Optical guidance and tracking for medical imaging

Abstract

Provided herein are techniques related to medical imaging and radiotherapy, methods and systems, in particular (but not limited to) methods and systems for monitoring safe movement of a patient positioning system, for validating settings of a patient positioning system, for validating settings of a patient on a patient positioning system, and for monitoring patient position during medical imaging and / or radiotherapy.

Description

[0001] This application claims the benefit of U.S. Provisional Patent Application Serial No. 63 / 462,563, filed April 28, 2023, the entire contents of which are incorporated herein by reference. Technical Field

[0002] This article provides techniques related to medical imaging and radiotherapy, particularly (but not limited to) methods and systems for monitoring the safe movement of patient positioning systems, for verifying the setup of patient positioning systems, for verifying the patient's setup on the patient positioning system, and for monitoring patient position to detect patient movement during medical imaging and / or radiotherapy. Background Technology

[0003] Medical imaging and radiation therapy are widely used in the medical diagnosis and treatment of diseases such as cancer. Precisely delivering radiation doses to the parts of the body to be imaged or treated, while avoiding exposure of healthy tissue, maximizes the therapeutic benefits of imaging and treatment and minimizes the risk of unnecessary radiation exposure. Therefore, medical imaging and radiation therapy procedures typically involve stabilizing the patient in a proper position so that the relevant areas of the patient's body to be imaged and / or treated are stable and still. Patient positioning systems support the patient's body in the position used for imaging and / or treatment, thereby providing comfortable patient fixation. Patient positioning systems are configurable devices with multiple movable parts to support and stabilize the patient's torso, arms, legs, hands, feet, head, and neck in the imaging and treatment position. See, for example, U.S. Patent Application Serial No. 17 / 894,335 and U.S. Patent Application Publication No. 20200268327, each of which is incorporated herein by reference. There is a need for technologies that assist healthcare providers in positioning and monitoring patients to improve patient outcomes and enhance the safety and efficiency of medical imaging and radiation therapy. Summary of the Invention

[0004] Accurate and repeatable positioning of the patient positioning system for imaging and treatment, and accurate and repeatable positioning of the patient on the patient positioning system for imaging and treatment, are both important for achieving positive treatment outcomes. See, for example, Verhey (1982) “Precise Positioning of Patients for Radiation Therapy” Int. J. Radiation Oncology Biol. Phys. 8: 289-94, which is incorporated herein by reference. Furthermore, monitoring the position of the patient positioning components during movement and setup is also important to avoid collisions with other objects and people that may be near the patient positioning system during configuration. Monitoring the patient's position and detecting patient movement during imaging and / or treatment improves the accuracy of imaging and / or treatment, reduces radiation exposure to healthy tissues, and can improve patient safety (e.g., by detecting patient falls or misplacement of healthy tissues in locations that may be exposed to radiation).

[0005] For example, a neglected aspect of patient positioning for radiation therapy is surface guidance (SG). SG technology images and monitors the patient's external surfaces to provide initial alignment of the patient's body before assessing the position of internal organs. In other words, detecting misalignment of the patient's external surfaces strongly suggests that internal organs are also misaligned. Therefore, SG technology offers a way to improve the accuracy and efficiency of patient imaging and treatment.

[0006] Therefore, in some embodiments, the technology provides an orthogonal implementation of three cameras (e.g., a top camera and two mutually orthogonal peripheral cameras). In some embodiments, the technology provides a method for correcting the position of an object (e.g., a patient) using the cameras; for example, the top camera shows rotational errors about a vertical (Z) axis and shows X and Y translations; and the peripheral cameras show errors in the vertical direction. In some embodiments, the technology provides a first camera directly facing the object (e.g., the patient), such that lateral movement of the object is detected in the first camera view, and longitudinal movement is detected by the other two cameras orthogonal to the first camera. In some embodiments, the technology provides the ability to obtain four-dimensional correction from the three orthogonal cameras, for example, determining adjustments in the X and Y directions and rotation about the Z axis by aligning the live view from the top camera with a reference image; and determining adjustments in vertical position by aligning the live view from the peripheral cameras with a reference image. In some embodiments, the reference images are grouped into scenes that can be invoked as needed. In some embodiments, the technology provides an interface that allows a user to select a region of interest from a single camera view to provide precise information about the object in the selected region. In some implementations, the camera sends only data within a selected region of interest to the host, thereby reducing the amount of data transferred to the computer and providing a fast frame rate. In some implementations, the technology provides an interface through which a user can select multiple cameras that provide the best view of an object (e.g., the patient) based on the patient's orientation and the camera's position. In some implementations, the technology provides an interface through which a user can draw reference lines (e.g., vertical and / or horizontal lines) on the camera images that do not move with the image. In some implementations, the lines can be adjusted to intersect with reference points (e.g., isocenters) in the treatment room. The lines can serve the same function as laser lines in the room. Moving the object until a point or marker on the object (visible in the live image) intersects a fixed reference line on both cameras allows for alignment of the object with the reference point in the room. In some implementations, the technology provides for offsetting the reference image based on a positional correction (e.g., a correction vector) to be applied to the patient and / or patient support. If the correction vector is applied correctly, the mismatch between the offset reference image and the live view will be minimized and / or eliminated, thus providing a technique for verifying the correct application of the correction vector.

[0007] For example, in some embodiments, the technology provides an Optical Guidance and Tracking System (OGTS). In some embodiments, the OGTS includes a top-mounted camera and a first peripheral camera, wherein the field of view of the top-mounted camera is orthogonal to the field of view of the first peripheral camera. In some embodiments, the OGTS further includes a second peripheral camera, wherein the field of view of the second peripheral camera is orthogonal to the field of view of the top-mounted camera, and the field of view of the second peripheral camera is orthogonal to the field of view of the first peripheral camera. In some embodiments, the OGTS further includes a third peripheral camera, wherein the field of view of any two of the peripheral cameras and the top-mounted camera is mutually orthogonal. In some embodiments, the OGTS further includes a fourth peripheral camera, wherein the field of view of any two of the peripheral cameras and the top-mounted camera is mutually orthogonal.

[0008] In some embodiments, the OGTS further includes a patient support. In some embodiments, the patient support rotates about a vertical (Z) axis. In some embodiments, the field of view of the top-mounted camera is aligned with the vertical (Z) axis.

[0009] In some embodiments, the OGTS further includes a radiation therapy device. In some embodiments, the radiation therapy device includes a static source. In some embodiments, the OGTS further includes a computed tomography (CT) scanner. In some embodiments, the overhead camera provides a view through an aperture in the scan ring of the CT scanner. In some embodiments, the overhead camera includes a color sensor array, and the first peripheral camera includes a color sensor array.

[0010] In some embodiments, the OGTS further includes a processor and a non-transitory computer-readable medium. In some embodiments, the non-transitory computer-readable medium includes a program, and the processor executes the program to acquire color images from the top-mounted camera and images from the peripheral cameras. In some embodiments, the OGTS further includes a display. In some embodiments, the non-transitory computer-readable medium includes a program, and the processor executes the program to overlay live video onto a reference image on the display. In some embodiments, the non-transitory computer-readable medium includes a program, and the processor executes the program to provide a graphical user interface on the display. In some embodiments, a user interacts with the graphical user interface to identify regions of interest in the camera views. In some embodiments, a user interacts with the graphical user interface to align the live video and the reference image on the display. In some embodiments, the processor calculates adjustments in actual space to properly position the patient for treatment. In some embodiments, the OGTS further includes a database containing saved scenes. In some embodiments, the saved scenes include images, information identifying the camera providing the images, and regions of interest of the images. In some embodiments, the first peripheral camera is located on the principal Y-axis of the OGTS. In some embodiments, the first peripheral camera is located on the principal Y-axis of the OGTS, and the second peripheral camera is located on the principal X-axis of the OGTS. In some embodiments, the top-mounted camera is located on the principal Z-axis of the OGTS.

[0011] This technology further provides implementations of the method. For example, in some implementations, the method includes obtaining a first reference image of a patient support and / or a patient; superimposing a first live image of the patient support and / or the patient onto the reference image; aligning the first live image with the first reference image to determine a displacement; and moving the patient support and / or the patient according to the displacement. In some implementations, the first reference image is provided by a first camera, and the first live image is provided by the first camera. In some implementations, the method further includes obtaining a second reference image of the patient support and / or the patient; and superimposing the second live image of the patient support and / or the patient onto the second reference image. In some implementations, the second reference image is provided by a second camera, and the second live image is provided by the second camera; and wherein the field of view of the second camera is orthogonal to the field of view of the first camera. In some implementations, the first camera is a top-mounted camera. In some implementations, the first camera is a peripheral camera. In some implementations, aligning the first live image and the first reference image includes user interaction with a graphical user interface to align the first live image and the first reference image. In some embodiments, aligning the first live image and the first reference image includes using image alignment software to align the first live image and the first reference image. In some embodiments, the saved scene includes the first reference image. In some embodiments, the saved scene includes the first reference image, information identifying the camera providing the first reference image, and the region of interest of the first reference image. In some embodiments, the displacement includes translation in the X, Y, and / or Z directions and / or rotation about the X-axis, Y-axis, and / or Z-axis. In some embodiments, the method further includes determining a relationship between the pixel size of the first camera and distance in actual space. In some embodiments, the method further includes exposing the patient to radiation. In some embodiments, the method further includes imaging the patient using computed tomography.

[0012] Other embodiments of the method include obtaining a first reference image of a patient support and / or the patient; overlaying a first live image of the patient support and / or the patient onto the reference image; shifting the reference image according to a correction vector; applying the correction vector to the patient support and / or the patient; and verifying the correct application of the correction vector using the alignment of the first live image and the first reference image. In some embodiments, the application of the correction vector is considered correct when the first live image and the first reference image are substantially, maximally, or substantially aligned.

[0013] Some sections of this specification describe implementations of the technology based on 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 communicate the substance of their work to others skilled in the art. While these operations are described functionally, computationally, or logically, they should be understood as being implemented by computer programs or equivalent circuits, microcode, etc. Furthermore, without loss of generality, it is sometimes convenient to arrange these operations as modules. The described operations and their associated modules can be embodied in software, firmware, hardware, or any combination thereof.

[0014] Some of the steps, operations, or processes described herein may be performed or implemented by one or more hardware or software modules, alone or in combination with other means. In some embodiments, the software modules are implemented as 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 described steps, operations, or processes.

[0015] In some implementations, the system includes a virtually provided computer and / or data storage (e.g., as a cloud computing resource). In particular implementations, the technology includes using cloud computing to provide a virtual computer system that includes the components as described herein and / or performs the functions of a computer as described herein. Therefore, in some implementations, cloud computing provides the infrastructure, applications, and software as described herein via a network and / or the Internet. In some implementations, computing resources (e.g., data analytics, computation, data storage, applications, file storage, etc.) are provided remotely via a network (e.g., the Internet; and / or cellular networks).

[0016] Implementations of this technology may also relate to devices for performing the operations described herein. Such devices may be specifically constructed for the desired purpose and / or may include general-purpose computing devices selectively activated or reconfigured by computer programs stored in a computer. Such computer programs may be stored on non-transitory, tangible, computer-readable storage media or any type of media suitable for storing electronic instructions, and may be coupled to a computer system bus. Furthermore, any computing system mentioned in the specification may include a single processor or may be an architecture employing a multiprocessor design to increase computing power.

[0017] Based on the teachings contained herein, additional implementation methods will be apparent to those skilled in the art. Attached Figure Description

[0018] These and other features, aspects, and advantages of this technology will be better understood with reference to the following figures.

[0019] Figure 1A This is a perspective view of the patient support, showing the axes of the coordinate system.

[0020] Figure 1B This is a side view of the patient support, showing the axes of the coordinate system.

[0021] Figure 1C This is a schematic diagram illustrating the data structure used in the scenario.

[0022] Figure 1D This is a schematic diagram illustrating the data structure used in the scenario.

[0023] Figure 2A This is a top view of a medical imaging and / or radiotherapy system, which includes an optically guided tracking system (including multiple cameras) and a patient positioning system (e.g., including a patient support).

[0024] Figure 2B A side view of a medical imaging and / or radiotherapy system, including an optically guided tracking system (including multiple cameras) and a patient positioning system (e.g., including a patient support).

[0025] Figure 2C This is a top view of a medical imaging and / or radiotherapy system, which includes an optically guided tracking system (including multiple cameras) and a patient positioning system (e.g., including a patient support).

[0026] Figure 2D A side view of a medical imaging and / or radiotherapy system, including an optically guided tracking system (including multiple cameras) and a patient positioning system (e.g., including a patient support).

[0027] Figure 2E This is a schematic diagram showing three mutually orthogonal cameras.

[0028] Figure 2F The diagram illustrates five cameras. Four cameras are placed on a plane at 90° intervals, and a fifth camera is located above the plane containing the four cameras, forming a 90° angle with each of the four cameras on the plane.

[0029] Figure 3 This is a schematic diagram illustrating three mutually orthogonal cameras and the correction of the patient's position (e.g., translation in the X, Y, and / or Z directions; and / or rotation about the X, Y, and / or Z axes) that can be derived from the view of each camera.

[0030] Figure 4 This is a perspective view of the patient support, indicating the configurable components of the patient support.

[0031] Figure 5A A rendering of a treatment room including upright patient positioning and an imaging system.

[0032] Figure 5B A diagram illustrating a clinical installation of the technology described herein is provided. The diagram shows an upright imaging and / or treatment system, four orthogonal cameras in a horizontal plane, and a top-mounted camera above the isocenter.

[0033] Figure 5C The design of an implementation of the OGTS system located in the treatment room 710, the OGTS control room 720, and the OGTS technology room 730 is shown.

[0034] Figure 5D It shows Figure 5C The view of the middle section A shows treatment room 710.

[0035] Figure 5E It shows Figure 5C The view of section B in the middle shows the control room 720 and the technical room 730.

[0036] Figure 6 The graphical user interface (GUI) of the OGTS software is shown on the monitor of the client computer.

[0037] Figure 7 The OGTS software GUI is shown, displaying a person in a patient support, with each camera zoomed in to a designated region of interest.

[0038] Figure 8 The OGTS software GUI is shown, displaying two scene selection panels. The left panel displays previously recorded setup scenes (e.g., including reference images) for retrieval. The right panel displays recorded treatment scenes (e.g., including reference images).

[0039] Figure 9 The GUI of the OGTS software is shown during the tracking period using reference and live-tracking images. The left and top panels of the GUI show the person's head slightly rotated to the left about the vertical axis, resulting in a significant mismatch between the live position (facing forward of the face) and the previously recorded patient position (shown in the reference image). Lateral alignment remains reasonable.

[0040] Figure 10A A flowchart illustrating the steps of an embodiment of a method for pre-treatment patient fixation and imaging.

[0041] Figure 10BThis is a flowchart illustrating the steps of an implementation of a method for initial patient fixation. The method for initial patient fixation can be performed, for example, with a new patient, a new treatment for a patient, treatment of a new area of ​​the patient, or treatment of a patient in a new position.

[0042] Figure 10C A flowchart illustrating the steps of an implementation of a method for subsequent patient fixation is provided. The method for initial subsequent fixation can be performed, for example, when the patient position, PPA or patient support configuration and / or imaging position have been previously determined and stored in a configuration setting scenario, a patient position setting scenario, and / or an imaging position scenario, respectively.

[0043] Figure 10D A flowchart illustrating the steps of an implementation of a method for obtaining a patient's pre-treatment CT scan.

[0044] Figure 11A A flowchart illustrating the steps of an implementation of a method for treating a patient with radiation is provided.

[0045] Figure 11B A flowchart illustrating the steps of an embodiment of a method for loading a patient onto a suitable PPA or patient support for patient treatment.

[0046] Figure 11C A flowchart illustrating the steps of an implementation of a method for imaging a patient for treatment, for example, by obtaining a treatment CT scan of the patient.

[0047] Figure 11D A flowchart illustrating the steps of an implementation of a method for treating a patient with radiation is provided.

[0048] It should be understood that the accompanying drawings are not necessarily drawn to scale, and the objects in the drawings are not necessarily drawn relative to each other. The drawings are descriptions intended to make clear and understandable various embodiments of the devices, systems, and methods disclosed herein. In all the drawings, the same reference numerals are used as much as 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 this teaching in any way. Detailed Implementation

[0049] This article provides techniques related to medical imaging and radiotherapy, particularly (but not limited to) methods and systems for monitoring the safe movement of patient positioning systems, for verifying the setup of patient positioning systems, for verifying the patient's setup on the patient positioning system, and for monitoring the patient's position during medical imaging and / or radiotherapy.

[0050] The technology presented in this paper is an Optical Guided and Tracking System (OGTS) comprising multiple (e.g., 3, 4, or 5) high-resolution (e.g., approximately 20 megapixels) optical cameras, wherein three or more cameras are positioned orthogonally to each other. The OGTS simultaneously acquires multiple (e.g., at least three) high-resolution two-dimensional images of the patient from at least three directions, thereby providing a simultaneous live view from at least three orthogonal directions. Therefore, using orthogonal live images provides an improved imaging technique compared to conventional techniques that acquire images first and then construct a three-dimensional image.

[0051] OGTS is used in methods that include recording reference images from multiple (e.g., 2, 3, 4, or 5) OGTS cameras when an object (e.g., a patient) is in a desired position and orientation. Furthermore, the method includes saving the reference images to provide a saved reference image for each camera. The reference images can be grouped into a scene and can be recalled as needed. In some implementations, the method includes tracking the position of an object (e.g., a patient) by acquiring live images from multiple cameras and overlaying the live images onto the saved reference images for each camera. In some implementations, the method for repositioning an object (e.g., a patient) includes retrieving a saved reference image from memory (e.g., as part of a saved scene), acquiring live images from multiple cameras, and overlaying the live images onto the saved reference images for each camera. The differences between the live and overlaid images can be used to determine appropriate translations and rotations to reposition the object (e.g., the patient) to reproduce its position in the reference images.

[0052] In the detailed description of the various embodiments, numerous specific details are set forth for illustrative purposes to provide a thorough understanding of the disclosed embodiments. However, those skilled in the art will understand that these various embodiments can be practiced with or without these specific details. In other instances, structures and apparatus are shown in block diagram form. Furthermore, those skilled in the art will readily understand that the specific order in which the methods are proposed and performed is illustrative, and that the order is expected to vary while still remaining within the spirit and scope of the various embodiments disclosed herein.

[0053] All references 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 herein by reference in their entirety for any purpose. Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the various embodiments described herein pertain. Where the definitions of terms in the incorporated references differ from those provided in this teaching, the definitions provided in this teaching shall prevail. Section headings used herein are for organizational purposes only and should not be construed as limiting the subject matter in any way.

