U.S. patent application number 17/455208 was filed with the patent office on 2022-03-10 for ultrasound positioning device, system, and method.
The applicant listed for this patent is Elekta LTD.. Invention is credited to Francois Marcil.
Application Number | 20220071591 17/455208 |
Document ID | / |
Family ID | 67391694 |
Filed Date | 2022-03-10 |
United States Patent
Application |
20220071591 |
Kind Code |
A1 |
Marcil; Francois |
March 10, 2022 |
ULTRASOUND POSITIONING DEVICE, SYSTEM, AND METHOD
Abstract
Systems and methods can include a system for positioning an
ultrasound probe proximal to anatomy of a patient on a radiation
couch including a substantially planar base including engagement
features to directly or indirectly index the substantially planar
base to the radiation couch and a centrally located guide extending
longitudinally along a top side of the base, a probe holder,
configured to be coupled to, to translate longitudinally, and to be
user-accessed and user-controlled from within, a central region of
the substantially planar base, a clamp, configured to localize the
probe holder at a specified location along a translation path in
the central region of the substantially planar base, leg supports
shaped to accommodate a patient's legs from behind, the pair of leg
supports being shaped and arranged to provide a space therebetween
that can accommodate an ultrasound probe holder.
Inventors: |
Marcil; Francois; (Montreal,
CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Elekta LTD. |
Montreal |
|
CA |
|
|
Family ID: |
67391694 |
Appl. No.: |
17/455208 |
Filed: |
November 16, 2021 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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15898486 |
Feb 17, 2018 |
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17455208 |
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62623463 |
Jan 29, 2018 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2090/376 20160201;
A61B 8/4227 20130101; A61B 90/57 20160201; A61B 2090/0808 20160201;
A61N 5/1049 20130101; A61N 2005/1097 20130101; A61N 5/1039
20130101; A61N 2005/1058 20130101; A61B 8/40 20130101; A61B 8/085
20130101; A61B 2090/378 20160201; A61B 8/4209 20130101; A61B 90/50
20160201 |
International
Class: |
A61B 8/00 20060101
A61B008/00; A61B 90/57 20060101 A61B090/57; A61N 5/10 20060101
A61N005/10; A61B 90/50 20060101 A61B090/50 |
Claims
1. A system for positioning an ultrasound probe proximal to anatomy
of a patient on a radiation couch, the system comprising: a
substantially planar base including engagement features to directly
or indirectly index the substantially planar base to the radiation
couch and a centrally located guide extending longitudinally along
a top side of the base; a probe holder, configured to be coupled
to, to translate longitudinally, and to be user-accessed and
user-controlled from within, a central region of the substantially
planar base; a clamp, configured to localize the probe holder at a
specified location along a translation path in the central region
of the substantially planar base; and leg supports shaped to
accommodate a patient's legs from behind, the pair of leg supports
being shaped and arranged to provide a space therebetween that can
accommodate an ultrasound probe holder.
2. The system of claim 1 comprising an indexing bar for providing a
transversely aligned interface between the substantially planar
base and the radiation couch, the indexing bar including
protrusions on a bottom side for engaging with slots in the
radiation couch and protrusions on a top side for engaging with the
substantially planar base.
3. The system of claim 2 wherein the centrally located guide
comprises a pair of rails including respective longitudinal grooves
centrally facing each other and arranged to guide the probe holder
during translational movement along a longitudinal axis of the base
and wherein the centrally located guide comprises a pair of rails
including respective longitudinal grooves, outwardly facing aw ay
from each other and arranged to engage at least one patient support
cushion.
4. The system of claim 3 comprising a pair of ankle supports
including a portion shaped to accommodate the patient's ankles and
latterly inwardly facing protrusions for contacting at least one
outwardly facing groove of the centrally located guide, the
inwardly facing protrusions capable of allowing adjustment of a
longitudinal position of the pair of ankle supports.
5. The system of claim 4 wherein the radiation couch includes a
scale capable of indexing the indexing bar and the substantially
planar base includes a scale capable of indexing the probe holder
and ankle supports.
6. The system of claim 1 comprising a clamp located within a hollow
central portion of the probe holder, the clamp being configured to
increase a frictional force between the probe holder and the
substantially planar base.
7. The system of claim 6 comprising a rotatable knob located within
a central portion of the probe holder body, the rotatable knob
being configured to apply a force to the substantially planar base
when engaging a relatively elevated portion of a disc below the
rotatable knob to provide an outwardly facing protrusion.
Description
CLAIM OF PRIORITY
[0001] This patent application is a divisional of U.S. application
Ser. No. 15/898,486, filed Feb. 17, 2018, which claims the benefit
of priority of U.S. Provisional Patent Application Ser. No.
62/623,463, filed on Jan. 29, 2018, naming Francois Marcil as
inventor, and entitled ULTRASOUND POSITIONING DEVICE, each of which
is hereby incorporated by reference herein in their entireties.
TECHNICAL FIELD
[0002] Embodiments of the present subject matter pertain generally
to a system for positioning an ultrasound device proximal to an
anatomy of a patient.
OVERVIEW
[0003] Radiotherapy is used to treat cancers and other ailments in
mammalian (e.g., human and animal) tissue. An example of
radiotherapy is provided using a linear accelerator (LINAC), by
which a target (e.g., a tumor) is irradiated by high-energy
particles in a radiation beam (e.g., electrons, photons, ions, or
the like). In an example of LINAC-based radiation treatment,
multiple radiation beams are directed toward the target from
different angles. The placement and dose of the radiation beam
should be accurately controlled to ensure that the tumor receives
the prescribed radiation, and the placement of the beam should be
such as to minimize damage to the surrounding healthy tissue, which
can be called the organ(s) at risk (OARs).
[0004] To prevent OARs from the severe collateral damage that can
be caused by the radiation beams, the doses received by these OARs
should be limited to a certain level. Such limitations on the doses
received by the OARs, sometimes called constraints, need to be
satisfied during radiation treatment planning.
[0005] Treatment planning is a process involving determination of
one or more specific radiotherapy parameters (e.g., radiation beam
angles, radiation intensity level at each angle, etc.) for
implementing a treatment goal under the constraints. A typical
treatment planning process includes delineating one or more targets
and one or more OARs from a medical image of the patient,
specifying radiation beam angles, or a range of angles in the case
of an arc plan, and determining an aperture shape or shapes and
radiation intensity levels for each shape at each beam angle.
Ultrasound imaging is one type of medical imaging that can be used
during treatment planning (e.g., 2D ultrasound, 3D ultrasound, 4D
ultrasound). The ultrasound imaging can also be used during the
radiation treatment such as to determine in real time if targets or
OARs have moved.
[0006] In certain radiation treatment systems, a patient can be
positioned on a radiation couch and an ultrasound probe can be
positioned proximal to anatomy of a patient, such as to acquire
ultrasound images of the patient anatomy for treatment planning or
during the radiation treatment of the patient.
[0007] The inventors have recognized, among other things, that the
process of positioning an ultrasound probe can be greatly improved
by providing a radiation treatment system in which the ultrasound
probe can be indexed to a radiation couch and additionally can be
centrally accessed and positioned while a patient is on the
radiation couch.
[0008] In an aspect, the disclosure can feature an overlay for
providing a movable interface between an ultrasound probe holder
and a couch for radiotherapy. The overlay can include a
substantially planar base including a top side. The overlay can
also include a centrally located elongated guide extending
longitudinally along the top side of the base, such as to guide
translational movement of the ultrasound probe holder along a
longitudinal axis of the overlay. The elongated guide can include a
longitudinal groove arranged to guide the ultrasound probe holder
during translational movement along the longitudinal axis of the
overlay. The elongated guide can include a pair of rails including
respective longitudinal grooves centrally facing each other and
arranged to guide the ultrasound probe holder during translational
movement along a longitudinal axis of the overlay. The elongated
guide can include a pair of rails including respective longitudinal
grooves, outwardly facing away from each other and arranged, such
as to engage at least one patient support cushion. The overlay can
also include indexed engagement features that can engage directly
or indirectly with the couch, a handle located at a first inferior
end of the base of the overlay, and one or more glides located on a
bottom side of the base at an opposing second superior end of the
base of the overlay. The indexed engagement features can be
arranged to engage with an indexing bar that engages with the
couch. A first inferior end of the elongated guide can include a
unidirectional entry and capture member, such as to allow entry and
engagement of a portion of the probe holder into the groove and to
inhibit exit from the groove without user-disengagement of the
unidirectional entry and capture member, and wherein a second
superior end of the elongated guide can include a stop to prevent
exit of the probe holder from the groove. The base can include leg
support base regions extending in laterally opposing directions
from the centrally located elongated guide, the leg support base
regions configured to provide indexed longitudinal and lateral
placement of respective knee support cushions and to provide
adjustable longitudinal placement of respective foot support
cushions. A pair of outwardly facing longitudinal grooves can be
configured to provide the adjustable longitudinal placement of the
respective foot cushions. The overlay can also include a plurality
of apertures at the second superior end of the base, the pair of
apertures configured, such as to provide a handle for providing
coarse positioning of the base with respect to the couch.
[0009] In an aspect, the disclosure can feature an overlay for
providing a movable indexed adjustable interface between a subject
and a radiation couch. The overlay can include a substantially
planar base including a top side and a bottom side. The overlay can
also include a handle located on a top side at an inferior
longitudinal end of the base. The overlay can also include one or
more glides located on a bottom side at an opposing superior
longitudinal end of the base. The overlay can also include indexed
engagement features, such as to engage directly or indirectly with
the radiation couch. The indexed engagement features can be
arranged to engage with an indexing bar that engages with the
radiation couch. The one or more glides can include a first set of
glides located on the bottom side at the inferior longitudinal end
of the base, the first set of glides being configured to provide
resistance to movement of the base along a longitudinal direction
and a second set of longitudinal glides located on bottom of the
superior longitudinal end of the base, the second set of glides
being configured to permit movement of the base along the
longitudinal direction.
