Robot arc-shaped treatment system and instrument

Abstract

The invention discloses a robot arc treatment system and apparatus, the system comprises an image acquisition module, a plan determination module and a treatment module, the plan determination module is used for constructing a cost function delivered to a target tumor and a cost function delivered to a normal organ, presetting parameter information of a radioactive source and inputting the parameter information into the cost function; iterating the parameter information of the radioactive source based on the semantic segmentation image until the cost function is converged, and determining a radiotherapy plan of the patient based on the parameter information corresponding to the converged cost function; the optimized kilovolt radiotherapy plan not only provides conformal prescription dose distribution for the target tumor volume, but also meets the dose limitation of risk organs. According to the invention, the robot of which the mechanical arm is loaded with the kilovolt radioactive source and the digital detector is used for executing image acquisition and an optimal treatment mechanism.

Description

Technical Field

[0001] The present invention relates to the technical field of radiotherapy, and in particular to a robotic arc therapy system and apparatus. Background Art

[0002] Most current radiotherapy equipment uses linear accelerators (LINACs) to generate high-energy megavoltage (6-15 MV) X-rays. The main drawback of LINAC systems is that they are primarily limited to large medical facilities due to complex system maintenance and operation, and the engineering costs can reach millions of dollars. Furthermore, this high-energy megavoltage radiation requires radiation shielding with 2-meter-thick concrete walls, ceilings, and floors. These limitations severely limit access to treatment for the general population in rural areas and low- and middle-income countries. To address the increasing demand for accessible cancer treatment, the present invention provides a robotic arc therapy system and instrument. Summary of the Invention

[0003] The purpose of the present invention is to improve and innovate the shortcomings and problems existing in the background technology, and to provide a robotic arc treatment system and equipment. The present invention involves the use of a kilovoltage radiation source and a dual-robot system to perform scanning images, and using this kilovoltage radiation source, after inverse optimization calculation, obtains the target volume radiation dose distribution, the dose limit of normal organs, the ray angle and the source axis distance. The robotic system is used to provide non-coplanar and isocentric therapeutic radiation beams, which are accurately focused on the tumor target to significantly reduce damage to surrounding normal tissues, thereby obtaining effective treatment.

[0004] According to a first aspect of the present invention, there is provided a robotic arc therapy system comprising: Image acquisition module, used to obtain synthetic tomographic images and complete semantic segmentation of normal organs and tumor tissues in the images; A plan determination module is used to construct a cost function for delivering radiation to the target tumor and a cost function for delivering radiation to normal organs. The parameter information of the radiation source is preset and input into the cost function. The parameter information of the radiation source is iterated based on the semantic segmentation image until the cost function converges. The patient's radiation treatment plan is determined based on the parameter information corresponding to the converged cost function. The treatment module is used to move the robotic arm carrying the kilovoltage radiation source according to the radiotherapy plan to deliver the treatment dose to the patient.

[0005] A further solution is that the image acquisition module includes: A scanning unit for acquiring cone-beam computed tomography images of a patient using a dual-robot system, wherein one of the robot arms carries a radiation source and the other robot arm carries a digital panel detector, and the paired dual robots simultaneously rotate around a target and perform image reconstruction; a conversion unit, configured to convert the cone-beam tomography image into a synthetic tomography image; The segmentation unit is used to perform semantic segmentation on the synthetic tomographic image and complete the segmentation of normal organs and tumor tissues as well as the segmentation of normal organs among each other in the image.

[0006] A further solution is that the plan determination module includes: A construction unit, configured to construct a cost function for delivering to a target tumor and a cost function for delivering to a normal organ; a preset unit, configured to randomly preset parameter information of the radiation source using a Monte Carlo algorithm; wherein the parameter information of the radiation source includes a radiation beam angle, a distance from the radiation source to the center of the tumor tissue at a corresponding radiation beam angle, and a residence time of the radiation source at a corresponding radiation beam angle; an iterative unit, configured to sequentially select a parameter from among the radiation beam angle, the distance from the radiation source to the center of the tumor tissue, and the radiation source dwell time at the corresponding radiation beam angle as an independent variable, and continuously optimize the value of the independent variable while keeping the unselected parameters unchanged until the cost function converges and the corresponding independent variable value is fixed; repeatedly selecting a parameter as the independent variable for optimization until all parameters have been optimized; wherein the repeatedly selected parameter information is a parameter that has not been optimized previously; The output unit is used to output the dose distribution of the patient's tumor tissue and normal organs.

[0007] A further embodiment is that the cost function of delivery to the target tumor is Where, is the prescribed dose to the target tumor, It is the dose delivered to the target tumor at a fixed location; The cost function of delivery to normal organs Where, It is the dose delivered to normal organs at a fixed position; It is the acceptable tolerance dose for normal organs.