[0054] definition To facilitate understanding of this technology, several terms and phrases are defined below. Additional definitions are set forth throughout the detailed description.

[0055] Throughout the specification and claims, unless the context clearly specifies otherwise, the following terms shall take on the meaning explicitly relevant 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 different embodiments, although it may refer to different embodiments. Therefore, as described below, various embodiments of the invention can be readily combined without departing from the scope or spirit of the invention.

[0056] Additionally, as used herein, unless the context explicitly states otherwise, the term "or" is an inclusive "or" operator and is equivalent to the term "and / or". Unless the context explicitly states otherwise, the term "based on" is not exclusive and allows for basing on additional factors not described. Furthermore, throughout the specification, "a / an" and "the" include plural references. "Within" includes both "within" and "on".

[0057] As used herein, the terms “about,” “approximately,” “substantially,” and “significantly” are understood by those skilled 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 those skilled in the art when considering the context in which they are used, “about” and “approximately” mean less than or equal to 10% plus or minus the particular term, and “substantially” and “significantly” mean greater than 10% plus or minus the particular term.

[0058] As used herein, the disclosure of a range includes the disclosure of all values ​​within the entire range and further subdivisions of the range (including endpoints and subranges given for the range). As used herein, the disclosure of a numerical range includes the endpoints and each intermediate number therebetween having the same precision. For example, for the range 6–9, the numbers 7 and 8 are expected in addition to 6 and 9, and for the range 6.0–7.0, the numbers 6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6.9, and 7.0 are explicitly expected.

[0059] As used herein, the suffix "-no" refers to a technical implementation that omits the features of the basic root word of the word with "-no" appended. That is, the term "no X" as used herein means "without X," where X is a technical feature omitted in the "no X" technology. For example, a "calcium-free" composition does not contain calcium, and a "mixing-free" method does not include a mixing step, etc.

[0060] Although the terms “first,” “second,” “third,” etc., may be used herein to describe various steps, elements, compositions, parts, regions, layers, and / or portions, these steps, elements, compositions, parts, regions, layers, and / or portions should not be limited by these terms unless otherwise stated. These terms are used to distinguish one step, element, composition, part, region, layer, and / or portion from another step, element, composition, part, region, layer, and / or portion. Unless the context clearly indicates otherwise, terms such as “first,” “second,” and other numerical terms used herein do not imply sequence or order. Therefore, without departing from the art, a first step, element, composition, part, region, layer, or portion discussed herein may be referred to as a second step, element, composition, part, region, layer, or portion.

[0061] As used herein, the terms “existent” or “non-existent” (or alternatively, “existent” or “non-existent”) are used in a relative sense to describe the quantity or level of a particular entity (e.g., component, effect, element). For example, when an entity is said to “exist,” it means that the level or quantity of that entity is above a predetermined threshold; conversely, when an entity is said to “non-existent,” it means that the level or quantity of that entity is below a predetermined threshold. The predetermined threshold can be a detectability threshold associated with a specific test used to detect the entity or any other threshold. When an entity is “detected,” it “exists”; when an entity is “not detected,” it “non-existent.”

[0062] As used herein, “increase” or “decrease” refers to a detectable (e.g., measurable) positive or negative change in the value of a variable relative to a previously measured value, a predetermined value, and / or a value relative to a standard control. An increase is a positive change relative to a previously measured value, a predetermined value, and / or a standard control, preferably at least 10%, more preferably 50%, even more preferably 2 times, even more preferably at least 5 times, and most preferably at least 10 times. Similarly, a decrease is a negative change relative to a previously measured value, a predetermined value, and / or a standard control, preferably at least 10%, more preferably 50%, even more preferably at least 80%, and most preferably at least 90%. Other terms indicating quantitative changes or differences, such as “more” or “less,” are used herein in the same manner as described above.

[0063] As used herein, "system" refers to a plurality of real and / or abstract components that operate together for a common purpose. In some embodiments, "system" is an integrated collection of hardware and / or software components. In some embodiments, each component of the system interacts with and / or is associated with one or more other components. In some embodiments, system refers to a combination of components and software used to control and direct methods. For example, a "system" or "subsystem" may include one or more of the following or any combination thereof: mechanical devices, hardware, hardware components, circuits, lines, logic designs, logic components, software, software modules, components of software or software modules, software processes, software instructions, software routines, software objects, software functions, software classes, software programs, files containing software, etc., to perform the functions of the system or subsystem. Therefore, methods and apparatus of embodiments, or certain aspects or portions thereof, may take the form of program code (e.g., instructions) embodied in tangible media such as floppy disks, CD-ROMs, hard disk drives, flash memory, or any other machine-readable storage media, wherein the machine becomes the apparatus for practicing the embodiments when the program code is loaded into and executed by the machine such as a computer. When the program code executes on a programmable computer, the computing device typically includes a processor, a processor-readable storage medium (e.g., volatile and non-volatile memory and / or storage elements), at least one input device, and at least one output device. One or more programs may implement or utilize the processes described in conjunction with the embodiments, for example, by using application programming interfaces (APIs), reusable controls, etc. Such programs are preferably implemented in a high-level procedural or object-oriented programming language to communicate with the computer system. However, if desired, one or more programs may be implemented in assembly language or machine language. In any case, the language may be a compiled or interpreted language and combined with the hardware implementation.

[0064] 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, computed tomography (CT) involves using an x-ray source and a detector that rotates around the patient, followed by the reconstruction of images onto different planes. In embodiments of CT described herein (e.g., devices, apparatuses, 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).

[0065] As used herein, the term "constructed as [verb]" means that the identified element or component has a structure that is shaped, sized, set, connected, and / or configured to perform the identified verb. For example, a component "constructed to move" is movably connected to another element and includes an element that causes the component to move, or the component is otherwise configured to move in response to other elements or components. Thus, as used herein, "constructed as [verb]" describes structure rather than function. Furthermore, as used herein, "constructed as [verb]" means that the identified element or component is intended and designed to perform the identified verb.

[0066] As used herein, the term "associated" means that elements are part of the same component and / or operate together or interact with each other in some way. For example, a car has four tires and four wheel covers. While all elements are connected as part of the car, it is understood that each wheel cover is "associated" with a specific tire.

[0067] As used herein, the term "connection" refers to two or more components fixed together by any suitable means. Therefore, in some embodiments, the expression "connected" of two or more parts or components should mean that these parts are directly or indirectly connected or operate together, for example, through one or more intermediate parts or components. As used herein, "direct connection" means that two elements are in direct contact with each other. As used herein, "fixed connection" or "fixed" means that two components are connected so as to move as a whole while maintaining a constant orientation relative to each other. Therefore, when two elements are connected, all parts of these elements are connected. However, when describing the connection of a specific part of a first element to a second element, for example, the connection of the first end of an axle to a first wheel, it means that the specific part of the first element is positioned closer to the second element than its other parts. Furthermore, unless the upper object is otherwise substantially held in place, an object resting on another object held in place only by gravity is not "connected" to the lower object. That is, for example, a book on a table is not connected to it, but a book glued to the table is connected to it.

[0068] As used herein, the terms "removable connection" or "temporary connection" mean that one component is connected to another component in a substantially temporary manner. That is, the two components are connected in a way that allows for easy connection or separation of the components without damaging them. Therefore, components with a "removable connection" can be easily disconnected and reconnected without causing damage to the components.

[0069] As used herein, the term "operably coupled" means that multiple elements or components are coupled such that when a first element moves from one location / configuration to another, a second element also moves between locations / configurations, wherein each of the multiple elements or components is movable between the first and second locations, or between the first and second configurations. It is noteworthy that the first element is "operably coupled" to another element, and vice versa.

[0070] As used herein, the term “rotatably coupled” means two or more components coupled in such a way that at least one component can rotate relative to the other component.

[0071] As used herein, the term “translationally coupled” refers to two or more components coupled in such a manner that at least one component can be translated relative to the other component.

[0072] As used herein, the term "temporarily set" 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 move without disengaging or otherwise manipulating it. For example, a book is simply placed on a table, for instance, without being glued or secured to the table, but is "temporarily set" on the table.

[0073] As used herein, the term "corresponding" means that two structural components are similar in size and shape to each other and are joined with minimal friction. Therefore, the opening "corresponding" to a component is slightly larger than the component, allowing the component to pass through the opening with minimal friction. This definition can be modified if the two components fit together "closely." In this case, the difference in component size is even smaller, thus increasing the amount of friction. If the element defining the opening and / or the component inserted into the opening is made of a deformable or compressible material, the opening can even be slightly smaller than the component inserted into the opening. Regarding surfaces, shapes, and lines, two or more "corresponding" surfaces, shapes, or lines generally have the same size, shape, and profile.

[0074] As used herein, the term "travel path" or "path" when used in association with a moving element includes the space through which the element moves during its motion. Therefore, all inherently moving elements have a "travel path" or "path".

[0075] As used herein, the expression “engages” two or more parts or components with each other shall mean that the elements apply force or bias to each other 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 it is in the described position. Therefore, it should be understood that the expressions “when element A moves to the first position of element A, element A engages element B” and “when element A is in the first position of element A, element A engages element B” are equivalent expressions and mean that element A engages element B either when it moves to the first position of element A and / or when element A is in the first position of element A.

[0076] As used herein, the term "operably engaged" means "engaged and movable." That is, when used relative to a first component that is configured to move or rotate, "operably engaged" means that the first component applies a force sufficient to cause the second component to move. For example, consider placing a screwdriver in contact with a screw. When no force is applied to the screwdriver, it is merely "attached" to the screw. If an axial force is applied to the screwdriver, it presses against the screw and "engages" it. However, when a rotational force is applied to the screwdriver, it "operably engages" the screw and causes it to rotate. Furthermore, for electronic components, "operably engaged" means that one component controls another component via a control signal or current.

[0077] As used herein, the term "orthogonal" means perpendicular, substantially perpendicular, or essentially perpendicular. Two orthogonal parts or elements (e.g., objects, lines, line segments, vectors, or axes) intersect at a 90° angle at their point of intersection.

[0078] As used herein, the term “quantity” should refer to an integer of one or more (e.g., multiple).

[0079] As used herein, in the phrases “[x] moves between its first and second positions” or “[y] is constructed to move [x] between its first and second positions,” “[x]” is the name of the element or component. Furthermore, when [x] is an element or component that moves between multiple positions, the pronoun “its” refers to “[x]”, i.e., the named element or component preceding the pronoun “its.”

[0080] As used herein, the “radial side / surface” of a circular or cylindrical body is a side / surface that extends around or through a height line at its center. As used herein, the “axial side / surface” of a circular or cylindrical body is a side extending in a plane substantially perpendicular to the height line at its center. That is, generally speaking, for a cylindrical soup pot, the “radial side / surface” is the substantially circular sidewall, and “one or more axial side / surfaces” are the top and bottom of the soup pot.

[0081] As used herein, a “diagnostic” test includes detecting or identifying a subject’s disease state or condition, 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 treatment, determining the prognosis (or possible progression or regression) of a subject with a disease or condition, and determining the effect of treatment on a subject with a disease or condition. For example, a diagnosis can be used to detect the presence or likelihood of a subject having cancer, or the likelihood that such a subject will have a favorable response to a compound (e.g., a drug, such as a pharmaceutical product) or other treatment.

[0082] As used in this article, the term "symptom" generally refers to a disease, pathology, injury, event, or change in health status.

[0083] As used herein, the term "treating" or "treatment" in relation to a condition means preventing the condition, slowing the onset or progression 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, generating complete or partial remission of the condition, or some combination thereof. In some embodiments, "treatment" includes exposing a patient or a part thereof (e.g., tissues, organs, body parts, or other local areas of the patient's body) to radiation (e.g., electromagnetic radiation, ionizing radiation).

[0084] 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 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.

[0085] As used herein, the terms "patient" or "subject" refer to a mammal 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 for clinical research. In some embodiments, the subject or patient has cancer and / or the subject or patient has been identified as having cancer or at risk of developing cancer.

[0086] As used herein, the terms "treatment volume" or "imaging volume" refer to the volume (e.g., tissue) of a patient selected for imaging and / or treatment with radiation. For example, in some embodiments, the "treatment volume" or "imaging volume" includes a tumor within a cancer patient. As used herein, the term "healthy tissue" refers to a patient volume (e.g., tissue) that is not and / or does not include the treatment volume. In some embodiments, the imaging volume is larger than and includes the treatment volume.

[0087] 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, a 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, a source produces particles (e.g., photons, electrons, neutrons, hadrons, ions (e.g., protons, carbon ions, other heavy ions)). In some embodiments, a source produces electromagnetic waves (e.g., X-rays and gamma rays with 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 a wave and sometimes as a particle. Therefore, without limiting the technique and understanding the quantum mechanical laws that stipulate that every particle or quantum entity is described as a particle or a wave, both descriptions will be used throughout.

[0088] As used herein, the term "static source" refers to a source that does not rotate around a patient during imaging or treatment. Specifically, the "static source" remains fixed relative to an axis passing through the patient during imaging or treatment. Although the patient may rotate around said axis to create a relative motion between the static source and the rotating patient equivalent to the relative motion of the source rotating around the static patient, the static source does not move during imaging or treatment with reference to a third object, a frame of reference (e.g., the patient's examination room), or the patient's axis of rotation, even though the patient rotates relative to said third object, said frame of reference (e.g., the patient's examination room), or the patient's axis of rotation during imaging or treatment. The static source can be mounted on a mobile platform, and the static source can move relative to the ground and fixed objects on the ground as the mobile platform moves to transport the static source. Therefore, the term "static source" can refer to a moving "static source" provided that the moving "static source" does not rotate around an axis of rotation passing through the patient during imaging or treatment. Additionally, a static source can be translated and / or rotated around the patient to position the static source before or after imaging or treatment of the patient. Therefore, the term "static source" can refer to a source that is translated or rotated around the patient during non-imaging and non-treatment use, such as positioning the source relative to the patient when the patient is not receiving imaging and / or treatment. In some implementations, the "static source" is a photon source and is therefore referred to as a "static photon source."

[0089] Implementations of the techniques described herein involve spatial positioning, translation along an axis, and / or rotation about an axis. In some implementations, a three-dimensional coordinate system is used, comprising an X-axis, Y-axis, and Z-axis defined relative to the patient support and / or the patient. See also Figure 1A and Figure 1B .like Figure 1A and Figure 1B As shown, the embodiment uses a coordinate system in which the X-axis and Y-axis lie together in and / or define a horizontal plane, and the Z-axis lies in and / or defines a vertical axis. Relative to a patient positioned on a patient support (e.g., a patient support in a patient positioning device or system), the X-axis is a left-right axis, a horizontal axis, or a frontal axis; the Y-axis is an anteroposterior axis, a dorsal-ventral axis, or a sagittal axis; and the Z-axis is a sagittal axis or a longitudinal axis. The X-axis and Y-axis lie together in and / or define a horizontal, lateral, and / or axial plane. The Y-axis and Z-axis lie together in and / or define a sagittal or longitudinal plane. The X-axis and Z-axis lie together in and / or define a frontal or coronal plane.

[0090] Therefore, in some embodiments, "forward" or "backward" movement is described as movement along the Y-axis; "left" or "right" movement is described as movement along the X-axis; and "up" and "down" movement is described as movement along the Z-axis. Furthermore, "roll" rotation is described as rotation about the Y-axis; "pitch" rotation is described as rotation about the X-axis; and "yaw" rotation is described as rotation about the Z-axis. The rotation angles about the X, Y, and Z axes can be represented as ψ (Pussy), φ (Phoney), and θ (Theta), respectively. Thus, in some embodiments, the technique is described as having six degrees of freedom, for example, translation along one or more of the X, Y, and / or Z axes; and / or rotation about one or more of the X, Y, and / or Z axes. Adjusting or changing position by translation in the X, Y, and Z directions can be represented by ΔX, ΔY, and ΔZ, respectively. The position can be adjusted or changed by rotating around the X-axis, Y-axis, and Z-axis, respectively, and can be represented by Δψ, Δφ, and Δθ.

[0091] As used herein, the term "scene" refers to a reference image and / or set of reference images, information identifying one or more cameras that captured the reference image and / or set of reference images, and the region of interest (ROI) settings for each camera used to capture the reference image and / or set of reference images. Scenes can be stored in and retrieved from non-volatile storage media to provide the retrieved scene. For example, a scene can be stored when a reference image is acquired, as well as for patient positioning settings, patient positioning device configuration settings, or imaging settings. Each image or set of reference images can be stored along with scene information associated with identifying the camera that acquired the reference image and the region of interest of the camera at the time the reference image was acquired. The information used to identify the camera can be any information that explicitly identifies the camera and is continuously or substantially continuously associated with the camera (e.g., at least between capturing the reference image with the camera and using the reference image for imaging the patient positioning device and / or patient). In some implementations, the information used to identify the camera is, for example, a hardware address (e.g., an Ethernet address, a Media Access Control (MAC) address, a static Internet Protocol (IP) address, or other identifiers (e.g., "Camera 1", "Camera 2", "Camera 3", "Camera 4", "Camera 5", etc.). The region of interest (ROI) of the camera may indicate the zoom level of the camera lens, or it may identify a subset of camera sensor pixels shown or saved as an image (e.g., "digital zoom") (e.g., a sensor array region including the pixel subset). Therefore, in some implementations, the ROI setting associated with the camera describes the camera sensor region providing the image pixels saved in the reference image. The ROI setting can then be used to select the same region of the camera sensor for providing live video to be overlaid on the saved reference image.

[0092] Therefore, scene information identifying the selected camera list and the region of interest of each camera identifies the cameras used to acquire and display live tracking images of the patient, as well as the sensor pixels of each camera, for alignment with reference images previously acquired using the selected camera list and the region of interest of each selected camera. Figure 1C The illustration shows an exemplary implementation of scene 500 data recording, which includes multiple images (images 511, 512, 513, 514, and 515 (e.g., at least three of which show views orthogonal to each other)), a camera list 520 for recording images (e.g., a list of explicit identifiers associated one-to-one with each physical camera of the OGTS), and a region of interest list 530 for each camera in the camera list. The scene can be retrieved to provide multiple reference images. Although Figure 1C The illustration shows a scene comprising five images, along with associated cameras and ROI information for the five cameras; however, the technique is not limited to scenes comprising five images. A scene can include 1, 2, 3, 4, or 5 images, and associated information identifying 1, 2, 3, 4, or 5 cameras and 1, 2, 3, 4, or 5 ROIs. For example, a particular implementation involves storing and retrieving a scene comprising three images taken by three mutually orthogonal cameras, a list of the three mutually orthogonal cameras, and a list of each ROI comprising each of the three mutually orthogonal cameras used to generate each of the three images. See also Figure 1D .

