Patient support plate

Abstract

Provided herein are techniques related to radioimaging and therapy, in particular (but not limited to) patient support systems configured to support a pediatric patient positioned in an upright position during medical imaging and / or medical therapy, and related methods, kits, and systems.

Description

[0001] Related application statement

[0002] This application claims the benefit of U.S. Provisional Patent Application No. 63 / 449,657, filed on March 3, 2023, which is incorporated herein by reference in its entirety for all purposes. Technical Field

[0003] Provided herein are technologies related to radiological imaging and therapy, particularly (but not limited to) support boards configured to support patients (e.g., pediatric patients) positioned in a generally upright position during medical imaging and / or during medical therapy, and related methods, kits, and systems. Background Art

[0004] Radioactive sources have many uses in medicine, including medical imaging and radiation therapy. Typically, a radioactive source is configured to move relative to a stationary patient, for example, to expose a specific part or area of ​​the patient to radiation produced by the source. Furthermore, while radiation therapy and associated diagnostic and planning imaging are typically performed with the patient in a prone or supine horizontal position, some patients benefit from therapy in unconventional positions, such as an upright position. The clinical benefits of upright imaging and radiation therapy treatment are numerous and well documented. Preliminary evidence of significant clinical benefits has recently been documented using this system for positioning real patients in a test environment.

[0005] Patients under the age of 18 are generally considered pediatric patients, and pediatric patients can be categorized as: (1) pediatric patients tall enough to fit within the design specifications of adult patients for this system; (2) smaller pediatric patients who do not require anesthesia; and (3) pediatric patients who require anesthesia. There is a need to develop support components that address the need for anesthesia for pediatric patients receiving treatment in an upright orientation. Summary of the Invention

[0006] Provided herein are technologies related to radiological imaging and therapy, particularly, but not limited to, support boards configured to support the front of a patient in an upright position during medical imaging and / or medical therapy, and related methods, kits, and systems. Some technologies for supporting a patient in an upright, stable position are described in U.S. Patent Application Publication No. 2020 / 0268327, which is incorporated herein by reference.

[0007] In some embodiments, a patient positioning system stabilizes and supports a pediatric patient in an upright (e.g., standing, sitting, kneeling, perched) position. Imaging and / or treating a patient in an upright position provides the benefit of increased patient comfort. Additionally, for many indications (e.g., lung cancer, breast cancer), diagnosing and / or treating a patient in an upright position provides advantages over conventionally diagnosing and / or treating a patient in a horizontal position. While imaging and / or treating an upright patient provides diagnostic and therapeutic advantages, medical imaging and treatment require an improved patient positioning system for stabilizing and supporting a pediatric patient in a suitable upright position for delivering a therapeutic radiation dose to a target area and planning treatment using medical imaging. The technology provided herein relates to an improved pediatric support for a patient positioning system for supporting a pediatric patient in an upright position.

[0008] In one aspect, the present disclosure provides a patient support system comprising: a base defining a central axis, a seat portion coupled to the base, and a plate coupled to the base. The plate comprises a first surface facing the central axis and a second surface opposite the first surface. The first surface of the plate is configured to engage a front face of a patient.

[0009] In some embodiments, the plate includes an aperture configured to receive at least a portion of the patient's head.

[0010] In some embodiments, the apertures are located in end portions of the plates.

[0011] In some embodiments, the board includes a first wing portion configured to at least partially support a first arm (e.g., a left arm) of the patient, and wherein the board includes a second wing portion configured to at least partially support a second arm (e.g., a right arm) of the patient. In some embodiments, the wing portions support both arms.

[0012] In some embodiments, an angle is defined between the plate and the central axis, and wherein the angle is in a range of 5 degrees to 45 degrees.

[0013] In some embodiments, the angle is adjustable.

[0014] In some embodiments, the first surface of the plate has a first dimension at the end portion and a second dimension at the narrow portion, the second dimension being smaller than the first dimension.

[0015] In some embodiments, the end portion includes an orifice.

[0016] In some embodiments, the first surface of the plate has a third dimension in the expanded portion, the third dimension being greater than the first dimension.

[0017] In some embodiments, the narrow portion is positioned between the end portion and the flared portion.

[0018] In some embodiments, the base is rotatable about the central axis.

[0019] In some embodiments, the base is movable along the central axis.

[0020] In some embodiments, the central axis is vertical.

[0021] In some embodiments, the system further comprises a vacuum formed bag.

[0022] In some embodiments, the vacuum formed bag is positioned over the seat portion.

[0023] In some embodiments, the system further includes a housing coupled to the plate and configured to support the patient's lower back.

[0024] In some embodiments, the system further comprises an attention capture component.

[0025] In some embodiments, the attention capturing component is a video display.

[0026] In some embodiments, the attention-capturing component is a toy (eg, a fidget spinner).

[0027] In some embodiments, the patient is less than 60 inches tall.

[0028] In one aspect, the present disclosure provides a heel raiser comprising a bottom surface including a recess configured to at least partially receive a heel support of an upright patient positioning system. The heel raiser further comprises a raised platform, a heel stop extending from the raised platform, and a roller extending from the bottom surface.

[0029] In one aspect, the present disclosure provides a patient support system comprising: a base defining a central axis; a base coupled to the base; and a support member pivotally coupled to the base member about a pivot axis. The support member comprises a lower portion, an upper portion, and an arcuate connecting portion between the lower portion and the upper portion.

[0030] In some embodiments, the pivot axis is orthogonal to the central axis.

[0031] In some embodiments, the support further includes a head portion extending from the upper portion and the head portion is configured to support a head of a patient.

