Radiotherapy apparatus for delivering radiation to a subject

Abstract

The present disclosure relates to a radiotherapy device for delivering radiation to a subject. The device includes a radiation source configured to rotate about an isocenter and emit radiation in a radiation plane containing the isocenter. The device also includes a subject support surface including a portion configured to be located substantially at the isocenter. The subject support surface includes a subject support surface rotation mechanism configured to rotate the subject support surface about a rotation axis parallel to and spaced apart from an axis passing through the isocenter. The subject support surface also includes a first section configured to move from a first position to a second position along at least one of a longitudinal direction and a lateral direction. The device also includes a processor configured to control longitudinal and / or lateral movement of the first section as a function of rotation of the subject support surface to maintain the portion of the subject support surface substantially at the isocenter.

Description

Technical Field

[0001] This disclosure generally relates to radiotherapy equipment, and more particularly to the positioning of a subject during the delivery or application of radiotherapy. Background Technology

[0002] Radiation therapy uses ionizing radiation to treat human or animal bodies. In particular, radiation therapy is commonly used to treat tumors in humans or animals. In such treatment, cells forming the tumor are irradiated with ionizing radiation to destroy or damage these cells. However, in order to deliver a prescribed dose of ionizing radiation to a target site or region, such as a tumor, the ionizing radiation typically also penetrates healthy tissue in the human or animal body. Therefore, radiation therapy has the desired result of irradiating and destroying the target area, but it can also have the undesirable result of irradiating and destroying healthy tissue. In radiation therapy, it is desirable to align the dose received by the target area with the prescribed dose and to minimize the dose received by the healthy tissue.

[0003] Modern radiotherapy uses techniques to reduce the radiation dose to healthy tissue, thus providing safe treatment. For example, one way to minimize the radiation dose received by healthy tissue surrounding the target area is to direct radiation to the target area from multiple different angles, such as by rotating a radiation source around the patient using a rotating gantry. In this case, the angle at which radiation is applied is chosen so that each beam passes through the target area. In this way, a cumulative radiation dose can be built up over the target area during the treatment arc, where the radiation source rotates at a certain angle. The radiation is emitted in a radiation plane that coincides with the plane of the gantry around which the radiation source rotates, so that regardless of the angle at which the radiation head rotates around the gantry, the radiation can be delivered to the radiation isocenter at the center of the gantry. Because radiation is applied from multiple different angles, the same high, cumulative radiation dose does not accumulate in the healthy tissue, as the specific healthy tissue through which the radiation passes varies with the angle. Therefore, the unit volume of healthy tissue receives a reduced radiation dose relative to the target area. Treatment utilizing gantry rotation in this way is called coplanar. However, after the radiation source has rotated 180°, it should be understood that any subsequent radiation beam begins to pass through areas of healthy tissue that have already been irradiated. This increases the radiation dose applied to the healthy tissue. Therefore, when using this method, the volume of healthy tissue available for distributing the radiation dose is relatively small, thus limiting the treatments that can be provided by such a device.

[0004] Therefore, an alternative approach to minimizing the radiation dose received by the healthy tissue surrounding the target area is to rotate the patient relative to the radiation plane. As the patient's angle changes relative to the plane of the gantry, the amount of healthy tissue through which the radiation passes also changes. To further reduce the radiation dose per unit volume relative to the target area, it is desirable to provide a treatment that combines both of these rotations. Figure 1 An example of a known device that combines rotation of the patient with rotation of the radiation source is shown. This demonstrates that the patient 140 (also referred to herein as patient support surface 114) supported on object support surface 114 can rotate, and the gantry 116 can also rotate about patient support surface 114. Figure 1 The gantry 116 shown is a C-arm gantry or an open gantry. A rotating mechanism 117 rotates the gantry 116 about a fixed axis 119. As the gantry 116 rotates, radiation emitted by the radiation source 106 can sweep out a circle. Radiation can be applied to the patient 140 from multiple angles around this circle. This circle can be described as lying in the radiation plane. The radiation axis lies in the radiation plane. The radiation axis forms a 90° angle with respect to the fixed axis 119.

[0005] The rotation mechanism 120 for the patient support surface 114 is located below the gantry 116 of the radiotherapy apparatus, while the rotation mechanism for the gantry 116 is located opposite the patient support surface 114. The rotation mechanism 120 for the patient support surface 114 is located below the gantry 116 such that the axis of rotation 111 of the patient support surface 114 lies in the radiation plane. Specifically, the axis of rotation 111 of the patient support surface passes through the isocenter 124 of the radiotherapy apparatus, causing the patient support surface 114 to rotate about the isocenter 124. When the patient support surface 114 is in its neutral position, the axis of rotation of the patient support surface 114 is approximately vertical (perpendicular to the plane of the base plate), and this can also be referred to as the vertical axis 111. The longitudinal axis 113 is parallel to the long side of the patient support surface 114 in its neutral position, and the transverse axis 115 is parallel to the short end of the patient support surface 114 in its neutral position. The rotation mechanism 120 lies in the radiation plane. Treatment utilizing radiation and the rotation of the patient 140 is referred to as non-coplanar treatment.

[0006] Some recently developed radiotherapy devices include ring-based gantry (or perforated structures), such as... Figure 2As shown in the diagram. Typically, the aperture of the radiotherapy device is cylindrical. A patient support surface 114 is positioned within the aperture so that radiation can be directed toward a patient 140 positioned on the support surface 114. The aperture of the device can be formed by a frame, which may also be described as a base, shielding structure, outer shell, or housing. The frame defines the outer surface of the device as seen by the patient 140 upon entering the treatment room, and the inner surface of the aperture as seen by the patient 140 when positioned within the aperture. The frame also defines a hollow region of annular cross-section in which the gantry 116 can rotate and tilt. Thus, the patient 140 is shielded from the rotating gantry 116. The movement of the gantry 116 is concealed from the patient's line of sight, reducing the threat and distress that might arise if the patient 140 could see the rotation of the large gantry 116 (as they would for a patient with a large gantry 116). Figure 1 The open gantry shown can be rotated as is, and also reduces the likelihood that a patient could accidentally touch or interfere with the movement of gantry 116. This means that gantry 116 can be rotated quickly, efficiently, and safely. Ring-based gantry are also desirable because they increase device stability. Ring-based gantry are supported and rest on a base plate. However, the geometry of ring-based gantry and its connection to the base plate make it impossible to use known systems to rotate the object support surface 114 in a manner that maintains a portion of the object support surface 114 approximately at the isocenter 124. Summary of the Invention

[0007] The invention is described in the claims. Attached Figure Description

[0008] The specific implementation method is now described by way of example only, with reference to the accompanying drawings, wherein:

[0009] Figure 1 A known radiotherapy device with a rotating mechanism located in the radiation plane is described;

[0010] Figure 2 A front view of a radiotherapy device is depicted;

[0011] Figure 3 An isometric view depicting an embodiment of a radiotherapy device;

[0012] Figure 4 An isometric view depicting an embodiment of a radiotherapy device including a hinge, wherein an object support surface is configured to rotate about the hinge, wherein the object support surface is in a lowered and non-extended position.

[0013] Figure 5 An isometric view of an embodiment of a radiotherapy device including a hinge is depicted, wherein the object support surface is in an elevated, non-rotating, and non-extended position;

[0014] Figure 6A An isometric view of an embodiment of a radiotherapy device including a hinge is depicted, wherein the object support surface is in an elevated, rotated, and non-extended position;

[0015] Figure 6B An isometric view of an embodiment of a radiotherapy device including a hinge is depicted, wherein the object support surface is in an elevated, rotated and extended position, and wherein the middle portion has been moved laterally to keep a portion of the object support surface approximately at the isocenter.

[0016] Figure 7 A plan view depicting an embodiment of a radiotherapy device including a hinge is shown, wherein the object support surface is in a rotated, raised, and extended position;

[0017] Figure 8 A side elevation view of an embodiment of a radiotherapy device with a rotating mechanism including a rotating arm is depicted.

[0018] Figure 9A An isometric view depicting an embodiment of a radiotherapy device with a rotating mechanism including a rotating arm and an object support surface in an elevated and rotated position;

[0019] Figure 9B An isometric view depicting an embodiment of a radiotherapy device with a rotating mechanism including a rotating arm and an object support surface in an elevated and rotated position;

[0020] Figure 9C A plan view of an embodiment of a radiotherapy device with a rotating mechanism is depicted, the rotating mechanism including a rotating arm and an object support surface in a rotating position;

[0021] Figure 10A A plan view of an embodiment of a radiotherapy device with a rotating mechanism is depicted, the rotating mechanism including a rotating arm and an object support surface in a non-rotating position;

[0022] Figure 10B A plan view of an embodiment of a radiotherapy device with a rotating mechanism is depicted, the rotating mechanism including a rotating arm and an object support surface in a rotating position, and the longitudinal movement of the recliner caused by the rotation is illustrated.

[0023] Figure 11A An isometric view of an embodiment of a radiotherapy device with a rotating mechanism, the rotating mechanism including a first sliding base and a second sliding base, is depicted.

[0024] Figure 11BAn isometric view of an embodiment of a radiotherapy device with a rotating mechanism, the rotating mechanism including a first sliding base and a second sliding base, is depicted.