[0093] Furthermore, while some implementations described herein relate to an OGTS system including five cameras, the envisioned implementations include more than five cameras, and the scenarios include images, camera lists, and ROI information from more than five cameras.

[0094] The sensor includes a pixel region comprising a matrix of N × M elements (called pixels or photosensitive points), where N represents the number of columns and M represents the number of rows. Each pixel includes a photosensitive area for accumulating incident light energy in the form of charge, and a transistor for controlling pixel operation and providing information from the pixel to a microprocessor and / or memory.

[0095] As used herein, the term “region of interest” (abbreviated as “ROI”) refers to a portion of a sensor selected for generating an image (e.g., for display in a window of the OGTS GUI). A sensor comprises an array of pixels (also called photosensitive points), and the ROI defines a subarray (e.g., a rectangular subarray) of sensor pixels that is read by the processor to form an image. Selecting a subarray of pixels from the sensor can also be referred to as “windowing.” Selecting an ROI is advantageous for providing magnified images of an object (e.g., a patient) or a portion of an object (e.g., a portion of a patient). Selecting an ROI also improves the display and refresh frame rate of the image in the OGTS GUI window. By selecting an ROI to reduce the number of pixels to be read, transferred, and displayed, the display throughput of the image per unit time is increased while maintaining a constant pixel throughput per unit time. Performing analysis or computation on a subset of pixels also improves the efficiency of performing analysis or computation on the image. For example, a gigabit data transfer rate provides a frame rate of approximately 2 frames per second for a 20-megapixel image. However, selecting a ROI of 4,000,000 pixels (e.g., described by approximately 100 megabits of data) increases the frame rate to approximately 10 frames per second. In some implementations, the region of interest (ROI) is defined by indicating the first and second pixels at opposite corners of a rectangular pixel subarray of the sensor. In some implementations, the ROI is defined by indicating the pixels at one corner of the rectangular pixel subarray of the sensor, as well as the height and width of the pixel subarray. In some implementations, the ROI is defined by indicating one or more pixels that define its perimeter (e.g., a regular or irregular shape). In some implementations, selection circuitry is used to provide control signals to selected pixels of the ROI.

[0096] As used in this article, the term "spatial resolution" for a camera refers to the camera's ability to resolve and reproduce the details of objects in a captured image. In other words, the term "spatial resolution" refers to the minimum distance at which a camera can distinguish different points of an object as individual points in an image of the object.

[0097] Image acquisition, storage, manipulation, and display technologies, such as those employed by Brinkmann, The Art and Science of Digital Compositing As described in (The Morgan Kaufmann Series in Computer Graphics, 2ndedition, Elsevier 2008), which is incorporated herein by reference.

[0098] Optical guidance tracking system The technology described herein provides an Optical Guided Tracking System (OGTS). In some embodiments, the OGTS is used with a patient positioning device (e.g., as described in U.S. Patent No. 11,529,109 (Patient Positioning Device), which is incorporated herein by reference) and / or a patient positioning system including a patient support (e.g., as described in U.S. Patent Application Serial No. 17 / 894,335 (Patient Positioning System), which is incorporated herein by reference). In some embodiments, the technology provided herein is used with a patient support, which is a component or subsystem of the patient positioning device or patient positioning system, as described in U.S. Patent No. 11,529,109 and / or U.S. Patent Application Serial No. 17 / 894,335. In some embodiments, the OGTS is used with medical imaging equipment (e.g., magnetic resonance imaging equipment, CT scanners (e.g., as described in U.S. Patent Application Serial No. 17 / 535,091, which is incorporated herein by reference), etc.). In some implementations, OGTS is used in conjunction with radiation therapy devices (e.g., radiation sources (e.g., fixed radiation sources)) for particle therapy (e.g., photon (e.g., x-ray) and / or hadron (e.g., proton) therapy). Figure 1A and Figure 1B An exemplary patient positioning device or patient support and its associated coordinate system are shown. Figures 2A to 2D A medical imaging and treatment system is shown, comprising a patient positioning device or patient support, a patient, and an OGTS component.

[0099] For example, such as Figures 2A to 2D As shown, an embodiment provides an OGTS 200, which includes a patient positioning system 220 (e.g., including a patient 900) and a camera system. In some embodiments, the OGTS is used in conjunction with a medical imaging device (e.g., a CT scanner 210). In some embodiments, the OGTS is used in conjunction with a radiation source (e.g., a static radiation source) to deliver a beam of therapeutic particles (e.g., photons, protons) to the patient.

[0100] OGTS has a main X-axis of 801 ( Figure 2A and Figure 2C ), principal Y-axis 802 ( Figure 2A and Figure 2C ) and main Z-axis 803 ( Figure 2B and Figure 2D ).like Figures 2A to 2D As further shown, the camera system includes a top-mounted camera 235 ( Figure 2B and Figure 2D ) and one or more peripheral cameras 231, 232, 233 and / or 234 ( Figure 2A and Figure 2BIn some embodiments, the system described herein includes any two, any three, or all four cameras 231, 232, 233, and / or 234. In some embodiments, the camera system includes a top-mounted camera 235 and at least two peripheral cameras 231, 232, 233, and / or 234. Figures 2A to 2D In some embodiments, the camera system includes a top-mounted camera 235 and four peripheral cameras 231, 232, 233, and 234. Figures 2A to 2D In some embodiments, the overhead camera 235 is positioned on the main Z-axis 803 of the patient positioning system 220 and / or the CT scanner 210. In some embodiments, the camera system includes two (e.g., at least two (e.g., two, three, or four)) peripheral cameras surrounding the periphery of the patient positioning system 220 (e.g., including the patient 900) and / or the CT scanner 210. Figure 2A and Figure 2C They are distributed at 90° intervals (e.g., substantially and / or essentially 90°).

[0101] In some implementations, cameras are used to monitor and / or correct the position of an object, for example, using a top-mounted camera to view and / or correct rotational errors of the object about the Z-axis, and to view and / or correct translational errors in the X or Y direction; and using one or more peripheral cameras to view and / or correct translational errors in the X, Y, or Z directions, and / or to view and / or correct rotational errors about the X, Y, or Z axis. The advantage of this technology is that it allows for the use of three orthogonal camera views and previously saved reference images to obtain corrections to the object's position (e.g., 4-degree correction) without requiring mathematical calculations to determine spatial transformations. In some implementations, the object is a patient.

[0102] As described herein, the technology does not limit the placement of the peripheral cameras, as long as two of the peripheral cameras are orthogonal to each other and each of the peripheral cameras is orthogonal to the top camera. Embodiments including exemplary camera placement positions are described below. The camera placement can be adjusted based on these exemplary positions to accommodate components of an imaging system, a radiotherapy system, or a patient positioning device used with an OGTS.

[0103] For example, such as Figure 2A and Figure 2C As shown, the embodiment provides a camera system including two, three, or four peripheral cameras 231, 232, 233, and / or 234, which are distributed at 90° (e.g., substantially and / or substantially 90°) intervals around the periphery of the patient positioning system 220 (e.g., including the patient 900) and / or the CT scanner 210.

[0104] In some implementations, two, three, or four peripheral cameras 231, 232, 233, and / or 234 are positioned on the main axes X and / or Y of the patient positioning system 220. Figure 2C and Figure 2D ).exist Figure 2C In this case, one or two peripheral cameras 232 and / or 234 are obscured by components of the CT scanner 210 and cannot be seen (e.g., as shown in the image). Figure 2C (As shown by the dashed rectangle in the diagram). One or two peripheral cameras 231 and / or 233 are positioned in front of and / or behind the patient positioning system 220. Figure 2D In the middle, the peripheral camera 233 (if present) is obscured by the patient positioning system 220 and / or the patient 900 and is therefore not visible. Figure 2C and Figure 2D The camera arrangement shown in this embodiment allows an object of interest (e.g., patient 900) to face one of the cameras. Therefore, the embodiment provides the ability to detect lateral movement of the object using the camera facing it, and longitudinal movement using other cameras (e.g., two other cameras) orthogonal to the camera facing it.

[0105] In addition, such as Figure 2A and 2B As shown, the embodiment provides that two, three, or four of the peripheral cameras 231, 232, 233, and / or 234 are positioned at locations displaced relative to the main X-axis 801 or main Y-axis 802 of the patient positioning system 220 and / or CT scanner 210, the displacement being a 45° rotation (e.g., substantially and / or substantially 45°) around the main Z-axis 803 in the XY plane.

[0106] Placement of top-mounted camera 235 ( Figure 2B and Figure 2D One or more peripheral cameras 231, 232, 233 and / or 234 are for imaging the patient positioning system 220 and the patient 900 positioned on the patient positioning system 220. Therefore, the top-mounted camera 235 ( Figure 2B and Figure 2D One or more peripheral cameras 231, 232, 233 and / or 234 provide multiple views of the patient positioning system 220 and the patient 900 positioned on the patient positioning system 220. The top camera 235 is positioned to provide a top view of the patient positioning system 220 and / or the patient 900, for example, through the central opening (e.g., a hole) of the scanning ring of the CT scanner 220. Figure 2A and Figure 2CViews of patient positioning system 220 and patient 900 are shown, viewed through the central opening of the scan ring by top-mounted camera 235. In some embodiments, adjacent peripheral camera pairs (e.g., 231 and 232, 232 and 233, 233 and 234, or 234 and 231) provide two views (e.g., orthogonal views) of patient positioning system 220 and / or patient 900 for constructing a three-dimensional image of patient positioning system 220 and / or patient 900 (e.g., using triangulation). See, for example, Hartley and Zisserman, Multiple View Geometry in Computer Vision (Cambridge University Press (New York), 2nd edition, 2003, incorporated herein by reference. In some embodiments, three or four cameras 231, 232, 233 and / or 234 provide three or four views of the patient positioning system 220 and / or the patient 900, which are used in conjunction with the views provided by the overhead camera 235 to construct a three-dimensional image (e.g., a surface rendering) of the patient positioning system 220 and / or the patient 900.)

[0107] In some implementations, the top camera 235 and two adjacent peripheral cameras 231, 232, 233 and / or 234 are positioned in space such that the principal axes of the field of view of the three cameras (e.g., top camera 235, peripheral camera 231 and peripheral camera 232; top camera 235, peripheral camera 232 and peripheral camera 233; top camera 235, peripheral camera 233 and peripheral camera 234; or top camera 235, peripheral camera 234 and peripheral camera 231) are orthogonal to each other in three-dimensional space. Figure 2E .

[0108] In some specific embodiments, the top-mounted camera 235 is positioned in space such that the principal axis of the field of view of the top-mounted camera 235 is perpendicular to the principal axis of the field of view of each of the peripheral cameras 231, 232, 233, and 234 (e.g., the principal axis of the field of view of the top-mounted camera 235 is perpendicular to the principal axis of the field of view of the peripheral camera 231, the principal axis of the field of view of the top-mounted camera 235 is perpendicular to the principal axis of the field of view of the peripheral camera 232, and the principal axis of the field of view of the top-mounted camera 235 is perpendicular to the principal axis of the field of view of the peripheral camera 234). The main axis of the field of view of camera 233, and the main axis of the field of view of top camera 235 are perpendicular to the main axis of the field of view of peripheral camera 234; and each adjacent pair of peripheral cameras (e.g., 231 and 232, 232 and 233, 233 and 234 and 234 and 231) are positioned in space such that the main axis of the field of view of each adjacent pair of peripheral cameras (e.g., 231 and 232, 232 and 233, 233 and 234 and 234 and 231) is perpendicular. Figure 2F .

[0109] In some implementations, the OGTS includes five cameras arranged as follows: Figure 2F As shown, it has a top-mounted camera 235 and four peripheral cameras 231, 232, 233 and 234, which are distributed at 90° intervals and each forms a 90° angle with the top-mounted camera 235. Figure 2F The illustrated arrangement can be modified to accommodate components in imaging and medical systems that may obstruct the installation of a complete five-camera system. Therefore, the technology includes an OGTS system comprising a top-mounted camera 235 and two, three, or four peripheral cameras 231, 232, 233, and / or 234, wherein at least three cameras are orthogonal to each other. Two-dimensional images provided from the three orthogonal views can be used to align the patient in the XY, XZ, and YZ planes, respectively. Figure 3 .

[0110] In some embodiments, cameras 231, 232, 233, 234, and / or 235 are typically positioned at a distance of approximately 2.5 to 4.0 meters (e.g., 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, or 4.0 meters) from the isocenter of the medical imaging and / or radiation therapy system including the patient positioning system 220.

[0111] The camera system includes multiple cameras. In some embodiments, the cameras have a spatial resolution of 1.0 mm or better (e.g., spatial resolutions of 1.00 mm, 0.95, 0.90, 0.85, 0.80, 0.75, 0.70, 0.65, 0.60, 0.55, 0.50, 0.45, 0.40, 0.35, 0.30, 0.25, 0.20, 0.15, or 0.10 mm), where better or higher resolution refers to a lower spatial resolution. In some implementations, the camera has a spatial resolution of 0.5 mm or better (e.g., spatial resolutions of 0.50, 0.49, 0.48, 0.47, 0.46, 0.45, 0.44, 0.43, 0.42, 0.41, 0.40, 0.39, 0.38, 0.37, 0.36, 0.35, 0.34, 0.33, 0.32, 0.31, 0.30, 0.29, 0.28, 0.27, 0.26, 0.25, 0.24, 0.23, 0.22, 0.21, 0.20, 0.19, 0.18, 0.17, 0.16, 0.15, 0.14, 0.13, 0.12, 0.11, or 0.10 mm). In some implementations, the camera has a spatial resolution of 0.5 mm or better in close-up zoom mode (e.g., spatial resolutions of 0.50, 0.49, 0.48, 0.47, 0.46, 0.45, 0.44, 0.43, 0.42, 0.41, 0.40, 0.39, 0.38, 0.37, 0.36, 0.35, 0.34, 0.33, 0.32, 0.31, 0.30, 0.29, 0.28, 0.27, 0.26, 0.25, 0.24, 0.23, 0.22, 0.21, 0.20, 0.19, 0.18, 0.17, 0.16, 0.15, 0.14, 0.13, 0.12, 0.11, or 0.10 mm).

[0112] In some implementations, the camera has a refresh rate of at least 5 Hz (e.g., at least 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 Hz). However, while some implementations of the technology do not require a high refresh rate, the technology is not limited to cameras with refresh rates of approximately 5 to 30 Hz, and also covers the use of cameras with higher refresh rates, such as 60 Hz, 120 Hz, or 240 Hz or more.

[0113] In some embodiments, one or more cameras include accelerometers and / or other components (e.g., gyroscopes, magnetometers) for determining the camera's orientation and / or position in space. In some embodiments, quaternion orientation solutions are provided using accelerometer and gyroscope data to determine the camera's orientation and / or position. In some embodiments, the OGTS includes beacons placed in static and known locations for determining the camera's orientation and / or position.

[0114] In some implementations, the camera has a color sensor comprising approximately 20 megapixels. For example, in some implementations, the camera has a sensor array of 5,496 pixels × 3,672 pixels, thus having a sensor comprising 20,181,312 pixels (also referred to as "photosensitive points"), or approximately 20.2 megapixels. The technology is not limited to cameras comprising approximately 20 megapixels. In some implementations, the camera includes 5 to 10 megapixels (e.g., 5.0, 5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7, 5.8, 5.9, 6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6.9, 7.0, 7.1, 7.2, 7.3, 7.4, 7.5, 7.6, 7.7, 7.8, 7.9, 8.0, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.8, 8.9, 9.0, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.8, 9.9, or 10.0 megapixels). In some implementations, the camera includes more than 20 megapixels. For example, implementations include using a camera with 20 or more, 30 or more, 40 or more, 50 or more, or 60 or more megapixels. Each sensor pixel transmits an electrical signal corresponding to the number of photons contacting that sensor pixel. The electrical signal is converted into a brightness value for all sensor pixels. The brightness value of each sensor pixel provides a signal for generating the image pixels in the final image. Therefore, a camera with a sensor comprising 5,496 sensor pixels × 3,672 sensor pixels will generate an image comprising 5,496 image pixels × 3,672 image pixels.

[0115] Implementations include determining or otherwise providing a relationship between real-world distance and the number of pixels (e.g., sensor pixels or image pixels) corresponding to that real-world distance. For example, a camera with a 1.0-meter horizontal field of view, captured by a sensor comprising 3,672 columns of pixels, has a horizontal relationship of 0.2723 mm per pixel. The same camera with a 1.5-meter vertical field of view, captured by a sensor comprising 5,496 rows of pixels, has a vertical relationship of 0.2729 mm per pixel. Therefore, in some implementations, the relationship between real-world distance and the number of pixels is approximately 0.27 mm per pixel (e.g., approximately 0.3 mm). That is, an offset of one pixel in the first image relative to the second image indicates that the object has been translated approximately 0.3 mm in the real world.

[0116] The camera provides images including red, green, and blue channels (e.g., RGB images). In some embodiments, the camera is a high-resolution gigabit Ethernet (GigE) camera. Therefore, in some embodiments, the camera transmits Ethernet frames at a rate of at least one gigabits per second. In some embodiments, the camera is connected to a wireless communication module or a wired communication medium, such as fiber optic cable (e.g., 1000BASE-X), twisted-pair cable (e.g., 1000BASE-T), or shielded balanced copper cable (e.g., 1000BASE-CX). In some embodiments, the camera receives power through the same cable used for data transmission (e.g., twisted-pair Ethernet cable), for example, the camera receives power through an Ethernet cable (e.g., Power over Ethernet (PoE)); and in some embodiments, the camera is powered by a separate external power supply.

[0117] In some embodiments, the camera includes multiple output interfaces (e.g., multiple GigE output interfaces), each output interface (e.g., each GigE output interface) providing output for each of multiple image data channels. For example, in some embodiments, the camera outputs image data in a red channel (e.g., including image data corresponding to a wavelength of approximately 550-750 nm), a green channel (e.g., including image data corresponding to a wavelength of approximately 450-650 nm), and a blue channel (e.g., including image data corresponding to a wavelength of approximately 350-550 nm), and the camera has an output interface (e.g., a GigE output interface) for each of the red, green, and blue channels. That is, in some embodiments, the camera has a red image channel output (e.g., a red image channel GigE output), a green image channel output (e.g., a green image channel GigE output), and a blue image channel output (e.g., a blue image channel GigE output).

