plan is illustrated. In a first task 2310, an initial radiation
treatment plan is provided, such as the auto-generated radiation
treatment plan 2126, described supra. The first task is a startup
task of an iterative loop of tasks and/or recurring set of tasks,
described herein as comprising tasks two to four.
[0278] In a second task 2320, the tumor 220 is treated using the
positively charged particles delivered from the synchrotron 130. In
a third task 2330, changes in the tumor shape and/or changes in the
tumor position relative to surrounding constituents of the patient
230 are observed, such as via any of the imaging systems described
herein. The imaging optionally occurs simultaneously, concurrently,
periodically, and/or intermittently with the second task while the
patient remains positioned by the patient positioning system. The
main controller 110 uses images from the imaging system(s) and the
provided and/or current radiation treatment plan to determine if
the treatment plan is to be followed or modified. Upon detected
relative movement of the tumor 220 relative to the other elements
of the patient 230 and/or change in a shape of the tumor 230, a
fourth task 2340 of updating the treatment plan is optionally and
preferably automatically implemented and/or use of the radiation
treatment plan development system 2200, described supra, is
implemented. The process of tasks two to four is optionally and
preferably repeated n times where n is a positive integer of
greater than 1, 2, 5, 10, 20, 50, or 100 and/or until a treatment
session of the tumor 220 ends and the patient 230 departs the
treatment room 922.
[0279] Automated Treatment
[0280] Referring now to FIG. 24, an automated cancer therapy
treatment system 2400 is illustrated. In the automated cancer
therapy treatment system 2400, a majority of tasks are implemented
according to a computer based algorithm and/or an intelligent
system. Optionally and preferably, a medical professional oversees
the automated cancer therapy treatment system 2400 and stops or
alters the treatment upon detection of an error but fundamentally
observes the process of computer algorithm guided implementation of
the system using electromechanical elements, such as any of the
hardware and/or software described herein. Optionally and
preferably, each sub-system and/or sub-task is automated.
Optionally, one or more of the sub-systems and/or sub-tasks are
performed by a medical professional. For instance, the patient 230
is optionally initially positioned in the patient positioning
system by the medical professional and/or the nozzle system 146
inserts are loaded by the medical professional. Optional and
preferably automated, such as computer algorithm implemented,
sub-tasks include one or more and preferably all of: [0281]
receiving the treatment plan input 2200, such as a prescription,
guidelines, patient motion guidelines 2230, dose distribution
guidelines 2220, intervening object 2210 information, and/or images
of the tumor 220; [0282] using the treatment plan input 2200 to
auto-generate a radiation treatment plan 2126; [0283]
auto-positioning 2122 the patient 230; [0284] auto-imaging 2124 the
tumor 220; [0285] implementing medical profession oversight 2138
instructions; [0286] auto-implementing the radiation treatment plan
2320/delivering the positively charged particles to the tumor 220;
[0287] auto-reposition the patient 2321 for subsequent radiation
delivery; [0288] auto-rotate a nozzle position 2322 of the nozzle
system 146 relative to the patient 230; [0289] auto-translate a
nozzle position 2323 of the nozzle system 146 relative to the
patient 230; [0290] auto-verify a clear treatment path using an
imaging system, such as to observe presence of a metal object or
unforeseen dense object via an X-ray image; [0291] auto-verify a
clear treatment path using fiducial indicators 2324; [0292] auto
control a state of the positively charge particle beam 2325, such
as energy, intensity, position (x,y,z), duration, and/or direction;
[0293] auto-control a particle beam path 2326, such as to a
selected beamline and/or to a selected nozzle; [0294] auto
implement positioning a tray insert and/or tray assembly; [0295]
auto-update a tumor image 2410; [0296] auto-observe tumor movement
2330; and/or [0297] generate an auto-modified radiation treatment
plan 2340/new treatment plan.
[0298] Still yet another embodiment includes any combination and/or
permutation of any of the elements described herein.