[0025] Figure 12 An isometric view depicting an embodiment of a radiotherapy device with a rotating mechanism including a first sliding base and a second sliding base, wherein the object support surface is in a non-rotating position;

[0026] Figure 13A An isometric view depicting an embodiment of a radiotherapy device with a rotating mechanism including a first sliding base and a second sliding base, the top section of which is not shown;

[0027] Figure 13B An isometric view of an embodiment of a radiotherapy device with a rotating mechanism, viewed from below, is depicted, the rotating mechanism including a first sliding base and a second sliding base;

[0028] Figure 14A An isometric view of an embodiment of a radiotherapy device with a rotating mechanism is depicted, the rotating mechanism including a first sliding base and a second sliding base, wherein the object support surface is in a laterally displaced position;

[0029] Figure 14B An isometric view of an embodiment of a radiotherapy device with a rotating mechanism is depicted, the rotating mechanism including a first sliding base and a second sliding base, with the object support surface in a rotating position;

[0030] Figure 15A An isometric view of an embodiment of a radiotherapy device with a rotating mechanism is depicted, the rotating mechanism including a first sliding base and a second sliding base, with the object support surface in a pitch position;

[0031] Figure 15B An isometric view of an embodiment of a radiotherapy device with a rotating mechanism including a first sliding base and a second sliding base, wherein the object support surface is in a tumbling position. Detailed Implementation

[0032] Overview

[0033] Several benefits are provided by providing a radiotherapy device for delivering radiation to a subject, the device comprising: a radiation source configured to rotate about an isocenter and emit radiation in a radiation plane containing the isocenter; a subject support surface including a portion configured to be substantially located at the isocenter. The subject support surface includes: a subject support surface rotation mechanism configured to rotate the subject support surface about a rotation axis parallel to and spaced apart from the axis passing through the isocenter; and a first segment configured to move from a first position to a second position along at least one of a longitudinal direction and a transverse direction. The device also includes a processor configured to control the longitudinal and / or transverse movement of the first segment as a function of the rotation of the subject support surface to maintain a portion of the subject support surface substantially at the isocenter.

[0034] For example, when an object support surface / recliner is used to support a patient as part of a treatment, rotating the object support surface via a rotating mechanism means that the radiation dose forming part of the treatment can propagate through the patient's healthy tissue. Therefore, the total radiation dose received by healthy tissue in specific areas surrounding the target region can be minimized. Simultaneously, functionally controlling the movement of the first segment to maintain a portion of the object support surface approximately at its isocenter allows for maximizing the amount of radiation, particularly through the target region, thus improving the efficiency of the treatment. This improves the patient's health. The device described herein, and the positioning of the rotating mechanism outside the radiation plane, enables the use of a recliner kick (a rotatable recliner) in a ring-gantry-based linear accelerator system.

[0035] Detailed description

[0036] When a radiotherapy device including a radiation source 106 configured to rotate about an isocenter 124 and emit radiation in a radiation plane containing the isocenter 124 is used to treat a subject or patient 140, rotating the subject while maintaining it approximately at the isocenter 124 allows for minimizing the dose received by healthy tissue during radiotherapy. This can be achieved by providing a subject support surface rotation mechanism 120 connected to a subject support surface 114 and configured to rotate the subject support surface 114 about an axis of rotation parallel to and spaced from the axis passing through the isocenter 124, while moving a top section 128 of the subject support surface 114 to compensate for relative movement of a specific portion of the subject support surface 114 caused by the rotation of the subject support surface 114. In particular, the top section can move longitudinally and / or laterally as a function of the rotation of the subject support surface 114 in order to maintain a portion of the subject support surface 114 approximately at the isocenter 124. Several beneficial effects are achieved by rotating the object support surface while simultaneously moving a first segment (which may be a top segment of the object support surface configured to move from a first position to a second position in at least one of the longitudinal and transverse directions, independent of the rest of the object support surface) to keep a portion of the object support surface 114 substantially at the isocenter 124. For example, when the device is used to treat patient 140, the radiation dose may diffuse through the healthy tissue of patient 140, minimizing the radiation dose received by the healthy tissue surrounding the target area. Simultaneously, a maximum amount of radiation can be ensured to pass through the target area, thereby improving treatment efficiency. This improves the health of patient 140. If the first segment 128 is not configured to move as a function of the rotation of the object support surface 114 to keep a portion of the object support surface 114 substantially at the isocenter 124, then the position of the target area will move relative to the isocenter 124 (and the focal point of radiation), which will correspondingly result in an increased radiation dose received by the healthy tissue. Furthermore, this will result in a longer treatment time because the target area will not receive the expected dose of radiation.

[0037] The portion of the object support surface maintained approximately at isocenter 124 may correspond to a portion of the patient 140, such as the target region of the patient 140. Therefore, by maintaining a portion of the object support surface approximately at isocenter 124, the target region can be maintained approximately at isocenter 124. Positioning the object support surface rotation mechanism 120 outside the radiation plane allows for minimizing the dose received by the healthy tissue of the object 140 during radiotherapy, for a wide variety of radiotherapy devices with different geometries. In particular, the disclosed object support surface 114 is well-suited for radiotherapy devices including openings for receiving the object 140.

[0038] According to one embodiment, Figure 3 A radiotherapy device suitable for delivering a radiation beam to a patient during radiotherapy treatment is described. To provide useful accompanying information for the invention, the device and its components will be generally described. Figure 3 The apparatus described herein is based on this disclosure and is suitable for use with the disclosed systems and devices, although not all features are required, or as... Figure 3 As depicted in [the text]. Although Figure 3 The device described is an MR-linac, but embodiments of this disclosure can be any radiotherapy device, such as a linac device. Figure 3 Features shared with known devices (especially, for example, Versa HD™), and features involved in the generation of the therapeutic beam 110. According to the invention, by providing an object support surface rotation mechanism 120, modifications are made relative to known devices. Figure 3 The embodiments shown are described in more detail below.

[0039] Figure 3 The device shown is an MR-linac. This device includes both an MR imaging unit 112 and a radiotherapy (RT) unit, which may include a linear accelerator (linac) unit. In operation, the MR scanner produces MR images of the patient 140, while the LINAC unit generates and shapes the radiation beam, guiding it toward a target area within the patient's body according to the radiotherapy plan. In a commercial setting such as a hospital, the usual "casing" covering the MR imaging unit 112 and the RT unit is not present. Figure 3 It is depicted in the text.

[0040] Figure 3 The MR-linac device depicted includes a radiation source 106. Radiation source 106 may include beam-generating devices such as one or more of the following: a radio frequency source 102, a circulator 118, an electron source 105, a waveguide 104, and a target (not shown). The MR-linac may also include a collimator 108 (e.g., a multi-leaf collimator) configured to collimate and shape the beam, an MR imaging device 112, and a patient support surface 114. The device also includes a housing that, together with the circumferential gantry, defines an aperture. The movable object support surface 114 can be used to move a patient or other object into the aperture when an MR scan and / or radiotherapy is about to begin or during treatment. The MR imaging device 112, the RT device, and the object support surface actuator are communicatively coupled to a controller or processor. The controller is also communicatively coupled to a memory device including computer-executable instructions executable by the controller.

[0041] The RT device includes a radiation source 106 and a radiation detector (not shown). Typically, the radiation detector is positioned radially opposite the radiation source 106. The radiation detector is adapted and configured to generate radiation intensity data. In particular, the radiation detector is positioned and configured to detect the intensity of radiation that has passed through an object. The radiation detector can also be described as a radiation detection device and can form part of an illumination field imaging system.

[0042] Radiation source 106 defines the point at which the treatment beam 110 is introduced into the aperture. Radiation source 106 may include a beam generation system, which may include an RF energy source 102, an electron gun 105, and a waveguide 104. The beam generation system is attached to a rotatable gantry 116 so as to rotate together with the gantry 116. In this way, radiation source 106 can rotate around patient 140, allowing the treatment beam 110 to be applied from different angles around gantry 116. In a preferred embodiment, gantry 116 can rotate continuously. In other words, gantry 116 can rotate 360 ​​degrees around patient, and in fact, can continue to rotate beyond 360 degrees. Gantry 116 rotates about a mechanical isocenter, which is the spatial point around which gantry 116 rotates, and rotates about a fixed axis 119, such as... Figure 1 As shown in the diagram. A radiation isocenter can be defined as the point where the radiation beams intersect. These two isocenters 124 need not be identical, although it is expected that they should be. In this disclosure, the term isocenter 124 can refer to one or both of these. The isocenter 124 lies within the radiation plane. The frame 116 can be annular. In other words, the frame 116 can be an annular frame with openings. The frame 116 may also not be annular, but can be as follows: Figure 1 The open rack shown.

[0043] A radio frequency (RF) source 102 (e.g., a magnetron) is configured to generate RF waves. The RF source 102 is coupled to a waveguide 104 via a circulator 118 and configured to pulse the RF wave into the waveguide 104. The RF wave can travel from the RF source 102 through an RF input window and into an RF input connection conduit or tube. An electron source 105 (e.g., an electron gun) is also coupled to the waveguide 104 and configured to inject electrons into the waveguide 104. In the electron source, electrons are thermally emitted from the cathode filament as it is heated. The temperature of the filament controls the number of electrons injected. The injection of electrons into the waveguide 104 is synchronized with the pumping of the RF wave into the waveguide 104. The design and operation of the RF source 102, the electron source, and the waveguide 104 are such that the RF wave accelerates the electrons to very high energies as they propagate through the waveguide 104.

[0044] Radiation source 106 is configured to direct therapeutic radiation beam 110 toward a patient positioned on patient support surface 114. Radiation source 106 may include a heavy metal target toward which high-energy electrons exiting a waveguide are directed. When electrons strike the target, X-rays are generated in various directions. A master collimator may block X-rays traveling in certain directions and allow only forward-traveling X-rays to pass through to generate therapeutic beam 110. X-rays may be filtered and may pass through one or more ion chambers for dose measurement. Before the beam enters the patient's body as part of radiotherapy, it may be shaped in various ways by beam-shaping devices, such as by using a multi-leaf collimator 108.