[0118] In some implementations, a pixel comprises three elements that provide each of the red, green, and blue signals for light contacting the pixel. Each color element is digitized to provide a range of intensities. In some implementations, the intensity of each color is described using 8 bits (1 byte), thus creating a range of 256 intensity values ​​for each color. Therefore, according to this example, each pixel provides 3 bytes or 24 bits of data. Thus, one frame of a 20-megapixel image is described by 20 megapixels × 24 bits / pixel = 480 megabits of data. Therefore, a gigabit data transfer rate provides a frame rate of approximately 2 frames per second for a complete 20-megapixel image.

[0119] In some embodiments, the camera is a mirrorless camera conforming to a Miniature Three-Quarter (MFT) system. In some embodiments, the camera includes an MFT lens. In some embodiments, the camera includes a motorized zoom / focus / aperture MFT lens, for example, for controlling the field of view, providing sufficient imaging detail, and / or imaging all or most of the patient and / or patient positioning system. In some embodiments, the camera is mounted to a pan-tilt unit that includes a mechanism for horizontally rotating and / or tilting the camera. In some embodiments, the OGTS includes a virtual pan-tilt module that cropps the image accordingly, thereby replacing the mechanical pan-tilt mechanism. In some embodiments, the OGTS includes a thermal imager (e.g., infrared) camera. In some embodiments, the thermal imager camera is used to monitor and / or detect the patient's respiratory and circulatory systems.

[0120] In some implementations, the OGTS includes a computer. Exemplary computers used in the implementations of the techniques described herein are industrial computers that include an Intel Core i9 central processing unit, 32 gigabytes of random access memory, one or more non-volatile memory fast interface (NVMe) solid-state drives (SSDs) for storing data and instructions, and a graphics processing unit (e.g., an NVIDIA GPU). In some implementations, the computer communicates with the camera via an application programming interface (API), such as using a generic programmable interface (API). In some implementations, the API conforms to the GENICAM standard (e.g., GENICAM version 2.1.1, which is incorporated herein by reference).

[0121] system In some embodiments, the technology relates to a system. In some embodiments, the system includes an OGTS as described herein and a computer, such as those described above and in the examples. In some embodiments, the system includes an OGTS, a computer, and a patient positioning system including a patient support or patient positioning device. In some embodiments, the system includes an OGTS as described herein and software and / or hardware components configured to rotate and / or translate the patient positioning system, the patient positioning device, and / or the patient support or configurable components thereof. For example, in some embodiments, the system includes a motor, a power supply, and software configured to power the motor to translate and / or rotate the patient positioning system, the patient positioning device, and / or the patient support or configurable components thereof, coupled to the patient positioning system, the patient positioning device, and / or the patient support or configurable components thereof. In some embodiments, the system includes software components configured to perform the methods described herein, such as determining adjustments (e.g., one or more of ΔX, ΔY, ΔZ, Δψ, Δφ and / or Δθ) and / or movements (e.g., translation and / or rotation) of a patient positioning system, patient positioning device, patient support, and / or configurable components thereof.

[0122] In some embodiments, the system includes an OGTS and a controller as described herein. In some embodiments, the OGTS communicates with the controller. In some embodiments, the controller activates the OGTS (e.g., activates one or more cameras of the OGTS) and collects one or more images from one or more cameras. In some embodiments, the controller controls the regions of interest displayed by one or more cameras. In some embodiments, the controller communicates with a graphics display terminal for displaying live images from one or more cameras. In some embodiments, the controller communicates with a graphics display terminal for displaying previously saved reference images (e.g., from a scene). In some embodiments, the controller communicates with a user input device (such as a keyboard) for receiving instructions from a user. In some embodiments, the controller has a general-purpose computer architecture including one or more processors communicating with memory for storing non-transient control programs. In some embodiments, the controller communicates with memory to store images from one or more cameras, retrieve previously acquired reference images from one or more cameras, store and / or retrieve scene settings and region of interest settings for one or more cameras.

[0123] In some embodiments, the system includes software configured to perform image recording, image analysis, image storage, image manipulation, image registration, and / or image comparison methods. In some embodiments, the system includes hardware components, such as microprocessors, graphics processors, and / or communication buses, configured to communicate, record, analyze, store, manipulate, and / or compare images.

[0124] Furthermore, in some embodiments, the system includes a graphics display that includes a graphical user interface (GUI). In some embodiments, the GUI includes viewing elements that display images from the camera. In some embodiments, the GUI includes multiple viewing elements, each displaying an image from the camera. See also Figure 6 and Figure 7 .

[0125] The GUI includes multiple control elements. For example, the GUI may include control elements for selecting cameras (e.g., one, two, three, or four peripheral cameras) for providing images in the GUI's viewing elements. Thus, in some implementations, a user can select one or more cameras (e.g., one, two, or three of the five cameras in an implementation including five cameras) to provide a useful patient camera view based on the patient's orientation and the camera providing the best patient view.

[0126] In some implementations, the GUI includes zoom control elements for setting the region of interest (ROI) of the camera, which provides the image in the view elements of the GUI. Thus, the GUI allows the user to select the ROI within a view provided by a single camera to obtain more precise information about objects within the selected area. Furthermore, in some implementations, the system controls the data transmitted by the camera so that only data collected within the selected ROI is sent to the computer for display on the GUI, thereby reducing the amount of data transferred from the camera to the computer and providing an increased frame rate (e.g., greater than 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 Hz or higher).

[0127] The GUI may include a capture button, which, when clicked by the user, causes the camera to provide and record images, or simultaneously record images from multiple cameras. The GUI may include image retrieval controls for selecting and retrieving reference images and / or sets of reference images. The GUI may include scene selection controls for selecting and retrieving saved scenes, which include reference images and / or sets of reference images, information identifying the camera that captured the reference images and / or sets of reference images, and region of interest settings for each camera that captured the reference images and / or sets of reference images. See also Figure 8.

[0128] In some implementations, the GUI provides a button to activate tracking mode. In tracking mode, a set of reference images is displayed in the view element on the display. A live image, provided by the same camera using the same region of interest setting used to acquire the reference image, is overlaid on the reference image within the appropriate view element. The user can interact with the view element using pointing devices such as a mouse, trackball, trackpad, finger or stylus, as well as touchscreens, eye tracking, etc., to manipulate the cursor displayed on the display. Interaction with the view element may include panning and / or rotating the reference image to match the position of the live tracking image overlaid on the reference image.

[0129] In some embodiments, the green and blue RGB components of the reference image are displayed in the viewing elements on the display, and the red RGB channel of each associated live tracking image is superimposed on the green and blue RGB components of the reference image in the viewing elements on the display. In some embodiments, the red and blue RGB components of the reference image are displayed in the viewing elements on the display, and the green RGB channel of each associated live tracking image is superimposed on the red and blue RGB components of the reference image in the viewing elements on the display. In some embodiments, the green and red RGB components of the reference image are displayed in the viewing elements on the display, and the blue RGB channel of each associated live tracking image is superimposed on the green and red RGB components of the reference image in the viewing elements on the display. Figure 9 Users can manipulate (e.g., transform and / or rotate) the reference image provided in the viewing element on the display to align the reference image and the live tracking image. Improved alignment accuracy is indicated by a reduction in the amount of misaligned red and green / blue (or green and red / blue or blue and green / red) portions in the viewing element.

[0130] In some implementations, users can interact with the GUI to draw reference lines or reference markers on reference images and / or live tracking images, for example, by placing reference lines or markers on viewing elements on the display. See, for example, Figure 9For example, a reference line can be provided on the GUI to intersect with a reference point in the treatment room (e.g., the center of treatment), as seen in a viewing element on the display. Thus, in some implementations, the reference line functions similarly to a laser line used in the treatment room. Therefore, in some implementations, the reference line can provide a virtual laser line. After a reference image or reference marker is set on one or more viewing elements on the display, the reference image or reference marker provides a fixed reference point that does not move with the image provided on the viewing element. Therefore, moving the object until a point or marker on the object seen in the live-tracking image intersects with a fixed reference point on both cameras provides a technique for aligning the object with a fixed reference point in the room.

[0131] method In some embodiments, the technology relates to implementations of methods. In some embodiments, the technology provides a method for imaging a patient. In some embodiments, the technology provides a method for treating a patient. In some embodiments, the method for treating a patient includes a method for imaging the patient. In some embodiments, the method for treating a patient includes a pre-treatment patient fixation and imaging phase 1000 (…). Figures 10A-10D ) and treatment phase 2000 ( Figures 11A-11D ).

[0132] For example, such as Figure 10A As shown, this technology provides a method 1000 (also referred to as a "simulation" phase) for pre-treatment patient fixation and imaging. The method 1000 for pre-treatment patient fixation and imaging includes a start 1100 Optical Guided Tracking System (OGTS) period. In some embodiments, the start 1100 OGTS period includes moving a patient positioning device or patient support (e.g., a patient support as part of a patient positioning system) to a patient loading position. Furthermore, the method 1000 for pre-treatment patient fixation and imaging includes determining 1200 whether initial patient fixation is required. For example, initial patient fixation may be required for new patients, new treatments for patients, treatment of new areas of the patient, or treatment of patients in new patient positions. Figure 10A As shown, if initial patient fixation is required (yes), the method 1000 for pre-treatment patient fixation and imaging includes performing initial patient fixation method 1300. Figure 10B If initial patient fixation is not required (no), the method 1000 for pre-treatment patient fixation and imaging includes performing subsequent patient fixation method 1400. Figure 10C Following the initial patient fixation method 1300 or subsequent patient fixation method 1400, the pre-treatment patient fixation method includes obtaining CT scans of 1500 patients. Figure 10D ).

[0133] Figure 10B An embodiment of the method 1300 for initial patient fixation is shown. (As...) Figure 10B As shown, an embodiment of the method 1300 for initial patient immobilization includes an initialization and tracking initiation step 1310. The initialization and tracking initiation step 1310 includes setting up the camera and preparing the OGTS for imaging the patient position settings and / or configuration settings, as described below. Figure 10B As shown, the initialization and tracking initiation step 1310 includes selecting 1311 multiple cameras for imaging the patient positioning and / or configuration settings. In some embodiments, at least three cameras (e.g., a top-mounted camera and two mutually orthogonal peripheral cameras) are selected for imaging the patient positioning and / or configuration settings. In some embodiments, four or five cameras (e.g., at least a top-mounted camera and two mutually orthogonal peripheral cameras) are selected for imaging the patient positioning and / or configuration settings. Figure 10B As further shown, an implementation of the initialization and tracing startup step 1310 includes resetting the region of interest 1312. In some implementations, the initialization and tracing startup step 1310 includes resetting reference lines or reference markers.

[0134] Furthermore, the initialization and tracking initiation step 1310 includes starting tracking 1313 by acquiring video provided by the selected cameras. Tracking 1313 may also include displaying live images provided by each selected camera in a separate window on the display so that the user can view each live image. The live images display real-time video of the patient's position and / or configuration settings in multiple orthogonal views (e.g., a top view and at least two peripheral views) provided by the selected cameras. In some embodiments, implementation of the method includes drawing reference lines or reference markers on the live tracking images, for example, placing reference lines or markers on viewing elements on the display. In some embodiments, the reference lines or reference markers intersect with reference points in the treatment room (e.g., treatment center), as seen in viewing elements on the display.

[0135] An embodiment of the method 1300 for initial patient immobilization further includes loading 1320 (e.g., placing the patient) onto a patient positioning device (PPA) or patient support.

[0136] An embodiment of the method 1300 for initial patient immobilization further includes determining 1330 a patient posture and configuring a patient positioning device (PPA) or patient support to support the patient posture, for example, by supporting the patient's body in a comfortable and stable position suitable for treatment. Determining 1330 a patient posture may include (e.g., by a technician or the patient positioning device or patient support) manipulating, guiding, and / or applying force to the patient to place the patient in a position suitable for treatment. Configuring the PPA or patient support may include moving (e.g., translating and / or rotating) the entire PPA or patient support, or may include moving (e.g., translating and / or rotating) one or more components of the PPA or patient support (e.g., one or more of a backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop). In some implementations, the method includes viewing the patient posture and / or the position of the PPA or patient support on a live-tracking image, and adjusting the patient posture and / or the position of the PPA or patient support using reference lines or reference markers provided on the live-tracking image that indicate reference points (e.g., treatment isocenters) in the treatment room.

[0137] Next, an implementation of the method 1300 for initial patient immobilization includes determining 1340 whether the patient is ready to continue. Determining whether the patient is ready to continue may include asking the patient if they are comfortable, determining if the patient's posture is stable, determining if the patient's posture is suitable for treatment, and / or otherwise confirming whether it is suitable to proceed with the subsequent steps of the method 1300 for initial patient immobilization. If the patient is not yet ready to continue (No), the steps of determining 1330 the patient's posture and configuring the patient positioning device (PPA) or patient support to support the patient's posture, and determining 1340 whether the patient is ready to continue are repeated. If the patient is ready to continue (Yes), the method proceeds to saving 1350 the patient position setting scenario.

[0138] Saving the 1350 patient position setup scenario primarily records the patient's posture (e.g., patient position) in a location suitable for subsequent treatment. Saving the 1350 patient position setup scenario includes saving a list of selected cameras providing images of the patient position, saving each patient position image provided by each selected camera, and saving the region of interest saved as an image for each selected camera during image acquisition. In some implementations, saving the 1350 patient position setup scenario optionally includes saving patient identification information, saving the date and time the patient position setup scenario is saved, saving the type of treatment to be performed on the patient in subsequent treatment phases, saving information identifying the OGTS user performing the method 1300 for initial patient fixation, etc.

[0139] Next, embodiments of the method 1300 for initial patient fixation include selecting a plurality of cameras for imaging the patient and PPA or patient support in the imaging position. In some embodiments, at least three cameras (e.g., a top-mounted camera and two peripheral cameras orthogonal to each other) are selected for imaging the patient and PPA or patient support in the imaging position. In some embodiments, four or five cameras (e.g., at least a top-mounted camera and two peripheral cameras orthogonal to each other) are selected for imaging the patient and PPA or patient support in the imaging position.

[0140] Implementations of the method 1300 for initial patient fixation include moving a PPA or patient support 1370 to an imaging position. Moving the PPA or patient support 1370 may include translating the PPA or patient support along an X-axis, Y-axis, or Z-axis, and / or rotating the PPA or patient support about one or more of the X-axis, Y-axis, or Z-axis. In some implementations, more than 1360 cameras are selected for imaging the patient and / or PPA or patient support at the imaging position before moving the PPA or patient support 1370 to the imaging position. In some implementations, moving the PPA or patient support 1370 to the imaging position is performed before selecting more than 1360 cameras for imaging the patient and / or PPA or patient support at the imaging position. In some implementations, the method includes drawing reference lines or reference markers on a live-tracking image of reference points in a marking room, such as treatment isocenters or imaging positions. In some implementations, the method includes viewing the PPA or patient support on a live-tracking image and adjusting the PPA or patient support using reference lines or reference markers provided on the live-tracking image to indicate reference points.

[0141] Next, an implementation of the method 1300 for initial patient fixation includes determining 1380 whether the patient is ready for imaging. Determining whether the patient is ready for imaging may include determining that the PPA or patient support and the patient are in the correct imaging position. In some implementations, determining whether the patient is ready for imaging may optionally include informing the patient that they are positioned for imaging, asking the patient if they are comfortable, determining whether the patient is in a stable posture, determining whether the patient is in a posture suitable for treatment, and / or otherwise confirming whether it is suitable to proceed with the subsequent steps of the method 1300 for initial patient fixation. If the patient is not yet ready for imaging (No), the step of moving the PPA or patient support 1370 to the imaging position and the step of determining whether the patient is ready for imaging (Yes) may be repeated. If the patient is ready for imaging (Yes), the method proceeds to saving the imaging position setting scenario 1390.

[0142] Saving the 1390 imaging position setup scene includes saving a list of selected cameras providing imaging position images, saving images of each imaging position provided by each selected camera, and saving the region of interest for each selected camera. In some embodiments, saving the 1390 imaging position setup scene optionally includes saving patient identification information, saving the date and time when the imaging position setup scene is saved, saving the type of treatment to be performed on the patient in subsequent treatment phases, saving information identifying the OGTS user performing the method 1300 for initial patient fixation, etc. After saving the 1390 imaging position setup scene, the method includes obtaining a 1500 CT scan (… Figure 10D For example, as described below.

[0143] Figure 10C An embodiment of the method 1400 for subsequent patient fixation is shown (e.g., reproducing the PPA or patient support configuration, patient position, and / or imaging position previously saved in a patient support configuration setting scenario, patient position setting scenario, and / or imaging position setting scenario). Figure 10C As shown, an implementation of method 1400 for subsequent patient fixation includes retrieving 1411 a saved configuration setup scene to provide the retrieved configuration setup scene. In some implementations, the saved configuration setup scene was previously saved during the execution of method 1500 for obtaining CT scans of 1500 patients after performing method 1300 for initial patient fixation (e.g., including saving configuration setup scene 1560), for example, as described below. The retrieved configuration setup scene includes saved PPA or patient support configuration images (e.g., images showing PPA or patient support views in at least three orthogonal directions), a list of cameras providing the saved PPA or patient support configuration images, and the region of interest for each selected camera that provided the images during image acquisition. In some implementations, the method further includes displaying each saved image showing at least three orthogonal views of the PPA or patient support in a separate window on the display so that a user can view each orthogonal view in each separate window. Each saved and displayed image shows the configuration setup view provided by the selected camera listed in the saved configuration setup scene. The retrieved images of the configuration settings scenario (e.g., displayed on a monitor) provide reference images for correctly configuring the PPA patient support.

[0144] Next, in some embodiments, the method includes configuring the 1412 patient positioning device or patient support. In some embodiments, the retrieved configuration setting scenario includes information describing the configuration of the PPA or patient support for configuring the 1412 patient positioning device or patient support. For example, in some embodiments, the retrieved configuration setting scenario includes information describing the location of the PPA or patient support and / or the location of one or more components of the PPA or patient support (e.g., the location of one or more of the backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop). In some embodiments, configuring the 1412 patient positioning device or patient support includes configuring the PPA or patient support according to standard presets describing the approximate positioning of the PPA or patient support and / or the approximate location of one or more components of the PPA or patient support (e.g., the location of one or more of the backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop).