[0008] Further plans include: a. Mechanically distributed energy radiation sources located outside and around the body or head for imaging and treatment of pathological lesions; b. The radiation energy is ionizing ablation electromagnetic kilovolt, ranging from 100-350 kVp; c. wherein the orientation of the radiant energy source comprises a combination of directing the ionizing output or beam toward the internal lesion by motion selected from the group consisting of rotation about an isocenter in a single plane or multiple planes, movement of a static or arcuate beam closer to or farther from the skin and lesion, non-coplanar delivery from any direction external to the body originating from concentric spheres around the targeted lesion, or varying the distance of the radiation source from the lesion in a radial direction from the targeted lesion; d. wherein energy is delivered non-invasively by employing workflow tasks including, but not limited to, components of the following list: i) imaging, ii) segmentation, iii) planning and optimization, iv) treatment; e. Wherein the energy emitting sources are arranged in a localized, circumferential, annular, or spherical distribution around the patient, along a delivery path originating from the tumor being treated, as a stand-alone arrangement, or arranged in a surface-conforming arrangement, or moved robotically without the need for a circular gantry; f. wherein the array of ionizing energy source locations is electronically or computer controlled to mechanically move the energy sources in space so that their output or beam is moved in different directions and contoured, thereby delivering a discrete, localized energy dose to a given depth or lateral location within the body and forming a narrow or focused distribution within the lesion; g. wherein the resulting contoured energy output or beam is not necessarily isocentric, but rather is a converging electromagnetic kilovoltage energy beam that deposits an energy dose in a targeted localized target volume to treat pathological tissue; h. wherein the compliance target region for the prescribed x-ray dose is discrete, encompasses, and is tailored to the deleterious phase or lesion in the body, thereby enhancing recovery by controlling parameters within a normal physiological range to achieve a healthy transition state; i. Electronic or computerized controls for energy sources, robots, and system operations, with access to power and cooling systems; j. Imaging for planning and guidance, a computer with treatment planning software, the ability to upload images used for planning and guidance, and a connection to an information system with recording and verification software; k. Media storing computer-executable process steps for reconstructing medical images, calculating and optimizing the efficacy of localized treatment with ionizing kilovoltage radiation, and robotic control firmware; l. wherein treatment planning utilizes synthetic CT images, wherein the reconstructed images are the basis for optimizing the treatment plan; m. Treatment tables or chairs capable of moving in three-dimensional space; n. Ionizing radiation therapy localizers that treat diseased tissue in response to received radiation energy; and o. Real-time non-intrusive x-ray source beam output measurement at the beam exit of the x-ray source.

[0009] According to a second aspect of the present invention, there is provided an apparatus comprising: a. Mechanically distributed energy radiation sources located outside and around the body or head for treatment and imaging of pathological lesions; b. The radiation energy is ionizing ablation electromagnetic kilovolt, ranging from 100-350 kVp; c. wherein the orientation of the radiant energy source comprises a combination of directing the ionizing output or beam toward the internal lesion by motion selected from the group consisting of rotation about an isocenter in a single plane or multiple planes, movement of a static or arcuate beam closer to or farther from the skin and lesion, non-coplanar delivery from any direction external to the body originating from concentric spheres around the targeted lesion, or varying the distance of the radiation source from the lesion in a radial direction from the targeted lesion; d. Where the energy is delivered non-invasively, without the use of devices or mechanisms that cut, puncture or traumatically penetrate the skin or other surfaces, and without the need for open surgery; e. Wherein the energy emitting sources are arranged in a localized, circumferential, annular, or spherical distribution around the patient, along a delivery path originating from the tumor being treated, as a stand-alone arrangement, or arranged in a surface-conforming arrangement, or moved robotically without the need for a circular gantry; f. wherein the array of ionizing energy source locations is electronically or computer controlled to mechanically move the energy sources in space so that their output or beam is moved in different directions and contoured, thereby delivering a discrete, localized energy dose to a given depth or lateral location within the body and forming a narrow or focused distribution within the lesion; g. wherein the resulting contoured energy output or beam is not necessarily isocentric, but rather is a converging electromagnetic kilovoltage energy beam that deposits an energy dose in a targeted localized target volume to treat pathological tissue; h. wherein the compliance target region for the prescribed x-ray dose is discrete, encompasses, and is tailored to the deleterious phase or lesion in the body, thereby enhancing recovery by controlling parameters within a normal physiological range to achieve a healthy transition state; i. Electronic or computerized controls for energy sources, robots, and system operations, with access to power and cooling systems; j. Media storing computer-executable process steps for reconstructing medical images, calculating and optimizing the efficacy of localized treatment with ionizing kilovoltage radiation, and robotic control firmware; k. wherein treatment planning utilizes synthetic CT images, wherein the reconstructed images are the basis for optimizing the treatment plan; and l. Real-time non-invasive X-ray source energy beam output measurement.

[0010] A further solution is to further include: a. Adjustable electronics for mapping different locations, shapes, sizes, frequencies, and timings of energy delivery or beams, as well as other treatment-related parameters; b. The treatment target volume can be maintained or adjusted to cover specific pathological, anatomical and functional structures or target areas; c. wherein the resulting adjustable radiation field size covers an internal treatment target volume with a diameter ranging from a few millimeters to several centimeters.

[0011] A further solution is to further include: a. a robotic interface for directing and guiding electromagnetic waves propagating in space and the secondary electrons generated thereby flowing through the human body, the robotic interface being connected to the system's integrated software; b. wherein the robot may or may not be capable of positioning the x-ray source about the isocenter; and c. Overlapping, directed waves that do not touch the patient's skin but provide cumulative energy deposition in a deep-seated target volume selected, previously delineated by imaging or functional assessment, to receive a boosted dose of kilovoltage energy or radiation.

[0012] In radiotherapy, inverse planning is a complex technique in which the radiation oncologist first plans the desired dose distribution within the patient's body, aiming to deliver the desired treatment to the tumor while limiting the amount of radiation delivered to normal organs. A computer optimization program is then used to determine the optimal beam configuration, angle, intensity, and distance to achieve this pre-planned treatment dose distribution to the tumor volume and limit the dose to normal organs, using a mathematical objective function.

[0013] The dose distribution of the kilovoltage treatment plan (<300 kV) after inverse optimization of the present invention compares favorably with the dose distribution of the megavoltage (6-15 mV) VMAT (Volume Modulated Arc Therapy) treatment plan. The prescribed dose of this kilovoltage treatment plan reaches 95% of the planning target volume (PTV). Furthermore, the dose distribution, dose volume histogram (DVH), and homogeneity index (HI) of the planning target volume are widely accepted in clinical evaluations. Like the megavoltage treatment plan (VMAT), the dose to normal organs (OARs) of this inverse-optimized kilovoltage treatment plan (KVAT) falls within standard dose constraints. The inverse-optimized kilovoltage treatment plan of the present invention can safely treat patients with deep malignant lesions while meeting the acceptable dose constraints for normal organs.