[0045] In some embodiments, the radiation source 106 is configured to emit an X-ray beam or an electron particle beam. Such an embodiment allows the device to provide electron beam therapy, i.e., an external beam therapy, in which electrons, rather than X-rays, are directed toward a target region. A "swap" can be made between a first mode emitting X-rays and a second mode emitting electrons by adjusting components of the linear accelerator. Essentially, the switching between the first and second modes is achieved by moving a heavy metal target into or out of the electron beam path and replacing the heavy metal target with a so-called "electron window." The electron window is substantially transparent to the electrons and allows the electrons to exit the flight tube.

[0046] Figure 3 The radiotherapy device / apparatus depicted also includes an MR imaging device 112. The MR imaging device 112 is configured to acquire images of an object positioned (i.e., located) on an object support surface 114. The MR imaging device 112 may also be referred to as an MR imager. The MR imaging device 112 may be a conventional MR imaging device 110 that operates in a known manner to acquire MR data (e.g., MR images). Those skilled in the art will understand that such an MR imaging device 112 may include a main magnet, one or more gradient coils, one or more receiving coils, and an RF pulse applicator. The operation of the MR imaging device is controlled by a controller.

[0047] A controller is a computer, processor, or other processing device. A controller may be formed from several discrete processors; for example, a controller may include an MR imaging device processor that controls the MR imaging device 112; an RT device processor that controls the operation of the RT device; and an object support surface processor that controls the operation and actuation of the object support surface. The controller is communicatively coupled to memory, i.e., a computer-readable medium.

[0048] As those skilled in the art will understand, linear accelerator devices also include several other components and systems. For example, appropriate shielding is provided to ensure that the linear accelerator does not leak radiation.

[0049] The patient support surface 114 can be used to support an object. The object can be a human body (e.g., a patient), an animal body, or a material sample. The object support surface 114 is configured to move parallel to a longitudinal axis 113 between a first position generally outside the aperture and a second position generally inside the aperture. In the first position, the patient 140 or the object can be mounted on the object support surface 114. The object support surface 114 and the patient 140 can then extend within the aperture to the second position to image the patient 140 using an MR imaging device 112 and / or to image or treat the patient 140 using an RT device. The terms object and patient are used interchangeably herein, such that the object support surface 114 can also be described as a patient support surface 114. The object support surface 114 may also be referred to herein as a patient support surface and a movable or adjustable recliner or table.

[0050] The present invention differs from known devices as follows. The object support surface 114 is connected to an object support surface rotation mechanism 120. The rotation mechanism 120 is configured to rotate the object support surface 114 (which is also described herein as a recliner 114, patient support surface 114, or patient positioning system 114) about a rotation axis parallel to and spaced apart from the axis passing through the isocenter 124 of the frame 116. The rotation mechanism 120 may be attached to a base plate, or, for example, to the device housing or frame 116 (e.g., as shown in the image). Figure 4 (As shown in the diagram). The patient support surface 114 or a portion thereof may rotate about (around) the longitudinal axis 113 of the recliner 114 (roll), about the lateral axis 115 of the recliner 114 (pitch), or about an axis perpendicular to the base plate 111 of the recliner 114 (yaw), regardless of whether the recliner is in a neutral orientation or a rotating orientation, or any combination thereof. Unless otherwise stated, these axes are referenced relative to the recliner 114, regardless of its current orientation.

[0051] Despite Figure 3In the diagram, the plane of rotation of the patient support surface 114 is shown parallel to the base plate (as defined by the xy plane, which corresponds to the plane in which the patient support surface 114 is in its neutral position, where x is the longitudinal axis 113 and y is the transverse axis 115), where the rotation is a yaw about the axis 111 of the recliner in the neutral position. However, as an example, the angle of the plane of rotation relative to the base plate (tilt) can be 3, 15, 45, or 90 degrees with respect to the base plate. However, for patient comfort, the angle will generally be kept quite low. The tilt can also be changed before or during treatment. The rotation mechanism 120 and / or the patient support surface 114 can also be connected to additional rotation mechanisms (not shown) configured to rotate the rotation mechanism 120 and / or the patient support surface 114 in different planes. In this way, the patient support surface 114 can be connected to more than one rotation mechanism 120, each rotation mechanism 120 configured to move the patient support surface 114 in different planes. Alternatively, a single rotation mechanism 120 may be configured to rotate the patient support surface 114 in more than one plane, the axis of rotation of each plane of rotation of the patient support surface 114 being parallel to and spaced apart from the axis passing through the isocenter 124.

[0052] Simply rotating the recliner 114 from a first rotational position to a second rotational position (also referred to herein as isocenter rotation) about an axis of rotation parallel to and spaced apart from the axis passing through the isocenter 124 will cause a portion of the recliner 114 located at the isocenter 124 when it is in its first rotational position to move away from the isocenter 124 when it is in its second rotational position. In a treatment setting, this will cause the target area of ​​the patient 140 on the recliner 114 to move away from the isocenter 124 when the recliner 114 is rotated, which will result in an increased radiation dose received by healthy tissue. Furthermore, this will result in a longer treatment time because the target area will not receive the expected dose of radiation.

[0053] Accordingly, the object support surface 114 is configured such that a specific segment of the object support surface 114 can be moved in a plane perpendicular to the axis of rotation, such that a portion of the recliner 114 can be maintained approximately at the isocenter 124 and is separate from the rest of the object support surface 114. Specifically, the object support surface includes one or more segments 127, 128 configured to move from a first position to a second position along at least one of the longitudinal direction 113 and the transverse direction 115, or along directions inclined to these directions. These directions are relative to the recliner 114 and are independent of the then rotational orientation of the recliner 114. The movement of this segment of the recliner 114 can be used to compensate for the relative displacement of a specific portion of the recliner 114 away from the isocenter 124 caused by the off-center rotation of the recliner 114. Specifically, sections 127 and 128 of the recliner 114 can be moved in such a way that specific portions of the object support surface 114 are maintained approximately at the isocenter 124 when the recliner 114 rotates itself. The movement of sections 127 and 128 of the recliner 114 is controlled by a processor as a function of the rotation of the object support surface 114, so as to maintain said portion of the object support surface 114 approximately at the isocenter 124.

[0054] For example, when the recliner 114 is in a neutral rotational position (where its longitudinal axis 113 is parallel to the fixed axis 119 of the frame 116 in its neutral position), a portion of the recliner 114 is located at the isocenter 124. When the recliner 114 is rotated to a rotational position by the rotation mechanism 120, for example, by 10 degrees clockwise, this portion moves away from the isocenter 124. The device also includes a memory that stores information such as the dimensions of the recliner 114, the different sections of the recliners 126, 127, and 128, the position of the isocenter 124, the dimensions of the frame 116 and the frame cover, the position of the rotation axis of the recliner 114 and its position relative to the isocenter 124, and other useful information. The processor can use this information in a collision matrix to ensure that the system knows when and how a collision may occur and controls the movement and rotation of the recliner 114 to avoid such a collision. The processor can use such information to calculate the movement of the portion of the recliner 114 caused or to be caused by a specific amount of rotation. The processor then calculates the amount of movement required in one or more directions (relative to the recliner 114 in its specific rotational position) for the portion of the recliner 114 to return (or remain) back to the isocenter 124. The processor then controls the movement of segments 127, 128 of the recliner 114 according to the calculated amounts in a manner that maintains (or returns) the portion of the recliner 114 to the isocenter 124.

[0055] The processor can also be configured to control the rotation of the recliner 114. The processor can be configured to calculate the necessary or desired movement of segments 127, 128 before the rotation actually occurs. For example, the processor can plan the rotation of the recliner 114 and the corresponding movement of segments 127, 128 as part of a treatment plan. The rotation and movement can therefore occur simultaneously to ensure that the aforementioned portions of the recliner 114 are maintained approximately at isocenter 124 in the first rotational position, the second rotational position, and the position of each rotation between these positions. Alternatively, the rotation of the recliner 114 can be performed manually (e.g., by an operator), and the processor can then reactively calculate and command the necessary movement of segments 127, 128 of the recliner 114, although this may appear to an observer to be real-time due to the rapid processing time. The processor can be included within the recliner 114 or can be located separately, for example, in a control room. The processor can also use information such as the size and relative configuration of rack 116 to determine the maximum possible rotation angle for a particular recliner 114 configuration without interference, thereby ensuring that rotation does not cause the recliner 114 to come into contact with rack 116 in an unwanted manner.

[0056] The processor controlling the movement of sections 127 and 128 can be the same processor used for MR imaging device 112 or RT device, and therefore can also be configured to control the emission and rotation of radiation source 106. In this way, the rotation of recliner 114 can be planned as part of a broader treatment plan, and the rotation of recliner 114 can be more generally coordinated with the operation of the RT device, thereby optimizing treatment by reducing treatment time and minimizing damage to healthy tissues.

[0057] Because the axis of rotation is parallel to and spaced apart from the axis passing through the isocenter 124, it is not necessary to... Figure 1The rotating mechanism 120 is positioned within the radiation plane as shown to achieve the benefits of true isocentric rotation. Conversely, various rotating mechanisms 120 can be used, such as those located outside the plane of the gantry 116 and therefore outside the radiation plane or isolines. This is particularly useful for annular gantry / aperture solutions or devices where gantry 116 rotates 360°, for which positioning the rotating mechanism 120 within the radiation plane without interfering with gantry 116 is problematic. However, this disclosure is applicable to any radiotherapy device. While this disclosure is not limited to aperture solutions (annular gantry), aperture solutions offer improved device stability. Furthermore, aperture solutions are less imposed or disturbing to the patient. Therefore, aperture solutions may be desirable. This disclosure provides a device for supplying non-coplanar treatment (where both gantry 116 and patient support surface 114 rotate) in a radiotherapy device with an aperture solution. Positioning the rotating mechanism outside the radiation plane also minimizes radiation interference.