[0145] Next, an implementation of the method 1400 for subsequent patient fixation provided herein includes determining that the 1420 PPA or patient support is configured correctly. In some implementations, determining whether the 1420 PPA or patient support is configured correctly includes using an image of a retrieved configuration setup scene (e.g., displayed on a monitor) as a reference image, and live video of the PPA or patient support for correctly configuring the PPA or patient support. Specifically, information stored in the configuration setup scene provides a list of cameras that provide saved images of the PPA or patient support configuration, and a region of interest (ROI) for each selected camera during image acquisition. This is used to select the same camera to provide live video of the PPA or patient support, and to set the ROI of each selected camera to the same ROI saved for each camera in the saved configuration setup scene. Thus, the live video provided by the selected camera shows the same view (e.g., the same orthogonal view) of the same ROI as the PPA or patient support provided in the saved configuration setup scene and the retrieved configuration setup scene. The user interacts with the GUI of the OGTS software to initiate tracing, which acquires live video from each selected camera. In some embodiments, the method includes drawing reference lines or reference markers on the live-tracking image to mark reference points in the marking room, such as treatment isocenters or imaging locations. In some embodiments, the method includes viewing the PPA or patient support on the live-tracking image and adjusting the PPA or patient support using the reference lines or reference markers provided on the live-tracking image to mark reference points.

[0146] Live video feeds from each selected camera, showing the PPA or patient support, are overlaid on a previously saved associated reference image of the PPA or patient support from the same camera on the monitor. In tracking mode, the OGTS software displays the red component of each reference image overlaid (e.g., added to) the green and blue components of each associated live image provided by each camera. When the reference image and the live image are aligned, the red and green colors in the images are aligned, thus providing a color-corrected RGB image in the aligned areas. Misaligned areas are displayed as green or red areas, indicating that the position or configuration of the PPA or patient support differs from the position or configuration shown in the reference image. As described in the examples, OGTS is used to calculate the misalignment between the reference image and the live image. The cameras are calibrated to provide a defined pixel-per-mm relationship (e.g., approximately 1 to 5 pixels / mm) at an isocentric plane in actual space. (For example, approximately 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4.0, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, or 5.0 pixels / mm). Therefore, by aligning the live image and the reference image in each camera view... For example, by determining the image pixel distance required to align the live image and the reference image, and calculating ΔX, ΔY, and / or ΔZ displacements based on the pixel-per-mm size relationship, one or more ΔX, ΔY, and / or ΔZ displacements can be obtained to obtain a suitable position for positioning and / or configuring the PPA or patient support or its components in the actual space recorded in the reference image. Furthermore, the OGTS software also allows for image rotation to determine Δψ, Δφ, and Δθ to correct for patient rotation relative to the previously captured reference image around the X, Y, and Z axes. Therefore, implementation includes using OGTS to determine 1420... Whether the PPA or patient support is configured and / or positioned correctly. If the PPA or patient support is not configured or positioned correctly (No), the user can use information from the OGTS related to ΔX, ΔY and / or ΔZ displacements and / or Δψ, Δφ and Δθ rotations suitable for correctly configuring the PPA or patient support, and can repeat steps 1412 to configure the PPA or patient support and 1420 to determine whether the PPA is configured correctly. If the PPA or patient support is correctly configured and / or positioned (Yes), the method 1400 for subsequent patient fixation proceeds to the next step retrieval 1431 of the saved patient position setting scenario.

[0147] like Figure 10CAs shown, an implementation of the method 1400 for subsequent patient fixation includes retrieving a saved patient position setting scene 1431 to provide the retrieved patient position setting scene. In some implementations, the saved patient position setting scene was previously saved during the execution of the method 1300 for initial patient fixation (e.g., including saving the patient position setting scene 1350). The retrieved patient position setting scene includes saved patient position images (e.g., images showing patient views in at least three orthogonal directions), a list of cameras providing the saved patient position images, and regions of interest for each selected camera that provided the images during image acquisition. The images show orthogonal views of the patient positioned on a PPA or patient support in a treatment-appropriate patient posture. In some implementations, the method further includes displaying each saved image showing at least three orthogonal directions in a separate window on a display so that a user can view each orthogonal view in each separate window. Each saved and displayed image shows a view of the patient position setting provided by the selected cameras listed in the retrieved configuration setting scene. The retrieved image of the patient position setting scene (e.g., displayed on a monitor) provides a reference image for correctly positioning the patient in the appropriate patient position (e.g., patient posture).

[0148] Next, in some embodiments, the method includes loading a patient 1432 onto a PPA or patient support and positioning the patient 1433 onto the PPA or patient support. In some embodiments, the retrieved patient positioning scenario includes information describing the patient position (e.g., patient posture) and / or the configuration of the PPA or patient support for positioning the patient 1433 into the correct patient position. For example, in some embodiments, the retrieved patient positioning scenario includes information describing the positioning and / or location of one or more components of the PPA or patient support (e.g., the location of one or more of the backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop) to provide an appropriate patient position. In some embodiments, positioning the patient 1433 includes positioning the patient into a standard patient position (e.g., a standard patient posture), which can be modified as needed by adjusting the configuration of the PPA or patient support (e.g., by adjusting the location of one or more of the backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop).

[0149] Next, an implementation of the method 1400 for subsequent patient fixation provided herein includes determining whether patient 1440 is correctly positioned. In some implementations, determining whether patient 1440 is correctly positioned includes using an image of a retrieved patient position setting scene (e.g., displayed on a monitor) as a reference image, and live video of the positioned patient for correct patient positioning (e.g., by configuring a PPA or patient support). Specifically, the information in the retrieved patient position setting scene provides a list of cameras that provides saved images of the patient position and region of interest (ROI) for each selected camera during image acquisition. This is used to select the same camera to provide live video of the patient and to set the ROI of each selected camera to the same ROI saved in each image of the saved patient position setting scene. Thus, the live video provided by the selected camera shows the same view (e.g., the same orthogonal view) of the patient and patient position saved in the saved patient position setting scene and provided in the retrieved patient position setting scene. The user interacts with the GUI of the OGTS software to initiate tracing, which will acquire live video from each selected camera. In some embodiments, the method includes drawing reference lines or reference markers on a live-tracking image to mark reference points in the marking room, such as treatment isocenters or imaging locations. In some embodiments, the method includes viewing a patient on a PPA or patient support on a live-tracking image and adjusting the patient and / or PPA or patient support using reference lines or reference markers provided on the live-tracking image to mark reference points.

[0150] Live video from each selected camera, showing the patient's position, is overlaid on a previously saved reference image of the patient's position from the same camera on the display. In tracking mode, the OGTS software displays the red component of each reference image overlaid (e.g., added to) the green and blue components of each associated live image provided by each camera. When the reference and live images are aligned, the red and green colors in the images are aligned, thus providing a color-corrected RGB image in the aligned areas. Misaligned areas are displayed as green or red areas, indicating that the patient's position differs from that shown in the reference image. As described in the example, OGTS is used to calculate the misalignment between the reference and live images. The cameras are calibrated to provide a defined pixel-per-mm relationship (e.g., approximately 1 to 5 pixels / mm) at an isocentric plane in actual space. (For example, approximately 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4.0, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, or 5.0 pixels / mm). Therefore, by aligning the live image and the reference image in each camera view, determining the required image pixel distance for alignment, and calculating the ΔX, ΔY, and / or ΔZ displacements based on the pixel-per-mm size relationship, a suitable position for positioning the patient in the matched reference image record in actual space can be obtained. One or more ΔX, ΔY, and / or ΔZ displacements of the patient's position. Furthermore, the OGTS software allows for image rotation to determine Δψ, Δφ, and Δθ to correct for patient rotation relative to a previously captured reference image around the X, Y, and Z axes. Therefore, the implementation includes using OGTS to determine if patient 1440 is correctly positioned. If the patient is incorrectly positioned (No), the user can use information from OGTS related to ΔX, ΔY, and / or ΔZ displacements and / or Δψ, Δφ, and Δθ rotations suitable for correct patient positioning, and can repeat the steps of positioning patient 1443 and determining if patient 1440 is correctly positioned. If the patient is correctly positioned (Yes), the method 1400 for subsequent patient fixation proceeds to the next retrieval 1450 of the saved imaging position setup scene.

[0151] like Figure 10CAs shown, an embodiment of the method 1400 for subsequent patient fixation includes retrieving 1450 a saved imaging position setting scene to provide the retrieved imaging position setting scene. In some embodiments, the saved imaging position setting scene was previously saved during the execution of the method 1300 for initial patient fixation (e.g., including saving 1390 the imaging position setting scene). The retrieved imaging position setting scene includes saved images of the patient and PPA or patient support in the imaging position (e.g., images showing at least three orthogonal views of the patient and PPA or patient support in the imaging position), a list of cameras providing the saved images of the patient and PPA or patient support in the imaging position, and the region of interest of each selected camera that provided the image during image acquisition. The images show orthogonal views of the patient positioned on the PPA or patient support in a treatment-appropriate patient posture and at a suitable imaging position. In some embodiments, the method further includes displaying each saved image showing at least three orthogonal views of the patient and PPA or patient support in the imaging position in a separate window on a display, so that a user can view each orthogonal view in each separate window. Each saved and displayed image shows a view of the imaging position settings provided by the selected camera listed in the retrieved imaging position setting scene. The images in the imaging position setting scene (e.g., displayed on a monitor) provide reference images for correctly positioning the patient in the appropriate imaging position.

[0152] Next, in some embodiments, the method includes moving the patient and PPA or patient support 1460 to the imaging position. In some embodiments, the retrieved imaging position setting scenario includes information describing the imaging position for moving the patient and PPA or patient support 1460 to the correct imaging position.

[0153] Next, an embodiment of the method 1400 for subsequent patient fixation provided herein includes determining whether patient 1470 is ready for imaging. In some embodiments, determining whether patient 1470 is ready for imaging includes using an image of a retrieved imaging position setup scene (e.g., displayed on a monitor) as a reference image, and live video of the patient positioned on a PPA or patient support for imaging. Specifically, the information in the retrieved imaging position setup scene provides a list of cameras that provides saved images of the imaging position and region of interest for each selected camera during image acquisition. This is used to select the same camera to provide live video of the patient on the PPA or patient support, and to set the region of interest of each selected camera to the same region of interest saved in each image of the imaging position setup scene. Thus, the live video provided by the selected camera shows the same view (e.g., the same orthogonal view) of the patient on the PPA or patient support as saved in the imaging position setup scene and provided in the retrieved imaging position scene. The user interacts with the GUI of the OGTS software to initiate tracking, which will acquire live video from each selected camera. In some embodiments, the method includes drawing reference lines or reference markers on the live-tracking image to mark reference points in the marking room, such as treatment isocenters or imaging locations. In some embodiments, the method includes viewing the patient and PPA or patient support on the live-tracking image and adjusting the patient and / or PPA or patient support using the reference lines or reference markers provided on the live-tracking image to mark reference points.

[0154] Live video from each selected camera, showing the imaging position, is overlaid on a previously saved reference image of the same camera's imaging position on the display. In tracking mode, the OGTS software displays the red component of each reference image overlaid (e.g., added to) the green and blue components of each associated live image provided by each camera. When the reference and live images are aligned, the red and green colors in the images are aligned, thus providing a color-corrected RGB image in the aligned areas. Misaligned areas are displayed as green or red areas, indicating that the patient's imaging position differs from the imaging position shown in the reference image. As described in the example, OGTS is used to calculate the misalignment between the reference and live images. The cameras are calibrated to provide a defined pixel-per-mm relationship (e.g., approximately 1 to 5 pixels / mm) at an isocentric plane in actual space. (For example, approximately 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4.0, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, or 5.0 pixels / mm). Therefore, by aligning the live image and the reference image in each camera view, determining the required image pixel distance for alignment, and calculating the ΔX, ΔY, and / or ΔZ displacements based on the pixel-per-mm size relationship, a suitable imaging position for positioning the patient and PPA or patient support in actual space to match the recorded reference image can be obtained. More than one or more ΔX, ΔY, and / or ΔZ displacements. Furthermore, the OGTS software allows for image rotation to determine Δψ, Δφ, and Δθ to correct for patient rotation relative to a previously captured reference image around the X, Y, and Z axes. Therefore, the implementation includes using OGTS to determine if patient 1470 is ready for imaging. If the patient is not yet ready for imaging (No), the user can use information from the OGTS related to ΔX, ΔY, and / or ΔZ displacements and / or Δψ, Δφ, and Δθ rotations suitable for proper positioning of the patient and PPA or patient support for imaging, and can repeat the steps of moving patient 1460 and PPA or patient support and determining if patient 1470 is ready for imaging. If the patient is ready for imaging (Yes), the method 1400 for subsequent patient fixation proceeds to the next step of obtaining a 1500 CT scan.

[0155] Figure 10D An embodiment of a method for obtaining CT scans (e.g., pre-treatment CT scans) of 1500 patients is shown, for example, during the initial patient fixation method 1300 ( Figure 10B) or perform subsequent patient fixation method 1400 ( Figure 10C After that. (e.g.) Figure 10D As shown, an embodiment of the method for obtaining CT scans of 1500 patients includes initiating a 1510 CT scan, for example, to obtain CT scans of the patients. In some embodiments, a multi-axis medical imaging device is used to obtain the CT scan, as described in U.S. Patent Application Publication No. 2022 / 0183641, which is incorporated herein by reference. Next, the method for obtaining CT scans of 1500 patients includes determining whether a 1520 CT scan is complete. In some embodiments, determining whether a 1520 CT scan is complete includes determining whether the quality of the CT scan is sufficient for treatment planning and patient treatment. If the CT scan is not complete (No), the steps of initiating the 1510 CT scan and determining whether the 1520 CT scan is complete are repeated. If the CT scan is complete (Yes), the method for obtaining CT scans of 1500 patients includes saving the CT scan as a pre-treatment CT scan for the patients, to be subsequently used for treatment planning and treatment. Next, the method proceeds to moving the PPA or patient support 1530 to an unloading position and unloading the patient from the PPA or patient support 1540. If a method for obtaining CT scans of 1500 patients is performed after the initial patient fixation method 1300, extra care should be taken during unloading 1540 to minimize interference with the PPA or patient support, thereby maintaining the configuration of the PPA or patient support previously determined in step 1330 of the initial patient fixation method 1300.

[0156] Next, if the method for obtaining CT scans of 1500 patients is performed after the subsequent patient fixation method 1400 (following), the OGTS period ends. If the method for obtaining CT scans of 1500 patients is performed after the initial patient fixation method 1300, the method includes saving a configuration setup scene 1560. Saving the configuration setup scene 1560 primarily records the configuration of the PPA or patient support for subsequent use in supporting the patient during treatment. Saving the configuration setup scene 1560 includes saving a list of selected cameras providing images of the PPA or patient support configuration, saving each image of the PPA or patient support configuration provided by each selected camera, and saving the region of interest for each selected camera during image acquisition. In some embodiments, saving the configuration setup scene 1560 may include optionally saving patient identification information, saving the date and time when the configuration setup scene is saved, saving the type of treatment performed on the patient in the subsequent treatment phase, saving information identifying the OGTS user performing the pre-treatment patient fixation and imaging method 1000, saving information describing the location of the PPA or patient support or its components, etc.

[0157] Furthermore, the embodiments of the technology provided herein relate to a method 2000 for treating a patient with radiation. For example, such as... Figure 11A As shown, the methods of treating patients include treating patients using the OGTS system described herein. Figure 11A The method shown includes starting the 2100 OGTS session, loading the patient 2200 onto the PPA or patient support to position them in a suitable treatment position. Figure 11B ), to perform imaging on the patient 2300 ( Figure 11C ), treating 2400 patients ( Figure 11D ), and the end of the OGTS period.

[0158] like Figure 11B As shown, an embodiment of the method for mounting a patient 2200 on a PPA or patient support and positioning it in a treatment-suitable position includes moving the PPA or patient support 2210 to the mounting position. Next, the method for mounting the patient 2200 on the PPA or patient support and positioning it in a treatment-suitable position includes retrieving a saved configuration setup scene 2220 to provide the retrieved configuration setup scene. In some embodiments, the saved configuration setup scene was previously saved during the execution of a method for obtaining CT scans of 1500 patients after performing a method 1300 for initial patient immobilization (e.g., including saving the configuration setup scene 1560). The retrieved configuration setup scene includes a saved PPA or patient support configuration image (e.g., an image showing PPA or patient support views in at least three orthogonal directions), a list of cameras providing the saved PPA or patient support configuration image, and the region of interest for each selected camera providing the image during image acquisition. In some embodiments, the method further includes displaying each saved image of a PPA or patient support showing at least three orthogonal views in a separate window on a display, so that a user can view each orthogonal view in each separate window. Each saved and displayed image shows a configuration setting view provided by a selected camera listed in the saved configuration setting scenario. Images of retrieved configuration setting scenarios (e.g., displayed on the display) provide reference images for correctly configuring the PPA or patient support. In some embodiments, the method includes drawing reference lines or reference markers on the live-tracking images to mark reference points in the room, such as treatment centers. In some embodiments, the method includes viewing the PPA or patient support on the live-tracking images and adjusting the PPA or patient support using the reference lines or reference markers provided on the live-tracking images to mark reference points.

[0159] Next, in some embodiments, the method for mounting a patient 2200 on a PPA or patient support and positioning them in a treatment-appropriate position includes configuring the PPA or patient support 2230. In some embodiments, the retrieved configuration setting scenario includes information describing the configuration of the PPA or patient support for configuring the 2230 PPA or patient support. For example, in some embodiments, the retrieved configuration setting scenario includes information describing the location of the PPA or patient support and / or the location of one or more components of the PPA or patient support (e.g., the location of one or more of the backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop). In some embodiments, configuring the 2230 PPA or patient support includes configuring the PPA or patient support according to standard presets describing the approximate positioning of the PPA or patient support and / or the approximate location of one or more components of the PPA or patient support (e.g., the location of one or more of the backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop).

[0160] Next, embodiments of the method for loading a patient 2200 onto a PPA or patient support and positioning it in a suitable treatment position include determining whether the 2240 PPA or patient support is configured correctly. In some embodiments, determining whether the 2240 PPA or patient support is configured correctly includes using an image of a retrieved configuration setup scene (e.g., displayed on a monitor) as a reference image, and a live video of the PPA or patient support for correctly configuring the PPA or patient support. Specifically, information stored in the configuration setup scene provides a list of cameras that provide saved images of the PPA or patient support configuration, and a region of interest (ROI) for each selected camera during image acquisition. This is used to select the same camera to provide the live video of the PPA or patient support, and to set the ROI of each selected camera to the same ROI saved for each camera in the saved configuration setup scene. Therefore, the live video provided by the selected camera shows the same view (e.g., the same orthogonal view) of the same ROI as the PPA or patient support provided in the saved configuration setup scene and the retrieved configuration setup scene. The user interacts with the OGTS software's GUI to initiate tracking, which acquires live video from each selected camera. In some implementations, the method includes drawing reference lines or reference markers on the live tracking images to mark reference points in the room, such as treatment isocenters or imaging locations. In some implementations, the method includes viewing the PPA or patient support on the live tracking images and adjusting the PPA or patient support using the reference lines or reference markers provided on the live tracking images to mark reference points.