[0010] In an aspect, the disclosure can feature a method of using
an overlay to index a position of an ultrasound probe holder to a
radiation couch, the overlay including a substantially planar base
including a top side, and including a centrally located elongated
guide extending longitudinally along the top side of the base to
guide translational movement of the ultrasound probe holder along a
longitudinal axis of the overlay. The method can include
positioning the overlay at an indexed position on a radiation
couch. The method can also include guiding translational movement
of the ultrasound probe holder along a longitudinal axis of the
overlay from within a central region of the overlay. The method can
also include guiding translational movement of the ultrasound probe
holder from within the central region of the overlay using a
longitudinal groove along the longitudinal axis of the overlay. The
method can also include guiding translational movement of the
ultrasound probe holder from within the central region of the
overlay using a pair of rails including respective longitudinal
grooves centrally facing each other along a longitudinal axis of
the overlay. The method can also include engaging at least one
patient support cushion using respective longitudinal grooves,
outwardly facing away from each other. The method can also include
positioning the overlay without engaging indexed engagement
features using a handle located at a first inferior end of the base
of the overlay, and one or more glides, located on a bottom side of
the base at an opposing superior second end of the base of the
overlay; and then placing the overlay into engagement with one or
more of the indexed engagement features. Providing indexed
engagement to a radiation couch can include using an indexing bar
that engages with the radiation couch and with the overlay.
[0011] In an aspect, the disclosure can feature a probe holder for
positioning an ultrasound probe. The probe holder can include a
probe holder body, configured to be coupled to, to translate
longitudinally within, and to be user-accessed and user-controlled
from within, a central region of a radiation couch or overlay
thereupon, the central region being located between lateral regions
that are arranged to be underlying a subject's legs. The probe
holder can also include a clamp, configured to localize the probe
holder at a specified location along a translation path in the
central region. The probe holder can also include a
rotatably-actuated clamp located within a central portion of the
probe holder body, the clamp being configured to increase a
frictional force between the probe holder body and the overlay to
localize the probe holder at a specified location along a
translation path in the central region. The probe holder can also
include transversely outwardly facing protrusions aligned along a
longitudinal direction, the outwardly facing protrusions configured
to interface with corresponding longitudinal grooves of the overlay
to provide for adjustment of the probe body along a longitudinal
direction. The probe holder can also include transversely outwardly
facing hemispherical protrusions having a semi-circular
cross-section aligned along a longitudinal direction, the outwardly
facing protrusions configured to interface with corresponding
longitudinal v-grooves of the overlay to provide for adjustment of
the probe body along a longitudinal direction. The probe holder can
also include a retractable flap configured to hold the ultrasound
probe in place upon the ultrasound probe engaging with the probe
holder and release the ultrasound probe upon being actuated by a
user. The probe holder can also include a rotatable knob located
within the central portion of the probe holder body, the rotatable
knob being configured to apply a force to the overlay when engaging
a relatively elevated portion of a disc below the rotatable knob to
provide an outwardly facing protrusion. The rotatable knob can be
configured to decrease a clearance between outwardly facing
protrusions of the probe holder and corresponding longitudinal
grooves of the overlay in response to a rotation in a first
direction. The rotatable knob can be configured to increase a
clearance between outwardly facing protrusions of the probe holder
and corresponding longitudinal grooves of the overlay in response
to further rotation in the first direction. The rotatable knob can
be configured to increase a clearance between outwardly facing
protrusions of the probe holder and corresponding longitudinal
grooves of the overlay in response to a further rotation in the
first direction or a rotation in a second direction opposite to the
first direction. The probe holder can also include a rotatable,
longitudinally aligned member configured to longitudinally
translate the ultrasound probe with respect to the overlay and to
be user-accessed and user-controlled from within, a central region
of a radiation couch or overlay thereupon. The rotatable,
longitudinally aligned member is located on a side opposite of the
ultrasound probe to provide for access to the rotatable,
longitudinally aligned member and is located to be user-accessed
and user-controlled from within, a central region of a radiation
couch or overlay thereupon.
[0012] In an aspect, the disclosure can feature a method for using
a probe holder for positioning an ultrasound probe at a specified
location along a longitudinal translation path within a central
region of a radiation couch or overlay thereupon, the central
region being located between lateral regions that are arranged to
be underlying a patient's legs. The method can include
user-accessing and user-controlling, from within the central
region, a probe holder for translating the probe longitudinally
toward and away from a portion of the patient. The method can also
include clamping, from within the central region, the probe holder
at a specified location along the translation path in the central
region. The method can also include rotating an actuator on a clamp
to increase a frictional force associated with the probe holder.
Translating the probe longitudinally can include using transversely
outwardly facing protrusions to interface with corresponding
longitudinal grooves. Clamping can include reducing a clearance
within a groove. The method can also include automatically engaging
or retaining the probe upon insertion onto the translation path and
requiring user-activated release of the probe upon removal from the
translation path. The clamping can include rotating a knob to
engage a relatively elevated portion of a disc having a variable
height. The method can also include unclamping, from within the
central region, the probe holder, the unclamping comprising
rotating the knob to engage a relatively lower portion of the disc
having a variable height. The unclamping can include rotating the
knob in an opposite direction as the rotating for clamping. The
method can also include fine-adjusting a longitudinal position of
the probe holder along the translation path using a separate
actuation from a gross-adjusting of the longitudinal position of
the probe holder along the translation path. The fine-adjusting can
be accessible from a side of the probe holder configured to be
inferior to the patient.
[0013] In an aspect, the disclosure can feature supports for a
lower body of a patient. The supports can include a pair of
separate knee supports, each individual knee support including a
portion shaped to accommodate a patient's knee from behind the
knee, the pair of knee supports being shaped and arranged to
provide a space therebetween that can accommodate an ultrasound
probe holder. The supports can also include a pair of knee supports
having a recessed portion corresponding to a raised mounting
portion of an overlay, wherein a recessed portion of each
individual knee support includes indexed engagement features for
engaging a corresponding mounting portion of the overlay. The
supports can also include a pair of knee supports having a
protruding portion corresponding to a recessed portion of an
overlay, w % herein a protruding portion of each individual knee
support includes indexed engagement features for engaging a
corresponding recessed portion of the overlay. The space between
the pair of knee supports can allow for access to a patient's
perineum. The supports can also include a pair of separate ankle
supports including a portion shaped to accommodate a patient's
ankles from behind and a lateral slide for engaging a corresponding
feature of an overlay for a radiation couch. The supports can also
include a booster shaped to be inserted between an individual one
of the knee supports and the overlay to provide an increased height
of the knee support with respect to the overlay. The booster can be
shaped to be inserted between an ankle support cushion and the
overlay to provide an increased height of the ankle support cushion
with respect to the overlay. The pair of ankle supports can include
a recessed portion on a bottom side of an individual one of the
ankle supports to provide clearance for an ultrasound probe
holder.
[0014] In an aspect, the disclosure can feature a method for
supporting a lower body of a patient. The method can include
supporting, on a first knee support on a radiation couch or an
overlay thereupon, a first knee of a patient from behind the first
knee. The method can also include supporting, on a second knee
support on the radiation couch or on the overlay thereupon, a
second knee of the patient from behind the second knee. The method
can also include providing access to a patient via a probe holder
in a central region formed by the first and second knee supports
being placed in lateral regions on opposing sides. The method can
also include placing the first and second knee supports on the
radiation couch or the overlay thereupon using an indexing
engagement feature of each individual knee support. The method can
also include providing access to the patient's perineum in a space
between the first and second knee supports. The method can also
include separately supporting, on an ankle support on a radiation
couch or an overlay thereupon, an ankle of the patient from behind
the ankle, and allowing longitudinal adjustment of the ankle
support along a longitudinal track. The method can also include
inserting a booster between at least one of the first or second
knee supports and the overlay to provide an increased height of the
at least one of the first or second knee support with respect to
the overlay. The method can also include inserting a booster
between the ankle support and the overlay to provide an increased
height of the ankle support with respect to the overlay. An
individual instance of the booster can adapted to be used
selectably with the first or second knee supports and with the
ankle support.
[0015] In an aspect, the disclosure can feature a method of
supporting a lower body of a patient. The method can include
supporting a patient's knees using a knee support shaped and
arranged to provide a space therebetween that can accommodate an
ultrasound probe holder. The method can also include indexing the
knee support to a raised mounting portion of an overlay using a
recessed portion of the knee support. The method can also include
providing access to the patient's perineum via the space between
the knee support. The method can also include adjusting a
longitudinal position of a pair of ankle supports in a longitudinal
direction along an exterior groove of an overlay. The method can
also include inserting a booster between the knee supports and an
overlay to provide an increased height of the knee supports with
respect to the overlay. The method can also include inserting a
booster between the ankle supports and the overlay to provide an
increased height of the ankle supports with respect to the
overlay.
[0016] In an aspect, the disclosure can feature a system for
positioning an ultrasound probe proximal to anatomy of a patient on
a radiation couch. The system can include a substantially planar
base including engagement features to directly or indirectly index
the substantially planar base to the radiation couch and a
centrally located guide extending longitudinally along a top side
of the base. The system can also include a probe holder, configured
to be coupled to, to translate longitudinally, and to be
user-accessed and user-controlled from within, a central region of
the substantially planar base. The system can also include a clamp,
configured to localize the probe holder at a specified location
along a translation path in the central region of the substantially
planar base. The system can also include leg supports shaped to
accommodate a patient's legs from behind, the pair of leg supports
being shaped and arranged to provide a space therebetween that can
accommodate an ultrasound probe holder. The system can also include
an indexing bar for providing a transversely aligned interface
between the substantially planar base and the radiation couch, the
indexing bar including protrusions on a bottom side for engaging
with slots in the radiation couch and protrusions on a top side for
engaging with the substantially planar base. The centrally located
guide can include a pair of rails including respective longitudinal
grooves centrally facing each other and arranged to guide the probe
holder during translational movement along a longitudinal axis of
the base and the centrally located guide can include a pair of
rails including respective longitudinal grooves, outwardly facing
away from each other and arranged to engage at least one patient
support cushion. The system can also include a pair of ankle
supports including a portion shaped to accommodate the patient's
ankles and latterly inwardly facing protrusions for contacting at
least one outwardly facing groove of the centrally located guide,
the inwardly facing protrusions capable of allowing adjustment of a
longitudinal position of the pair of ankle supports. The radiation
couch can include a scale capable of indexing the indexing bar and
the substantially planar base includes a scale capable of indexing
the probe holder and ankle supports. The system can also include a
clamp located within a hollow central portion of the probe holder,
the clamp being configured to increase a frictional force between
the probe holder and the substantially planar base. The system can
also include a rotatable knob located within a central portion of
the probe holder body, the rotatable knob being configured to apply
a force to the substantially planar base when engaging a relatively
elevated portion of a disc below the rotatable knob to provide an
outwardly facing protrusion.