[0014] The present invention uses a low-energy kilovolt X-ray source for imaging and treatment technology with several advantages: (1) the system does not require a 2-meter concrete radiation shield; (2) the equipment engineering design is simple, robust, and has low maintenance costs; (3) by using machine learning algorithms to convert cone-beam computed tomography images into synthetic tomography images (synthetic CT), it provides high-quality planning-type computed tomography images that can be directly used to design complex and automatable treatment plans, thus avoiding the need for the use of traditional computed tomography imaging equipment; (4) the use of robots to transmit non-coplanar treatment beams in the treatment plan can greatly improve the treatment effect and reduce damage to normal organ tissue around the tumor target; (5) the entire imaging and treatment plan can be automated, so the system can be installed in rural or remote areas, and can be controlled and verified at a remote core facility to ensure accurate treatment results. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the following briefly introduces the drawings required for use in the embodiments. Obviously, the drawings described below are only some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying any creative work.

[0016] Figure 1 A schematic diagram of a dual-robot system for cone-beam tomography provided by an embodiment of the present invention; Figure 2 A schematic diagram of converting a cone-beam tomography image into a semantic segmentation image according to an embodiment of the present invention; Figure 3 A schematic structural diagram of a robotic arc therapy system provided by an embodiment of the present invention; Figure 4 A schematic diagram of non-coplanar treatment using a robotic arm carrying a kilovoltage radiation source according to an embodiment of the present invention; Figure 5 A schematic diagram comparing the conformal dose distribution of a 200 kilovolt radiotherapy plan (KVAT) and a megavolt volumetric modulated arc therapy (VMAT) for a patient with right breast cancer provided by an embodiment of the present invention; FIG6 is a comparative diagram of dose-volume histograms for a patient with right breast cancer treated with a 200 kilovolt radiotherapy plan (KVAT) and a megavolt volumetric modulated arc therapy (VMAT) according to an embodiment of the present invention; Figure 7 A schematic diagram comparing the conformal dose distribution of a 225 kilovolt radiotherapy plan (KVAT) and a megavolt volumetric modulated arc therapy (VMAT) for a patient with right lung adenocarcinoma provided by an embodiment of the present invention; FIG8 is a comparative diagram of dose-volume histograms for a patient with right lung adenocarcinoma treated with a 225 kilovolt radiotherapy plan (KVAT) and a megavolt volumetric modulated arc therapy (VMAT) according to an embodiment of the present invention; Figure 9 A schematic diagram of coplanar beamlet therapy provided by an embodiment of the present invention; Figure 10 Schematic diagram of coplanar beamlet therapy (normal organ avoidance) provided in an embodiment of the present invention; Figure 11 This is a schematic diagram of non-coplanar beamlet therapy provided by an embodiment of the present invention. DETAILED DESCRIPTION

[0017] In order to make the objects, features and advantages of the present invention more obvious and easy to understand, the specific embodiments of the present invention are described in detail below with reference to the accompanying drawings.

[0018] It should be noted that when an element is referred to as being “fixed to” another element, it may be directly on the other element or there may be an intermediate element. When an element is referred to as being “connected to” another element, it may be directly connected to the other element or there may be an intermediate element.

[0019] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by those skilled in the art to which this invention pertains. The terms used in this specification of the present invention are for the purpose of describing specific embodiments only and are not intended to limit the present invention. The term "and / or" as used herein includes any and all combinations of one or more of the associated listed items.

[0020] Please refer to Figure 3 , Figure 3 This is a structural schematic diagram of a robotic arc treatment system provided in an embodiment of the present application. The treatment system includes an image acquisition module, a plan determination module and a treatment module.

[0021] Image acquisition module, used to obtain synthetic tomography (sCT) images and complete semantic segmentation of normal organs and tumor tissues in the images; Specifically, the image acquisition module is used to scan and obtain the patient's cone-beam tomography image, and then convert the cone-beam tomography image into a synthetic tomography image (sCT); then, the synthetic tomography image (sCT) is semantically segmented to complete the semantic segmentation of normal organs (risk organs) and tumor tissues in the image.

[0022] Among them, the image acquisition module includes: A scanning unit for acquiring cone-beam computed tomography images of a patient using a dual-robot system, wherein one robotic arm carries a radiation source and the other robotic arm carries a digital panel detector, and the paired dual robots simultaneously rotate around a target and perform image reconstruction; a conversion unit, configured to convert the cone-beam tomography image into a synthetic tomography image; The segmentation unit is used to perform semantic segmentation on the synthetic tomographic image, and complete the segmentation of risk organs and tumor tissues in the image, as well as the segmentation of risk organs among each other.

[0023] In this embodiment, the present invention uses a dual robot system to acquire cone beam computed tomography images of a patient, wherein one robot arm carries a radiation source to irradiate the patient with radiation, and the other robot arm carries a digital panel detector to receive the radiation that penetrates the patient, such as Figure 1 As shown in the figure, the paired dual robots rotate around the target simultaneously and perform image reconstruction to produce cone-beam computed tomography images. The reconstructed cone-beam scan images are then converted into more accurate synthetic tomography images (sCT) ( Figure 2). Dahiya (Med.Phys.2021) described the conversion from cone-beam scanning images to synthetic images using AI machine learning technology. The resulting synthetic image is similar to a planned tomographic image. The present invention obtains a synthetic tomographic image (sCT) based on this. Finally, the synthetic tomographic image (sCT) is semantically segmented by a semantic segmentation model to complete the semantic segmentation of risk organs and tumor tissues in the image. Semantic segmentation technology can accurately distinguish different tissues or organs in medical images (such as CT, MRI, etc.) to form segmented images of tumor tissue and various normal organs. These images provide accurate anatomical information for subsequent dose calculations. The semantically segmented image can obtain parameter information such as the volume of risk organs and tumor tissues at various angles, as well as the specific depth of the tumor tissue, so as to guide the dose distribution of the radiation source during treatment to avoid damage to normal organs (risk organs) tissues by the radiation beam.