[0058] In this way, a portion of the recliner 114 (and therefore the target area of ​​the patient 140) can be maintained approximately at the isocenter 124 while the recliner 114 (and patient 140) is rotated, allowing the radiation dose to propagate through healthy tissue. This means that the radiation dose received by the healthy tissue surrounding the target area is minimized. This improves the health of the patient 140. This disclosure also provides an apparatus utilizing a rotating device 120 located outside the plane of the frame 116, and therefore outside the radiation plane or isolines. Positioning the rotating device 120 outside the radiation plane minimizes radiation interference.

[0059] Examples of specific connectors and structures will now be described.

[0060] exist Figure 4 , Figure 5 , Figure 6A , Figure 6B and Figure 7An embodiment is shown from different perspectives and positions. These figures illustrate an object support surface 114 supported and connected to a rotating mechanism 120. The rotating mechanism 120 includes a rigid hinge 122 (the longitudinal axis of which is parallel to the vertical axis 111), a rotatable support 123, and two vertical sliders or rails 125. The rotatable support 123 is configured to rotate about the hinge 122, and thus about the vertical axis. The rotation of the hinge can be driven by one or more motors (e.g., electric motors), although in some examples it can also be rotated manually, for example, in certain increments. The hinge 122 is directly attached to and fixed relative to the frame 116 (or frame cover). The rotatable support 124 is rotatably connected to the hinge 122, for example, by a mechanical pivot, such that it is configured to rotate about a rotation axis passing through the longitudinal axis of the hinge 122. Hinge 122 is spaced apart from isocenter 124; therefore, by rotating about hinge 122, recliner 114 is configured to rotate about a rotational axis parallel to and spaced apart from the axis passing through isocenter 124. The entire rotation mechanism 120 lies outside the plane of frame 116 and outside the radial plane. Figure 5 As can be seen, the rotating support 123 is configured to hold two guide rails 125, which are bolted to the rotating support 123. The recliner 114 is directly connected to the rotating mechanism 120, or connected via an intermediate element, and can be connected by any suitable means, such as a mechanical connection. The rotation is controlled by a processor, which may be included in the patient support surface 114 or may be located elsewhere. For example, the processor may control the rotation speed or rotation angle of the recliner 114.

[0061] The rotating mechanism 120 also includes a sliding cover 129 that covers the guide rail 125 to prevent anything from getting caught in the vertical movement mechanism and to prevent pinching hazards. The sliding cover 129 is configured to accommodate rotation of the support 123. In one example, the sliding cover 129 is made of a flexible material such as rubber that can accommodate such rotation. Alternatively, the sliding cover 129 may be detachable from the rotating mechanism but attached to the frame 116, thus still protecting the vertical guide rail 125 when the recliner 114 is in both the non-rotating and rotating positions.

[0062] The recliner 114 includes a bottom section 126, a middle section 127, and a top section 128. The bottom section 126 is movably connected to two vertical rails 125, such that the bottom section 126 is configured to move from a first position to a second position along a vertical direction (along a vertical axis 111, which is an axis perpendicular to the base plate). In one example, the bottom section 126 includes a carrier (rail carriage) 131 configured to slide along a linear guide (rail) 125 connected to a rotatable support 123. This movement is driven by one or more motors, which may be located on the rotatable support 123 or on the bottom section 126. The vertical direction 111 can also be described as a Z-direction 111 or simply as vertical. For example, the bottom section 126 can be lowered from a lowered position (e.g., Figure 4 (As shown) it moves vertically to the raised position. The top section 128 is supported by the middle section 127, which in turn is supported by the bottom section 126. Therefore, when the bottom section 126 is raised or lowered, the middle section 127 and the top section 128 also rise or fall. In this way, the entire recliner 114 can be raised or lowered (moved vertically from the first position to the second position) along the vertical slider of the rotating mechanism 120.

[0063] The intermediate section 127 (which may be described as a first section or a second section) is configured to move from a first position to a second position in the lateral direction (along the lateral axis 113 of the patient support surface 114) independently of the bottom section 126. In one example, the intermediate section 127 is configured to move along a guide rail, and this movement may be powered by one or more motors and, for example, ball screws, belt drives, or other suitable devices. The lateral or transverse direction 115 may be described as an X-direction 115. The top section 128 is supported by the intermediate section 127, so that when the intermediate section 127 moves in the lateral direction 115, the top section 128 also moves in the lateral direction. In one example, the intermediate section 127 is configured to move in the lateral direction when the bottom section 126 is in the raised position.

[0064] The top section 128 (which may be described as a first section or a second section) is configured to move from a first position to a second position in the longitudinal direction (along the longitudinal axis 113 of the patient support surface 114) independently of the bottom section 126 and the middle section 127. In one example, the top section 128 is configured to move along a guide rail, and this movement may be powered by one or more motors and, for example, ball screws, belt drives, or other suitable devices. The longitudinal direction 113 may be described as the Y direction 113.

[0065] In one example, the top segment 128 and the middle segment 127 are actually the same segment, and the combined segment (which can be described as a first segment) is configured to move from a first position to a second position independently of the bottom segment 126 in at least one of the longitudinal direction 113 and the transverse direction 115 or in a direction inclined to these directions.

[0066] The processor is configured to control the movement of the bottom section 126, the middle section 127, and the top section 128. In this example, the processor is the same as the processor that controls the rotation of the recliner 114.

[0067] As previously described, hinge 122 is spaced apart from isocenter 124 and rotatable support 123, thus the recliner 114 (attached to support 123) is configured to rotate about hinge 122. Therefore, the recliner 114 is configured to rotate about a rotation axis parallel to and spaced apart from the axis passing through isocenter 124. As previously described, this causes a portion of the recliner 114 located at the isocenter in its non-rotational position to move away from isocenter 124 as the recliner 114 rotates. The device also includes a memory in which information such as the dimensions of different segments 126, 127, 128 of the recliner 114, the position of hinge 122 relative to isocenter 124, the dimensions of frame 116 and frame cover, and other information useful for performing treatments is stored. The processor uses such information to calculate how much the previously mentioned portion of the recliner 114 will move for a specific angle of rotation of the recliner 114. The processor then calculates how much lateral and / or longitudinal movement is required for that rotation angle to keep said portion of the recliner 114 at the isocenter 124. In this example, the processor then executes commands that cause the recliner 114 to rotate to a specific angle, the amount of lateral movement required for the middle section 127, and the amount of longitudinal movement required for the top section 128.

[0068] In this example, the processor is also used to control the rotation and emission of radiation, and can also be used to control other operations of the radiotherapy device. This allows the rotation of the recliner 114 to be synchronized with the operation of the radiotherapy device or the implementation of radiotherapy treatment. An example of treatment will now be described.

[0069] like Figure 4As shown, the recliner 114 begins in a lowered neutral position (the bottom section 126 is lowered, the middle and top sections 127, 128 are not extended, and the recliner 114 is not rotated). The patient 140 then lies on the recliner 114 at the top of the top section 128, which is convenient for the patient 140 due to the recliner 114 being lower than the ground. The operator then begins the treatment, for example, by pressing a start button. The operator can also input several treatment parameters into a computer, which the processor can then use to control the treatment. Figure 5 As shown, the bottom section 126 is first raised (thus raising the recliner 114 and the patient 140). The movement of the bottom section 126 is controlled by one or more guide carriages 131 configured to move up and down along guide rails 125, which are bolted to a rotatable support 123. Figure 5 The object support surface 114 is depicted in an elevated, non-extended, and non-rotated position.

[0070] Once the recliner 114 has been raised, its top section 128, with the patient 140, extends into the openings in the frame and into the radiating plane. Alternatively, as Figure 6A As shown, the recliner 114 can rotate without first extending the top section 128. Then, after the recliner 114 has rotated, the top section 128 can then extend, as shown. Figure 6B As shown in the diagram. The approximate location of the target area for patient 140 is known prior to treatment, so the operator or processor can estimate how far patient 140 should be extended into the aperture to roughly position the target area at the same point as isocenter 124. This initial positioning (including the amount of vertical and longitudinal movement of the recliner) can be performed by the operator using a control panel attached to recliner 114 or a remote positioning device, and can be assisted by using a laser or markers on the patient's body. In one example, when the target area is on one side of the patient's body, the lateral movement of the intermediate segment 127 can also be controlled at this stage to position the target area in the desired location.

[0071] In one example, the patient 140 is then scanned using an MR imaging device 112 that allows for the precise location of a target region (e.g., a tumor). The operator or processor can then make any necessary minor adjustments to the positioning of different segments of the recliner 114 based on the determined location of the in-situ target region, so that the target region can be precisely positioned at the isocenter 124 or other desired location. When the recliner 114 (and therefore the patient 140) is in the correct starting position for treatment, this position is recorded by the operator to indicate that it is in the correct position, and the processor then stores this position and the relative positions of all segments in the processor's memory as the starting position.