[0032] In some embodiments, the system further includes a shin stop coupled to the lower portion, the shin stop configured to support a shin of a patient.

[0033] Some portions of this description describe implementations of the technology in terms of algorithms and symbolic representations of information operations. These algorithmic descriptions and representations are commonly used by those skilled in the art of data processing to effectively convey the essence of their work to others skilled in the art. Although these operations are described functionally, computationally, or logically, they can be understood as being implemented by computer programs or equivalent circuits, microcode, etc. In addition, without loss of generality, it sometimes proves convenient to refer to these arrangements of operations as modules. The described operations and their associated modules can be embodied in software, firmware, hardware, or any combination thereof.

[0034] Certain steps, operations, or processes described herein may be performed or implemented using one or more hardware or software modules, alone or in combination with other devices. In some embodiments, the software modules are implemented using a computer program product comprising a computer-readable medium containing computer program code that can be executed by a computer processor to perform any or all of the steps, operations, or processes described.

[0035] In some embodiments, the system includes a virtually provided computer and / or data storage (e.g., as a cloud computing resource). In certain embodiments, the technology includes using cloud computing to provide a virtual computer system that includes components as described herein and / or performs the functions of a computer as described herein. Thus, in some embodiments, cloud computing provides the infrastructure, applications, and software as described herein over a network and / or via the Internet. In some embodiments, computing resources (e.g., data analysis, computation, data storage, applications, file storage, etc.) are provided remotely over a network (e.g., the Internet; and / or a cellular network).

[0036] Embodiments of the technology may also relate to an apparatus for performing the operations herein. The apparatus may be specially constructed for the desired purpose and / or it may comprise a general-purpose computing device that is selectively activated or reconfigured by a computer program stored in a computer. Such a computer program may be stored in a non-transitory, tangible computer-readable storage medium or any type of medium suitable for storing electronic instructions, which may be connected to a computer system bus. Furthermore, any computing system referred to in the specification may comprise a single processor or may be an architecture that employs a multi-processor design to increase computing power.

[0037] Other implementations will be apparent to persons skilled in the relevant art(s) based on the teachings contained herein. BRIEF DESCRIPTION OF THE DRAWINGS

[0038] This patent or application file contains at least one drawing printed in color. Copies of this patent or patent application publication with one or more color drawing(s) will be provided by the Office upon request and payment of the necessary fee.

[0039] These and other features, aspects and advantages of the present technology will be better understood with reference to the following drawings.

[0040] Figure 1 This figure illustrates design considerations for an upright patient positioner used to treat lesions in the upper thigh. The smaller figure represents the size of the 5% of Japanese women, and the larger figure represents the size of the 95% of American men.

[0041] Figure 2 is a photo of a booster chair used to fit a patient into an upright patient positioning system.

[0042] Figure 3 is a schematic diagram of a heel raiser used to make the upright patient positioning system compatible with shorter patients.

[0043] Figure 4 shows a conceptual design of a rear-tilting patient restraint. Panel A illustrates the upright patient positioning system inserted into a standard backrest. Panel B illustrates the rear-tilting patient restraint inserted into the backrest slot and tilted to an upright position. Panel C illustrates a patient positioned in the rear-tilting patient restraint and tilted to a supine position. Panel D illustrates a patient in imaging position.

[0044] Figure 5 is a conceptual design of a forward-supported patient board. Panel A shows an upright patient positioning system with a standard backrest inserted. Panel B illustrates the forward-supported patient board. Panel C illustrates the upright patient positioning system with the patient tilted toward the forward-supported patient board.

[0045] Figure 6 is a perspective view of an imaging system, a therapy system, and an upright patient positioning system with a front-supported patient board.

[0046] Figure 7A yes Figure 6 A perspective view of the system in FIG. 1 shows the imaging system in an angled configuration.

[0047] Figure 7B yes Figure 6 A perspective view of the system is shown in the treatment position.

[0048] Figure 7C yes Figure 6 A perspective view of the system in FIG. 1 shows the treatment system in the treatment position and the patient support system in the lowered position.

[0049] Figure 7D yes Figure 6 A perspective view of the system in FIG, showing the treatment system in a treatment position and the patient support system in a lowered and rotated position.

[0050] Figure 7E yes Figure 6 A perspective view of the system in FIG. 1 shows the treatment system in a treatment position and the patient support system in another lowered and rotated position.

[0051] Figure 8 This is the front view of the front-supported patient board.

[0052] Figure 9 is included Figure 8 Perspective view of the test fixture for the mid-front support patient board.

[0053] Figure 10 yes Figure 9 Photo of the test fixture.

[0054] Figure 11 yes Figure 9 Schematic diagram of the test fixture illustrating the connection of the face mask, body shell, and vacuum-formed bag.

[0055] Figure 12 is a photo of the example patient.

[0056] Figure 13 yes Figure 12 In the case of patients Figure 10 A series of photographs of the device being supported in a test fixture.

[0057] Figure 14 yes Figure 12 In the case of patients Figure 10 Another series of photos of the device supported in a test fixture.

[0058] Figure 15 The main body shell is supported on Figure 10Schematic diagram of a patient in a test fixture.

[0059] It should be understood that the drawings are not necessarily drawn to scale, nor are the objects in the drawings drawn in proportional relationship to each other. The drawings are intended to facilitate a clear and understandable description of the various embodiments of the devices, systems, and methods disclosed herein. Throughout the drawings, the same reference numerals are used whenever possible to refer to the same or similar parts. Furthermore, it should be understood that the drawings are not intended to limit the scope of the present teachings in any way. DETAILED DESCRIPTION

[0060] Provided herein are technologies related to radiation imaging and therapy, particularly (but not limited to) a support board configured to support a frontal portion of a patient positioned in an upright position during medical imaging and / or during medical therapy, and related methods, kits, and systems.