[0024] When the tumor tissue is right lung adenocarcinoma, normal organs may be other parts of the body such as the heart, esophagus, ribs, and healthy left lung. The semantic segmentation image not only segments the tumor tissue, but also segments the normal organs. Different colors are used in the semantic segmentation image to distinguish normal organs such as the heart, esophagus, ribs, and healthy left lung.

[0025] A plan determination module is used to construct a cost function for delivering radiation to the target tumor and a cost function for delivering radiation to normal organs. The parameter information of the radiation source is preset and input into the cost function. The parameter information of the radiation source is iterated based on the semantic segmentation image until the cost function converges. The patient's radiation treatment plan is determined based on the parameter information corresponding to the converged cost function. Specifically, the plan determination module includes a construction unit, a preset unit, an iteration unit and an output unit.

[0026] A construction unit, configured to construct a cost function for delivering to a target tumor and a cost function for delivering to a normal organ; in, Where, is the cost function for delivery to the target tumor, is the prescribed dose to the target tumor, It is the dose delivered to the target tumor at a fixed location; Where, is the cost function for delivery to normal organs, It is the dose delivered to normal organs at a fixed position; It is the acceptable tolerance dose for normal organs.

[0027] It's important to note that there are strict standards and guidelines for both the prescribed dose to the target tumor and the acceptable tolerance dose to various normal organs. These standards and guidelines are typically established by international professional organizations such as the International Commission on Radiological Protection (ICRP), the International Commission on Radiation Units and Measurements (ICRU), the National Comprehensive Cancer Network (NCCN), and the European Society for Medical Oncology (ESMO), as well as by national medical associations and health departments. Physicians can obtain these guidelines by carefully consulting relevant materials. Therefore, the cost function for delivering radiation to the target tumor depends on the prescribed dose delivered to the target tumor at each fixed location, while the cost function for delivering radiation to normal organs depends on the dose delivered to normal organs at each fixed location. In order to deliver a highly conformal dose to the tumor while minimizing radiation exposure to surrounding healthy organs, it is necessary to minimize the cost function.

[0028] Since different normal organs have different acceptable tolerance doses, radiation passes through different normal organs to reach tumor tissue at different fixed positions; therefore, the normal organs corresponding to different fixed positions have different acceptable tolerance doses; this application determines the normal organs that radiation passes through at fixed positions based on semantic segmentation images, thereby determining the acceptable tolerance dose of normal organs.

[0029] It should be further explained that the robotic arc therapy system of the present application provides therapy beams at different angles and planes. Since it has multiple planes, the robotic arc therapy system of the present application is a non-coplanar therapy system. Figure 4 As shown, the robot can conveniently move the radiation source to different positions and change the position of the radiation source to achieve the transmission of coplanar and non-coplanar treatment beams, which can greatly improve the treatment effect and reduce the damage to normal organ tissues around the tumor target.

[0030] a preset unit, configured to randomly preset parameter information of the radiation source using a Monte Carlo algorithm; wherein the parameter information of the radiation source includes a radiation beam angle, a distance from the radiation source to the center of the tumor tissue at a corresponding radiation beam angle, and a residence time of the radiation source at a corresponding radiation beam angle; In specific implementation, after the parameter information of the radiation source is determined, the volume of the risk organs and tumor tissues at various angles, as well as the specific depth of the tumor tissue, and other parameter information have been obtained through semantic segmentation of the image; therefore, the dose delivered to the target tumor at a fixed position can be obtained. and the dose delivered to normal organs at a fixed location ; This also allows us to obtain the cost function for delivering to the target tumor and the cost function for delivery to normal organs .

[0031] In this embodiment, the radiation source consists of a tungsten transmission anode operating at 200-300 keV for radiotherapy and lower kilovoltage imaging. A 0.4 mm copper filter is located beneath the anode to harden the radiation beam. This kilovoltage radiotherapy approach, unlike most current radiotherapy devices that use linear accelerators (LINACs) to generate high-energy megavolt (6-15 MV) X-rays, offers the advantages of low production costs and the absence of heavy shielding.

[0032] An iris collimator is located below the copper filter. The collimator's aperture can be adjusted to suit the size of the intended tumor. The collimator's aperture is sized so that the cone-shaped beam emitted by the radiation source covers the intended tumor's width upon reaching the target. Therefore, the collimator's aperture diameter is calculated based on the intended tumor size and the distance between the radiation source and the target tumor.

[0033] It should be noted that since the parameter information of the radiation source is randomly preset, the dose delivered to the target tumor Prescription dose to target tumor Generally, the deviation is large, and the dose delivered to normal organs Acceptable tolerance dose for normal organs Generally, the deviation is also large, which does not meet the requirement of minimum quantization of the cost function value, making it difficult to improve the treatment effect of tumor tissue and minimize the damage to normal organs and tissues around the tumor target. Therefore, this application optimizes the parameter information of the radiation source through an iterative unit.

[0034] The iterative unit is used to sequentially select a parameter from the radiation beam angle, the distance from the radiation source to the center of the tumor tissue, and the radiation source residence time under the corresponding radiation beam angle as an independent variable, continuously optimize the value of the independent variable, and keep the unselected parameters unchanged until the cost function converges and the corresponding independent variable value is fixed; repeatedly select a parameter as the independent variable for optimization until all parameters have been optimized; wherein the repeatedly selected parameter information is a parameter that has not been optimized before.