[0072] The processor can then control the radiotherapy apparatus by controlling the radiation source 106 to emit the treatment beam 110 and by rotating the gantry 116 to rotate the radiation source 106 around the isocenter 124, thereby exposing the target area to the desired amount of radiation from a series of different angles, as is known in the art. In this example, once the patient 140 has been exposed to the desired level of radiation from the angle in the current radiation plane, the radiation source 106 is temporarily stopped. In one example, the processor then instructs the rotating mechanism 120 to rotate from a first neutral position to a second rotating position, for example, 10 degrees clockwise, which causes the recliner 114 to rotate 10 degrees clockwise to the recliner kick position. Figure 6B and Figure 7 A recliner 114 is shown in its raised, rotated, and extended positions. It should be noted that rotation and extension can occur sequentially or simultaneously. Simultaneously, the processor is configured to instruct the intermediate segment 127 and the top segment 128 to extend laterally and / or longitudinally by the desired amount to maintain the target area approximately at the isocenter 124 while the recliner 114 is in the rotated position. The rotation and movement of the different segments 127, 128 are performed simultaneously, and in one example, the rotation and movement of the different segments 127, 128 are controlled at a speed that ensures the same time is taken to complete the movement and rotation of each segment, so that the patient 140 moves smoothly into the rotated position and minimizes the jitter caused by the rotating and sequentially moved segments. This maximizes patient comfort 140 during rotation.

[0073] Once the recliner 114 is in its rotated and adjusted position, the processor then instructs the radiotherapy device to be controlled in a manner similar to that previously described. The radiation plane will then pass through different parts of the patient's body, except at the isocenter 124 where the target area is located, where it will be exposed to a second dose of radiation. Again, once the patient 140 or the target area has been exposed to the desired amount of radiation, radiation is stopped. The recliner 114 can then be rotated to another angle, as previously described, with segments 127, 128 compensating for this rotation, and the process is repeated. This can be done for any number of different rotation angles (although in this example, it is limited to neutral clockwise and counterclockwise 30-degree angles by the obstruction of the gantry cover). As described above, treatment begins in the neutral position, then moves 10 degrees clockwise, then subsequently 20 and 30 degrees clockwise, and then 10, 20, and 30 degrees counterclockwise (made from the neutral position), resulting in a total of seven radiation doses at seven different angles. Alternatively, treatment can begin by rotating the recliner 114 to its maximum rotation angle in one direction, and then moving it only in one direction until the treatment is ready to end. Many other such treatment plans are also possible.

[0074] Once the patient 140 has been exposed to the desired level of radiation from all desired angles, the rotating mechanism 120 returns to its neutral, non-rotating position, sections 127 and 128 return to their neutral (retracted / unextended) positions, and then the recliner 114 is lowered vertically to allow the patient 140 to dismount easily. The ability to begin from the lowered position of the recliner 114 results in a lower boarding / dismounting height for the patient 140, which may be advantageous for patients with limited mobility (e.g., overweight).

[0075] The recliner 114 can be made of many different materials. In one example, the tabletop 128 is made of or incorporates composite materials, such as carbon fiber or similar strength fibers like Kevlar. The swivel support 123, hinge 122, bottom section 126, and middle section 127 can be made of metal, such as steel, cast iron, or aluminum, or other suitable materials. In one example, the swivel support 123 and hinge 122 are made of steel, the bottom section 126 is made of steel or cast aluminum, and the middle section 127 is made of aluminum, which can be cast, milled, or a combination of both.

[0076] By mounting the rotating mechanism 120 directly onto the frame 116, the device can be pre-aligned in the factory during manufacturing. It also maintains an open base area beneath the recliner 114, which, for example, makes it easier for the patient 140 to board the recliner 114. It requires no additional space around the recliner, thus not interfering with the radiotherapist (operator) during patient positioning. Furthermore, the device provides a recliner kick (rotatable recliner 114) with regularly sized top and base. Therefore, there are no bulky structures that would obstruct the radiotherapist.

[0077] As described in the above embodiments, the recliner 114 includes three distinct sections 126, 127, and 128, each responsible for a different axis of motion. However, the top section 128 and the middle section 127 may actually be just one upper section configured to move in two directions, or at an angle tilted to both directions, as will be described in more detail with reference to other embodiments.

[0078] Rotation of the patient support system 114 can occur before, during, or after treatment. Rotation can be continuous or discrete / static. Rotation of the recliner 114 can also occur with or without the top section 128 extended. Movement of different sections 126, 127, 128 of the recliner 114 can occur simultaneously with each other and with the rotation of the recliner 114, or they can occur separately and sequentially. The speed of movement can be controlled such that the time of a particular movement is the same as the time of a corresponding rotation performed at a particular speed. Rotation of one or more movement or rotation mechanisms 120 of sections 126, 127, 128 can also be manually controlled by the operator, with the processor calculating and compensating for such movement.

[0079] The recliner 114 may include several casters or other components and sections 126, 127, and 128. In these figures, the swivel mechanism 120 is directly connected to the frame 116, but it may alternatively or additionally be connected to the base plate, wall, or other support structure. For example, when it is mentioned that a portion of the recliner 114 is maintained approximately at the isocenter 124, this may actually be at the isocenter 124 or within 0.005 to 0.015 mm, more preferably 0.01 mm; 0.05 mm to 0.15 mm, more preferably 0.1 mm; 0.15 mm to 0.25 mm, more preferably 0.2 mm; 0.25 to 0.35 mm, more preferably 0.3 mm; 0.35 mm to 0.45 mm, more preferably 0.4 mm; 0.45 mm to 0.55 mm, more preferably 0.5 mm; 0.5 mm to 1.5 mm, more preferably 1 mm; or at another distance.

[0080] Figure 8 , Figure 9A , Figure 9B , Figure 9C , Figure 10A and Figure 10BThe middle figure illustrates another embodiment. These show a patient support surface 114 supported by and connected to a rotating mechanism 120. The rotating mechanism 120 includes a rotating arm 130. The rotating arm 130 has two axes of rotation and includes a first rotation point 132 and a second rotation point 134. The rotating arm 130 is connected to the base plate at the first rotation point 132 toward the end of the rotating arm 130 closest to the radiotherapy device. The rotating arm 130 may be directly connected to the base plate at the first rotation point 132, or via an intermediate element such as a gear, and may be connected by any suitable means, such as a mechanical pivot. In one example, at the first rotation point 132, the rotating arm 130 is connected to the base plate via a first gear rigidly connected to the base plate. The rotating arm 130 is pivotally connected to the first gear. The rotating arm 130 is configured to rotate about the center of the first gear located at the first rotation point 132. The first gear is located below the rotating arm 130 (in other words, between the rotating arm 130 and the base plate), but may alternatively be located above the rotating arm 130.

[0081] The rotating arm 130 is connected at a second rotation point 134 to a recliner 114 toward the end of the radiotherapy device. The recliner 114 can be directly connected to the rotating arm 130 at the second rotation point 134, or via an intermediate element such as a gear, and can be connected by any suitable means, such as a mechanical pivot. In one example, at the second rotation point 134, the rotating arm 130 is connected to the recliner 114 via a second gear rigidly connected to the upper part of the recliner 114. The rotating arm 130 is pivotally connected to the second gear. The second gear and the recliner 114 are rigidly connected and do not rotate relative to each other, but are both configured to rotate about the second rotation point 134 and together with respect to the rotating arm 130. The second gear is located below the rotating arm 130 (in other words, between the rotating arm 130 and the base plate), but can alternatively be located above the rotating arm 130.

[0082] The rotating arm 130, the first rotation point 132, and the second rotation point 134 are all located outside the plane and the radial plane of the frame 116. Correspondingly, the rotating mechanism 120 is located outside the plane and the radial plane of the frame 116.

[0083] The rotating arm 130 may include a belt, sprocket, gear, or other suitable feature located at the first rotation point 132 and the second rotation point 134. For example... Figure 9CAs shown, the first rotation point 132 and the second rotation point 134, as well as the features located at these points, can be connected by a connecting belt or chain 142. The length of the rotating arm 130 (given by the distance between the centers of the rotation points) is half the distance between the isocenter 124 and the second rotation point 134. The two rotation points are connected between the first rotation point 132 and the second rotation point 134 with a tooth ratio of 1:2. This can be achieved by various suitable means, such as using gears located at the rotation points, as described above. In one example, at each of the first rotation point 132 and the second rotation point 134, there is a steel shaft, two (angular contact) bearings, and a chain or toothed pulley. The connection between the two rotation points 132, 134 can be a chain or a toothed belt.

[0084] Two gears, sprockets, or other features located at the rotation point act as transmission components, facilitating the coordinated rotation of the rotating arm 130 relative to the base plate and the recliner 114 relative to the rotating arm 130. For example, a first wheel is rigidly connected to the base plate at a first rotation point 132, and a second wheel is rigidly connected to the recliner 114 at a second rotation point 134. The rotating arm 130 is pivotally connected to the first and second wheels. In one operating mode, the recliner is rotated by applying an external force (e.g., by being manually pushed by the operator). With the wheels as the transmission points of rotation, the rotation mechanism 120 enables the recliner 114 to automatically rotate about an axis parallel to and spaced apart from the axis passing through the isocenter 124, without even requiring a motor to drive the rotation.

[0085] Alternatively, the rotation of the sprockets can be driven by one or more motors, such that when the first sprocket at the first rotation point 132 rotates, the second sprocket at the second rotation point 134 rotates at half the speed. This, together with the distance determined above, causes the recliner 114 to rotate about an axis parallel to and spaced apart from the axis passing through the isocenter 124, such that the longitudinal axis of the recliner 114 always points towards the isocenter 124, as... Figure 9A , Figure 9B and Figure 9C As shown in the image.

[0086] Clearly, there are other configuration examples that would result in similar rotation of the recliner 114. For example, if the first gear is rigidly connected to the rotating arm 130 and pivotally connected to the base plate, or if the second gear is rigidly connected to the rotating arm 130 and pivotally connected to the recliner 114.