[0161] Live video feeds from each selected camera, showing the PPA or patient support, are overlaid on a previously saved associated reference image of the PPA or patient support from the same camera on the monitor. In tracking mode, the OGTS software displays the red component of each reference image overlaid (e.g., added to) the green and blue components of each associated live image provided by each camera. When the reference image and the live image are aligned, the red and green colors in the images are aligned, thus providing a color-corrected RGB image in the aligned areas. Misaligned areas are displayed as green or red areas, indicating that the position or configuration of the PPA or patient support differs from the position or configuration shown in the reference image. As described in the examples, OGTS is used to calculate the misalignment between the reference image and the live image. The cameras are calibrated to provide a defined pixel-per-mm relationship (e.g., approximately 1 to 5 pixels / mm) at an isocentric plane in actual space. (For example, approximately 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4.0, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, or 5.0 pixels / mm). Therefore, by aligning the live image and the reference image in each camera view... By determining the required image pixel distance to align the live image and the reference image, and calculating ΔX, ΔY, and / or ΔZ displacements based on the pixel-per-mm size relationship, one or more ΔX, ΔY, and / or ΔZ displacements can be obtained to obtain a suitable position for positioning and / or configuring the PPA or patient support or its components in the actual space recorded in the reference image. Furthermore, the OGTS software also allows for image rotation to determine Δψ, Δφ, and Δθ to correct for patient rotation relative to the previously captured reference image around the X, Y, and Z axes. Therefore, implementations include using OGTS to determine 2240... Whether the PPA or patient support is configured and / or positioned correctly. If the PPA or patient support is not configured or positioned correctly (No), the user can use information from the OGTS related to ΔX, ΔY and / or ΔZ displacements and / or Δψ, Δφ and Δθ rotations suitable for correctly configuring the PPA or patient support, and can repeat the steps of configuring the PPA or patient support 2230 and determining whether the PPA 2240 is configured correctly. If the PPA or patient support is correctly configured and / or positioned (Yes), the method for loading the patient 2200 onto the PPA or patient support to place it in a position suitable for treatment proceeds to the next step of retrieving the saved patient position setting scenario 2250.

[0162] like Figure 11BAs shown, an embodiment of the method for mounting a patient 2200 on a PPA or patient support to position them in a treatment-appropriate position includes retrieving 2250 a saved patient position setting scene to provide the retrieved patient position setting scene. In some embodiments, the saved patient position setting scene was previously saved during the execution of method 1300 for initial patient immobilization (e.g., including saving 1350 the patient position setting scene). The retrieved patient position setting scene includes saved patient position images (e.g., images showing patient views in at least three orthogonal directions), a list of cameras providing the saved patient position images, and regions of interest for each selected camera that provided the images during image acquisition. The images show orthogonal views of the patient positioned on the PPA or patient support in a treatment-appropriate patient posture. In some embodiments, the method further includes displaying each saved image showing at least three orthogonal views in a separate window on a display so that a user can view each orthogonal view in each separate window. Each saved and displayed image shows a view of the patient position setting provided by the selected cameras listed in the retrieved configuration setting scene. The retrieved image of the patient position setting scene (e.g., displayed on a monitor) provides a reference image for correctly positioning the patient in the appropriate patient position (e.g., patient posture).

[0163] Next, in some embodiments, the method includes loading a patient 2260 onto a PPA or patient support and positioning the patient 2270 onto the PPA or patient support. In some embodiments, the retrieved patient positioning scenario includes information describing the patient position (e.g., patient posture) and / or the configuration of the PPA or patient support for positioning the patient 2270 into the correct patient position. For example, in some embodiments, the retrieved patient positioning scenario includes information describing the positioning and / or location of one or more components of the PPA or patient support (e.g., the location of one or more of the backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop) to provide an appropriate patient position. In some embodiments, positioning the patient 2270 includes positioning the patient into a standard patient position (e.g., a standard patient posture), which can be modified as needed by adjusting the configuration of the PPA or patient support (e.g., by adjusting the location of one or more of the backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop).

[0164] Next, an implementation of the method for mounting the patient 2200 on a PPA or patient support to position him in a suitable treatment location includes determining whether the patient 2280 is correctly positioned. In some implementations, determining whether the patient 2280 is correctly positioned includes using an image of a retrieved patient position setting scene (e.g., displayed on a monitor) as a reference image, and live video of the positioned patient for correctly positioning the patient (e.g., by configuring the PPA or patient support). Specifically, the information in the retrieved patient position setting scene provides a list of cameras that provides saved images of the patient position and region of interest (ROI) for each selected camera during image acquisition. This is used to select the same camera to provide live video of the patient and to set the ROI of each selected camera to the same ROI saved in each image of the saved patient position setting scene. Thus, the live video provided by the selected camera shows the same view (e.g., the same orthogonal view) of the patient and patient position saved in the saved patient position setting scene and provided in the retrieved patient position setting scene. The user interacts with the GUI of the OGTS software to initiate tracking, which acquires live video from each selected camera. In some embodiments, the method includes drawing reference lines or reference markers on a live-tracking image to mark reference points in the marking room, such as treatment isocenters or imaging locations. In some embodiments, the method includes viewing a patient on a PPA or patient support on a live-tracking image and adjusting the patient and / or PPA or patient support using reference lines or reference markers provided on the live-tracking image to mark reference points.

[0165] Live video from each selected camera, showing the patient's position, is overlaid on a previously saved reference image of the patient's position from the same camera on the display. In tracking mode, the OGTS software displays the red component of each reference image overlaid (e.g., added to) the green and blue components of each associated live image provided by each camera. When the reference and live images are aligned, the red and green colors in the images are aligned, thus providing a color-corrected RGB image in the aligned areas. Misaligned areas are displayed as green or red areas, indicating that the patient's position differs from that shown in the reference image. As described in the example, OGTS is used to calculate the misalignment between the reference and live images. The cameras are calibrated to provide a defined pixel-per-mm relationship (e.g., approximately 1 to 5 pixels / mm) at an isocentric plane in actual space. (For example, approximately 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4.0, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, or 5.0 pixels / mm). Therefore, by aligning the live image and the reference image in each camera view, determining the required image pixel distance for alignment, and calculating the ΔX, ΔY, and / or ΔZ displacements based on the pixel-per-mm size relationship, one or more suitable positions for positioning the patient in actual space to match the reference image recording can be obtained. ΔX, ΔY, and / or ΔZ displacements. Furthermore, the OGTS software allows for image rotation to determine Δψ, Δφ, and Δθ to correct for patient rotation relative to a previously captured reference image around the X, Y, and Z axes. Therefore, the implementation includes using OGTS to determine if patient 2280 is correctly positioned. If the patient is incorrectly positioned (No), the user can use information from OGTS related to the ΔX, ΔY, and / or ΔZ displacements and / or Δψ, Δφ, and Δθ rotations suitable for correct patient positioning, and can repeat the steps of positioning patient 2270 and determining if patient 2280 is correctly positioned. If the patient is correctly positioned (Yes), the method for loading patient 2200 onto PPA or patient support to position them in a suitable treatment position proceeds to the next step of imaging patient 2300 for treatment.

[0166] like Figure 11CAs shown, an embodiment of the method for imaging a patient 2300 for treatment includes retrieving 2310 a saved imaging position setting scene to provide the retrieved imaging position setting scene. In some embodiments, the saved imaging position setting scene was previously saved during the execution of method 1300 for initial patient immobilization (e.g., including saving 1390 the imaging setting scene). The retrieved imaging position setting scene includes saved images of the patient and PPA or patient support in the imaging position (e.g., images showing at least three orthogonal views of the patient and PPA or patient support in the imaging position), a list of cameras providing the saved images of the patient and PPA or patient support in the imaging position, and the region of interest for each selected camera that provided the image during image acquisition. The images show orthogonal views of the patient positioned on the PPA or patient support in a patient posture suitable for treatment and at a suitable imaging position. In some embodiments, the method further includes displaying each saved image showing at least three orthogonal views of the patient and PPA or patient support in the imaging position in a separate window on a display, so that a user can view each orthogonal view in each separate window. Each saved and displayed image shows a view of the imaging position settings provided by the selected camera listed in the retrieved imaging position setting scene. The images in the imaging position setting scene (e.g., displayed on a monitor) provide reference images for correctly positioning the patient in the appropriate imaging position.

[0167] Next, in some embodiments, the method for imaging a patient 2300 for treatment includes moving the patient and PPA or patient support 2320 to the imaging position. In some embodiments, the retrieved imaging position setting scenario includes information describing the imaging position for moving the patient and PPA or patient support 2320 to the correct imaging position.

[0168] Next, an implementation of the method for imaging a patient 2300 for treatment includes determining 2230 whether the patient is ready for imaging. In some implementations, determining whether the patient is ready for imaging includes using an image of a retrieved imaging position setting scene (e.g., displayed on a monitor) as a reference image, and a live video of the patient positioned on a PPA or patient support for imaging. Specifically, the information in the retrieved imaging position setting scene provides a list of cameras that provides saved images of the imaging position and region of interest for each selected camera during image acquisition. This is used to select the same camera to provide the live video of the patient on the PPA or patient support, and to set the region of interest of each selected camera to the same region of interest saved in each image of the imaging position setting scene. Thus, the live video provided by the selected camera shows the same view (e.g., the same orthogonal view) of the patient on the PPA or patient support as the view saved in the imaging position setting scene and provided in the retrieved imaging position scene. The user interacts with the OGTS software's GUI to initiate tracking, which acquires live video from each selected camera. In some implementations, the method includes drawing reference lines or reference markers on the live tracking images to mark reference points in the room, such as treatment centers. In some implementations, the method includes viewing the patient on a PPA or patient support on the live tracking images and adjusting the patient and / or PPA or patient support using the reference lines or reference markers provided on the live tracking images to mark reference points.

[0169] Live video from each selected camera, showing the imaging position, is overlaid on a previously saved reference image of the same camera's imaging position on the display. In tracking mode, the OGTS software displays the red component of each reference image overlaid (e.g., added to) the green and blue components of each associated live image provided by each camera. When the reference and live images are aligned, the red and green colors in the images are aligned, thus providing a color-corrected RGB image in the aligned areas. Misaligned areas are displayed as green or red areas, indicating that the patient's imaging position differs from the imaging position shown in the reference image. As described in the example, OGTS is used to calculate the misalignment between the reference and live images. The cameras are calibrated to provide a defined pixel-per-mm relationship (e.g., approximately 1 to 5 pixels / mm) at an isocentric plane in actual space. (For example, approximately 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4.0, 4.1, 4.2, 4.3, 4.4, 4.5) (4.6, 4.7, 4.8, 4.9, or 5.0 pixels / mm). Therefore, by aligning the live image and the reference image in each camera view, the required image pixel distance for alignment is determined, and the ΔX, ΔY, and / or ΔZ displacements are calculated based on the pixel-per-mm size relationship. This yields one or more ΔX and ΔY displacements suitable for positioning the patient and PPA or patient support in actual space to the imaging position recorded in the matching reference image. X, ΔY, and / or ΔZ displacements. Furthermore, the OGTS software allows for image rotation to determine Δψ, Δφ, and Δθ to correct for patient rotation relative to a previously captured reference image around the X, Y, and Z axes. Therefore, the implementation includes using OGTS to determine if patient 2230 is ready for imaging. If the patient is not yet ready for imaging (No), the user can use information from the OGTS related to ΔX, ΔY, and / or ΔZ displacements and / or Δψ, Δφ, and Δθ rotations suitable for proper positioning of the patient and PPA or patient support for imaging, and can repeat the steps of moving patient 2320 and PPA or patient support and determining patient 2230 readiness for imaging. If the patient is ready for imaging (Yes), the method for imaging the patient 2300 for treatment proceeds to the next step of obtaining a CT scan.

[0170] like Figure 11CAs shown, an embodiment of the method for imaging a patient 2300 for treatment includes obtaining a CT scan (e.g., a therapeutic CT scan). Specifically, the method for imaging a patient 2300 for treatment includes initiating a 2240 CT scan, for example, to obtain a CT scan of the patient. In some embodiments, a multi-axis medical imaging device is used to obtain the CT scan, as described in U.S. Patent Application Publication No. 2022 / 0183641, which is incorporated herein by reference. Next, the method for imaging a patient 2300 for treatment includes determining whether a 2250 CT scan is complete. In some embodiments, determining whether a 2250 CT scan is complete includes determining whether the quality of the CT scan is sufficient for the treatment of the patient. If the CT scan is not complete (no), the steps of initiating the 2240 CT scan and determining whether the 2250 CT scan is complete are repeated. If the CT scan is complete (yes), the method for imaging a patient 2300 for treatment includes saving the patient's CT scan as the patient's therapeutic CT scan for subsequent registration with the pre-treatment CT scan and for subsequent treatment. Next, the method of radiation therapy was used on 2000 patients to treat 2400 patients.

[0171] like Figure 11D As shown, the method for treating patient 2440 with radiation includes obtaining a pre-treatment CT scan (e.g., a method provided by a method for obtaining a CT scan of patient 1500 during the pre-treatment patient fixation and imaging phase 1000, wherein the method includes saving the CT scan as the patient's pre-treatment CT scan) and obtaining a treatment CT scan (e.g., a method provided by a method for imaging patient 2300 during the treatment phase 2000, wherein the method includes saving the patient's CT scan as the patient's treatment CT scan). Next, the method includes registering the treatment CT scan 2410 and the pre-treatment CT scan and obtaining a correction vector. In some embodiments, registering the treatment CT scan 2410 and the pre-treatment CT scan provides for matching the treatment plan to the treatment volume of interest within the patient, thereby accurately delivering radiation therapy to the treatment volume of interest. In some embodiments, registering the treatment CT scan 2410 and the pre-treatment CT scan provides for detecting and evaluating anatomical changes that may occur after obtaining the pre-treatment scan and before the treatment phase. Therefore, registering the treatment CT scan 2410 and the pre-treatment scan provides important information for patient treatment. The difference between the pre-treatment CT scan and the treatment CT scan is used to determine a correction vector to bring the treatment plan (e.g., the treatment beam) into contact with the treatment volume of interest within the patient. In some implementations, the method includes verifying that the correction vector is correctly applied to the positioned patient, for example, as described below.

[0172] This technology is used to treat a large number of patients. fEach treatment field (e.g., 1, 2, 3, 4, 5, ..., f treatment fields) includes the treatment volume of interest within the patient's body. Therefore, the method includes treating the treatment fields. n ,in n Iterate from 1 (treatment field 1) to the number of treatment fields to be treated, f (treatment fields f). Next, the method for treating 2440 patients with radiation includes selecting 2420 treatment fields. n 2430. Move the patient to position him on the PPA or patient support, and apply the corrective vector obtained in step 2410 to the radiation therapy plan.

[0173] Next, the method of treating 2400 patients with radiation includes determining the 2440 treatment field. n Is the treatment of the patient a therapeutic field? n The first example of treating a patient. If in a treatment setting... n The treatment of patients is the treatment field n The first case of treating patients (is) involves using radiation to treat 2440 patients, including preserving 2460 fields. n The treatment scenario. If in a treatment setting... n Treatment for patients is not a treatment field n If the first case of treating a patient is not specified, then the method of treating patient 2440 with radiation includes retrieving the treatment field 2450. n Treatment scenarios.

[0174] Preserve 2460 treatment fields n Treatment scenarios include providing patients and PPAs or patient support devices in the treatment area. n A list of selected cameras providing images of the treatment location, saving images of the patient and PPA or patient support provided by each selected camera in the treatment area. n Each image of the treatment location, and the region of interest for each selected camera is saved. In some implementations, 2460 treatment fields are saved. n The treatment scenario includes the optional storage of patient identification information and the storage of the treatment scene. n The treatment scene is saved with the date and time, the type of treatment to be performed on the patient, and information about the OGTS user who will identify the method used to perform treatment on patient 2440. Treatment scene 2460 is saved. n Following the treatment scenario, the method includes determining whether 2470 patients are ready to receive treatment, as described below.

[0175] Search 2450 saved treatment sites n The treatment scenarios provided the retrieved treatment scenarios. n The treatment scenario. In some implementations, the saved treatment scenario nThe treatment scenario has previously been used to perform radiation therapy on 2400 patients (e.g., including preserving 2460 preserved treatment scenarios). n The retrieved treatment scene is saved during the treatment session. n Treatment scenarios include patients and PPAs or patient support devices in the treatment area. n Saved images of the treatment location (e.g., showing at least three orthogonal directions in the treatment field) n Images of the patient and PPA or patient support at the treatment location (providing a saved view of the patient in the treatment area) are available. n A list of cameras providing images of the patient and PPA or patient support at the treatment location, and the region of interest for each selected camera providing the image during image acquisition. The images show the patient and PPA or patient support in the treatment field. n An orthogonal view of the treatment position. In some embodiments, the method further includes displaying each saved image, showing at least three orthogonal directions within the treatment field, in a separate window on the display. n Images of the patient and PPA or patient support views at the treatment location are provided so that the user can view each orthogonal view in a separate window. Each saved and displayed image shows the retrieved treatment field. n The selected camera provided in the treatment scene is listed in the treatment scene. n The view of the patient and PPA or patient support at the treatment location. Retrieved treatment area. n Images of the treatment scene (e.g., displayed on a monitor) provide reference images for properly positioning the patient and PPA or patient support in the treatment area. n The treatment should be appropriately positioned and / or located.

[0176] Next, an implementation of the method for treating 2400 patients with radiation includes determining whether 2470 patients are ready to receive treatment. In some implementations, determining whether 2470 patients are ready to receive treatment includes using a retrieved treatment field. n Images of the treatment scene (e.g., displayed on a monitor) are used as reference images, along with live video of the patient and PPA or patient support device to correctly position the patient and PPA or patient support device in the treatment area. n The treatment should be appropriately positioned and / or located.

[0177] In particular, the treatment room n Information in the treatment setting provides information for those in the treatment setting. n A list of cameras with saved images of the patient and PPA or patient support at the treatment location, and a region of interest for each selected camera during image acquisition, which is used to select the same camera to provide images of the patient in the treatment area. nThe live video of the patient on the PPA or patient support at the treatment location is used to set the region of interest of each selected camera relative to the treatment field. n Each image of the treatment scene preserves the same region of interest. Therefore, the live video provided by the selected camera shows the treatment scene... n The treatment scenes saved and retrieved in the treatment scene n The treatment scenario provided in the treatment field n The same view (e.g., the same orthogonal view) of the same region of interest for the patient and PPA or patient support at the treatment location. The user interacts with the GUI of the OGTS software to initiate a tracking that acquires live video from each selected camera.