[0061] In this detailed description of various embodiments, for ease of explanation, numerous specific details are listed to provide a thorough understanding of the disclosed embodiments. However, those skilled in the art will appreciate that these various embodiments may be practiced with or without these specific details. In other cases, structures and devices are shown in block diagram form. Furthermore, those skilled in the art will readily appreciate that the specific order in which the methods are presented and performed is illustrative, and it is contemplated that the order may be varied and still remain within the spirit and scope of the various embodiments disclosed herein.

[0062] All documents and similar materials cited in this application, including but not limited to patents, patent applications, articles, books, papers and internet web pages, are expressly incorporated by reference in their entirety for any purpose. Unless otherwise defined, all technical and scientific terms used herein have the same meanings as commonly understood by those of ordinary skill in the art to which the various embodiments described herein belong. When the definitions of terms in the incorporated references differ from the definitions provided in this teaching, the definitions provided in this teaching shall prevail. The section headings used herein are for organizational purposes only and should not be construed as limiting the subject matter described in any way.

[0063] definition To facilitate understanding of the present technology, various terms and phrases are defined below. Additional definitions are set forth throughout the detailed description.

[0064] Throughout the specification and claims, unless the context clearly dictates otherwise, the following terms have the meanings explicitly associated with them herein. As used herein, the phrase "in one embodiment" does not necessarily refer to the same embodiment, although it may refer to the same embodiment. Furthermore, as used herein, the phrase "in another embodiment" does not necessarily refer to a different embodiment, although it may refer to a different embodiment. Thus, as described below, the various embodiments of the present invention may be readily combined without departing from the scope or spirit of the invention.

[0065] In addition, as used herein, unless the context clearly dictates otherwise, the term "or" is an inclusive "or" operator and is equivalent to the term "and / or". Unless the context clearly dictates otherwise, the term "based on" is not exclusive and allows for being based on additional factors that are not described. In addition, throughout the specification, the meanings of "a / an" and "the" include plural references. The meaning of "in..." includes "in..." and "on..."

[0066] As used herein, the terms "about," "approximately," "substantially," and "significantly" are understood by those of ordinary skill in the art and will vary to some extent depending on the context in which they are used. If the use of these terms is unclear to one of ordinary skill in the art considering the context in which they are used, "about" and "approximately" mean plus or minus less than or equal to 10% of the particular term, and "substantially" and "significantly" mean plus or minus greater than 10% of the particular term.

[0067] As used herein, disclosure of a range includes disclosure of all values ​​within the entire range and further divided ranges (including endpoints and subranges provided for the range). As used herein, disclosure of a numerical range includes endpoints and each intermediate digit with the same degree of accuracy therebetween. For example, for a range of 6-9, in addition to 6 and 9, numerals 7 and 8 are also contemplated, and for a range of 6.0-7.0, numerals 6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6.9, and 7.0 are clearly contemplated.

[0068] As used herein, the suffix "-without" refers to embodiments of the technology that omit features of the base root of the word to which "-without" is appended. That is, the term "without X" as used herein means "without X," where X is the feature of the technology omitted from the "without X" technology. For example, a "calcium-free" composition does not include calcium, a "no-mixing" method does not include a mixing step, etc.

[0069] Although the terms "first", "second", "third" etc. are used in this article to describe various steps, elements, compositions, components, regions, layers and / or parts, unless otherwise indicated, these steps, elements, compositions, components, regions, layers and / or parts should not be limited by these terms. These terms are used to distinguish one step, element, composition, component, region, layer and / or part from another step, element, composition, component, region, layer and / or part. Unless the context clearly indicates otherwise, the terms such as "first", "second" and other numerical terms used herein do not imply a sequence or order. Therefore, without departing from the technology, the first step, element, composition, component, region, layer or part discussed herein may be referred to as a second step, element, composition, component, region, layer or part.

[0070] As used herein, the terms "present" or "absent" (or alternatively, "existing" or "absent") are used in a relative sense to describe the amount or level of a particular entity (e.g., a component, an effect, an element). For example, when an entity is referred to as being "present," it means that the level or amount of the entity is above a predetermined threshold; conversely, when an entity is referred to as being "absent," it means that the level or amount of the entity is below a predetermined threshold. The predetermined threshold may be a detectability threshold or any other threshold associated with a particular test for detecting the entity. When an entity is "detected," it is "present"; when an entity is "not detected," it is "absent."

[0071] As used herein, "increase" or "decrease" refers to a detectable (e.g., measured) positive or negative change in the value of a variable relative to a previously measured variable value, relative to a predetermined value, and / or relative to a standard control, respectively. An increase is a positive change in the value of a variable relative to a previously measured variable value, a predetermined value, and / or a standard control, preferably by at least 10%, more preferably by 50%, still more preferably by 2 times, even more preferably by at least 5 times, and most preferably by at least 10 times. Similarly, a decrease is a negative change in the value of a variable relative to a previously measured variable value, a predetermined value, and / or a standard control, preferably by at least 10%, more preferably by 50%, still more preferably by at least 80%, and most preferably by at least 90%. Other terms representing a quantitative change or difference, such as "more" or "less," are used herein in the same manner as described above.