[0087] The patient support system 114 may include several rollers, a top section (or upper section) 128, a bottom section 126, or other parts. For example... Figure 8As shown, the recliner 114 can extend vertically and / or longitudinally to achieve optimal positioning of the patient 140 under the treatment bundle 110 by maintaining a portion of the object support surface 114 approximately at the isocenter 124. When the recliner 114 rotates, the position of the recliner 114 relative to the isocenter 124 varies with a given angle of rotation, as previously described. This is in Figure 10A and Figure 10B The diagram illustrates isocenters 124 located at different portions of the recliner 114 for two different rotation angles. Accordingly, the recliner 114 (or a portion thereof in the form of a top segment 128) extends along its longitudinal axis 113 in its rotated position to compensate for this distance variation. This extension can be performed manually or controlled by a processor, such as a processor that also controls the rotation of the recliner 114. Thus, the extension of the recliner 114, or a portion thereof, can be synchronized with the rotation of the recliner 114, thereby maintaining optimal positioning of the patient 140 under the treatment bundle 110.

[0088] Furthermore, the recliner 114 or the top section 128 can rotate (tumble), and / or pivot, as well as extend, about the axis of the opening. In this way, six degrees of freedom are achieved regarding the positioning of the patient 140. To extend the top section 128 of the recliner 114, power can be supplied to the recliner 114 via a cable 136 extending from a power source and passing through the rotating arm 130. Other cables may also pass through the rotating arm 130, for example, to send control signals to the recliner 114.

[0089] The first rotation point 132 of the rotating arm 130 is located along the axis of the hole 119. When the rotating arm 130 is parallel to the axis of the hole, the second rotation point is also located along the axis of the hole 119. Accordingly, in the neutral position of the recliner 114, the isocenter 124 and the first and second rotation points (132, 134) are all aligned, as shown below. Figure 10A As shown in the image. Figure 10B This diagram shows that when the recliner 114 is in the rotated position, the axis 113 of the longitudinal centerline of the recliner 114 passes through the isocenter line 124. As described above, this rotation is automatically initiated due to the configuration of the rotation mechanism 120.

[0090] Rotation of the patient positioning system 114 can occur before, during, or after treatment. Rotation can be continuous or discrete / static. Rotation of the recliner 114 can also occur with or without the top section 128 extended. Rotation of the recliner 114 can also occur simultaneously with the top section 128 extended. In one example, the patient 140 lies on the recliner 114 in its non-extended position. The recliner 114 then extends, and the patient 140 is scanned and exposed to radiation. Radiation then stops, and the recliner 114 is rotated (yawed) by rotating the rotating arm 130 around a first rotation point 132 and a second rotation point 134, as shown. Figure 9A and Figure 9B As shown, patient 140 is then exposed to further radiation. In another example, the radiation is not stopped and the rotation of the recliner 114 occurs automatically, while patient 140 is simultaneously exposed to radiation.

[0091] Rotation around the first rotation point 132 can be clockwise or counterclockwise. The direction of rotation of the second rotation point 134 is opposite to that of the first rotation point 132. It should be understood that when referring to the first rotation point 132 and the second rotation point 134, reference can be made to any physical entity located at the rotation point, such as a shaft, motor, or gear. The rotational speed at the second rotation point 134 is half the rotational speed at the first rotation point 132. This rotation can be caused by any suitable device. For example, the rotation of the first rotation point 132 can be caused by a motor. The rotational speed at the first rotation point 132 can be controlled by a processor, which can be included in the patient support surface 114 or can be found elsewhere, such as in a control room. The rotation at the second rotation point 134 can then be caused by a mechanical or physical connection to the first rotation point 132.

[0092] Alternatively, the rotational speeds of the two rotation points 132 and 134 can be controlled by a processor. For example, the processor can send a signal to a motor configured to cause the rotating arm 130 to rotate at the first rotation point 132, instructing the motor to rotate at a speed of 1 revolution per minute. The processor can also send a signal to a different motor configured to cause the rotating arm 130 to rotate at the second rotation point 134, causing the recliner 114 on top of the rotating arm 130 to rotate at a speed of 2 revolutions per minute. These speeds are just examples; other speeds are possible. The rotational speed should not be so high as to cause discomfort to the patient 140, nor should it be so slow as to be inefficient and increase treatment time. If used, the placement of the motors is not essential to the function of the device. One or more motors can be located at the first rotation point 132, the second rotation point 134, or even somewhere between the rotation points, acting directly on the belt or chain connecting these rotation points. Alternatively, as described above, the recliner 114 can be rotated manually without any motor, while using the device's configuration to achieve a specific rotation of the recliner 114.

[0093] The same processor can also be used to control radiation emission or other operations of the radiotherapy device. This allows the rotation of the recliner 114 to be synchronized with the delivery of radiotherapy treatment. Alternatively, the operation of the radiotherapy device and the radiotherapy treatment can be controlled by different, separate processors.

[0094] When installing the rotating mechanism 120 and the recliner 114, the position of the recliner 114 can be calibrated before use. This can be done, for example, by positioning the recliner 114 in a neutral position with its longitudinal axis 113 parallel to the longitudinal axis of the rotating arm 130. This can be set to a 0° rotation, and subsequent rotations of the recliner 114 can be measured around this position. The neutral position is when the longitudinal axis 113 of the recliner 114 is aligned with the axis of the hole in the frame 116 (in some configurations, this may be perpendicular to the radial plane and parallel to the base plate). Figure 10A When aligned (as shown in the diagram), the patient support system 114 may rotate less when fully extended into the orifice compared to when it is not extended or only partially extended. As a result, this system is particularly suitable for treatment of the head and neck.

[0095] The rotating arm 130 can be made of one or more different materials, such as steel (e.g., welded steel plate metal structure), cast iron, aluminum, titanium, composite materials, or any other material with high rigidity suitable for supporting the required load.

[0096] Figure 11A and Figure 11BThe middle figure illustrates another embodiment. These show a patient support surface 114 supported and connected to a rotation mechanism 120. The rotation mechanism 120 includes a first sliding base 150 on a first side of a frame 116, a second sliding base 152 on a second side of the frame 116, a first support 154, a second support 156, and a third support 158. The first sliding base 150 is connected to and supports the first and second supports 154 and 156. The second sliding base 152 is connected to and supports the third support 158. A recliner 114 is connected to and supported by the first and second supports 154 and 156 at its proximal end. The recliner 114 is connected to and supported by the third support 158 ​​at its distal end. The section of the recliner 114 that connects to the first support 154, the second support 156 and the third support 158 ​​can also be referred to as the bridge or the bottom section.

[0097] In one example, a first sliding base 150 is directly mounted to a rack 116 or a portion thereof, protruding 200-300 mm below the horizontal level of the base plate, such that the first sliding base 150 is mounted on the portion of the rack 116 below the base plate. The first sliding base 150 is configured to move laterally from a first position to a second position along a guide rail on the portion of the rack 116 mounted to the base plate. Alternatively, the first sliding base 150 is supported by the base plate itself and configured to move laterally from a first position to a second position along the base plate in the lateral direction 113. Similarly, in one example, a second sliding base 152 is directly mounted to a rack 116 or a portion thereof, protruding 200-300 mm below the horizontal level of the base plate, such that the second sliding base 152 is mounted on the portion of the rack 116 below the base plate. The second sliding base 152 is configured to move laterally from a first position to a second position along a guide rail on the portion of the rack 116 mounted to the base plate. Alternatively, the second sliding base 152 is supported by the base plate itself and is also configured to move from a first position to a second position along the base plate in the lateral direction 113. In one example, the first sliding base 150 and the second sliding base 152 are guided during this lateral movement by guide rails set in the base plate and supported by a portion of the frame's base plate. In another example, the first sliding base 150 and the second sliding base 152 are guided by a first elongated slot and a second elongated slot in the base plate, and the sliding bases 150, 152 are configured to slide along the first elongated slot and the second elongated slot. The longitudinal axis of these elongated slots is aligned with the lateral axis 113 (neutral lateral axis 113) of the recliner 114 in its neutral position, meaning that the sliding bases 150, 152 are configured to slide parallel to each other along the neutral lateral axis 113. For example, the first sliding base 150 and the second sliding base 152 move along linear movement guides and are driven by a motor controlled by a processor and / or operated by, for example, one or more buttons.

[0098] The first support member 154 and the second support member 156, both connected to the first sliding base 150, are aligned along the neutral transverse axis 113 and spaced apart from each other, but are equidistant from the center point of the first sliding base 150. The third support member 158 is connected to the second sliding base 152 and is located at the center point of the second sliding base 152.

[0099] The recliner 114 includes a bottom section 126 (bridge) and a top section 128, the top section 128 being supported by the bottom section 126. The bottom section 126 is connected to the rotating mechanism 120 at three points. A second support member 156 is rotatably connected to the bottom section 126 at connection point 160. For example, this connection could be as follows: Figure 12The ball-and-socket joint shown here includes a ball that is incorporated as part of the second support 156 and a socket that is incorporated in the bottom section 126 of the recliner 114, and vice versa. In this way, the bottom section 126 can rotate about an axis of rotation passing through the second support 156 and the connection point 160.

[0100] To achieve this rotation, the first support 154 is movably connected to the bottom section 126 at a point that changes as the bottom section 126 rotates about the second support 156. To enable this point of connection to the bottom section 126 to move, the bottom section 126 includes a curved groove / guide 162 (e.g., Figure 13A As shown in the diagram, it is an arc along a circle in the plane of the bottom section 126, with the center point of the circle at the connection point 160. The bottom section 126 is movably connected to the first support 154 by a ball and groove (elongated socket) of a kinetic joint construction or an equivalent other type of connection. Other kinetic joint constructions are also possible, as long as they allow movement in some directions and constrain it in others. This connection enables rotational, longitudinal, and lateral movement to accommodate rotation of the recliner 114 or the bridge. Because the opening of the groove 162 in the bottom section 126 is smaller than the size of the ball on top of the first support, the first support 154 is prevented from passing through the bottom section 126. In another example, the groove 162 does not extend all the way through the bottom section 126, but instead is only exposed on the underside of the bottom section 126.