[0035] Specifically, we first select one of the parameters, namely, the radiation beam angle, the distance from the radiation source to the center of the tumor tissue, and the radiation source dwell time under the corresponding radiation beam angle, as the independent variable, while the values ​​of other parameters remain unchanged. We continuously iterate the values ​​of the independent variables until the cost function converges. The condition for the convergence of the cost function can be that the number of iterations reaches a preset number or that the cost function delivered to the target tumor is complete. and the cost function for delivery to normal organs The sum of is less than the preset threshold.

[0036] Once the cost function has initially converged, a parameter is repeatedly selected as the independent variable for optimization. This parameter is not previously optimized, while the previously optimized parameters remain unchanged and are input into the cost function. This process continues until the corresponding cost function converges again, ultimately achieving optimization of all parameters. The patient's radiotherapy plan is then implemented based on the optimized beam angle, the distance from the radiation source to the tumor center, and the radiation source dwell time at the corresponding beam angle.

[0037] An output unit, used to output the dose distribution of the patient's tumor tissue and normal organs; Once the treatment plan is determined, that is, the parameter information of the radiation source is determined, combined with the semantic segmentation images of the patient's tumor tissue and normal organs, the dose distribution of the tumor tissue and various normal organs can be obtained. The dose distribution includes axial, sagittal and coronal dose distribution, so that the dose volume histogram can be output to comprehensively evaluate the dose distribution of the target tumor and risk organs, which makes it easier for doctors to evaluate whether the treatment plan is acceptable.

[0038] The treatment module is used to move the robotic arm carrying the kilovoltage radiation source according to the radiotherapy plan to deliver the treatment dose to the patient.

[0039] After obtaining the patient's radiation treatment plan, the movement of the robotic arm can be controlled by solid software so that the radiation source emits radiation according to the parameter information determined by the treatment plan.

[0040] In this embodiment, the radiation energy is 200 keV, the thickness of the radiation source tungsten transmission anode is 10-40 μm, the copper filter is 0.4 mm, and the distance from the radiation source to the center of the tumor tissue is 10-40 cm.

[0041] Comparison of 200 kV and 6 mV radiation therapy plans for a right breast cancer case: According to the treatment planning of this application, the dose distribution that needs to be delivered to the tumor in the patient with right breast cancer is first planned, and the amount of radiation delivered to the risk organs is limited. Then, a computer optimization program is used to set the mathematical objective function to achieve this pre-planned dose distribution to the tumor and risk organs. The right breast cancer tumor prescription dose and risk organ dose limit were compared with the RTOG scheme (Table 1). The patient with right breast cancer received radiotherapy with a prescription dose of 38.5 Gy in 10 fractions at a dose of 3.85 Gy / fraction, and the total treatment time was 28.3 minutes (Table 2). All prescription doses were specified as 95% of the planned tumor volume (D 95 ), and all presented dose distributions were normalized to D 95In the case of right breast cancer patients, the organs at risk considered are the ribs, left lung, heart, left breast tissue, and skin. Table 1 lists the dose limits for these organs at risk.

[0042] Table 1 Dose limitations for right breast cancer risk organs

[0043] Table 2. Calculated treatment time and patient prescription dose for a 10-treatment kilovoltage radiotherapy plan.

[0044]

[0045] Figure 5 shows a comparison of isodose lines showing axial, coronal, and sagittal dose distributions for right breast cancer treated with kilovoltage and megavoltage radiation therapy. Figure 5 (a) shows the axial, coronal, and sagittal dose distributions of 180-degree 200 kV radiotherapy for right breast cancer. Figure 5 (b) Axial, coronal, and sagittal dose distributions for the treatment of right breast cancer with 180° 6 mV volumetric modulated arc therapy (VMAT). The dose distributions were normalized to D 95 The isodose lines represent 10% (blue), 50% (yellow), and 100% (red). The dose distribution is normalized to D 95 The isodose lines represent 10% (blue), 50% (yellow), and 100% (red). Comparing these isodose lines, it is clear that kilovoltage radiotherapy plans can achieve the same conformal dose distribution as megavoltage volumetric modulated arc therapy (VMAT).

[0046] Figure 6 A comparison of dose-volume histograms (DVHs) for a right breast cancer treated with 200 kV radiotherapy (solid line) and 6 megavolt volumetric modulated arc therapy (VMAT) (dashed line) is shown. This comparison of histograms demonstrates that the kilovoltage radiotherapy of the present invention, like high-energy megavolt radiotherapy, provides adequate dose distribution to the target tumor while maintaining acceptable radiation doses to organs at risk. Table 3 lists the dose constraints for organs at risk for the right breast cancer and demonstrates that both kilovolt and megavolt treatments maintain dose constraints for the organs at risk.

[0047] Table 3 Dose limitations for right breast cancer risk organs and comparison of actual doses to risk organs during kilovoltage and megavoltage therapy

[0048] According to the recommendations of the International Commission on Radiation Units and Measurements (ICRU 83), the tumor volume dose uniformity index can be used to measure the uniformity of radiation dose distribution within the target volume. The formula for the planned target volume dose uniformity index is: Homogeneity Index (HI) = (D2−D 98 ) / D 50 D2 is the maximum dose received by 2% of the planned target volume, and D 98 is the minimum dose received by 98% of the planned target volume, D 50 is the mean dose received by 50% of the planned target volume.

[0049] The uniformity index of the planned tumor volume dose is the ratio of the maximum dose (D2) to the minimum dose (D 98 ) and the mean dose (D 50 ) is standardized to provide uniformity of dose distribution within the target volume. A lower uniformity index indicates a more uniform dose distribution, which in radiotherapy can ensure that the entire target receives an adequate dose while minimizing hot spots that may cause complications. Table 4 shows the average dose values ​​for the organs at risk for this patient with right breast cancer calculated based on the kilovolt radiotherapy plan, D 50 Therefore, the tumor volume dose uniformity index (HI) of kilovoltage and megavoltage treatments for right breast cancer can be compared based on the uniformity index formula (Table 5).