[0017] In an aspect, the disclosure can feature a method of
positioning an ultrasound probe proximal to anatomy of a patient on
a couch for radiotherapy. The method can include positioning an
indexing bar on the radiation couch at a marked position of the
couch. The method can also include positioning an overlay with
respect to the indexing bar at a first marked position of the
overlay. The method can also include positioning the patient on the
couch and overlay. The method can also include attaching a pair of
knee cushions to a raised portion of the overlay. The method can
also include adjusting a position of the overlay to position the
overlay with respect to the indexing bar at a second marked
position of the overlay. The method can also include coupling a
probe holder to a central guide region of the overlay. The method
can also include coupling an ultrasound probe to the probe holder
in a central guide region of the overlay. The method can also
include adjusting a position of a pair of ankle cushions to provide
support to the patient's ankles. The method can also include
longitudinally adjusting a position of the probe holder to bring an
ultrasound probe into proximity to a perineum of the patient. The
method can also include recording the marked position of the
radiation couch and the marked position of the overlay. The method
can also include removing the overlay and the indexing bar from the
radiation couch. The method can also include using the recorded
marked positions to position the indexing bar and overlay. The
method can also include accessing and controlling the probe holder
from within a central region of the radiation couch to adjust a
longitudinal position of the probe holder. The method can also
include rotating an actuator located within a central region of the
probe holder to increase a frictional force between outwardly
facing protrusions of the probe holder and corresponding
longitudinal grooves of the overlay in response to a rotation in a
first direction. The method can also include rotating an actuator
located within a central region of the probe holder to increase a
frictional force associated with the probe holder. The method can
also include individually adjusting the pair of knee cushions to
provide support to a back of the patient's knees. The method can
also include automatically engaging or retaining the ultrasound
probe upon insertion onto a translation path and requiring
user-activated release of the ultrasound probe upon removal from
the translation path. The method can also include guiding
translational movement of the probe holder from within the central
guide region of the overlay using a longitudinal groove along a
longitudinal axis of the overlay. The method can also include
engaging the pair of ankle cushions using respective longitudinal
grooves of the overlay, outwardly facing away from each other. The
method can also include positioning the overlay using a handle
located at a first end of the overlay, and one or more glides,
located on a bottom side of the overlay on an opposing second end
of the overlay; and then placing the overlay into engagement with
one or more of indexed engagement features.
[0018] The above overview is intended to provide an overview of
subject matter of the present patent application. It is not
intended to provide an exclusive or exhaustive explanation of the
invention. The detailed description is included to provide further
information about the present patent application.
BRIEF DESCRIPTION OF THE DRAWINGS
[0019] In the drawings, which are not necessarily drawn to scale,
like numerals describe substantially similar components throughout
the several views. Like numerals having different letter suffixes
represent different instances of substantially similar components.
The drawings illustrate generally, by way of example but not by way
of limitation, various embodiments discussed in the present
document.
[0020] FIG. 1 illustrates an example of portions of a radiotherapy
system, according to some embodiments of the present
disclosure.
[0021] FIG. 2 illustrates an example of portions of radiation
therapy system that can include radiation therapy output configured
to provide a therapy beam.
[0022] FIGS. 3A and 3B illustrate an example of portions of an
ultrasound positioning system.
[0023] FIG. 4 illustrates an example of a method of using an
ultrasound positioning system.
[0024] FIGS. 5A and 5B illustrate an example of an overlay.
[0025] FIG. 6 illustrates an example of portions of method of using
an overlay.
[0026] FIG. 7A illustrates an example of portions of an ultrasound
probe holder.
[0027] FIGS. 7B and 7C illustrate an example of portions of a
clamping mechanism in an ultrasound probe holder.
[0028] FIG. 8 illustrates an example of portions of a method of
using an ultrasound probe holder.
[0029] FIGS. 9A-91 illustrate examples of a patient support
cushions.
[0030] FIG. 10 illustrates an example of a method of using one or
more patient support cushions.
DETAILED DESCRIPTION
[0031] In certain radiation treatment systems, a patient can be
positioned on a surface such as can be provided by radiation couch,
and an ultrasound probe can be positioned with respect to anatomy
of a patient, such as to acquire ultrasound images of the patient
anatomy for treatment planning or during the radiation treatment of
the patient. The ultrasound probe may ha % e to be repositioned
many times over the course of radiation treatment planning or
radiation treatment.
[0032] The present inventor has recognized, among other things,
that the process of positioning an ultrasound probe can be greatly
improved by providing a radiation treatment system in which the
ultrasound probe can be indexed with respect to a radiation couch
and additionally can be centrally accessed and positioned while a
patient is on the radiation couch, such as to improve the speed and
accuracy at which the patient and ultrasound probe can be
positioned, such as can improve patient workflows (e.g., allow for
each patient to be treated in less time and with more accuracy).
Accessing the ultrasound probe from just one side of the radiation
couch may be awkward or inefficient, while central access from
either side of the radiation couch can help provide improved
ease-of-access and use, which can make a treatment planning session
or treatment procedure more efficient.
[0033] FIG. 1 illustrates an example of a radiotherapy system 100
for providing radiation therapy to a patient. The radiotherapy
system 100 can include or be coupled to an image processing device
112. The image processing device 112 may be connected to one or
more of a local or a wide area communications or other network 120.
For example, the network 120 may be connected to the Internet 122.
The network 120 can connect the image processing device 112 with
one or more of a database 124, a hospital database 126, an oncology
information system (OIS) 128, a radiation therapy device 130, an
image acquisition device 132, a display device 134, or a user
interface 136. The image processing device 112 can be configured to
be used to generate one or more radiation therapy treatment plans
142 to be used by the radiation therapy device 130.
[0034] The image processing device 112 may include a memory device
116, a processor 114 circuit and a communication interface 118. The
memory device 116 may store computer-executable instructions, such
as an operating system 143, one or more radiation therapy treatment
plans 142 (e.g., original treatment plans, adapted treatment plans,
or the like), software programs 144 (e.g., artificial intelligence,
deep learning, neural networks, radiotherapy treatment plan
software), or any other computer-executable instructions to be
executed by the processor 114. In an embodiment, the software
programs 144 may convert medical images of one format (e.g., MRI)
to another format (e.g., CT) such as b % producing one or more
synthetic images, such as a pseudo-CT image. For instance, the
software programs 144 may include image processing programs such as
to train a predictive model for converting a medial image 146 in
one modality (e.g., an MRI image) into a synthetic image of a
different modality (e.g., a pseudo CT image); alternatively, the
trained predictive model may convert a CT image into an MRI image.
In another embodiment, the software programs 144 may register the
patient image (e.g., a CT image or an MR image) with that patient's
dose distribution (which can also be represented as an image) so
that corresponding image voxels and dose voxels are associated
appropriately by the network. In yet another embodiment, the
software programs 144 may substitute one or more functions of the
patient images such as signed distance functions or processed
versions of the images that emphasize some aspect of the image
information. Such functions may emphasize edges or differences in
voxel textures, or any other structural aspect useful to neural
network learning. In another embodiment, the software programs 144
may substitute one or more functions of the dose distribution that
can emphasize some aspect of the dose information. Such functions
may emphasize steep gradients around the target, or any other
structural aspect useful to neural network learning. The memory
device 116 may store data, including medical images 146, patient
data 145, and other data useful to create and implement a radiation
therapy treatment plan 142
[0035] In addition to the memory 116 storing the software programs
144, it is contemplated that software programs 144 may be stored on
a removable computer medium, such as a hard drive, a computer disk,
a CD-ROM, a DVD, a HD, a Blu-Ray DVD. USB flash drive, a SD card, a
memory stick, or any other suitable medium, and the software
programs 144 when downloaded to image processing device 112 may be
executed by image processor 114
[0036] The processor 114 may be communicatively coupled to the
memory device 116, and the processor 114 may be configured to
execute computer executable instructions stored thereon. The
processor 114 may send or receive medical images 146 to memory 116.
For example, the processor 114 may receive medical images 146 from
the image acquisition des ice 132 via the communication interface
118 and network 120 to be stored in memory 116. The processor 114
may also send medical images 146 stored in memory 116 via the
communication interface 118 to the network 120 be either stored in
database 124 or the hospital database 126.
[0037] Further, the processor 114 may utilize software programs 144
(e.g., a treatment planning software) along with the medical images
146 and patient data 145 to create the radiation therapy treatment
plan 142. Medical images 146 may include information such as
imaging data associated with a patient anatomical region, organ, or
volume of interest segmentation data. Patient data 145 may include
information such as (1) functional organ modeling data (e.g.,
serial versus parallel organs, appropriate dose response models,
etc.); (2) radiation dosage data (e.g., dose-volume histogram (DVH)
information; or (3) other clinical information about the patient
and course of treatment (e.g., other surgeries, chemotherapy,
previous radiotherapy, etc.).
[0038] In addition, the processor 114 may utilize software programs
to generate intermediate data such as updated parameters to be
used, for example, by a neural network model; or generate
intermediate 2D or 3D images, which may then subsequently be stored
in memory 116. The processor 114 may subsequently then transmit the
executable radiation therapy treatment plan 142 via the
communication interface 18 to the network 120 to the radiation
therapy device 130, where the radiation therapy plan will be used
to treat a patient with radiation. In addition, the processor 114
may execute software programs 144 to implement functions such as
image conversion, image segmentation, deep learning, neural
networks, and artificial intelligence. For instance, the processor
114 may execute software programs 144 that train or contour a
medical image, such software 144 when executed may train a boundary
detector, or utilize a shape dictionary.