[0178] Each selected camera shows the patient and PPA or patient support in the treatment area. n The live video of the treatment location used for treatment will be overlaid on the monitor with the previously saved video of the treatment area from the same camera. n The OGTS software displays a reference image associated with the patient and PPA or patient support at the treatment location. In tracking mode, the OGTS software shows the red component of each reference image superimposed (e.g., added to) the green and blue components of each associated live image provided by each camera. When the reference image and the live image are aligned, the red and green colors in the image are aligned, thus providing a color-corrected RGB image in the aligned areas. Misaligned areas are displayed as green or red areas, indicating the patient's position in the treatment area. n The treatment location used for treatment is the same as the treatment field shown in the reference image. nThe treatment locations used for treatment differ. As described in the example, OGTS is used to calculate the misalignment between the reference image and the live image. The camera is calibrated to provide a defined pixel-to-mm relationship (e.g., approximately 1 to 5 pixels / mm) at an isocentric plane in real space. (For example, approximately 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4.0, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, or 5.0 pixels / mm). Therefore, by aligning the live image and the reference image in each camera view, determining the required image pixel distance for alignment, and calculating the ΔX, ΔY, and / or ΔZ displacements based on the pixel-per-mm size relationship, a suitable positioning for placing the patient and PPA or patient support in the actual space can be obtained. The reference image records one or more ΔX, ΔY, and / or ΔZ displacements of the imaging position. Furthermore, the OGTS software allows for image rotation to determine Δψ, Δφ, and Δθ to correct for patient rotation relative to a previously captured reference image around the X, Y, and Z axes. Therefore, the implementation includes using OGTS to determine if patient 2470 is ready for treatment. If the patient is not yet ready for treatment (No), the user can use information from OGTS related to ΔX, ΔY, and / or ΔZ displacements and / or Δψ, Δφ, and Δθ rotations suitable for proper positioning of the patient and PPA or patient support for treatment. Therefore, if the patient is not yet ready for treatment (No), the steps of moving patient 2430 and PPA or patient support and / or applying correction vectors are repeated to determine treatment field 2440. n Is the treatment of the patient a therapeutic field? n The first case of treating a patient involved steps and the preservation of 2460 treatment sites. n Treatment scenarios or search for 2450 treatment scenarios n The appropriate procedures for the treatment scenario, and the steps to determine whether patients 2470 are ready to receive treatment. If the patients are ready to receive treatment (yes), then the treatment proceeds to the next treatment scene using the same method as for patients 2400. n The steps. In some implementations, the treatment field... n Including making the treatment field n The patient's body area is exposed to radiation known in the art, such as photons (e.g., X-rays, electrons) or hadrons (e.g., protons, neutrons, heavy ions (e.g., carbon ions). 4 He ions, neon ions, etc.) come into contact.

[0179] Next, the method of treating 2400 patients with radiation includes determining the treatment field for 2491. n Whether the treatment is complete. In some implementations, the 2491 treatment field is determined. n Whether the treatment is completed includes determining whether the treatment has been directed to the treatment site. n The correct radiation dose was provided. If the treatment area... n If the treatment is not completed (no), repeat treatment 2480 times. n And determine 2491 treatment sites n The treatment process is considered complete. If the treatment area... n If the treatment is completed (yes), then the method of treating patient 2400 with radiation includes determining whether the treatment plan for patient 2492 includes treatment at another treatment site. If the treatment plan includes treatment at another treatment site (yes), then n The number is increased by 1 (e.g., n = n+1), and the method returns to step 2420 of the method for treating 2400 patients with radiation, which includes selecting the next treatment field n (with the updated...). n (Value). If the treatment plan does not include treatment of another treatment site (no), the method includes ending the 2500 OGTS period.

[0180] Methods for monitoring patient movement In some implementations, the technology provides methods for monitoring patient movement (e.g., during treatment). These methods are used to identify patient movements during the treatment phase that may cause the treatment field to move out of the treatment location or healthy tissue to move into the radiation path. The methods also monitor rhythmic changes in patient body movement, such as rhythmic changes due to respiratory movements.

[0181] For example, methods for monitoring patient movement include using one or more reference images and live video during a treatment phase to monitor and / or identify patient movements that may require technician intervention to correct the position of the patient and PPA or patient support. In some embodiments, the method for monitoring patient movement includes providing images of the patient and PPA or patient support in a treatment position as reference images. In some embodiments, the reference images are provided by a retrieved treatment scene, for example, by a method or step of retrieving 2450 saved treatment scenes. In some embodiments, the reference images are provided by acquiring images of the patient and PPA or patient support in a patient treatment position, for example, by a method or step of saving 2460 treatment scenes. Thus, the reference images provide images of the patient and PPA or patient support in a treatment position, for example, images showing at least three orthogonal views of the patient and PPA or patient support in the treatment position. In some embodiments, the method further includes displaying each saved image showing at least three orthogonal views of the patient and PPA or patient support in a separate window on a display, so that a user can view each orthogonal view in each separate window. Each saved and displayed image shows a view of the patient and PPA or patient support in the treatment position, provided by the selected camera listed in the retrieved treatment scene.

[0182] Images of the treatment scene (e.g., displayed on a monitor) provide reference images for monitoring patient movement. In some embodiments, monitoring patient movement includes monitoring the patient's position relative to the reference images using reference images and live video of the patient and PPA or patient support. Specifically, in some embodiments, information associated with the treatment scene images provides a list of cameras providing reference images and a region of interest (ROI) for each selected camera during image acquisition. This is used to select the same camera to provide live video of the patient positioned on the PPA or patient support, and to set the ROI of each selected camera to the same ROI saved for each image of the treatment scene. Thus, the live video provided by the selected camera shows the same view (e.g., the same orthogonal view) of the same ROI of the patient and PPA or patient support in the treatment position saved in the treatment scene. The user interacts with the GUI of the OGTS software to initiate tracking, which acquires live video from each selected camera.

[0183] Live video from each selected camera, showing the patient and PPA or patient support, is overlaid on the monitor onto an associated reference image of the patient and PPA or patient support in the treatment position. In tracking mode, the OGTS software displays the red component of each reference image overlaid (e.g., added to) the green and blue components of each associated live image provided by each camera. When the reference image and the live image are aligned, the red and green colors in the image are aligned, thus providing a color-corrected RGB image in the aligned areas. Misaligned areas are displayed as green or red areas, indicating that the patient's treatment position differs from the treatment position shown in the reference image. As described in the example, OGTS is used to determine misalignment between the reference image and the live image. The cameras are calibrated to provide a defined pixel-per-mm relationship (e.g., approximately 1 to 5 pixels / mm) at an isocentric plane in actual space. (For example, approximately 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4.0, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, or 5.0 pixels / mm). Therefore, by each camera view... By aligning the live image and the reference image, determining the required image pixel distance for alignment, and calculating ΔX, ΔY, and / or ΔZ displacements based on the pixel-per-mm size relationship, one or more ΔX, ΔY, and / or ΔZ displacements can be obtained to position the patient and PPA or patient support in actual space to the imaging position recorded in the matching reference image. Furthermore, the OGTS software also allows for image rotation to determine Δψ, Δφ, and Δθ to correct for patient rotation relative to the previously captured reference image around the X, Y, and Z axes.

[0184] Therefore, implementations include using OGTS to monitor patient movement by monitoring the alignment of a reference image with live video. In some implementations, the user can observe the alignment of the reference image with the live video and determine whether the reference image is aligned or misaligned. If the reference image and live video are misaligned, the user can determine whether intervention is needed to stop treatment and / or realign the patient. In some implementations, image registration methods (e.g., the Lucas-Kanade image alignment algorithm, the Baker-Dellaert-Matthews image alignment algorithm, or the OpenCV image alignment package) are used to determine whether the reference image and live video are aligned or misaligned. In some implementations, a mismatch threshold is set (e.g., from 1 to 50 mm). (For example, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0, 8.5, 9.0, 9.5, 10.0, 10.5, 11.0, 11.5, 12.0, 12.5, 13.0, 13.5, 14.0, 14.5, 15.0, 15.5, 16.0, 16.5, 17.0, 17.5, 18.0, 18.5, 19.0, 19.5, 20.0, 20.5, 21.0, 21.5, 22.0, 22.5, 23.0, 23.5, 24.0, 24.5, 25.0, 25.5, 26.0) 26.5, 27.0, 27.5, 28.0, 28.5, 29.0, 29.5, 30.0, 30.5, 31.0, 31.5, 32.0, 32.5, 33.0, 33.5, 34.0, 34.5, 35.0, 35.5, 36.0, 36.5, 37.0, 37.5, 38.0, 38.5, 39.0, 39.5, 40.0, 40.5, 41.0, 41.5, 42.0, 42.5, 43.0, 43.5, 44.0, 44.5, 45.0, 45.5, 46.0, 46.5, 47.0, 47.5, 48.0, 48.5, 49.0, 49.5 or 50.0 mm). In some implementations, the method includes providing an alarm or alert (e.g., a visual, auditory, or tactile alarm) if the reference image and live video are misaligned for more than a threshold. In some implementations, the method includes suggesting corrections (e.g., translation and / or rotation) to properly position the patient so that treatment can proceed. For example, the user can use information from the OGTS relating to ΔX, ΔY, and / or ΔZ translations and / or Δψ, Δφ, and Δθ rotations suitable for proper patient positioning and for the PPA or patient support used for treatment. In some implementations, the method includes determining the patient's respiratory cycles and determining appropriate compensatory rhythmic translations and / or rotations of the patient automatically generated through automated translations and / or rotations of the PPA or patient support.

[0185] Methods for verifying the correct application of correction vectors In some embodiments, this technology provides methods for verifying the correct application of correction vectors. For example, the methods include obtaining correction vectors (e.g., as described herein, by obtaining a pre-treatment CT scan (e.g., provided by a method for obtaining 1500 patient CT scans during pre-treatment patient fixation and imaging phase 1000, wherein the method includes saving the CT scan as the patient's pre-treatment CT scan); obtaining a treatment CT scan (e.g., provided by a method for imaging the patient 2300 during treatment phase 2000, wherein the method includes saving the patient's CT scan as the patient's treatment CT scan); and registering 2410 treatment CT scans and pre-treatment CT scans to obtain correction vectors.

[0186] Next, the method for verifying the correct application of the correction vector includes providing a reference image. In some embodiments, the reference image is provided by a retrieved treatment scene, for example, by a method or step of retrieving a saved treatment scene 2450. In some embodiments, the reference image is provided by acquiring an image of the patient and the PPA or patient support in the patient treatment position, for example, by a method or step of saving the treatment scene 2460.

[0187] Furthermore, the method includes using correction vectors to calculate ΔX, ΔY, and / or ΔZ displacements and / or Δψ, Δφ, and / or Δθ rotations in actual space, which is suitable for aligning the treatment volume of interest within the patient with the treatment plan, thereby accurately delivering radiotherapy to the treatment volume of interest.

[0188] Next, the reference image on the display is calculated using the pixel-per-mm size relationship at the isocenter plane in actual space (e.g., approximately 1 to 5 pixels / mm (e.g., approximately 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4.0, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, or 5.0 pixels / mm). The method involves applying an offset (e.g., translation and / or rotation) to a reference image to provide an offset reference image on a display, thereby indicating the appropriate position of the patient and PPA or patient support for treatment. Thus, after applying the correction vector, the offset reference image provides an image of the patient and PPA or patient support in the appropriate treatment position. Appropriately applying the correction vector to move the patient and PPA or patient support in actual space according to the correction vector will align the live video with the displaced reference image, thereby providing verification that the correction vector has been correctly applied.

[0189] Methods for aligning images As described herein, the method includes aligning reference images with live video images, for example, aligning a reference image of a PPA or patient support configuration with a live video image of a PPA or patient support configuration, aligning a reference image of a patient position with a live video image of a patient position, aligning a reference image of an imaging position with a live video image of an imaging position, and / or using the treatment field n Reference images of the patient's and PPA's or patient support's positioning and / or location for treatment field. n Alignment of live video images of the patient's position and / or location with that of the PPA or patient support during treatment.

[0190] In some embodiments, the method includes drawing reference lines or reference markers on the live-tracking image to mark reference points in the marking room, such as treatment centers or imaging locations. In some embodiments, the method includes viewing the patient and / or PPA or patient support on the live-tracking image and adjusting the patient and / or PPA or patient support using the reference lines or reference markers provided on the live-tracking image to mark reference points. See, for example, Figure 9 .

[0191] Furthermore, for convenience, regarding the method of superimposing and aligning the red component of a reference image provided by a camera with the green and blue components of an associated live image, while certain embodiments of the technique are described herein, the technique is not limited to such embodiments. The technique also covers embodiments of substantially equivalent methods, including superimposing and aligning the green component of a reference image provided by a camera with the red and blue components of an associated live image, and embodiments including superimposing and aligning the blue component of a reference image provided by a camera with the red and green components of an associated live image.

[0192] In some implementations, the alignment of the live image and the reference image is performed manually by a user interacting with a computer via an input device (e.g., mouse, keyboard, touchscreen, trackball, virtual reality device, etc.) to manipulate (e.g., pan and / or rotate) the live image displayed on the screen and align it with the reference image. The user can use their eyes to align the live image and the reference image to determine a sufficient match between them. However, in some implementations, the alignment of the live image and the reference image is performed using image registration methods, such as the Lucas-Kanade image alignment algorithm, the Baker-Dellaert-Matthews image alignment algorithm, or using the OpenCV image alignment package. In some implementations, feature-based automatic alignment, pixel-based automatic alignment, or fast Fourier transform are used to align the images; these are methods coded in software and executed by a computer. Additional image registration techniques are provided by Cocianu (2023) “Evolutionary Image Registration: A Review” Sensors 23: 967; Bierbrier (2022) “Estimating medical image registration error and confidence: A taxonomy and scoping review” Medical Image Analysis 81: 102531; John and John (2019) “A Review of Image Registration Methods in Medical Imaging” International Journal of Computer Applications 178: 38–45; and Chen (2021) “Deep Learning in Medical Image Registration” Progress in Medical Imaging 3: 012003, each of which is incorporated herein by reference.

[0193] In some implementations, the steps of the described image alignment method are implemented in software code, such as a series of program steps instructing a computer and / or microprocessor to generate and / or transform the data as described above. In some implementations, the software instructions are encoded in a programming language such as, for example, BASIC, C, C++, Java, MATLAB, Mathematica, Perl, Python, or R.

[0194] In some implementations, one or more steps or components are provided as a single software object connected in a modular system. In some implementations, the software object is scalable and portable. In some implementations, the object includes data structures and operations for transforming object data. In some implementations, the object is used by manipulating its data and invoking its methods. Therefore, implementations provide software objects that simulate, model, or provide manipulable concrete entities, such as numbers, shapes, or data structures. In some implementations, the software object runs in a computer or microprocessor. In some implementations, the software object is stored on a computer-readable medium.

[0195] In some implementations, a step of the method described herein is provided as an object method. In some implementations, the data and / or data structures described herein are provided as object data structures.

[0196] Implementation methods include using code that generates and manipulates software objects, for example, coded in languages ​​such as, but not limited to, Java, C++, C#, Python, PHP, Ruby, Perl, Object Pascal, Objective-C, Swift, Scala, CommonLisp, and Smalltalk.

[0197] Mobile and configurable patient placement system In some embodiments, the technology relates to a patient positioning system including a movable and configurable patient support. In some embodiments, the technology relates to a patient positioning system including a movable and configurable electrically powered patient support. See U.S. Patent No. 11,529,109; see also U.S. Patent Application Serial No. 17 / 894,335 and U.S. Provisional Patent Application Serial No. 63 / 438,978, each of which is incorporated herein by reference. Certain aspects of embodiments of the patient positioning system and patient support technology are described below.

[0198] In some embodiments, the patient support is configured to translate in the X, Y, and / or Z directions. In some embodiments, the patient support is configured to rotate about the X-axis, Y-axis, and / or Z-axis. In some embodiments, the patient support is configured to have six degrees of freedom of movement, for example, the patient support is configured to translate in the X, Y, and / or Z directions, and the patient support is configured to rotate about the X-axis, Y-axis, and / or Z-axis.

[0199] For example, in some embodiments, the patient support includes a pivotable base, and the patient support is configured to pivot about an X-axis, Y-axis, and / or Z-axis to provide pitch, roll, and yaw rotation. Thus, in embodiments including a pivotable base, the configurable patient support is configured to pitch or pivot relative to a horizontal plane of a translational member or any other fixed horizontal surface. Embodiments include motors and drive mechanisms engaged with the patient positioning system and / or the patient support to translate and / or rotate the patient positioning system and / or translate and / or rotate the patient support.

[0200] As other examples, in some embodiments, the patient positioning system includes a vertically translatable member such that the translatable member is hinged toward and away from a surface supporting the patient positioning system. In some embodiments, the translatable member is mounted to a support structure, which in turn is mounted to the surface. In some embodiments, the support structure provides stability to the patient positioning system and houses a drive mechanism to achieve vertical movement of the translatable member. A patient support is configured to receive and secure a patient in a generally upright position. In some embodiments, the patient support is rotatably mounted to the translatable member such that the patient support can rotate relative to the translatable member about a vertical axis (e.g., a substantially vertical and / or substantially vertical axis). In some embodiments, the lower end of the patient support is mounted to a rotating disk. In some embodiments, the upper end of the patient support is mounted to another rotating disk. With this arrangement, the patient support is rotatably mounted to the translatable member such that the patient support can rotate about a vertical axis. Furthermore, since the translational member can be vertically hinged, the patient support mounted to the translational member can also be similarly vertically hinged. In addition, in some embodiments, the patient support, besides being able to rotate about a vertical axis, can also translate in a horizontal (e.g., XY) plane. In some embodiments, the patient support can translate in a horizontal plane orthogonal to the vertical axis of rotation. In some embodiments, the patient support includes two pairs of orthogonally related parallel guide rails; the patient support is slidably connected to a first pair of guide rails for translation in a first orthogonal direction, and the first set of guide rails is slidably connected to a second pair of guide rails for translation in a second orthogonal direction. In some embodiments, a motor and drive mechanism engage with each set of guide rails to cause the patient support to translate in the X and Y directions.