[0050] Table 4 Average dose values ​​of right breast cancer risk organs, D 50

[0051] Table 5 Tumor volume dose uniformity index (HI) for kilovoltage and megavoltage treatment plans for right breast cancer

[0052] This example discloses the dose distribution required to deliver to the tumor and the dose constraints of risk organs in patients with right breast cancer (Table 1, Table 2), and makes various comparisons with the treatment of megavoltage volume modulated arc therapy (VMAT). Figure 6 The dose-volume histogram (DVH) and the doses delivered to organs at risk during kilovolt and megavoltage radiotherapy (Table 3) and the tumor volume dose uniformity index (HI) (Table 5) show that the results of the kilovolt radiotherapy system compare favorably with megavoltage volumetric modulated arc therapy treatments modeled after clinical linear accelerators. The kilovolt radiotherapy system plan met the dose constraints for organs at risk while also delivering an adequate prescribed dose to the planned tumor volume. Therefore, the optimized kilovolt radiotherapy system can be considered safe and effective.

[0053] Comparison of 225 kV and 6 mV radiotherapy plans for right lung adenocarcinoma: This application first estimates the dose distribution required to be delivered to the tumor in patients with lung adenocarcinoma, while limiting the amount of radiation delivered to organs at risk. A computer optimization program is then used to set a mathematical objective function to achieve this pre-planned dose distribution to the tumor and organs at risk.

[0054] The prescription dose and organ-at-risk dose constraints for patients with right lung adenocarcinoma were compared with the RTOG regimen. Patients with right lung adenocarcinoma were treated with a prescription dose of 60 Gy in 30 fractions at a dose of 2 Gy per fraction (Table 5). All prescription doses were assigned to 95% of the planned tumor volume (D 95 ), and all presented dose distributions were normalized to D 95 .

[0055] Table 6 Treatment duration and prescribed dose calculated from the kilovoltage radiotherapy plan for a patient with right lung adenocarcinoma, divided into 30 treatment sessions

[0056] In the case of a patient with right lung adenocarcinoma, the organs at risk considered were the esophagus, spinal canal, ribs, heart, skin, and left lung.

[0057] Table 7 Dose limitations for organs at risk in patients with right lung adenocarcinoma

[0058] Figure 7 Comparison of isodose lines showing axial, coronal, and sagittal dose distributions for right lung adenocarcinoma treated with 225 kV and 6 mV radiotherapy. The dose distributions were normalized to D 95 The isodose lines represent 10% (blue), 50% (yellow), and 100% (red). The ratio of the prescribed isodose volume, R100%, was less than 1.2, which is in line with the Radiation Therapy Oncology Group (RTOG) 0813 guidelines.

[0059] Figure 8 Dose-volume histograms (DVHs) for the planned tumor volume, heart, uninvolved healthy left lung tissue, ribs, esophagus, and spinal canal for 225 kV radiotherapy (solid line) and 6 mV volumetric modulated arc therapy (VMAT) (dashed line) are shown. Each treatment lasted 2.6 minutes. The maximum kilovoltage skin dose per treatment was 0.58 Gy. Table 8 shows the dose constraints for organs at risk for right lung adenocarcinoma and a comparison of the actual kilovoltage and megavoltage delivered doses to these organs during treatment.

[0060] Table 8 Comparison of dose constraints for risk organs and actual doses to risk organs in patients with right lung adenocarcinoma

[0061] To measure the uniformity of radiation dose distribution within the target volume, the tumor volume dose uniformity index can be calculated. Table 9 shows the average dose values ​​of the risk organs of this patient with right lung adenocarcinoma calculated based on the kilovoltage radiotherapy plan, D 50 Therefore, the tumor volume dose uniformity index (HI) of kilovoltage and megavoltage treatments for lung cancer can be compared based on the uniformity index formula, see (Table 10).

[0062] Table 9 Average dose values ​​of risk organs for right lung adenocarcinoma, D 50

[0063] Table 10 Tumor volume dose uniformity index (HI) for right lung adenocarcinoma treatment plans with kilovoltage and megavoltage treatments

[0064] Table 10 shows that the tumor volume uniformity index for kilovoltage treatment (0.076) is lower than that for megavoltage treatment (0.147). This indicates that the dose distribution across the tumor volume is more uniform with kilovoltage treatment than with megavoltage treatment. This can ensure that the entire target tumor receives an adequate dose during radiotherapy while reducing hot spots that may lead to complications.

[0065] Kilovoltage radiotherapy planning system for optimizing coplanar beamlets for treatment: The system includes a GUI (Graphical User Interface) for use, Figure 9 A system diagram showing an example of coplanar beamlet therapy using optimized coplanar beamlets in a focused distribution. Reference numeral 10 indicates the position of the radiation source, which is mounted on a robotic arm and can be moved around the isocenter target tumor. Reference numeral 15 indicates the skin, 20 indicates the path of the radiation beam within the body, numerals 12 and 19 indicate the path of movement between the radiation sources, numeral 26 indicates the target tumor, and numeral 27 indicates the contrast agent, which allows for more detailed identification of the target location in the image. This kilovolt treatment system includes three subsystems; the first subsystem is equipped with a computer that contains optimized kilovolt treatment plans 02. This computer is also loaded with software that can operate information recording, verification, data storage and analysis 03. This computer is also loaded with software that collects data obtained from the digital panel detector and reconstructs it into a cone beam tomography image 06. It then uses an AI machine learning algorithm to convert the cone beam tomography image into a synthetic image 08; the second subsystem is the firmware software that controls the movement of the robotic arm, controlling the operation of the collimator and dual robotic arms 01; the third subsystem supplies the kilovolt radiation energy source 04, the dual robotic arm power supply 07 and the cooling system power supply 05.