[0039] The processor 114 may be a processing device, and may
include one or more general-purpose processing devices such as a
microprocessor, a central processing unit (CPU), a graphics
processing unit (GPU), an accelerated processing unit (APU), or the
like. More particularly, the processor 114 may be a complex
instruction set computing (CISC) microprocessor, a reduced
instruction set computing (RISC) microprocessor, a very long
instruction Word (VLIW) microprocessor, a processor implementing
other instruction sets, or processors implementing a combination of
instruction sets. The processor 114 may also be implemented by one
or more special-purpose processing devices such as an application
specific integrated circuit (ASIC), a field programmable gate array
(FPGA), a digital signal processor (DSP), a System on a Chip (SoC),
or the like. As would be appreciated by those skilled in the art,
in some embodiments, the processor 114 may be a special-purpose
processor, rather than a general-purpose processor. The processor
114 may include one or more known processing devices, such as a
microprocessor from the Pentium.TM., Core.TM., Xeon.TM., or
Itanium.RTM. family manufactured by Intel.TM., the Turion.TM.,
Athlon.TM., Sempron.TM., Opteron.TM., FX.TM., Phenom.TM. family
manufactured by AMD.TM., or any of various processors manufactured
by Sun Microsystems. The processor 114 may also include graphical
processing units such as a GPU from the GeForce.RTM., Quadro.RTM.,
Tesla.RTM. family manufactured by Nvidia.TM., GMA, Iris.TM. family
manufactured by Intel.TM., or the Radeon.TM. family manufactured by
AMD.TM.. The processor 114 may also include accelerated processing
units such as the Xeon Phi.TM. family manufactured by Intel.TM..
The disclosed embodiments are not limited to any type of
processor(s) otherwise configured to meet the computing demands of
identifying, analyzing, maintaining, generating, and/or providing
large amounts of data or manipulating such data to perform the
methods disclosed herein. In addition, the term `processor` may
include more than one processor, for example, a multi-core circuit
design or a plurality of processors each having a multi-core
design. The processor 114 can execute sequences of computer program
instructions, stored in memory 116, to perform various operations,
processes, methods that will be explained in greater detail
below.
[0040] The memory device 116 can store medical images 146. In some
embodiments, the medical images 146 may include one or more MRI
image (e.g., 2D MRI, 3D MRI, 2D streaming MRI, 4D MRI, 4D
volumetric MRI, 4D cine MRI, etc.), functional MRI images (e.g.,
fMRI, DCE-MRI, diffusion MRI), Computed Tomography (CT) images
(e.g., 2D CT, Cone beam CT, 3D CT, 4D CT), ultrasound images (e.g.,
2D ultrasound, 3D ultrasound, 4D ultrasound), Positron Emission
Tomography (PET) images, X-ray images, fluoroscopic images,
radiotherapy portal images. Single-Photo Emission Computed
Tomography (SPECT) images, computer generated synthetic images
(e.g., pseudo-CT images) and the like. Further, the medical images
146 may also include medical image data, for instance, training
images, and ground truth images, contoured images, and dose images.
In an embodiment, the medical images 146 may be received from the
image acquisition device 132. Accordingly, image acquisition device
132 may include a MRI imaging device, a CT imaging device, a PET
imaging device, an ultrasound imaging device, a fluoroscopic
device, a SPECT imaging device, an integrated Linear Accelerator
and MRI imaging device, or other medical imaging devices for
obtaining the medical images of the patient. The medical images 116
may be received and stored in any type of data or any type of
format that the image processing de; ice 112 may use to perform
operations consistent with the disclosed embodiments. The memory
device 116 may be a non-transitory computer-readable medium, such
as a read-only memory (ROM), a phase-change random access memory
(PRAM), a static random access memory (SRAM), a flash memory, a
random access memory (RAM), a dynamic random access memory (DRAM)
such as synchronous DRAM (SDRAM), an electrically erasable
programmable read-only memory (EEPROM), a static memory (e.g.,
flash memory, flash disk, static random access memory) as well as
other types of random access memories, a cache, a register, a
compact disc read-only memory (CD-ROM), a digital versatile disc
(DVD) or other optical storage, a cassette tape, other magnetic
storage device, or any other non-transitory medium that may be used
to store information including image, data, or computer executable
instructions (e.g., stored in any format) capable of being accessed
by the processor 114, or any other type of computer device. The
computer program instructions can be accessed by the processor 114,
read from the ROM, or any other suitable memory location, and
loaded into the RAM for execution by the processor 114. For
example, the memory 116 may store one or more software applications
Software applications stored in the memory 116 may include, for
example, an operating system 143 for common computer systems as
well as for software-controlled devices. Further, the memory 116
may store an entire software application, or only a part of a
software application, that are executable by the processor 111. For
example, the memory deice 116 may store one or more radiation
therapy treatment plans 142.
[0041] The image processing device 112 can communicate with the
network 120 via the communication interface 118, which can be
communicatively coupled to the processor 114 and the memory 116.
The Communication interface 118 may provide communication
connections between the image processing device 112 and
radiotherapy system 100 components (e.g., permitting the exchange
of data with external devices). For instance, the communication
interface 118 may in some embodiments have appropriate interfacing
circuitry to connect to the user interface 136, which may be a
hardware keyboard, a keypad, or a touch screen through which a user
may input information into radiotherapy s stem 100.
[0042] Communication interface 118 may include, for example, a
network adaptor, a cable connector, a serial connector, a USB
connector, a parallel connector, a high-speed data transmission
adaptor (e.g., such as fiber, USB 3.0, thunderbolt, and the like),
a wireless network adaptor (e.g., such as a WiFi adaptor), a
telecommunication adaptor (e.g., 3G, 4G/LTE and the like), and the
like. Communication interface 118 may include one or more digital
and/or analog communication devices that permit image processing
device 112 to communicate with other machines and devices, such as
remotely located components, via the network 120.
[0043] The network 120 may provide the functionality of a local
area network (LAN), a wireless network, a cloud computing
environment (e.g., software as a service, platform as a service,
infrastructure as a service, etc.), a client-server, a wide area
network (WAN), and the like. For example, network 120 may be a LAN
or a WAN that may include other systems S1 (138), S2 (140), and
S3(141). Systems S1, S2, and S3 may be identical to image
processing device 112 or may be different systems. In some
embodiments, one or more of systems in network 120 may form a
distributed computing/simulation environment that collaboratively
performs the embodiments described herein. In some embodiments, one
or more systems S1, S2, and S3 may include a CT scanner that obtain
CT images (e.g., medical images 146). In addition, network 120 may
be connected to internet 122 to communicate with servers and
clients that reside remotely on the internet.
[0044] Therefore, network 120 can allow data transmission between
the image processing device 112 and a number of various other
systems and devices, such as the OIS 128, the radiation therapy
device 130, and the image acquisition device 132. Further, data
generated by the OIS 128 and/or the image acquisition device 132
may be stored in the memory 116, the database 124, and/or the
hospital database 126. The data may be transmitted/received via
network 120, through communication interface 118 such as to be
accessed by the processor 114, as required.
[0045] The image processing device 112 may communicate with
database 124 through network 120 to send/receive a plurality of
various types of data stored on database 124. For example, database
124 may include machine data that is information associated with a
radiation therapy device 130, image acquisition device 132, or
other machines relevant to radiotherapy Machine data information
may include radiation beam size, arc placement, beam on and off
time duration, machine parameters, segments, multi-leaf collimator
(MLC) configuration, gantry speed, MRI pulse sequence, and the
like. Database 124 may be a storage device and may be equipped with
appropriate database administration software programs. One skilled
in the art would appreciate that database 124 may include a
plurality of devices located either in a central or a distributed
manner.
[0046] In some embodiments, database 124 may include a
processor-readable storage medium (not shown). While the
processor-readable storage medium in an embodiment may be a single
medium, the term "processor-readable storage medium" should be
taken to include a single medium or multiple media (e.g., a
centralized or distributed database, and/or associated caches and
servers) that store the one or more sets of computer executable
instructions or data. The term "processor-readable storage medium"
shall also be taken to include any medium that is capable of
storing or encoding a set of instructions for execution by a
processor and that cause the processor to perform an, one or more
of the methodologies of the present disclosure. The term "processor
readable storage medium" shall accordingly be taken to include, but
not be limited to, solid-state memories, optical and magnetic
media. For example, the processor readable storage medium can be
one or more volatile, non-transitory, or non-volatile tangible
computer-readable media.
[0047] Image processor 114 may communicate with database 124 to
read images into memory 116 or store images from memory 116 to
database 124. For example, the database 124 may be configured to
store a plurality of images (e.g., 3D MRI, 4D MRI, 2D MRI slice
images, CT images, 2D Fluoroscopy images, X-ray images, raw data
from MR scans or CT scans, Digital Imaging and Communications in
Medicine (DIMCOM) data, etc.) that the database 124 received from
image acquisition device 132. Database 124 may store data to be
used by the image processor 114 when executing software program
144, or when creating radiation therapy treatment plans 142.
Database 124 may store the data produced by the trained neural
network including the network parameters constituting the model
learned by the network and the resulting predicted data. The image
processing device 112 may receive the imaging data 146 (e.g., 2D
MRI slice images, CT images, 2D Fluoroscopy images, X-ray images,
3D MRI images, 4D MRI images, etc.) either from the database 124,
the radiation therapy device 130 (e.g., a MRI-Linac), and or the
image acquisition device 132 to generate a treatment plan 142.