[0072] As used herein, a "system" refers to a plurality of real and / or abstract components that operate together for a common purpose. In some embodiments, a "system" is an integrated assembly of hardware and / or software components. In some embodiments, each component of a system interacts with and / or is associated with one or more other components. In some embodiments, a system refers to a combination of components and software used to control and direct a method. For example, a "system" or "subsystem" may include one or more of the following, or any combination thereof: a mechanical device, hardware, a component of hardware, a circuit, a circuit, a logic design, a logic component, software, a software module, a component of software or a software module, a software process, a software instruction, a software routine, a software object, a software function, a software class, a software program, a file containing software, etc., to perform the functions of the system or subsystem. Thus, the methods and apparatus of the embodiments, or certain aspects or portions thereof, may take the form of program code (e.g., instructions) embodied in a tangible medium such as a floppy disk, CD-ROM, hard drive, flash memory, or any other machine-readable storage medium, wherein, when the program code is loaded into and executed by a machine such as a computer, the machine becomes an apparatus for practicing the embodiments. When the program code is executed on a programmable computer, the computing device generally includes a processor, a storage medium readable by the processor (e.g., volatile and non-volatile memory and / or storage element), at least one input device, and at least one output device. One or more programs can implement or utilize the process described in conjunction with the embodiment, for example, by using an application program interface (API), reusable controls, etc. Such programs are preferably implemented in a high-level process or object-oriented programming language to communicate with the computer system. However, if necessary, one or more programs can be implemented in assembly language or machine language. In any case, the language is a compiled or interpreted language and is combined with hardware implementation.

[0073] As used herein, the term "computed tomography" is abbreviated as "CT" and refers to both tomographic and non-tomographic radiography. For example, the term "CT" refers to various forms of CT, including but not limited to X-ray CT, positron emission tomography (PET), single photon emission computed tomography (SPECT), and photon counting computed tomography. Generally speaking, computed tomography (CT) involves the use of an X-ray source and a detector that rotates around a patient and subsequently reconstructing the image into different planes. In embodiments of CT described herein (e.g., devices, apparatus, and methods provided for CT), the X-ray source is a static source and the patient rotates relative to the static source. The X-ray current used in CT describes the current flow from the cathode to the anode and is typically measured in milliamperes (mA).

[0074] As used herein, the term "configured to [verb]" means that the identified element or component has a structure that is shaped, sized, arranged, coupled, and / or configured to perform the identified verb. For example, a member that is "configured to move" is movably coupled to another element and includes an element that causes the member to move, or the member is otherwise configured to move in response to the other element or component. Thus, as used herein, "configured to [verb]" describes structure rather than function. Furthermore, as used herein, "configured to [verb]" means that the identified element or component is intended and designed to perform the identified verb.

[0075] As used herein, the term "associated" means that elements are part of the same assembly and / or function together or interact with each other in some manner. For example, a car has four tires and four hubcaps. While all elements are connected as part of the car, it is understood that each hubcap is "associated" with a specific tire.

[0076] As used herein, the term "coupled" refers to two or more components that are fixed together by any suitable means. Thus, in some embodiments, the statement that two or more parts or components are "coupled" should mean that these parts are directly or indirectly connected or operate together, such as through one or more intermediate parts or components. As used herein, "directly coupled" means that two elements are directly in contact with each other. As used herein, "fixedly coupled" or "fixed" means that two components are coupled so that they move as a unit while maintaining a constant orientation relative to each other. Therefore, when two elements are coupled, all parts of these elements are coupled. However, when describing a specific part of a first element as being coupled to a second element, for example, the first end of an axle is coupled to the first wheel, it means that the specific part of the first element is positioned closer to the second element than other parts of the axle. Furthermore, an object resting on another object that is held in place solely by gravity will not be "coupled" to the lower object unless the upper object is otherwise substantially maintained in place. That is, for example, a book on a table is not coupled to it, but a book glued to the table is coupled to it.

[0077] As used herein, the term "removably coupled" or "temporarily coupled" means that one component is coupled to another component in a substantially temporary manner. That is, the two components are coupled in such a manner that the components can be easily connected or disconnected without damaging the components. Thus, "removably coupled" components can be easily uncoupled and recoupled without causing damage to the components.

[0078] As used herein, the term "operably coupled" means that a plurality of elements or components are coupled such that when a first element moves from one position / configuration to another position / configuration, a second element also moves between positions / configurations, wherein each of the plurality of elements or components is movable between the first position and the second position, or between the first configuration and the second configuration. Notably, a first element is "operably coupled" to another element and vice versa.

[0079] As used herein, the term "rotatably coupled" refers to two or more components being coupled in a manner such that at least one component is capable of rotation relative to another component.

[0080] As used herein, the term "translatably coupled" refers to two or more components being coupled in a manner such that at least one component is capable of translation relative to another component.

[0081] As used herein, the term "temporarily disposed" means that a first element or component is placed on a second element or component in a manner that allows the first element / component to be moved without decoupling or otherwise manipulating the first element. For example, a book is simply placed on a table, e.g., the book is not glued or fastened to the table, but is "temporarily disposed" on the table.

[0082] As used herein, the term "corresponding" means that two structural components are similar in size and shape to each other and are coupled with a minimum of friction. Thus, an opening that "corresponds" to a component is sized slightly larger than the component so that the component can pass through the opening with a minimum of friction. This definition can be modified if the two components fit together "tightly." In this case, the difference between the component sizes is even smaller, thereby increasing the amount of friction. If the elements defining the opening and / or the components inserted into the opening are made of a deformable or compressible material, the opening can even be slightly smaller than the components inserted into the opening. With respect to surfaces, shapes, and lines, two or more "corresponding" surfaces, shapes, or lines generally have the same size, shape, and contour.