[0066] A system for optimizing the kilovolt radiotherapy plan to select the radiation source position and source axis distance for treatment: The system includes a GUI (Graphical User Interface) for use, Figure 10 Element displaying the array's radiation source position. Kilovolt radiotherapy plans optimize the selection of radiation source positions and source axis distances for treatment, improving dose measurement for target tumors. The optimized radiation source output pattern effectively directs radiation to pathological locations, avoiding or reducing dose distribution to organs at risk. 010 represents robotic arm movement, 10 represents the radiation source position, and the source axis distance can be adjusted based on the treatment optimization plan. 37 represents the organ at risk (critical structure) where the radiation source avoids this organ according to the optimized treatment plan. 35 represents the body, 11 represents the path between radiation source movements, 12 represents the safe zone path, 25 represents the treatment target, and 20 represents the radiation source path within the body. This kilovolt treatment system includes three subsystems; the first subsystem is equipped with a computer that contains optimized kilovolt treatment plans 02. This computer is also loaded with software that can operate information recording, verification, data storage and analysis 03. This computer is also loaded with software that collects data obtained from the digital panel detector and reconstructs it into a cone beam tomography image 06. It then uses an AI machine learning algorithm to convert the cone beam tomography image into a synthetic image 08; the second subsystem is the firmware software that controls the movement of the robotic arm, controlling the operation of the collimator and dual robotic arms 01; the third subsystem supplies the kilovolt radiation energy source 04, the dual robotic arm power supply 07 and the cooling system power supply 05.

[0067] Kilovoltage radiotherapy planning optimization system for selecting radiation sources for treatment in non-common planes: The system includes a GUI (Graphical User Interface) for use, Figure 11 This figure shows a simplified perspective diagram of optimized radiation source position and delivery components for in-plane and out-of-plane arrays, according to some examples, which improves dosimetry to a target tumor. Reference numerals 10 denote the radiation source position, 010 denotes robotic arm movement, 37 denotes the organ at risk (critical structure), 11 denotes the radiation source path, 12 denotes the safe zone path, 20 denotes the treatment radiation source path, 35 denotes the body, 51 denotes the out-of-plane and in-plane radiation source beams, 25 denotes the planned treatment target volume, 53 denotes radiation source movement, 54 denotes the skin, 55 denotes the treatment target, 56 denotes the out-of-plane radiation source beam, and 57 denotes the digital panel detector. This kilovolt treatment system includes three subsystems; the first subsystem is equipped with a computer that contains optimized kilovolt treatment plans 02. This computer is also loaded with software that can operate information recording, verification, data storage and analysis 03. This computer is also loaded with software that collects data obtained from the digital panel detector and reconstructs it into a cone beam tomography image 06. It then uses an AI machine learning algorithm to convert the cone beam tomography image into a synthetic image 08; the second subsystem is the firmware software that controls the movement of the robotic arm, controlling the operation of the collimator and dual robotic arms 01; the third subsystem supplies the kilovolt radiation energy source 04, the dual robotic arm power supply 07 and the cooling system power supply 05.

[0068] The embodiments of the present invention are described in detail above with reference to the accompanying drawings, but the present invention is not limited thereto. Various changes can be made within the knowledge of those skilled in the art without departing from the spirit of the present invention.

Claims

1. A robotic arc therapy system, characterized in that: include: Image acquisition module, used to obtain synthetic tomographic images and complete semantic segmentation of normal organs and tumor tissues in the images; A plan determination module is used to construct a cost function for delivering radiation to the target tumor and a cost function for delivering radiation to normal organs. The parameter information of the radiation source is preset and input into the cost function. The parameter information of the radiation source is iterated based on the semantic segmentation image until the cost function converges. The patient's radiation treatment plan is determined based on the parameter information corresponding to the converged cost function. The treatment module is used to move the robotic arm carrying the kilovoltage radiation source according to the radiotherapy plan to deliver the treatment dose to the patient.

2. A robotic arc therapy system according to claim 1, characterized in that: The image acquisition module includes: A scanning unit for acquiring cone-beam computed tomography images of a patient using a dual-robot system, wherein one of the robot arms carries a radiation source and the other robot arm carries a digital panel detector, and the paired dual robots simultaneously rotate around a target and perform image reconstruction; a conversion unit, configured to convert the cone-beam tomography image into a synthetic tomography image; The segmentation unit is used to perform semantic segmentation on the synthetic tomographic image and complete the segmentation of normal organs and tumor tissues as well as the segmentation of normal organs among each other in the image.

3. The robotic arc therapy system according to claim 1, characterized in that: The plan determination module includes: A construction unit, configured to construct a cost function for delivering to a target tumor and a cost function for delivering to a normal organ; a preset unit, configured to randomly preset parameter information of the radiation source using a Monte Carlo algorithm; wherein the parameter information of the radiation source includes a radiation beam angle, a distance from the radiation source to the center of the tumor tissue at a corresponding radiation beam angle, and a residence time of the radiation source at a corresponding radiation beam angle; an iterative unit, configured to sequentially select a parameter from among the radiation beam angle, the distance from the radiation source to the center of the tumor tissue, and the radiation source dwell time at the corresponding radiation beam angle as an independent variable, and continuously optimize the value of the independent variable while keeping the unselected parameters unchanged until the cost function converges and the corresponding independent variable value is fixed; repeatedly selecting a parameter as the independent variable for optimization until all parameters have been optimized; wherein the repeatedly selected parameter information is a parameter that has not been optimized previously; The output unit is used to output the dose distribution of the patient's tumor tissue and normal organs.

4. The robotic arc therapy system according to claim 3, characterized in that: The cost function for delivery to the target tumor Where, is the prescribed dose to the target tumor, It is the dose delivered to the target tumor at a fixed location; The cost function of delivery to normal organs Where, It is the dose delivered to normal organs at a fixed position; It is the acceptable tolerance dose for normal organs.