[0101] The bottom section 126 also includes an elongated slot / guide 164 located at a portion of the longitudinal centerline of the bottom section 126. The elongated slot 164 is contained within the bottom section 126 and is generally located at the distal end of the recliner 114, but in some configurations it may extend through the plane of the frame 116. A third support 158 ​​is movably connected to the bottom section 126. In one example, they are connected by a ball and slot in a motion joint configuration, but they may also be connected by another equivalent joint. Because the opening of the slot 164 in the bottom section 126 is smaller than the size of the ball on top of the third support 158, the third support 158 ​​is prevented from passing through the bottom section 126. When the bottom section 126 (about the connection point 160) rotates, the elongated slot 164 allows the third support 158 ​​to move from a first position to a second position along the longitudinal axis 115 of the recliner 114. This movement accommodates the relative longitudinal extension of the bottom section 126 caused by the rotation of the recliner 114.

[0102] Figure 13BThe diagram shows a view taken from below the horizontal level of the recliner 114, clearly illustrating the connection between the first sliding base 150, set in the base plate, and the first support 154 and the second support 156. As indicated by the arrows at connection points 160, 162, and 164, these connections allow six degrees of freedom, enabling the recliner 114 to rotate, tilt, and pitch while remaining connected to the first support 154, the second support 158, and the third support 158 ​​at connection points 160, 162, and 164.

[0103] like Figure 14A As shown, sliding bases 150 and 152 can move synchronously and in the same direction to produce pure lateral movement of the recliner 114. In one example, the lateral movement of the recliner 114 can be controlled as part of a treatment plan and can be controlled in conjunction with the rotation of the recliner 114 and / or the movement of the top section 128. The rotation of the recliner 114 is driven by only one of the sliding bases 150 and 152, or by both sliding bases 150 and 152 moving in the same direction but at different rates, or by the lateral movement of both sliding bases 150 and 152 moving in opposite directions at the same or different rates, producing a lateral movement such as... Figure 14B The rotating configuration is shown. Sliding bases 150 and 152 can move simultaneously or at different times, regardless of direction. Moving sliding bases 150 and 152 in opposite directions allows the recliner 114 to rotate to its maximum possible angle. For example, if the first slider 150 moves in the first direction (along the neutral transverse axis 115) while the second slider 152 moves in the opposite direction, this will cause the recliner 114 to rotate because it is connected to the second support 156 at point 160, and the second support 156 is connected to the first slider 150. The curved groove 162 and the elongated groove 164 are configured to accommodate the rotation of the recliner 114. The movement of the sliding bases 150 and 152 is controlled by a processor, which may be the same processor as any or all other functions of the control device. By controlling the movement of the sliding bases 150 and 152, the processor can rotate the recliner 114, and the effective rotation of the recliner 114 can be controlled by controlling the relative movement of the sliding bases 150 and 152. The processor can also control the movement of the recliner 114 along the neutral transverse axis 115.

[0104] The top section 128 is configured to move from a first position to a second position along at least one of the longitudinal direction 115 and the transverse direction 113. When the recliner 114 is rotated by the rotation mechanism 120, as described above, the axis of rotation of the recliner 114 passes through the longitudinal axis of the second support 156, which itself moves along the neutral transverse axis 113. Accordingly, the rotation mechanism 120 is configured to cause the recliner 114 to rotate about an axis of rotation parallel to and spaced apart from the axis passing through the isocenter 124. As previously described, this causes a portion of the recliner 114 to move away from the isocenter 124.

[0105] This can be compensated for by moving the third support 158 ​​supported by the sliding base 152 in the direction opposite to the movement of the sliding base 150. Lateral movement of the recliner 114 can also be used to compensate for movement of the portion of the recliner 114 away from the isocenter 124 caused by rotation of the recliner 114. The top section 128 can also be used to compensate for this movement of the recliner 114, thereby maintaining this portion of the object support surface 114 approximately at the isocenter 124. The amount of movement of the top section 128 required to maintain a portion of the object support surface 114 approximately at the isocenter 124 is proportional to the rotation and lateral movement of the recliner 114. Accordingly, the top section 128 can move in the longitudinal direction, for example, as a function of the rotation of the object support surface 114 and / or the lateral movement of the recliner 114 or one of the sliding bases 150, 152. The movement of the top section 128 of the recliner 114 is controlled by a processor as a function of the rotation of the object support surface 114, so as to maintain said portion of the object support surface 114 approximately at the isocenter 124. In one example, the neutral longitudinal axis 113 of the recliner is initially aligned with the axis of the hole, and the rotation of the recliner 114 caused by the rotating mechanism 120 includes an amount that moves the first sliding base 150 and the second sliding base 152 by an equal amount, but in the opposite direction, the top section 128 may not need to move in order to maintain a particular portion of the recliner 114 approximately at the isocenter 124.

[0106] The processor is configured to determine the current positions of the first sliding base 150 and the second sliding base 152, and thus determine the positions of the first support 154, the second support 156, and the third support 158, the rotation angle of the recliner 114, and the extension / position of the top section 128. The processor can use this information to calculate the amount of compensation required for a specific rotation angle. The processor then instructs the top section 128 to move by the required amount.

[0107] In addition to controlling the movement of the top section 128 to maintain the portion of the object support surface 114 approximately at the isocenter 124, the lateral movement of the rotation mechanism 120 (thus controlling the recliner 114 itself, which is supported by the rotation mechanism 120) can also be controlled to help maintain the portion of the object support surface 114 approximately at the isocenter 124. As previously described, this lateral movement can be achieved by synchronously moving the two sliding bases 150, 152 in a specific direction. This can be controlled by a processor.

[0108] In one example, the processor controls the longitudinal movement of the top section 128 while simultaneously controlling the lateral movement of the rotating mechanism 120, both as a function of the rotation angle of the recliner 114, thereby maintaining a portion of the object support surface 114 approximately at the isocenter 124.

[0109] The first support 154, the second support 156, and the third support 158 ​​are extendable or retractable in the vertical direction 111. For example, each support is a telescopic support that can be extended by any suitable device, such as an internal helical mechanism, piston, linear motor, or belt drive. The extension of each of these supports 154, 156, 158 can be independently controlled by the processor. By controlling the extension of these supports 154, 156, 158, the recliner 114 can also rotate (tumble) about its longitudinal axis 113 and / or about its transverse axis 115 (pivot). Thus, the processor is configured to control the tumbling and tilting of the recliner 114, which can be controlled as part of a treatment or treatment plan. In this way, the patient 140 can be positioned with six degrees of freedom. These additional types of rotation can occur when the recliner is in a neutral rotational position (yaw) or when it is in a rotational position.

[0110] For example, such as Figure 15A As shown, the recliner 114 can be tilted with the distal end of the recliner 114 raised and the proximal end of the recliner 114 lowered. This is achieved by extending the third support 158 ​​while retracting the first support 154 and the second support 156. This can also be combined with the extension / retraction of the top section 128 of the recliner 114, such that a portion of the recliner 114 is lowered below the height of the bottom of the opening, thereby making it easier for the patient 140 to climb onto the recliner 114 (e.g., Figure 15A (As shown in the diagram). Pitching can also be used as part of the treatment to help diffuse radiation through healthy tissue, similar to how this is achieved by rotating the recliner 114.

[0111] For similar reasons, it might be desirable to roll over in the recliner 114 as part of the treatment, such as Figure 15BAs shown in the diagram. This can be achieved, for example, by retracting / lowering the height of the first support 154 and extending / raising the height of the second support 156, which will cause the recliner 114 to roll toward the first support 154. This can be performed as part of a treatment, although the roll angle will generally be kept low to maintain patient 140 comfort. To accommodate the rolling and tilting of the recliner 114, the attachment points of the first support 154, the second support 156, and the third support 158 ​​to the recliner 114 are designed to allow for such movement. As previously mentioned, in one example, attachment point 160 is a ball-and-socket joint, while the other connections are ball-and-groove joints, where the ball is contained within a groove but can move freely along the groove while also allowing the recliner 114 to tilt and roll.

[0112] To control the rotation, tilt, and roll of the recliner 114, as well as its lateral movement and the extension of the top section 128, the control system (which can be implemented by a processor) needs feedback regarding the position / state of various components, including the first sliding base 150 and the second sliding base 152; the extension or current height of the first support 154, the second support 156, and the third support 158; and the position of the top section 128 relative to the bottom section / bridge 126. Therefore, several sensors can be used to provide this feedback. For example, an absolute encoder can be used to determine the amount of movement caused by a particular motor in relation to one of the aforementioned measurements. Many suitable ways exist to receive positional feedback, and any suitable method can be used.

[0113] The processor can also be configured to use data from memory that stores information such as the dimensions and configuration of components, so that this information can be used in calculations to control the movement of various components and to prevent, for example, the recliner 114 from colliding with the rack 116.

[0114] It should be noted that various embodiments can be implemented in hardware, software, or a combination thereof. Various embodiments and / or components, such as components and controllers used therein, can also be implemented as part of one or more computers or processors or field-programmable gate arrays (FPGAs). A computer or processor or FPGA may include computing devices, input devices, display units, and interfaces, for example, for accessing the Internet. A computer or processor may include a microprocessor. The microprocessor may be connected to a communication bus. A computer or processor or FPGA may also include memory. Memory may include random access memory (RAM) and read-only memory (ROM). A computer or processor or FPGA may also include a storage device, which may be a hard disk drive or a removable storage drive, such as an optical disk drive. The storage device may also be other similar means for loading computer programs or other instructions into the computer or processor.