[0048] In an embodiment, the radiotherapy system 100 can include an
image acquisition device 132 that can acquire medical images (e.g.,
Magnetic Resonance Imaging (MRI) images, 3D MRI, 2D streaming MRI,
4D volumetric MRI, Computed Tomography (CT) images, Cone-Beam CT,
Positron Emission Tomography (PET) images, functional MRI images
(e.g., fMRI, DCE-MRI and diffusion MRI), X-ray images, fluoroscopic
image, ultrasound images, radiotherapy portal images, single-photo
emission computed tomography (SPECT) images, and the like) of the
patient Image acquisition device 132 may, for example, be an MRI
imaging device, a CT imaging device, a PET imaging device, an
ultrasound device, a fluoroscopic device, a SPECT imaging device,
or any other suitable medical imaging device for obtaining one or
more medical images of the patient. Images acquired by the imaging
acquisition device 132 can be stored within database 124 as either
imaging data and/or test data By way of example, the images
acquired by the imaging acquisition device 132 can be also stored
by the image processing device 112, as medical image data 146 in
memory 116.
[0049] In an embodiment, for example, the image acquisition device
132 may be integrated with the radiation therapy device 130 as a
single apparatus (e.g., a MRI device combined with a linear
accelerator, also referred to as an "MRI-Linac." Such an MRI-Linac
can be used, for example, to determine a location of a target organ
or a target tumor in the patient, so as to direct radiation therapy
accurately according to the radiation therapy treatment plan 142 to
a predetermined target
[0050] The image acquisition device 132 can be configured to
acquire one or more images of the patient's anatomy for a region of
interest (e.g., a target organ, a target tumor or both). Each
image, typically a 2D image or slice, can include one or more
parameters (e.g., a 2D slice thickness, an orientation, and a
location, etc.) In an embodiment, the image acquisition device 132
can acquire a 2D slice in any orientation. For example, an
orientation of the 2D slice can include a sagittal orientation, a
coronal orientation, or an axial orientation. The processor 114 can
adjust one or more parameters, such as the thickness and/or
orientation of the 2D slice, to include the target organ and/or
target tumor. In an embodiment, 2D slices can be determined from
information such as a 3D MRI volume. Such 2D slices can be acquired
by the image acquisition device 132 in "near real-time" while a
patient is undergoing radiation therapy treatment, for example,
when using the radiation therapy device 130. "Near real-time"
meaning acquiring the data in at least milliseconds or less.
[0051] The image processing device 112 may generate and store
radiation therapy treatment plans 142 for one or more patients. The
radiation therapy treatment plans 142 may provide information about
a particular radiation dose to be applied to each patient. The
radiation therapy treatment plans 142 may also include other
radiotherapy information, such as beam angles,
dose-histogram-volume information, the number of radiation beams to
be used during therapy, the dose per beam, or the like.
[0052] The image processor 114 may generate the radiation therapy
treatment plan 142 by using software programs 144 such as treatment
planning software, such as Monaco.RTM., manufactured by Elekta AB
of Stockholm, Sweden. In order to generate the radiation therapy
treatment plans 142, the image processor 114 may communicate with
the image acquisition device 132 (e.g., a CT device, a MRI device,
a PET device, an X-ray device, an ultrasound device, etc.) to
access images of the patient and to delineate a target, such as a
tumor. In some embodiments, the delineation of one or more organs
at risk (OARs), such as healthy tissue surrounding the tumor or in
close proximity to the tumor may be required. Therefore,
segmentation of the OAR may be performed when the OAR is close to
the target tumor. In addition, if the target tumor is close to the
OAR (e.g., prostate in near proximity to the bladder and rectum),
then by segmenting the OAR from the tumor, the radiotherapy system
100 may study the dose distribution not only in the target, but
also in the OAR.
[0053] In order to delineate a target organ or a target tumor from
the OAR, medical images, such as MRI images, CT images, PET images,
fMRI images, X-ray images, ultrasound images, radiotherapy portal
images. SPECT images and the like, of the patient undergoing
radiotherapy mac be obtained non-invasively by the image
acquisition device 132 to reveal the internal structure of a body
part. Based on the information from the medical images, a 3D
structure of the relevant anatomical portion may be obtained. In
addition, during a treatment planning process, many parameters may
be taken into consideration to achieve a balance between efficient
treatment of the target tumor (e.g., such that the target tumor
receives enough radiation dose for an effective therapy) and low
irradiation of the OAR(s) (e.g., the OAR(s) receives as low a
radiation dose as possible). Other parameters that may be
considered include the location of the target organ and the target
tumor, the location of the OAR, and the movement of the target in
relation to the OAR For example, the 3D structure may be obtained
by contouring the target or contouring the OAR within each 2D layer
or slice of an MRI or CT image and combining the contour of each 2D
layer or slice. The contour may be generated manually (e.g., by a
physician, dosimetrist, or health care worker using a program such
as MONACO.RTM. manufactured by Elekta AB of Stockholm. Sweden) or
automatically (e.g., using a program such as the Atlas-based
auto-segmentation software, ABAS.TM., manufactured by Elekta AB of
Stockholm. Sweden). In certain embodiments, the 3D structure of a
target tumor or an OAR may be generated automatically by the
treatment planning software
[0054] After the target tumor and the OAR(s) have been located and
delineated, a dosimetrist, physician or healthcare worker may
determine a dose of radiation to be applied to the target tumor, as
well as any maximum amounts of dose that may be received by the OAR
proximate to the tumor (e.g., left and right parotid, optic nerves,
eyes, lens, inner ears, spinal cord, brain stem, and the like).
After the radiation dose is determined for each anatomical
structure (e.g., target tumor, OAR), a process known as inverse
planning may be performed to determine one or more treatment plan
parameters that would achieve the desired radiation dose
distribution. Examples of treatment plan parameters include volume
delineation parameters (e.g., which define target volumes, contour
sensitive structures, etc.), margins around the target tumor and
OARs, beam angle selection, collimator settings, and beam-on times
During the inverse-planning process, the physician may define dose
constraint parameters that set bounds on how much radiation an OAR
may receive (e.g., defining full dose to the tumor target and zero
dose to any OAR; defining 95% of dose to the target tumor; defining
that the spinal cord, brain stem, and optic structures receive
.ltoreq.45Gy, .ltoreq.55Gy and <54Gy, respectively). The result
of inverse planning may constitute a radiation therapy treatment
plan 142 that may be stored in memory 116 or database 124. Some of
these treatment parameters may be correlated. For example, tuning
one parameter (e.g., weights for different objectives, such as
increasing the dose to the target tumor) m an attempt to change the
treatment plan may affect at feast one other parameter, which in
turn may result in the development of a different treatment plan
Thus, the image processing device 112 can generate a tailored
radiation therapy treatment plan 142 having these parameters in
order for the radiation therapy device 130 to provide radiotherapy
treatment to the patient
[0055] In addition, the radiotherapy system 100 may include a
display device 134 and a user interface 136. The display device 134
may include one or more display screens that display medical
images, interface information, treatment planning parameters (e.g.,
contours, dosages, beam angles, etc.) treatment plans, a target,
localizing a target and/or tracking a target, or any related
information to the user. The user interface 136 may be a key board,
a keypad, a touch screen or any type of device that a user may
input information to radiotherapy system 100. Alternatively, the
display device 134 and the user interface 136 may be integrated
into a device such as a tablet computer, e.g., Apple iPad.RTM.,
Lenovo Thinkpad.RTM., Samsung Galaxy.RTM., etc.
[0056] Furthermore, any and all components of the radiotherapy
system 100 may be implemented as a virtual machine (e.g., VMWare,
Hyper-V, and the like). For instance, a virtual machine can be
software that functions as hardware Therefore, a virtual machine
can include at least one or more virtual processors, one or more
virtual memories, and one or more virtual communication interfaces
that together function as hardware. For example, the image
processing device 112, the OIS 128, the image acquisition device
132 could be implemented as a virtual machine Given the processing
power, memory, and computational capability available, the entire
radiotherapy system 100 could be implemented as a virtual
machine
[0057] FIG. 2 illustrates an example of portions of radiation
therapy device 202 that may include a radiation source, such as an
X-ray source or a linear accelerator, a couch 216, an imaging
detector 214, and a radiation therapy output 204. The radiation
therapy device 202 may be configured to emu a radiation beam 208 to
provide therapy to a patient. The radiation therapy output 204 can
include one or more attenuators or collimators, such as a
multi-leaf collimator (MLC).
[0058] In FIG. 2, a patient can be positioned in a region 212,
supported by the treatment couch 216 to receive a radiation therapy
dose according to a radiation therapy treatment plan. The radiation
therapy output 204 can be mounted or attached to a gantry 206 or
other mechanical support. One or more chassis motors (not shown)
may rotate the gantry 206 and the radiation therapy output 204
around couch 216 when the couch 216 is inserted into or located
within the treatment area. In an embodiment, gantry 206 may be
continuously rotatable around couch 216 when the couch 216 is
inserted into or located within the treatment area. In another
embodiment, gantry 206 may rotate to a predetermined or specified
position when the couch 216 is inserted into the treatment area.
For example, the gantry 206 can be configured to rotate the therapy
output 204 around an axis ("A") that can point in a longitudinal
direction. Both the couch 216 and the radiation therapy output 204
can be independently moveable to other positions around the
patient, such as moveable in transverse direction ("T"), moveable
in a lateral direction ("L"), or as rotation about one or more
other axes, such as rotation about a transverse axis (indicated as
"R"). A controller communicatively connected to one or more
actuators (not shown) may control the couch 216 movements or
rotations in order to properly position the patient in or out of
the radiation beam 208 according to a radiation therapy treatment
plan. As both the couch 216 and the gantry 206 are independently
moveable from one another in multiple degrees of freedom, winch
allows the patient to be positioned such that the radiation beam
208 precisely can target the tumor.
[0059] The coordinate system (including axes A, T, and L) shown in
FIG. 2 can have an origin located at an isocenter 210. The
isocenter can be defined as a location where the central axis of
the radiation therapy beam 208 intersects the origin of a
coordinate axis, such as to deliver a prescribed radiation dose to
a location on or within a patient. Alternatively, the isocenter 210
can be defined as a location where the central axis of the
radiation therapy beam 208 intersects the patient for various
rotational positions of the radiation therapy output 204 as
positioned by the gantry 206 around the axis A.