[0083] As used herein, a "path of travel" or "path" when used in connection with a moving element includes the space through which the element moves when in motion. Thus, an inherently moving element has a "path of travel" or "path."

[0084] As used herein, the statement that two or more parts or components "engage" one another shall mean that the elements apply a force or bias to one another, either directly or through one or more intermediate elements or components. Furthermore, as used herein with respect to a moving part, the moving part may "engage" another element during movement from one position to another and / or may "engage" another element once in the described position. Thus, it will be understood that the statements "element A engages element B when element A is moved to the element A first position" and "element A engages element B when element A is in the element A first position" are equivalent statements and mean that element A either engages element B when moved to the element A first position and / or element A engages element B when either is in the element A first position.

[0085] As used herein, the term "operably engaged" means "engage and move." That is, when used relative to a first component that is configured to move a movable or rotatable second component, "operably engaged" means that the first component applies a force sufficient to cause the second component to move. For example, a screwdriver is placed in contact with a screw. When no force is applied to the screwdriver, the screwdriver is simply "coupled" to the screw. If an axial force is applied to the screwdriver, the screwdriver presses against the screw and "engages" the screw. However, when a rotational force is applied to the screwdriver, the screwdriver "operably engages" the screw and causes the screw to rotate. Additionally, with respect to electronic components, "operably engaged" means that one component controls another component by controlling a signal or current.

[0086] As used herein, the term "number" shall mean one or an integer greater than one (eg, a plurality).

[0087] As used herein, in the phrase “[x] moves between its first position and second position” or “[y] is configured to move [x] between its first position and second position,” “[x]” is the name of an element or component. Furthermore, when [x] is an element or component that moves between multiple positions, the pronoun “its” means “[x],” that is, the named element or component preceding the pronoun “its.”

[0088] As used herein, a "radial side / surface" of a circular or cylindrical body is a side / surface that extends around or encircles its center or a height line passing through its center. As used herein, an "axial side / surface" of a circular or cylindrical body is a side that extends in a plane that extends generally perpendicular to the height line passing through the center. That is, generally speaking, for a cylindrical soup can, the "radial side / surface" is the generally circular sidewall, and the "one or more axial sides / surfaces" are the top and bottom of the soup can.

[0089] As used herein, "diagnostic" tests include detecting or identifying a disease state or condition in a subject, determining the likelihood that a subject is infected with a given disease or condition, determining the likelihood that a subject with a disease or condition will respond to a treatment, determining the prognosis of a subject with a disease or condition (or its likely progression or regression), and determining the effect of a treatment on a subject with a disease or condition. For example, diagnostics can be used to detect the presence or likelihood that a subject has cancer, or the likelihood that such a subject will respond favorably to a compound (e.g., a drug, such as a pharmaceutical) or other treatment.

[0090] As used herein, the term "disorder" generally refers to a disease, condition, injury, event, or change in health status.

[0091] As used herein, the terms "treating" or "treatment," with respect to a condition, means preventing the condition, slowing the onset or rate of development of the condition, reducing the risk of developing the condition, preventing or delaying the development of symptoms associated with the condition, reducing or ending symptoms associated with the condition, producing complete or partial regression of the condition, or some combination thereof. In some embodiments, "treating" comprises exposing a patient or a portion thereof (e.g., a tissue, organ, body part, or other localized area of ​​a patient's body) to radiation (e.g., electromagnetic radiation, ionizing radiation).

[0092] As used herein, the term "beam" refers to a stream of radiation (e.g., electromagnetic waves and / or particle radiation). In some embodiments, the beam is generated by a source and is confined to a small solid angle. In some embodiments, the beam is collimated. In some embodiments, the beam is generally unidirectional. In some embodiments, the beam is divergent.

[0093] As used herein, the term "patient" or "subject" refers to a mammal that has been identified and / or selected for imaging and / or treatment with radiation. Thus, in some embodiments, the patient or subject is exposed to a beam of radiation, such as a primary beam generated by a radiation source. In some embodiments, the patient or subject is a human. In some embodiments, the patient or subject is a veterinary or farm animal, livestock or pet, or an animal used in clinical research. In some embodiments, the subject or patient has cancer and / or the subject or patient has been identified as having cancer or being at risk for cancer.

[0094] As used herein, the term "treatment volume" or "imaging volume" refers to the volume (e.g., tissue) of a patient that is selected for imaging and / or treatment with radiation. For example, in some embodiments, the "treatment volume" or "imaging volume" includes a tumor in a cancer patient. As used herein, the term "healthy tissue" refers to a volume (e.g., tissue) of a patient that is not and / or does not include the treatment volume. In some embodiments, the imaging volume is larger than the treatment volume and includes the treatment volume.

[0095] As used herein, the term "radiation source" or "source" refers to a device that produces radiation (e.g., ionizing radiation) in the form of photons (e.g., described as particles or waves). In some embodiments, the radiation source is a linear accelerator ("linac") that produces x-rays or electrons to treat cancer patients by contacting tumors with x-ray or electron beams. In some embodiments, the source produces particles (e.g., photons, electrons, neutrons, hadrons, ions (e.g., protons, carbon ions, other heavy ions)). In some embodiments, the source produces electromagnetic waves (e.g., x-rays and gamma rays having wavelengths in the range of about 1 pm to about 1 nm). Although it is understood that radiation can be described as having wave-particle duality, it is sometimes convenient to refer to radiation as waves and sometimes as particles. Therefore, without limiting the technology and understanding the laws of quantum mechanics that dictate that every particle or quantum entity be described as a particle or a wave, both descriptions will be used throughout.