[0299] The main controller, a localized communication apparatus,
and/or a system for communication of information optionally
comprises one or more subsystems stored on a client. The client is
a computing platform configured to act as a client device or other
computing device, such as a computer, personal computer, a digital
media device, and/or a personal digital assistant. The client
comprises a processor that is optionally coupled to one or more
internal or external input device, such as a mouse, a keyboard, a
display device, a voice recognition system, a motion recognition
system, or the like. The processor is also communicatively coupled
to an output device, such as a display screen or data link to
display or send data and/or processed information, respectively. In
one embodiment, the communication apparatus is the processor. In
another embodiment, the communication apparatus is a set of
instructions stored in memory that is carried out by the
processor.
[0300] The client includes a computer-readable storage medium, such
as memory. The memory includes, but is not limited to, an
electronic, optical, magnetic, or another storage or transmission
data storage medium capable of coupling to a processor, such as a
processor in communication with a touch-sensitive input device
linked to computer-readable instructions. Other examples of
suitable media include, for example, a flash drive, a CD-ROM, read
only memory (ROM), random access memory (RAM), an
application-specific integrated circuit (ASIC), a DVD, magnetic
disk, an optical disk, and/or a memory chip. The processor executes
a set of computer-executable program code instructions stored in
the memory. The instructions may comprise code from any
computer-programming language, including, for example, C originally
of Bell Laboratories, C++, C#, Visual Basic.RTM. (Microsoft,
Redmond, Wash.), Matlab.RTM. (MathWorks, Natick, Mass.), Java.RTM.
(Oracle Corporation, Redwood City, Calif.), and JavaScript.RTM.
(Oracle Corporation, Redwood City, Calif.).
[0301] Herein, any number, such as 1, 2, 3, 4, 5, is optionally
more than the number, less than the number, or within 1, 2, 5, 10,
20, or 50 percent of the number.
[0302] Herein, an element and/or object is optionally manually
and/or mechanically moved, such as along a guiding element, with a
motor, and/or under control of the main controller.
[0303] The particular implementations shown and described are
illustrative of the invention and its best mode and are not
intended to otherwise limit the scope of the present invention in
any way. Indeed, for the sake of brevity, conventional
manufacturing, connection, preparation, and other functional
aspects of the system may not be described in detail. Furthermore,
the connecting lines shown in the various figures are intended to
represent exemplary functional relationships and/or physical
couplings between the various elements. Many alternative or
additional functional relationships or physical connections may be
present in a practical system.
[0304] In the foregoing description, the invention has been
described with reference to specific exemplary embodiments;
however, it will be appreciated that various modifications and
changes may be made without departing from the scope of the present
invention as set forth herein. The description and figures are to
be regarded in an illustrative manner, rather than a restrictive
one and all such modifications are intended to be included within
the scope of the present invention. Accordingly, the scope of the
invention should be determined by the generic embodiments described
herein and their legal equivalents rather than by merely the
specific examples described above. For example, the steps recited
in any method or process embodiment may be executed in any order
and are not limited to the explicit order presented in the specific
examples. Additionally, the components and/or elements recited in
any apparatus embodiment may be assembled or otherwise
operationally configured in a variety of permutations to produce
substantially the same result as the present invention and are
accordingly not limited to the specific configuration recited in
the specific examples.
[0305] Benefits, other advantages and solutions to problems have
been described above with regard to particular embodiments;
however, any benefit, advantage, solution to problems or any
element that may cause any particular benefit, advantage or
solution to occur or to become more pronounced are not to be
construed as critical, required or essential features or
components.
[0306] As used herein, the terms "comprises", "comprising", or any
variation thereof, are intended to reference a non-exclusive
inclusion, such that a process, method, article, composition or
apparatus that comprises a list of elements does not include only
those elements recited, but may also include other elements not
expressly listed or inherent to such process, method, article,
composition or apparatus. Other combinations and/or modifications
of the above-described structures, arrangements, applications,
proportions, elements, materials or components used in the practice
of the present invention, in addition to those not specifically
recited, may be varied or otherwise particularly adapted to
specific environments, manufacturing specifications, design
parameters or other operating requirements without departing from
the general principles of the same.
[0307] Although the invention has been described herein with
reference to certain preferred embodiments, one skilled in the art
will readily appreciate that other applications may be substituted
for those set forth herein without departing from the spirit and
scope of the present invention. Accordingly, the invention should
only be limited by the Claims included below.
* * * * *