[0060] Gantry 206 may also have an attached imaging detector 214.
The imaging detector 214 preferably located opposite to the
radiation source 204, and in an embodiment, the imaging detector
214 can be located within a field of the therapy beam 208.
[0061] The imaging detector 214 can be mounted on the gantry 206
preferably opposite the radiation therapy output 204, such as to
maintain alignment with the therapy beam 208. The imaging detector
214 rotating about the rotational axis as the gantry 206 rotates.
In an embodiment, the imaging detector 214 can be a flat panel
detector (e.g., a direct detector or a scintillator detector). In
this manner, the imaging detector 214 can be used to monitor the
therapy beam 208 or the imaging detector 214 can be used for
imaging the patient's anatomy, such as portal imaging. The control
circuitry of radiotherapy device 202 may be integrated within
system 100 or remote from it
[0062] In an illustrative embodiment, one or more of the couch 216,
the therapy output 204, or the gantry 206 can be automatically
positioned, and the therapy output 204 can establish the therapy
beam 208 according to a specified dose for a particular therapy
delivery instance. A sequence of therapy deliveries can be
specified according to a radiation therapy treatment plan, such as
using one or more different orientations or locations of the gantry
206, couch 216, or therapy output 204. The therapy deliveries can
occur sequentially, but can intersect in a desired therapy locus on
or within the patient, such as at the isocenter 210. A prescribed
cumulative dose of radiation therapy can thereby be delivered to
the therapy locus while damage to tissue nearby the therapy locus
can be reduced or avoided.
[0063] FIG. 2 generally illustrates an embodiment of a radiation
therapy device configured to provide radiotherapy treatment to a
patient, including a configuration where a radiation therapy output
can be rotated around a central axis (e.g., an axis "A"). Other
radiation therapy output configurations can be used. For example, a
radiation therapy output can be mounted to a robotic arm or
manipulator having multiple degrees of freedom. In yet another
embodiment, the therapy output can be fixed, such as located in a
region laterally separated from the patient, and a platform
supporting the patient can be used to align a radiation therapy
isocenter with a specified target locus within the patient. In
another embodiment, a radiation therapy device can be a combination
of a linear accelerator and an image acquisition device. In some
embodiments, the image acquisition device may be an MRI, an X-ray,
a CT, a CBCT, a spiral CT, a PET, a SPECT, an optical tomography, a
fluorescence imaging, ultrasound imaging, or radiotherapy portal
imaging device, etc., as would be recognized by one of ordinary
skill in the art.
[0064] FIG. 3A illustrates tin example of portions of an ultrasound
positioning system 300. The ultrasound positioning system 300 can
include an overlay 304, an ultrasound probe holder 308, knee
cushions 312, and ankle cushions 316. One or more portions of the
ultrasound positioning system 300 can be directly or indirectly
attached to a radiation couch 216, such as via an indexing bar 320
and the overlay 304. The radiation couch 216 can include markings
along a longitudinal direction, such as can be used to mark a
position of the indexing bar 320, such as with respect to the
radiation couch 216. The indexing bar 320 can include reciprocal
engagement features or other like mating features, such as on a top
and bottom side of the indexing bar 320. The mating features on the
bottom side of the indexing bar 320 can be coupled to or engaged
with corresponding mating features of the radiation couch 216, such
as to selectively position the indexing bar 320 at a marked
position with respect to the radiation couch 216. The overlay 304
can include markings and corresponding reciprocal engagement
features or other like mating features along a longitudinal
direction of the overlay 304. The overlay 304 can be positioned
with respect to and engaged or attached to the indexing bar, such
as at a desired marked position of the overlay 304. This can
include coupling or engaging mating features on a top side of the
indexing bar 320 to desired locations of corresponding mating
features of the overlay 304. Additionally, the locations of the
heels of a patient can be determined using the markings (e.g.,
ruled markings) of the overlay 304, such as when the patient's
ankles are resting flat on the overlay 304. The ultrasound probe
holder 308 can be inserted into a central guide region of the
overlay 304, such as from a distal edge of the overlay 304 that is
located m a direction that is away from the patient's torso. The
ultrasound probe holder 308 can include a clamp, which can be used
to determine whether the ultrasound probe holder 308 can freely
move along a longitudinal direction within the central guide region
of the overlay 304, or whether the ultrasound probe holder 308 can
be fixed at a particular location along the longitudinal direction.
Bach of the knee cushions 312 can include a mating feature that can
be engaged or coupled to a corresponding mating feature of the
overlay 304, such as to fix a position of the knee cushion 312 with
respect to the overlay 304. The ankle cushions 316 can be movable
coupled to a central guide region of the overlay 304 and can move
freely along a longitudinal direction of the overlay 304. An
ultrasound probe 324 can be inserted into the ultrasound probe
holder 308, such as illustrated in FIG. 3B. A position of the
ultrasound probe 324 can then be adjusted, using the ultrasound
probe holder 308, such as until the ultrasound probe 324 is brought
against or into proximity with a portion of anatomy of a patient
328.
[0065] FIG. 4 illustrates an example of portions of a method 400 of
using portions of an ultrasound positioning system, such as
ultrasound positioning system 300. An indexing bar, such as
indexing bar 320, can be positioned at a selected position (e.g.,
of multiple available indexed positions) on a radiation couch or
other platform for radiotherapy, such as couch 216 (step 404) The
indexing bar 320 can be selectively placed at a desired marked
position of the couch 216. An overlay, such as overlay 304, can be
positioned with respect to the indexing bar 320 (step 408) The
overlay 304 can be positioned to engage the indexing bar 320 at a
marked position of the overlay 304. A patient, such as patient 328,
can be positioned overlay 304 on the couch 216 (step 412). In an
example, one or more permanent or temporary markings (e.g.,
tattoos) on the patient can be used to position the patient, such
as with respect to the couch 216 and overlay 304. Knee cushions,
such as knee cushions 312 can be coupled at a fixed position with
respect to the overlay 304 (step 416) A pair of ankle cushions,
such as ankle cushions 316 can be adjustably located at a desired
position along a longitudinal direction, such as to provide support
for the patient's ankles (step 420) A position of the overlay 304
can be adjusted with respect to the couch 216 or the patient 328,
such as by adjusting a marked position of the overlay 304 with
respect to the indexing bar 320 (step 424). The position of the
overlay 304 can be adjusted to provide comfort to the patient 328,
such as based on contemporaneous or previous feedback from the
patient 328. The marked position of the overlay 304 can be recorded
and used in a subsequent radiation therapy session, such as to
allow for convenient positioning of the overlay 304 without
requiring further adjustments. An ultrasound probe, such as the
ultrasound probe 324 can be coupled to the ultrasound probe holder
308 in a central guide region of the overlay 304 (step 428) The
ultrasound probe holder 308 can be manually translated (e.g.,
pushed or pulled by a clinician) in a longitudinal direction
towards patient anatomy (e g, a perineum of the patient) until the
ultrasound probe 324 contacts the patient (step 432) The ultrasound
probe holder 308 can then be clamped m position. Further (e.g.,
fine) adjustments of the longitudinal position of the ultrasound
probe holder 308 can then be made via a centrally accessible
actuator of the ultrasound probe holder 308 (step 436). The further
adjustments of the longitudinal position can be used to adjust a
pressure exerted on the patient by the ultrasound probe 324. Such
fine adjustment can help bring the ultrasound probe close enough
against the patient to obtain a good quality image, while limiting
the amount of discomfort felt by the patient by tire probe pressing
against the patient.
[0066] FIG. 5A illustrates an example of an overlay, such as the
overlay 304. The overlay 304 can include indexed engagement
features 532 such as for coupling the overlay to an indexing bar,
such as the indexing bar 320. Each of the engagement features 532
can correspond to at least one corresponding marking 528 of the
overlay 304. For example, the corresponding markings can convey
information about the spacing between adjacent engagement features
532, or about a cumulative distance from a reference marking and
corresponding engagement feature 532. The engagement features 532
can engage directly to a couch, such as couch 216, or indirectly to
the couch 216, such as via the indexing bar 320. The overlay 304
can include a central guide region 504, such as indicated by the
dashed lines in FIG. 5A. The central guide region 504 can include
one or more (e.g., a pair) of guide rails 508. Each of the guide
rails 508 can include a V-shaped or other interior (e.g.,
inward-facing) groove 512 and V-shaped or other exterior (e.g.,
laterally outward facing) groove 510. The interior grooves 512 can
face each other. An ultrasound probe holder, such as the ultrasound
probe holder 324 can engage with and can be guided in a
longitudinal direction by the interior grooves 512 and a channel
therebetween. The overlay 304 can also include a retention feature
such as a spring-biased, resiliency-biased, or other flap 511, such
as can be configured to allow the probe holder 324 to be inserted
into the channel between the interior grooves 512. Inserting the
probe holder 324 into the grooves 512 can automatically push the
flap out of the way upon such insertion. The flap 511 can then
automatically spring outward when the probe holder 324 has been
moved along the grooves 512, such as to help prevent the probe
holder from being removed from the channel in the absence of manual
actuation of the flap 511. Then, when release of the probe holder
324 is desired, the user can depress or otherwise manually actuate
the flap 511. The exterior grooves 510 can face outwardly away from
each other. Ankle cushions, such as ankle cushions 316 can engage
with and can be guided in a longitudinal direction by the exterior
grooves 510. The overlay 304 can also include one or more mating
features 516 (e.g., one or more protrusions or depressions) that
can be coupled to one or more corresponding features of knee
cushions, such as on the undersides of the knee cushions 312. The
knee cushions can be indexed to the mating features 516. The
overlay 304 can also include at feast one glide 536 on a bottom
side of the overlay 304 as illustrated in FIG. 5B which shows a
side view of the overlay 304. In an example, the glide can be
formed from a material including poly oxymethylene (POM), also
known as acetal. An individual glide 536 can include a protrusion
from the bottom of the overlay 304 and can be made of a hard
plastic or other material having a relatively low coefficient of
friction with the couch 216. The at feast one glide 536 can allow
the overlay 304 to easily slide back and forth on the couch 216.