[0115] The disclosure of this embodiment is merely exemplary, and many possible variations will lead to the same or similar effects, as will be apparent to those skilled in the art. As an example, although the third support 158 ​​has been described as being located at the center of the second sliding base 152, it may also be positioned outside the center of the second sliding base 152, and the processor will take this into account when controlling movement. Therefore, the above description includes examples of the disclosed embodiments, which are generally preferred examples, but are not intended to adhere strictly to the literal meaning of the words, and other variations that will lead to substantially the same effects will be apparent to those skilled in the art.

[0116] As described in the above embodiments, the recliner 114 includes means that allow it to move vertically relative to the rotation mechanism 120. The means enabling vertical movement can be included within the recliner 114, within the rotation mechanism 120, or shared between them. Alternatively, the rotation mechanism 120 itself can move vertically to effectively raise or lower the recliner 114. The patient support surface 114 can move in any direction.

[0117] In addition to rotating the recliner 114 about the vertical axis 111, the recliner 114 or one or more segments 126, 127, 128 of the recliner 114 may also rotate (roll) about the longitudinal axis 113 of the recliner 114 and / or rotate (pivot) about the transverse axis 115 of the recliner 114. In this way, the patient 140 can be positioned with six degrees of freedom. These additional types of rotation can occur when the recliner is in a neutral rotational position (yaw) or when it is in a rotational position. For the sake of patient 140 comfort and to prevent them from having to be strapped to the recliner 114, the amount of rolling and tilting is generally limited to small amounts; for example, a forward or backward tilt of 10 degrees can be used in conjunction with rotation about the vertical axis 111 as described more generally herein. In some examples, segments of the recliner 114 pitch about an axis spaced apart from the isocenter 124, while different segments are moved to compensate for and maintain a portion of the recliner 114 approximately at the isocenter 124. In this way, the propagation of radiation through healthy tissue can be maximized, while the radiation dose received at the target area can also be maximized.

[0118] At the same time or at different times, synchronously or separately from the patient support surface 114, the radiation source or gantry 116 itself may also rotate (pitch) partially about the lateral axis of the short end of the patient support surface 114 in its neutral position, although not necessarily when the patient support surface 114 is in its neutral position. This may also be controlled by the same processor as part of the treatment.

[0119] The above embodiment enables the use of a reclining kick (rotatable reclining chair 114) in a linear accelerator system based on a ring-shaped frame. It effectively provides isocentric reclining chair rotation but does not require physical rotation around isocenter 124.

[0120] If a section of the recliner does not move as a function of the rotation of the recliner 114 (assuming that rotation is not around the isocenter 124), then the position of the target area will shift relative to the isocenter 124 (and the focal point of radiation), thus resulting in an increased radiation dose received by healthy tissue. Furthermore, this will lead to a longer treatment time because the target area will not receive the intended dose of radiation. By rotating the recliner 114 and thus the patient 140 while maintaining a specific section approximately at the isocenter 124, the radiation dose can diffuse through the healthy tissue, minimizing the radiation dose received by the healthy tissue surrounding the target area.

Claims

1. A radiotherapy device for delivering radiation to a subject, the device comprising: A radiation source configured to rotate about an isocenter and emit radiation in a radiation plane containing the isocenter; An object support surface, including a portion configured to be approximately located at the isocenter, the object support surface comprising: An object support surface rotation mechanism configured to rotate the object support surface about a rotation axis parallel to and spaced apart from the axis passing through the isocenter; and A first segment, configured to move from a first position to a second position along at least one of a longitudinal direction and a transverse direction; and the device further includes: A processor configured to control longitudinal and / or lateral movement of the first segment as a function of the rotation of the object support surface, so as to maintain the portion of the object support surface approximately at the isocenter. The rotating mechanism is distributed on both sides of the radiating plane, and the rotating mechanism is connected to: The proximal end of the object support surface on one side of the radiation plane; and The far end of the object support surface on one side of the radiation plane.

2. The radiotherapy device according to claim 1, wherein, The axis of rotation is at least one of a longitudinal axis, a transverse axis, or a vertical axis.

3. The radiotherapy device according to claim 1, wherein, The rotating mechanism is located outside the radiation plane.

4. The radiotherapy device according to claim 1, wherein, The object support surface is additionally configured to move from a first position to a second position along a vertical direction.

5. The radiotherapy device according to claim 1, wherein, The object support surface includes a second segment, wherein the second segment is configured to move from a first position to a second position along at least one of a longitudinal direction and a transverse direction.

6. The radiotherapy device according to claim 5, wherein, The processor is configured to control the movement of the first segment and the second segment as a function of the rotation of the object support surface, so as to maintain the portion of the object support surface approximately at the isocenter.

7. The radiotherapy device according to claim 1, wherein, The object support surface rotation mechanism includes a hinge around which the object support surface rotates, wherein the axis of rotation of the object support surface passes through the hinge.

8. The radiotherapy device according to any one of claims 1 to 6, wherein, The object support surface rotation mechanism includes a rotating arm connected to the object support surface.

9. The radiotherapy device according to claim 8, wherein, The rotating arm includes a first rotation point and a second rotation point, wherein the rotating arm is configured to be connected to a support surface at the first rotation point and to the object support surface at the second rotation point.

10. The radiotherapy device according to claim 9, wherein, The first rotation point is toward the end of the rotating arm that is close to the isocenter, and the second rotation point is toward the end of the rotating arm that is away from the isocenter.

11. The radiotherapy device according to claim 10, wherein, The length of the rotating arm is half the distance between the isocenter and the second rotation point.

12. The radiotherapy device according to claim 9, wherein, The rotating arm includes a first rotating device and a second rotating device located at the first rotating point and the second rotating point, respectively, wherein the first rotating device and the second rotating device have a rotation speed ratio of 2:

1.

13. The radiotherapy device according to claim 1, wherein, The rotating mechanism includes: A first sliding base, indirectly connected to the proximal end of the object support surface, and configured to move laterally from a first position to a second position; and A second sliding base, which is connected to the distal end of the object support surface, is configured to move laterally from a first position to a second position, wherein the processor is configured to control the lateral movement of the first and second sliding bases to rotate the object support surface.

14. The radiotherapy device according to claim 13, wherein, The processor is configured to control the lateral movement of the first sliding base and the second sliding base to move the rotating mechanism in the lateral direction.

15. The radiotherapy device according to claim 14, wherein, The processor is configured to control the lateral movement of the rotating mechanism as a function of the rotation of the object support surface, so as to maintain the portion of the object support surface approximately at the isocenter.

16. The radiotherapy device according to any one of claims 13 to 15, wherein, The rotating mechanism includes one or more extendable supports.

17. The radiotherapy device according to claim 16, wherein, The processor is configured to selectively extend the one or more extendable supports to control the tumbling and / or pitching of the object support surface.

18. The radiotherapy device according to claim 17, wherein, The processor is configured to control the tumbling and / or pitching of the object's supporting surface as part of the treatment plan.

19. The radiotherapy device according to claim 1, wherein, The processor is configured to control the rotation of the object support surface rotation mechanism as part of the treatment plan.

20. The radiotherapy device according to claim 1, wherein, The processor is configured to control the emission of the radiation and / or the rotation of the radiation source as part of a treatment plan.

21. The radiotherapy device according to claim 1, wherein, The object support surface rotation mechanism is configured to rotate the object support surface before, after, or during treatment, wherein the rotation is continuous or discrete.

22. The radiotherapy device according to claim 1, wherein, The radiotherapy device includes a hole for accommodating the object.

23. The radiotherapy device according to claim 1, wherein, The object support surface rotation mechanism is configured to rotate the object support surface around the object support surface rotation axis by + / - 30 degrees.

24. A method for controlling an object support surface in a radiotherapy apparatus, the radiotherapy apparatus including a radiation source configured to rotate about an isocenter and emit radiation in a radiation plane containing the isocenter, the method comprising: Provide an object support surface, the object support surface being configured such that a portion of the object support surface can be located approximately at the isocenter; The object support surface is rotated about an axis of rotation that is parallel to and spaced apart from the axis passing through the isocenter using an object support surface rotation mechanism. as well as Using a function of the rotation of the object-supporting surface, a first segment of the object-supporting surface is moved from a first position to a second position along at least one of the longitudinal and transverse directions, so as to maintain the portion of the object-supporting surface approximately at the isocenter. The rotating mechanism is distributed on both sides of the radiating plane, and the rotating mechanism is connected to: The proximal end of the object support surface on one side of the radiation plane; and The far end of the object support surface on one side of the radiation plane.

25. The method of claim 24, further comprising moving the object support surface vertically from a first position to a second position.

26. The method according to any one of claims 24 or 25, further comprising moving a second segment of the object support surface from a first position to a second position along at least one of a longitudinal direction and a transverse direction.

27. The method of claim 26, further comprising controlling the movement of the first segment and the second segment as a function of the rotation of the object support surface, so as to maintain a portion of the object support surface approximately at the isocenter.

28. The method of claim 24, further comprising controlling the rotation of the object support surface rotation mechanism as part of a treatment plan.

29. The method of claim 24, further comprising controlling the emission of the radiation and / or the rotation of the radiation source as part of a treatment plan.

30. A computer-readable medium comprising instructions that, when executed by a computer, cause the computer to perform the steps of the method according to any one of claims 24 to 29.

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