5. The robotic arc therapy system according to claim 1, characterized in that: Also includes: a. Mechanically distributed energy radiation sources located outside and around the body or head for imaging and treatment of pathological lesions; b. The radiation energy is ionizing ablation electromagnetic kilovolt, ranging from 100-350 kVp; c. wherein the orientation of the radiant energy source comprises a combination of directing the ionizing output or beam toward the internal lesion by motion selected from the group consisting of rotation about an isocenter in a single plane or multiple planes, movement of a static or arcuate beam closer to or farther from the skin and lesion, non-coplanar delivery from any direction external to the body originating from concentric spheres around the targeted lesion, or varying the distance of the radiation source from the lesion in a radial direction from the targeted lesion; d. wherein energy is delivered non-invasively by employing workflow tasks including, but not limited to, components of the following list: i) imaging, ii) segmentation, iii) planning and optimization, iv) treatment; e. Wherein the energy emitting sources are arranged in a localized, circumferential, annular, or spherical distribution around the patient, along a delivery path originating from the tumor being treated, as a stand-alone arrangement, or arranged in a surface-conforming arrangement, or moved robotically without the need for a circular gantry; f. wherein the array of ionizing energy source locations is electronically or computer controlled to mechanically move the energy sources in space so that their output or beam is moved in different directions and contoured, thereby delivering a discrete, localized energy dose to a given depth or lateral location within the body and forming a narrow or focused distribution within the lesion; g. wherein the resulting contoured energy output or beam is not necessarily isocentric, but rather is a converging electromagnetic kilovoltage energy beam that deposits an energy dose in a targeted localized target volume to treat pathological tissue; h. wherein the compliance target region for the prescribed x-ray dose is discrete, encompasses, and is tailored to the deleterious phase or lesion in the body, thereby enhancing recovery by controlling parameters within a normal physiological range to achieve a healthy transition state; i. Electronic or computerized controls for energy sources, robots, and system operations, with access to power and cooling systems; j. Imaging for planning and guidance, a computer with treatment planning software, the ability to upload images used for planning and guidance, and a connection to an information system with recording and verification software; k. Media storing computer-executable process steps for reconstructing medical images, calculating and optimizing the efficacy of localized treatment with ionizing kilovoltage radiation, and robotic control firmware; l. wherein treatment planning utilizes synthetic CT images, wherein the reconstructed images are the basis for optimizing the treatment plan; m. Treatment tables or chairs capable of moving in three-dimensional space; n. Ionizing radiation therapy localizers that treat diseased tissue in response to received radiation energy; and o. Real-time non-intrusive x-ray source beam output measurement at the beam exit of the x-ray source.

6. An apparatus, characterized in that: include: a. Mechanically distributed energy radiation sources located outside and around the body or head for treatment and imaging of pathological lesions; b. The radiation energy is ionizing ablation electromagnetic kilovolt, ranging from 100-350 kVp; c. wherein the orientation of the radiant energy source comprises a combination of directing the ionizing output or beam toward the internal lesion by motion selected from the group consisting of rotation about an isocenter in a single plane or multiple planes, movement of a static or arcuate beam closer to or farther from the skin and lesion, non-coplanar delivery from any direction external to the body originating from concentric spheres around the targeted lesion, or varying the distance of the radiation source from the lesion in a radial direction from the targeted lesion; d. Where the energy is delivered non-invasively, without the use of devices or mechanisms that cut, puncture or traumatically penetrate the skin or other surfaces, and without the need for open surgery; e. Wherein the energy emitting sources are arranged in a localized, circumferential, annular, or spherical distribution around the patient, along a delivery path originating from the tumor being treated, as a stand-alone arrangement, or arranged in a surface-conforming arrangement, or moved robotically without the need for a circular gantry; f. wherein the array of ionizing energy source locations is electronically or computer controlled to mechanically move the energy sources in space so that their output or beam is moved in different directions and contoured, thereby delivering a discrete, localized energy dose to a given depth or lateral location within the body and forming a narrow or focused distribution within the lesion; g. wherein the resulting contoured energy output or beam is not necessarily isocentric, but rather is a converging electromagnetic kilovoltage energy beam that deposits an energy dose in a targeted localized target volume to treat pathological tissue; h. wherein the compliance target region for the prescribed x-ray dose is discrete, encompasses, and is tailored to the deleterious phase or lesion in the body, thereby enhancing recovery by controlling parameters within a normal physiological range to achieve a healthy transition state; i. Electronic or computerized controls for energy sources, robots, and system operations, with access to power and cooling systems; j. Media storing computer-executable process steps for reconstructing medical images, calculating and optimizing the efficacy of localized treatment with ionizing kilovoltage radiation, and robotic control firmware; k. wherein treatment planning utilizes synthetic CT images, wherein the reconstructed images are the basis for optimizing the treatment plan; and l. Real-time non-invasive X-ray source energy beam output measurement.

7. The apparatus according to claim 6, further comprising: a. Adjustable electronics for mapping different locations, shapes, sizes, frequencies, and timings of energy delivery or beams, as well as other treatment-related parameters; b. The treatment target volume can be maintained or adjusted to cover specific pathological, anatomical and functional structures or target areas; c. wherein the resulting adjustable radiation field size covers an internal treatment target volume with a diameter ranging from a few millimeters to several centimeters.

8. The apparatus according to claim 7, further comprising: a. a robotic interface for directing and guiding electromagnetic waves propagating in space and the secondary electrons generated thereby flowing through the human body, the robotic interface being connected to the system's integrated software; b. wherein the robot may or may not be capable of positioning the x-ray source about the isocenter; and c. Overlapping, directed waves that do not touch the patient's skin but provide cumulative energy deposition in a deep-seated target volume selected, previously delineated by imaging or functional assessment, to receive a boosted dose of kilovoltage energy or radiation.

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