The overlay 304 can also include at least one sticky bump 540. An
individual sticky bump 540 can include a protrusion from the bottom
of the overlay 304 and can be made of a soft plastic or other
material having a relatively large coefficient of friction with the
couch 216. In an example, the sticky bump can be formed from a
material including polyurethane (PUR) or synthetic rubber. The at
least one sticky bump 540 can be configured to provide resistance
to sliding movement of the overlay 304 when the at least one sticky
bump 540 is in contact with the couch 216. The overlay 304 can also
include a handle 524 that can be used to elevate an inferior end
(e.g., end of overlay further from the patient's head) of the
overlay 304 where the handle 524 is located. When the handle 524 is
elevated, the at least one sticky bump 540 can be brought out of
contact with the couch 216, while the at least one glide 536 can
remain in contact with the couch 216. Then, with only the at least
one glide 536 in contact with the couch 216, the overlay 304 can be
repositioned. The handle 524 can then be lowered to bring the at
least one sticky bump 540 back into contact with the couch 216.
[0067] FIG. 6 illustrates a method 600 of using an overlay, such as
the overlay 304. The overlay can be positioned at an indexed
position on a couch, such as couch 216 (step 604). The overlay 304
can guide translational movement of an ultrasound probe holder;
such as the ultrasound probe holder 308, along a longitudinal axis
of the overlay from within a central region of the overlay (step
608). A longitudinal groove, such as one or both of the interior
grooves 512 can be used to guide the translational movement of the
ultrasound probe holder One or more patient support cushions can be
engaged using one or more longitudinal grooves, such as the
exterior grooves 510 of the overlay (step 612). One or more patient
support cushions can also be engaged to one or more mating features
(e.g., protrusions or depressions) on a top surface of the overlay
304. The overlay can be initially positioned or re-positioned
without indexed engagement using a handle and one or more glides,
such as the handle 524 the at least one glide 536. After being
positioned, the overlay can be placed into engagement with one or
more indexed engagement features, such as one or more mating
features of an indexing bat, such as the index mg bar 320.
[0068] FIG. 7A illustrates an example of an ultrasound probe
holder, such as the ultrasound probe holder 308. The ultrasound
probe holder 308 can include a clamp 708, a fine adjustment
mechanism 704, a retractable flap 712, a first body portion 716a, a
second body portion 716b, and protrusions 720. The retractable flap
712 can lock an ultrasound probe, such as the ultrasound probe 324
into position when the ultrasound probe is coupled to the second
body portion 716b. The retractable flap 712 can be manually
actuated to release the ultrasound probe 324 from the second body
716b. The protrusions 720 can include outwardly facing protrusions
aligned along a longitudinal direction. The protrusions 720 can
interface with corresponding longitudinal grooves of an overlay,
such as the interior grooves 512, such as to allow the ultrasound
probe holder 308 to be translated within a central guide region of
the overlay 304 in a longitudinal direction. In an example, the
protrusions 720 can have a semi-circular cross section and the
interior grooves 512 can have a v-shaped cross section that can
accommodate the protrusions 720. The clamp 708 can be centrally
located within the ultrasound probe holder and can include a
rotatable knob 710, a disc 724, find a plate 728 such as
illustrated in FIGS. 7B-7C. One or more springs and associated
mechanical linkage can be used to maintain contact between the disc
724 find the rotatable knob 710, even as the rotatable knob 710 is
rotated between different positions. At least one roller 709 can be
attached to fin underside of the knob 710. The at least one roller
709 can slide along the disc 724 when the knob 710 is rotated. The
disc can include at least one notched portion 726 that can be
shaped to accommodate the at least one roller 709. A position of
the knob 710 can be locked (e.g., held in place in the absence of
manual rotation of the knob 710) when the at least one roller 709
is resting in the at least one notched portion 726.
[0069] In an example, the clamp 708 can include two rollers 709
that can be diametrically opposing to one another. The disc 724 can
include four notches 726 spaced at ninety degree intervals along
the disc 724. A first pair of the four notches 726 can be spaced by
one hundred and eights degrees and can correspond to a first
height. A second pair of the four notches 726 can be spaced by one
hundred and eights degrees and can correspond to a second height.
When the two rollers 709 engage with the first pair of the four
notches 726 (a first knob position), such as can be illustrated in
FIG. 7B, the disc 728 can extend from a bottom of the ultrasound
probe holder 308 by a first distance d.sub.2, such as can provide a
clamping force to lock the ultrasound probe holder 308 in place
with respect to the overlay 304. The clamping force can be provided
by a frictional force between the disc 728 and the overlay 304. The
disc 728 can include a relatively sticky substance (e.g.,
polyurethane (PUR) or synthetic rubber) on a surface to provide
increased friction between the disc 728 and the overlay 304.
Additional clamping force can be provided by the protrusions 720
being brought into closer contact with the interior grooves 512
when the disc 728 extends from the bottom of the ultrasound probe
holder 308 by the first distance d.sub.2. When the two rollers 709
engage with the second pair of the four notches 726 (a second knob
position), such as can be illustrated in FIG. 7C, the disc 728 can
extend from a bottom of the ultrasound probe holder 308 by a second
distance d.sub.2 smaller than the first distance do such as can
reduce a clamping force to allow the ultrasound probe holder 308 to
move freely in a longitudinal direction with respect to the overlay
304. Additionally, a clearance between the protrusions 720 and the
interior grooves 512 can be increased when the two rollers 709
engage with the second pair of the four notches 726. Thus, by
toggling between the first and second knob positions, the
ultrasound probe holder 308 can be clamped or unclamped to the
overlay 304.
[0070] The fine adjustment mechanism 704 can include a rotatable
knob that can be centrally accessed when the patient is resting on
the overlay 304 and radiation couch 216 as illustrated in FIG. 3B
(e.g., the fine adjustment mechanism can be accessed from a central
region of the overlay 304, and need not be accessed laterally from
the side). The rotatable knob can be actuated, such as to adjust a
distance between the first body portion 716a and the second bods
portion 716b. In an example where an ultrasound probe, such as the
ultrasound probe 324 can be mounted to the second body portion
716b, a position of the ultrasound probe can be adjusted with
respect to the overlay 304 by using actuating the rotatable knob of
the One adjustment mechanism 704. The rotatable knob can be turned
m a first direction, such as to cause the first body portion 716a
to move away from the second bods portion 716b, such as to increase
a distance d.sub.1 between the first body portion 716a and 716b.
The rotatable knob can also be turned in a second direction
different from the first direction, such as to cause the first body
portion 716a to move toward the second body portion 716b, such as
to decrease a distance d.sub.1 between the first body portion 716a
and 716b The rotatable knob can adjust the distance d.sub.1 between
the first body portion 716a and 716b independent of whether the
ultrasound probe holder 308 is clamped to tire overlay 304
[0071] FIG. 8 illustrates an exemplary method 800 of using an
ultrasound probe holder. The probe holder can be inserted into a
central guide region of an overlay, such as the overlay 304 (step
804). The ultrasound probe holder can be automatically engaged to
the overlay upon insertion onto a longitudinal path in a central
guide region of the overlay 304. The probe holder can be
user-accessed and user-controlled from within a central region to
translate the probe longitudinally toward or away from patient
anatomy (step 808) The probe holder can be clamped at a specified
location along tire longitudinal translation path (step 812). The
clamping can reduce a clearance within a groove, such as an
interior groove 512. An actuator on the clamp can be rotated to
increase a frictional force associated with the probe holder. The
actuator can be rotated m a first direction to provide clamping of
the ultrasound probe holder 308 to tire overlay 304. The actuator
can then be further rotated in the first direction or rotated in a
second direction opposite to the first direction to reduce clamping
of the ultrasound probe holder 308 to the overlay 304. An
ultrasound probe, such as the ultrasound probe 324 can then be
attached to the ultrasound probe holder. The ultrasound probe can
be attached a portion of the ultrasound probe holder and can be
locked into place by a retractable flap. The ultrasound probe 324
can be further translated along a longitudinal direction, such as
by using a centrally located and centrally accessible fine
adjustment mechanism, such as the fine adjustment mechanism 704
(step 816).
[0072] FIGS. 9A and 9B illustrate examples of a patient support
cushions, such as ankle cushions 316 and knee support cushions 312.
The knee support cushions 312 can include portions shaped to
accommodate a patient's knee from behind the knee Additionally,
tire knee support cushions 312 can be shaped and arranged to
provide a space therebetween that can accommodate an ultrasound
probe holder, such as ultrasound probe holder 308. Thus, the
ultrasound probe holder 308 can freely slide between the knee
support cushions 312 in a central guide region of the overlay 304.
As illustrated in FIG. VC, the knee support cushions can include a
recessed mounting portion that includes indexed engagement features
for engaging a corresponding raised mounting portion of an overlay,
such as overlay 304. The knee support cushions can also include a
raised mounting portion that includes indexed engagement features
for engaging a corresponding recessed mounting portion of an
overlay, such as overlay 304. The knee support cushions can be
indexed to the overlay in a longitudinal and/or lateral direction.
The space provided between the knee support cushions can allow for
access to a patient's perineum. A booster can be shaped to be
inserted between an individual one of the knee support cushions and
the overlay, such as to adjust a height of the individual knee
support cushion. The ankle cushions 310 can include a lateral slide
for engaging a corresponding feature of an overlay, such as the
overlay 304. A bottom side of the ankle cushions can include a
recessed portion 317 that can provide a space to accommodate an
ultrasound probe holder-such as the ultrasound probe holder 308.
The recessed portion 317 can include slides that can engage with at
least one exterior groove, such as exterior groove 510 of the
overlay. The ankle cushions 316 can then be translated in a
longitudinal direction along the overlay 304. The recessed portion
317 can have a height d.sub.3 that can accommodate the height of
the ultrasound probe holder, such that the ultrasound probe holder
can slide underneath the ankle cushions, or vice versa. In an
example, the recessed portions can have a height d.sub.3 that can
accommodate only a portion of the height of the ultrasound probe
holder, such that only a portion of the ultrasound probe holder can
slide underneath the ankle cushions. For example, tire height
d.sub.3 may not be large enough to accommodate a knob of the
ultrasound probe holder, such that the knob of the ultrasound probe
holder acts as a stop to limit relative longitudinal translation
between the knee cushions and the ultrasound probe holder.