[0096] As used herein, the term "static source" refers to a source that does not rotate about a patient during imaging or therapy using the source. In particular, a "static source" remains fixed relative to an axis passing through the patient while imaging or therapy is being performed on the patient. Although the patient may rotate about the axis to produce relative motion between the static source and the rotating patient that is comparable to the relative motion of the source rotating about the static patient, the static source does not move relative to a third object, a reference frame (e.g., the patient's examination room), or the patient's axis of rotation during imaging or therapy, even though the patient rotates relative to the third object, the reference frame (e.g., the patient's examination room), or the patient's axis of rotation during imaging or therapy. Thus, a static source is mounted on a mobile platform and, when the mobile platform moves to transport the static source, the static source may thereby move relative to the ground and stationary objects on the ground. Thus, the term "static source" may refer to a mobile "static source" provided that the mobile "static source" does not rotate about the axis of rotation passing through the patient during imaging or therapy. Additionally, a static source can be translated and / or rotated about a patient to position the static source before or after imaging or treatment of the patient. Thus, the term "static source" can refer to a source that is translated or rotated about a patient during non-imaging and non-treatment use of the patient, such as to position the source relative to the patient when the patient is not being imaged and / or treated. In some embodiments, the "static source" is a photon source and is therefore referred to as a "static photon source."

[0097] Some embodiments herein relate to a patient support assembly configured to accommodate patients whose heights conform to the 95th percentile for American males and the 5th percentile for Japanese females. It should be understood that this is a preferred embodiment that is applicable to a wide range of patient populations, and that patient support assemblies configured to accommodate patients of varying height ranges are equally feasible. The 5th percentile for Japanese female patients is approximately 1490 mm tall. The 95th percentile for American male patients is approximately 1900 mm tall.

[0098] In some embodiments, the patient support assembly provides a "perching position" for the patient. As used herein, the term "perching position" refers to a patient generally in a standing position with the torso tilted backward relative to a vertical axis, optionally also with the knees flexed.

[0099] describe The Upright Patient Positioning System (UPPS) is designed to position patients within a range of heights (lengths), including those with heights based on the 95th percentile for American males and the 5th percentile for Japanese females. This Upright Patient Positioning System is described in detail in U.S. Patent Application Publication No. 2020 / 0268327 (U.S. Application No. 16 / 649,337), the entire contents of which are incorporated herein by reference. Figure 1Patients within these lengths can be positioned for imaging and treatment in a sitting or upright position without the need for additional or special fixation and support devices.

[0100] The first category of pediatric patients includes young patients whose height is equal to or greater than the 5th percentile for Japanese females. These patients can be positioned in a standard or pre-planned manner. In some embodiments, pediatric patients in this first category may require additional measures or specialized procedures for treatment due to patient maturity and / or medical conditions. It is generally considered or assumed that patients in this first category are old enough to cooperate with treatment requirements without sedation or anesthesia.

[0101] The second category of pediatric patients are those who are shorter than the 5% of Japanese females and who can complete the treatment process without sedation or anesthesia. These pediatric patients may not fit comfortably in standard upright patient positioning systems and may require additional immobilization or heightening devices to accommodate them. As detailed herein, there are two positioning options for this second category of patients: (1) in a sitting or perched position or oriented posteriorly for pelvic, chest, head, neck, and intracranial targets; and (2) in an anteriorly tilted position for posterior lesions, particularly craniospinal irradiation (CSI) therapy. The support devices for each are detailed herein.

[0102] Rear Tilt: In some embodiments, a booster seat or specially designed support system is coupled with the standard backrest of an upright patient positioning system. Figure 2 An example of a commercially available booster seat is shown. See, for example, the Special Tomato® Soft-Touch® Floor Sitter with Wedge Cushion (https: / / www.adaptivemall.com / special-tomato-soft-touch-floor-sitter.html).

[0103] refer to Figure 3 In some embodiments, the positioning system includes a heel raiser 10 that can be used to raise the height of the ground to compensate for shorter legs while still allowing a standard knee to be supported and function. In an exemplary embodiment, the heel raiser 10 includes a bottom surface 14 that includes a recess 18 that at least partially receives an existing heel support 22 of the upright patient positioning system. The heel raiser 10 further includes a raised platform 26 positioned above the existing heel stop 22, and a raised heel stop 30 extending from the raised platform 26. The heel raiser 10 further includes rollers 34 (e.g., roller bars) extending from the bottom surface 14 and configured to assist in moving the heel raiser 10 relative to the existing heel support 22.

[0104] Referring to FIG4 , a conceptual design of a reclining patient support device is illustrated. Panel A illustrates an upright patient support system inserted into a standard backrest. Panel B illustrates a pediatric-specific device inserted into a backrest slot and tilted into an upright position. The patient support system 38 includes a base 42 defining a central axis 46, a base 50 coupled to the base 42 (e.g., inserted into a backrest slot), and a support member 54 (e.g., a support plate) pivotally coupled to the base 50 about a pivot axis 58. Panel C shows a patient positioned within the system 38 and tilted into a supine position. Panel D shows a patient positioned within the system 38 and positioned in an imaging position.

[0105] In some embodiments, support member 54 is shaped like a car seat, which children are accustomed to and familiar with. Support member 54 includes a lower portion 62, an upper portion 66, and an arcuate connecting portion 70 between lower portion 62 and upper portion 66. In the exemplary embodiment, support member 54 further includes a head portion 74 extending from upper portion 66. Head portion 74 is configured to support the back of a patient's head. In the exemplary embodiment, a shin stop 78 is coupled to lower portion 62 and is configured to support the patient's shin.