Additionally, each of the individual knee support cushions 312 can
include a handle 913 on an underside of the individual knee support
cushion 312 as shown in FIGS. 9D and 9E. The handle 913 can include
a protrusion shaped to be gripped by a human hand. The handle 913
can be shaped such as to provide ease of grabbing the knee support
cushion 312 with a single hand. This can be useful for a therapist
when setting up the patient on the radiation couch. For example,
one hand can be used to lift the patient's leg while the other hand
can be used to insert the knee support cushion 312. A similar
handle 915 can be included on an underside of a booster as shown in
FIGS. 9F and 9G. The handle 915 can include recessed portions that
can be gripped by fingers of a clinician or therapist. The various
recessed portions can be spaced and arranged to accommodate
different hand sizes. A similar handle 917 can be included on an
underside of the ankle cushions 316 as illustrated in FIGS. 9H and
9I. The handle 917 can include recessed portions that can be
gripped by fingers of a clinician or therapist. The various
recessed portions can be spaced and arranged to accommodate
different hand sizes.
[0073] FIG. 10 illustrates a method of using patient support
cushions, such as knee cushions 312 and ankle cushions 316. A first
knee cushion 312 can be used to support a patient's first knee from
behind the knee (step 1004). A second knee cushion 312 can be used
to support a patient's second knee from behind the knee (step
1008). The first and second knee cushions can provide access to a
patient via a probe holder m a central region formed by the first
and second knee cushions being placed in lateral regions on
opposing sides. Each of the individual knee cushions can be indexed
to an overlay, such as the overlay 304. An ankle cushion can be
used to support the patient's ankles from behind the ankles (step
1012). The ankle cushion can be translated in a longitudinal
direction along a longitudinal track A booster can be provided
between an individual one of the knee cushions and the overlay,
such as to adjust a height of the individual knee cushion. The
booster can also be used between the ankle cushion and the overlay,
such as to adjust a height of the ankle cushion.
ADDITIONAL NOTES
[0074] The above detailed description includes references to the
accompanying drawings, which form a part of the detailed
description. The drawings show, by wav of illustration but not by
way of limitation, specific embodiments in which the invention can
be practiced. These embodiments are also referred to herein as
"examples." Such examples can include elements in addition to those
shown or described. However, the present inventors also contemplate
examples in which only those elements shown or described are
provided. Moreover, the present inventors also contemplate examples
using any combination or permutation of those elements shown or
described (or one or more aspects thereof), either with respect to
a particular example (or one or more aspects thereof), or with
respect to other examples (or one or more aspects thereof) shown or
described herein.
[0075] All publications, patents, and patent documents referred to
in this document are incorporated by reference herein in their
entirety, as though individually incorporated by reference. In the
event of inconsistent usages between this document and those
documents so incorporated by reference, the usage in the
incorporated referenced) should be considered supplementary to that
of this document; for irreconcilable inconsistencies, the usage in
this document controls.
[0076] In this document, the terms "a," "an," "the," and "said" are
used when introducing elements of aspects of the invention or in
the embodiments thereof, as is common in patent documents, to
include one or more than one or more of the elements, independent
of any other instances or usages of "at least one" or "one or
more." In this document, the term "or" is used to refer to a
nonexclusive or, such that "A or B" includes "A but not B," "B but
not A," and "A and B," unless otherwise indicated.
[0077] In the appended claims, the terms "including" and "in which"
are used as the plain-English equivalents of the respective terms
"comprising" and "wherein." Also, in the following claims, the
terms "comprising," "including," and "having" are intended to be
open-ended to mean that there may be additional elements other than
the listed elements, such that after such a term (e.g., comprising,
including, having) in a claim are still deemed to fall within the
scope of that claim. Moreover, in the following claims, the terms
"first," "second," and "third," etc., are used merely as labels,
and are not intended to impose numerical requirements on their
objects.
[0078] Embodiments of the invention may be implemented with
computer-executable instructions. The computer-executable
instructions (e.g., software code) may be organized into one or
more computer-executable components or modules. Aspects of the
invention may be implemented with any number and organization of
such components or modules. For example, aspects of the invention
are not limited to the specific computer-executable instructions or
the specific components or modules illustrated in the figures and
described herein. Other embodiments of the invention may include
different computer-executable instructions or components having
more or less functionality than illustrated and described
herein
[0079] Method examples (e.g., operations and functions) described
herein can be machine or computer-implemented at least in part
(e.g., implemented as software code or instructions). Some examples
can include a computer-readable medium or machine-readable medium
encoded with instructions operable to configure an electronic
device to perform methods as described in the above examples. An
implementation of such methods can include software code, such as
microcode, assembly language code, a higher-level language code, or
the like (e.g., "source code") Such software code can include
computer readable instructions for performing various methods
(e.g., "object" or "executable code"). The software code may form
portions of computer program products. Software implementations of
the embodiments described herein may be provided via an article of
manufacture with the code or instructions stored thereon, or via a
method of operating a communication interface to send data via a
communication interface (e.g., wirelessly, over the internet, via
satellite communications, and the like).
[0080] Further, the software code may be tangibly stored on one or
more volatile or non-volatile computer-readable storage media
during execution or at other times. These computer-readable storage
media may include any mechanism that stores information in a form
accessible by a machine (e.g., computing device, electronic system,
and the like), such as, but are not limited to, floppy disks, hard
disks, removable magnetic disks, any form of magnetic disk storage
media, CDROMS, magnetic-optical disks, removable optical disks
(e.g., compact disks and digital video disks), flash memory
devices, magnetic cassettes, memory cards or sticks (e.g., secure
digital cards), random access memories (RAMs) (e.g., CMOS RAM and
the like), recordable/non-recordable media (e.g., read only
memories (ROMs)), EPROMS, EEPROMS, or any type of media suitable
for storing electronic instructions, and the like. Such computer
readable storage medium coupled to a computer system bus to be
accessible by the processor and other parts of the OIS
[0081] In an embodiment the computer-readable storage medium may
have encoded a data structure for a treatment planning, wherein the
treatment plan may be adaptive. The data structure for the
computer-readable storage medium may be at least one of a Digital
Imaging and Communications in Medicine (DICOM) format an extended
DICOM format a XML format, and the like. DICOM is an international
communications standard that defines the format used to transfer
medical image-related data between various types of medical
equipment. DICOM RT refers to the communication standards that are
specific to radiation therapy
[0082] In various embodiments of the invention, the method of
creating a component or module can be implemented in software,
hardware, or a combination thereof. The methods provided by various
embodiments of the present invention, for example, can be
implemented in software by using standard programming languages
such as, for example, C, C++, Java, Python, and the like; and
combinations thereof. As used herein, the terms "software" and
"firmware" are interchangeable, and include any computer program
stored in memory for execution by a computer.
[0083] A communication interface includes any mechanism that
interfaces to any of a hardwired, wireless, optical, and the like,
medium to communicate to another device, such as a memory bus
interface, a processor bus interface, an Internet connection, a
disk controller, and the like. The communication interface can be
configured by providing configuration parameters and/or sending
signals to prepare the communication interface to provide a data
signal describing the software content. The communication interface
can be accessed via one or more commands or signals sent to the
communication interface.
[0084] The present invention also relates to a system for
performing the operations herein. This system may be specially
constructed for the required purposes, or it may comprise a general
purpose computer selectively activated or reconfigured by a
computer program stored in the computer. The order of execution or
performance of the operations in embodiments of the invention
illustrated and described herein is not essential, unless otherwise
specified That is, the operations may be performed in any order,
unless otherwise specified, and embodiments of the invention may
include additional or fewer operations than those disclosed herein.
For example, it is contemplated that executing or performing a
particular operation before, contemporaneously with, or after
another operation is within the scope of aspects of the
invention.
[0085] In view of the above, it will be seen that the several
objects of the invention are achieved and other advantageous
results attained. Having described aspects of the invention in
detail, it will be apparent that modifications and variations are
possible without departing from the scope of aspects of the
invention as defined in the appended claims. As various changes
could be made in the above constructions, products, and methods
without departing from the scope of aspects of the invention, it is
intended that all matter contained in the above description and
shown in the accompanying drawings shall be interpreted as
illustrative and not in a limiting sense.
[0086] The above description is intended to be illustrative, and
not restrictive. For example, the above-described examples (or one
or more aspects thereof) may be used in combination with each
other. In addition, many modifications may be made to adapt a
particular situation or material to the teachings of the invention
without departing from its scope. While the dimensions, types of
materials and coatings described herein are intended to define the
parameters of the invention, they are by no means limiting and are
exemplary embodiments. Many other embodiments will be apparent to
those of skill in the art upon reviewing the above description. The
scope of the invention should, therefore, be determined with
reference to the appended claims, along with the full scope of
equivalents to which such claims are entitled.
[0087] Also, in the above Detailed Description, various features
may be grouped together to streamline the disclosure. This should
not be interpreted as intending that an unclaimed disclosed feature
is essential to any claim. Rather, inventive subject matter may lie
in less than all features of a particular disclosed embodiment.
Thus, the following claims are hereby incorporated into the
Detailed Description, with each claim standing on its own as a
separate embodiment. The scope of the invention should be
determined with reference to the appended claims, along with the
full scope of equivalents to which such claims are entitled.
Further, the limitations of the following claims are not written in
means-plus-function format and are not intended to be interpreted
based on 35 U.S.C. .sctn. 112, sixth paragraph, unless and until
such claim limitations expressly use the phrase "means for"
followed by a statement of function void of further structure.
[0088] The Abstract is provided to comply with 37 C.F.R. .sctn.
1.72(b), to allow the reader to quickly ascertain the nature of the
technical disclosure. It is submitted with the understanding that
it will not be used to interpret or limit the scope or meaning of
the claims
* * * * *