[0106] In the exemplary embodiment, the pivot axis 58 is orthogonal to the central axis 46. In the exemplary embodiment, the pivot axis 58 is positioned behind the patient so that the patient can be tilted backward ( FIG. 4C ) to a supine position. For example, a supine position may be desirable for easier and safer medical procedures (e.g., installing a fixation device, administering anesthesia, inserting an intravenous catheter).

[0107] In some embodiments, the base 50 and support 54 are radiolucent. In some embodiments, the support 54 and / or base 50 are portable and removable from the base 42. In the illustrated embodiment, the base 50 is attached to and detached from a backrest slot 82 formed in the base 42. Advantageously, a portable patient support facilitates easy patient entry and exit from the treatment room. For example, the patient can be transported to and from the treatment room within or on the support 54.

[0108] Leaning Forward: Referring to FIG5 , a patient support system 110 is illustrated for supporting a patient in a forward leaning position. This position is suitable, for example, for craniospinal irradiation (CSI) treatment. The system 110 includes a base 114 defining a central axis 118 and a seat portion 122 coupled to the base 114. The system 110 further includes a plate 126 (also referred to herein as a front support or support plate) coupled to the base 114. Panel A of FIG5 illustrates an upright patient positioning system inserted into a standard backrest. Panel B of FIG5 illustrates the plate 126 (e.g., a front support). Panel C of FIG5 illustrates a patient leaning forward onto the plate 126. The plate 126 includes a first surface 130 facing the central axis 118 and a second surface 134 positioned opposite the first surface 130. As further described herein, the first surface 130 of the plate 126 is configured to engage and support the front face of the patient.

[0109] In some embodiments, plate 126 is inserted into backrest slot 138 of base 114 of an upright patient positioning system. In an exemplary embodiment, plate 126 defines an angle 142 ( FIG. 5B ) with respect to central axis 118. In some embodiments, angle 142 is within a range of approximately 5 degrees to approximately 45 degrees. In some embodiments, angle 142 is adjustable.

[0110] refer to Figure 6 , system 110 is shown together with an imaging system. Plate 126 includes a first wing portion 146 configured to at least partially support one arm of a patient and a second wing portion 150 configured to at least partially support the other arm of the patient.

[0111] In the illustrated embodiment, the plate 126 includes an aperture 154 configured to receive at least a portion of the patient's head. In some embodiments, the aperture 154 is positioned in an end portion 158 of the plate 126 .

[0112] refer to Figures 7A-7E , shows the patient and patient support system 110 in various imaging and treatment configurations. As illustrated, the base 114 can rotate about a central axis 118, and the base 114 can move along the central axis 118. In the illustrated embodiment, the central axis 118 is vertical.

[0113] refer to Figure 8 、 Figure 9 and Figure 10, illustrates one embodiment of a front support plate 162 with a test frame 166. Plate 162 is similar to and interchangeable with plate 126. Front support plate 162 is sized for children between the ages of 1.5 and 7 years old. In some embodiments, the total body length suitable for front support plate 162 ranges from 30 inches to 52 inches. In some embodiments, the total body length of the patient is less than approximately 60 inches tall.

[0114] refer to Figure 8 , the plate 162 includes an end portion 170 having an aperture 174, a narrow portion 178, and a flared portion 182 having wings 186. In the illustrated embodiment, the narrow portion 178 is positioned between the end portion 170 and the flared portion 182. The first surface 190 of the plate 162 has a first dimension 194 at the end portion 170 and a second dimension 198 at the narrow portion 178. The second dimension 198 is smaller than the first dimension 194. The first surface 190 of the plate 162 has a third dimension 202 at the flared portion 182. The third dimension 202 is larger than the first dimension 194.

[0115] refer to Figure 11 The system further includes a vacuum-formed bag 206 (e.g., a Vac-Loc bag or pad). In some embodiments, the vacuum-formed bag 206 is positioned over the seat portion 122 and formed to provide a customized seat contour for the patient. The vacuum-formed bag 206 is used to secure the patient's hips (e.g., pelvic region) to the seat portion. The patient's vertical position along the board is adjusted by the overall thickness of the vacuum-formed bag 206 beneath the patient.

[0116] Continue to refer Figure 11 The system further includes a housing 210 coupled to the plate 162 and configured to support the patient's lower back. Figure 15 In some embodiments, the shell 210 is a thermoplastic body shell. In some embodiments, both ends of the shell 210 are releasably connected to the wings 186 of the plate 162. The plate 162 provides a flat surface in the abdominal area that allows the thermoplastic body shell 210 to be attached around the patient's back to hold the patient in a repeatable and comfortable position.

[0117] Continue to refer Figure 11, the system further includes a facial mask 214 for supporting and / or securing the patient's head. In some embodiments, an aperture 174 in the end portion 170 of the plate 162 selectively receives a portion of the facial mask 214. In some embodiments, the facial mask 214 is a thermoplastic facial mask. The aperture 174 is capable of accommodating a prone facial mask system. In some embodiments, the facial mask 214 is releasably secured to the plate 162 at the aperture 174. The facial mask 214 enables the patient to view films during CT simulation and treatment. This makes the treatment (e.g., CSI treatment) technology compatible with the Stanford Avatar Project (see Susie Hineker's communication / paper). The facial mask system will also allow the thermoplastic shell to be attached to the back of the patient's head to hold the entire head in place.

[0118] In some embodiments, the system includes an attention capturing component 218 that is configured to attract or distract the patient while the patient is positioned on the board 162. In other words, the patient's face protrudes through the aperture 170 so that the patient can view or interact with the attention capturing component 218. In some embodiments, the attention capturing component 218 is visible to the patient when the patient's face is inserted into the aperture 170 of the board 162. In other words, the patient can see the attention capturing component 218 through the aperture 170 and can interact with or operate the attention capturing component 218 with their hands. In some embodiments, the attention capturing component is a video display or a tablet computer ( Figure 13 、 14 In other embodiments, the attention-grabbing component is a toy such as a fidget spinner or other suitable manipulable toy ( Figure 13 、 14 ). In some embodiments, a mounting bracket for the attention capture component is coupled to the board.

[0119] In some embodiments, the system further comprises arm and leg support systems to immobilize the patient's arms and legs.

[0120] refer to Figure 12-14 , showing various sizes of example patients by Figure 10 The plate 162 and the test frame 166 support. For reference, Figure 12 A meter stick is shown positioned relative to an example patient.

[0121] Finally, there is a third category of pediatric patients who are shorter than 5% of Japanese females and must undergo treatment under sedation or anesthesia. In some embodiments, anesthesia is administered to patients who are secured in an upright position using the system detailed herein.

[0122] Although the disclosure herein refers to certain exemplary embodiments, it should be understood that these embodiments are presented by way of example, not limitation.

[0123] For all purposes, all publications and patents mentioned in the above description are incorporated herein by reference in their entirety. Various modifications and variations of the use of the described compositions, methods, and techniques will be apparent to those skilled in the art without departing from the scope and spirit of the described technology. Although the technology has been described in conjunction with specific exemplary embodiments, it should be understood that the claimed invention should not be unduly limited to these specific embodiments. In fact, various modifications of the described modes for implementing the present invention that are apparent to those skilled in the art are intended to fall within the scope of the appended claims.

[0124] References 1.Yang J, et al. Advantages of simulating thoracic cancer patients in an upright position. Pract Radiat Oncol. 2014;4:e53-e58.2. 2.McCarroll, RE, et al (2017), Reproducibility of patient setup in the seated treatment position: A novel treatment chair design. J Appl ClinMed Phys, 18: 223-229. doi:10.1002 / acm2.12024 3. Thomas Rockwell Mackie, et al “Is upright radiotherapy medically and financially better?”, AIP Conference Proceedings 2348, 020002 (2021) https: / / doi.org / 10.1063 / 5.0051770 4.S. Boisbouvier, et al Upright patient positioning for pelvicradiotherapy treatments, Technical Innovations&Patient Support in RadiationOncology, Volume 24, 2022, Pages 124-130, ISSN 2405-6324, https: / / doi.org / 10.1016 / j.tipsro.2022.11.003。

Claims

1. A patient support system comprising: a base defining a central axis; a seat portion coupled to the base; a plate coupled to the base; The plate includes a first surface facing the central axis and a second surface opposite the first surface; Wherein the first surface of the plate is configured to engage a front face of a patient.

2. The system according to claim 1, wherein: The plate includes an aperture configured to receive at least a portion of the patient's head.

3. The system according to claim 2, wherein: The apertures are positioned in the end portions of the plates.

4. The system according to claim 1, wherein: The plate includes a first wing portion configured to at least partially support a first arm of the patient, and wherein the plate includes a second wing portion configured to at least partially support a second arm of the patient.

5. The system according to claim 1, wherein: An angle is defined between the plate and the central axis, and wherein the angle is in the range of 5 degrees to 45 degrees.

6. The system according to claim 5, wherein: The angle is adjustable.

7. The system according to claim 1, wherein: The first surface of the plate has a first dimension at the end portion and a second dimension at the narrow portion, the second dimension being smaller than the first dimension.

8. The system according to claim 7, wherein: The end portion includes an aperture.

9. The system according to claim 8, wherein: The first surface of the plate has a third dimension at the flared portion, the third dimension being greater than the first dimension.

10. The system according to claim 9, wherein: The narrow portion is positioned between the end portion and the flared portion.

11. The system according to claim 1, wherein: The base is rotatable about the central axis.

12. The system according to claim 1, wherein: The base is movable along the central axis.

13. The system of claim 1, wherein: The central axis is vertical.

14. The system of claim 1, further comprising a vacuum formed bag.

15. The system according to claim 14, wherein: The vacuum formed bag is positioned over the seat portion.

16. The system of claim 1, further comprising a housing coupled to the plate and configured to support the patient's lower back.

17. The system of claim 1, further comprising an attention capture component.

18. The system according to claim 17, wherein: The attention capturing component is a video display.

19. The system according to claim 18, wherein: The attention-capturing component is a toy.

20. The system of claim 1, wherein: The patient is less than 60 inches tall.

21. A heel raiser comprising a bottom surface, the bottom surface including a groove configured to at least partially receive a heel support of an upright patient positioning system; the heel raiser further comprising a raised platform, a heel stop extending from the raised platform, and a roller extending from the bottom surface.

22. A patient support system comprising: a base defining a central axis; a base coupled to the foundation; and a support pivotally coupled to the base about a pivot axis; Wherein, the support member includes a lower part, an upper part and an arc-shaped connecting part between the lower part and the upper part.

23. A patient support system according to claim 22, wherein: The pivot axis is orthogonal to the central axis.

24. The patient support system of claim 22, wherein: The support further includes a head portion extending from the upper portion and configured to support a patient's head.

25. The patient support system of claim 22, further comprising a shin stop coupled to the lower portion and configured to support a shin of the patient.

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