[0201] In some embodiments, the patient support includes a backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop. Embodiments provide that the backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop can be configured in multiple positions to accommodate patient entry and / or exit from the patient support system (e.g., patient support assembly) and / or to support the patient in multiple positions for imaging or treatment. Figure 4A configurable patient support 100 is shown, comprising one or more configurable and movable components, such as a backrest 110 (e.g., a configurable and movable backrest), an armrest 170 (e.g., a configurable and movable armrest), a seat 140 (e.g., a configurable and movable seat), a shin support 150 (e.g., a configurable and movable shin support), and / or a foot support (e.g., a configurable and movable foot support) or a heel stop 160 (e.g., a configurable and movable heel stop). In some embodiments, the patient support (e.g., an integrated or non-integrated patient support) further includes a headrest (e.g., a configurable and movable headrest).

[0202] In some embodiments, each component (e.g., backrest 110, armrest 170, seat 140, shin support 150, footrest or heel stop 160, and headrest) can be manipulated by a human user to position the component in the desired configuration. In some embodiments, each component (e.g., backrest 110, armrest 170, seat 140, shin support 150, footrest or heel stop 160, and headrest) can be moved (e.g., translated and / or rotated) by a human using their hand to apply force to the component, and not exceeding the typical force that an average person can provide.

[0203] In some embodiments, the patient support 100 includes one or more electric components, such as an electric backrest (e.g., a backrest 110 operatively engaged with a backrest motor), an electric headrest (e.g., a headrest operatively engaged with a headrest motor), an electric armrest (e.g., an armrest 170 operatively engaged with an armrest motor), an electric seat (e.g., a seat 140 operatively engaged with a seat motor), an electric shin support (e.g., a shin support 150 operatively engaged with a shin support motor), and / or an electric foot support (e.g., a foot support operatively engaged with a foot support motor) or an electric heel stop (e.g., a heel stop 160 operatively engaged with a heel stop motor). Therefore, the backrest motor is configured to move (e.g., translate and / or rotate) the backrest 110, the headrest motor is configured to move (e.g., translate and / or rotate) the headrest, the armrest motor is configured to move (e.g., translate and / or rotate) the armrest 170, the seat motor is configured to move (e.g., translate and / or rotate) the seat member 140, the shin support motor is configured to move (e.g., translate and / or rotate) the shin support 150, and / or the foot support motor or heel stop motor is configured to move (e.g., translate and / or rotate) the foot support or heel stop motor.

[0204] In some embodiments, the OGTS provides components (e.g., a computer, microcontroller, and / or microprocessor) configured to coordinate control and / or movement (e.g., translation) of the patient support in the X, Y, and / or Z directions. In some embodiments, the OGTS provides components (e.g., a computer, microcontroller, and / or microprocessor) configured to coordinate control and / or movement (e.g., rotation) of the patient support about the X-axis, Y-axis, and / or Z-axis. In some embodiments, the OGTS provides components (e.g., a computer, microcontroller, and / or microprocessor) configured to coordinate control and / or movement (e.g., translation) of the patient support in the X, Y, and / or Z directions, and configured to coordinate control and / or movement (e.g., rotation) of the patient support about the X-axis, Y-axis, and / or Z-axis. In some implementations, the OGTS provides components (e.g., a computer, microcontroller, and / or microprocessor) configured to coordinate the control and / or movement of one or more electrically powered components, such as electrically powered backrests, electrically powered headrests, electrically powered armrests, electrically powered seat panels, electrically powered shin supports, and / or electrically powered foot supports or electrically powered heel stops, to provide the patient support to one or more specific configurations, including electrically powered backrests, electrically powered headrests, electrically powered armrests, electrically powered seat panels, electrically powered shin supports, and / or electrically powered foot supports or electrically powered heel stops in specific positions. Coordinating the control and / or movement (e.g., translation and / or rotation) of the patient support or one or more configurable components of the patient support includes supplying or removing current or voltage from a power source to a motor engaged with the patient support and / or one or more configurable components of the patient support to move the patient support and / or one or more configurable components of the patient support to the appropriate position.

[0205] After determining one or more of ΔX, ΔY, ΔZ, Δψ, Δφ, and / or Δθ as described above, one or more of the patient positioning system, patient support and / or backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop will be appropriately translated and / or rotated to move the patient support and / or patient into a suitable position for imaging or treatment. In some embodiments, movement (e.g., translation and / or rotation) of one or more of the patient positioning system, patient support and / or backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop is performed by motors and drive mechanisms (e.g., by supplying current and / or voltage to one or more motors) engaging with one or more of the patient positioning system, patient support and / or backrest, seat, shin support, armrest, headrest, and / or foot support or heel stop. In some implementations, movement (e.g., translation and / or rotation) of one or more of the patient positioning system, patient support and / or backrest, seat, shin support, armrest, headrest and / or foot support or heel stop is performed by a user engaging and moving with one or more of the patient positioning system, patient support and / or backrest, seat, shin support, armrest, headrest and / or foot support or heel stop.

[0206] Although some exemplary implementations are disclosed herein, it should be understood that these implementations are presented in an exemplary manner rather than in a limiting manner.

[0207] Example Example 1 - Optical Guidance and Tracking System like Figure 3 As shown in the provided diagram, the provided OGTS includes three cameras. Camera 1 (“front”) and camera 2 (“side”) are mounted in a horizontal plane (XY plane) and spaced 90 degrees apart. The patient is positioned to face camera 1. The live image seen on camera 1 shows inconsistencies in translation in the left-right (X) and up-down (Z) directions compared to the reference image, and / or inconsistencies in rotation about the axis (Y) of camera 1 compared to the reference image.

[0208] The provided camera 2 is at a 90-degree angle to camera 1, thus providing a lateral view of the patient. Inconsistencies are observed between the live image and the reference image in the front-to-back (Y) and up-to-down (Z) directions of translation, and / or between the live image and the reference image in rotation about the axis (X) of camera 2.

[0209] The provided camera 3 is positioned orthogonal to both camera 1 and camera 2. Therefore, camera 3 is positioned on the normal to the horizontal (XY) plane (i.e., above or below the patient). In practice, camera 3 is positioned above the patient to provide a top-view view of the patient. Inconsistencies exist between the live image and the reference image seen on camera 3 in the front-back (Y) and left-right (X) directions of translation, and / or between the live image and the reference image in rotation about the axis (Z) of camera 3.

[0210] Assuming the patient only translates in space, aligning the live image from each camera view with a reference image provides appropriate ΔX, ΔY, and / or ΔZ displacements in actual space that position the object (e.g., the patient) to the same position where the object (e.g., the patient) was positioned when the reference image was acquired and saved. Furthermore, rotation in space is calculated by analyzing the differences between the live views from the three cameras and the saved images.

[0211] Example 2 - Upright Imaging and Positioning System This technology relates to an imaging system, including a patient positioner in an upright patient positioning device or patient positioning system (see, for example, Figure 1A and Figure 1B ) and upright spiral CT scanners (see, for example, Figures 2A to 2D See, for example, U.S. Patent Application Publication No. 2022 / 0183641, MULTI-AXIS MEDICAL IMAGING (U.S. Patent Application Serial No. 17 / 535,091), which is expressly incorporated herein by reference. A patient positioning device or patient positioning system provides for positioning a patient in a sitting or reclining (semi-standing) position while CT acquires diagnostic-quality CT images of the patient in a therapeutic orientation. See also Figure 5A Beam delivery systems are typically located behind the posterior wall and include high-energy X-ray or electron beam delivery systems or particle therapy beam delivery systems.

[0212] The upright imaging and positioning system allows for the installation of OGTS systems including five cameras. Figure 5B A typical camera installation in a treatment room is shown. Cameras 1, 2, 4, and 5 are mounted on a horizontal plane, and camera 3 is mounted directly above the isocenter. As discussed above, cameras 1, 2, and 3 are orthogonal to each other. The technique is not limited to this arrangement. For example, the technique also envisions an implementation in which cameras 4 and 5 are also orthogonal to each other and each orthogonal to camera 3.

[0213] exist Figure 5BIn the illustrated embodiment, cameras 1 and 2 are located closest to the chamber entrance and are used in conjunction with camera 3 to capture reference images of the patient in the set position and to verify the patient's position during subsequent imaging and treatment procedures. Cameras 4 and 5 are used to verify and track the patient's position during imaging and in various treatment fields obtained by rotating the patient around the vertical (Z) axis.

[0214] Figure 5C The design of an embodiment of the OGTS system treatment room 710, control room 720, and technology room 730 is shown. Figure 5D and Figure 5E Views are shown in section A of treatment room 710 and section B of control room 720 and technology room 730, respectively. Treatment room 710 includes an OGTS (Optical Guided Terminal System) comprising an overhead camera E (235) and four peripheral cameras A, B, C, and D (231, 232, 233, and 234), the positions of which are exemplary and not limiting. The treatment room further includes a patient positioning system. A technician 901 is shown in treatment room 710. One illustration shows a keyboard, mouse, and monitor in treatment room 710 for use by technician 901, for example, to control the OGTS and perform the methods described herein; and a second illustration shows a keyboard, mouse, and monitor in control room 720, for example, to control the OGTS and perform the methods described herein. The treatment room and control room may each include a table or shelf, a network outlet, and a single-phase power outlet. The technology room may include a computer for data analysis, data storage, computing power, system diagnostics, and / or other computing support for the OGTS system. The technical room includes multiple network outlets for connecting to OGTS components in the treatment and control rooms.

[0215] In some embodiments, the four peripheral cameras A, B, C, and D (231, 232, 233, and 234) are positioned at the same height as the isocenter of the treatment room, for example, with a tolerance of ±50 mm. In some embodiments, each of the four peripheral cameras A, B, C, and D (231, 232, 233, and 234) is positioned at a distance of 2300 mm to 6800 mm from the isocenter of the treatment room. In some embodiments, the cameras have lens ranges of 2300–3400 mm, 3200–4800 mm, or 4600–6800 mm to show an 80% to 120% field of view.

[0216] In some implementations, the OGTS uses a 20.2-megapixel camera (e.g., an SVS Vistek EXO 183 TR, 1” sensor format) with a resolution of 5,496 × 3,672 pixels and a high-quality lens. In some implementations, the camera has exemplary focal lengths of 25 mm, 35 mm, or 50 mm. The camera is positioned at a defined distance from the isocenter of the treatment room, and the lens is selected based on the distance between the camera and the isocenter of the treatment room to obtain a field of view of approximately 1.5 m (vertical) × 1.0 m (horizontal) at the isocenter plane. Therefore, in some implementations, the ratio of real-world distance to pixel distance (e.g., pixel distance on the camera sensor and / or pixel distance in the image generated by the camera) is approximately 1500 mm / 5496 pixels = 0.273 mm / pixel. This corresponds to approximately 3.7 pixels of real-world distance or translation on the sensor for every 1 mm of real-world distance or translation. Or in other words, one pixel in an image recorded by the camera represents a distance of approximately 300 µm in the real world.

[0217] All cameras connect to a central computer (“Host”) using a dedicated Ethernet port and a fixed IP address for each camera. The Host processes images and communicates with an unlimited number of client computers that provide a graphical user interface for users. One client computer can act as a master client, used to start a new OGTS session and stop open sessions on all other clients. All other clients can be used to monitor OGTS activity.

[0218] The graphical user interface (GUI) of the OGTS software displayed on the client computer, such as Figure 6 As shown. Camera configuration, settings, operating parameters, and / or camera calibration (e.g., converting pixels to real-world distance) are set on the host GUI and described in the OGTS User Manual. The GUI allows selection of two to four cameras mounted on a horizontal plane, which are then displayed in the left and right windows. Figure 6 The top camera is always selected and displayed in the top center window. (Example:) Figure 6 As shown, camera 1 is selected, facing the patient positioning device or patient positioner. Camera 2 shows the patient positioning device or patient positioner as seen from the left. Camera 3 is positioned above the patient positioning device or patient positioner. Figure 6 On the left side of the image shown are the software control buttons, which users can use to start and stop tracking, start tracking with a new reference image, and save the current viewing configuration as a new recording scene.

[0219] Figure 6The camera images shown are those provided by the cameras when they are fully zoomed out to provide the full field of view for each camera. These fields of view can be used to capture and verify information describing the configuration of a patient positioning device or patient positioner, such as the initial position settings of the patient positioning device or patient positioner before placing the patient on the device and securing the patient in an appropriate posture for imaging or treatment. The initial position settings of the patient positioning device or patient positioner may include information describing the position of the seat, footrest or heel stop, shin support, backrest, and / or armrest.

[0220] Regions of interest (ROIs) can be selected in each camera view to magnify specific areas of an image (e.g., by selecting a subset of the camera sensor array to display as an image). ROIs can be used to magnify specific ROIs of a patient, typically during patient treatment. Once an ROI is selected for a particular camera, the camera sends information to the host, providing a rapid data transfer rate and therefore rapid monitoring of repetition rates. The recorded scene contains information that identifies the specific viewing environment (e.g., the selected camera and the ROI for each camera). Figure 7 This shows a person placed in a patient positioning device or patient positioning unit, with the camera zoomed in according to the different ROIs for each camera. A zoomed-out view of the patient (see...) Figure 6 The camera is used to capture patient posture fixation devices, while a magnified or specific ROI view is used to focus on a specific region of interest (e.g., the anatomical area to be treated). The magnified view provides a higher frame rate from the camera because the camera sends less information over the network.

[0221] OGTS can record and save scenes for later use. Once the patient is posed at a specific location, the OGTS configuration (e.g., selected camera and ROI) can be saved as a setup scene or treatment scene using software controls in the left panel of the GUI. Camera images of the patient and / or the patient positioning device or patient positioner are saved as reference images. Scenes and reference images can be retrieved to reproduce the patient's pose at a later time. The scene selection panel is as follows: Figure 8 As shown. Thumbnail images of the actual scenes are displayed in the selection dialog box. The left panel shows the recorded setup scenes; the right panel shows some recorded treatment scenes. Any of these scenes can be selected during the workflow. Setup scenes are used in the initial stages of the workflow and are typically shown in a zoomed-out view to provide more information. Treatment scenes are used in later stages of the workflow and are shown in a zoomed-in view.

[0222] Figure 8 The scene selection is shown in the right panel. Figure 9The example demonstrates the result of selecting a scene named "Treatment 7". Selecting a scene automatically initiates the tracking routine. In tracking mode, the OGTS software displays the sum of the red components of the RGB reference image and the green and blue components of the live RGB image in each camera view. When the reference and live images are aligned, the red and green components in the image disappear because all parts of the RGB image are aligned, thus providing a color-corrected RGB image (at least in the aligned areas). Figure 9 As seen in the left and top panels of the GUI, the patient's head is slightly rotated to the left around the vertical axis, resulting in a noticeable misalignment in the front of their face. Lateral alignment remains reasonable.

[0223] OGTS is used to calculate the misalignment between a reference image and an image in the live scene. The camera is calibrated to provide a pixel-per-mm size relationship defined at an isocenter plane in real space. For example, as discussed above, the camera used during the development of embodiments of the techniques described herein has a real-world distance to camera sensor pixels and / or image pixels ratio of approximately 0.2723 mm / pixel in the horizontal direction and approximately 0.2729 mm / pixel in the vertical direction (e.g., about 0.3 mm / pixel), which corresponds to 3.672 pixels / mm in the horizontal direction and 3.6620 pixels / mm in the vertical direction (e.g., about 3.7 pixels / mm). Therefore, a misalignment of, for example, 100 pixels between the live image and the reference image indicates that the patient should be spatially translated approximately 30 mm in the appropriate plane of the camera imaging to reproduce the setup position recorded in the reference image.

[0224] Therefore, by aligning the live image and the reference image in each camera view, determining the image pixel distance required for aligning the live image and the reference image, and calculating the ΔX, ΔY, and / or ΔZ displacements based on the pixel size relationship per mm, the ΔX, ΔY, and / or ΔZ displacements suitable for bringing the patient to the actual space recorded in the reference image can be obtained.

[0225] In addition, the OGTS software allows for image rotation to determine Δψ, Δφ, and Δθ to correct for patient rotation relative to previously captured reference images around the X, Y, and Z axes.

[0226] For all purposes, all publications and patents mentioned in the foregoing specification are incorporated herein by reference in their entirety. Various modifications and variations in 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. Indeed, various modifications to the described modes of implementation that are obvious to those skilled in the art are intended to fall within the scope of the appended claims.

Claims

1. An optical guidance and tracking system (OGTS), comprising: Top-mounted camera; and First peripheral camera, The field of view of the top-mounted camera is orthogonal to the field of view of the first peripheral camera.

2. The OGTS according to claim 1, further comprising a second peripheral camera, in, The field of view of the second peripheral camera is orthogonal to the field of view of the top camera; and the field of view of the second peripheral camera is orthogonal to the field of view of the first peripheral camera.

3. The OGTS according to claim 2, further comprising a third peripheral camera, wherein, The fields of view of any two of the peripheral cameras and the top camera are orthogonal to each other.

4. The OGTS according to claim 3, further comprising a fourth peripheral camera, wherein, The fields of view of any two of the peripheral cameras and the top camera are orthogonal to each other.

5. The OGTS according to claim 1, further comprising a patient support component.

6. The OGTS according to claim 5, wherein, The patient support rotates about a vertical (Z) axis.

7. The OGTS according to claim 6, wherein, The field of view of the top-mounted camera is aligned with the vertical (Z) axis.

8. The OGTS according to claim 1, further comprising a radiation therapy device.

9. The OGTS according to claim 8, wherein, The radiation therapy device includes a static source.

10. The OGTS of claim 1, further comprising a computed tomography (CT) scanner.

11. The OGTS according to claim 10, wherein, The top-mounted camera provides a view through a hole in the scanning ring of the CT scanner.

12. The OGTS according to claim 1, wherein, The top-mounted camera includes a color sensor array, and the first peripheral camera also includes a color sensor array.

13. The OGTS of claim 1, further comprising a processor and a non-transitory computer-readable medium.

14. The OGTS according to claim 13, wherein, The non-transitory computer-readable medium includes a program, and the processor executes the program to acquire color images from the top-mounted camera and images from the peripheral camera.

15. The OGTS of claim 13, further comprising a display.

16. The OGTS according to claim 15, wherein, The non-transitory computer-readable medium includes a program, and the processor executes the program to overlay live video onto a reference image on the display.

17. The OGTS according to claim 16, wherein, The non-transitory computer-readable medium includes a program, and the processor executes the program to provide a graphical user interface on the display.

18. The OGTS according to claim 17, wherein, Users interact with the graphical user interface to identify regions of interest in the camera view.

19. The OGTS according to claim 17, wherein, The user interacts with the graphical user interface to align the live video and the reference image on the display.

20. The OGTS according to claim 19, wherein, The processor calculates adjustments in the actual space to properly position the patient for treatment.

21. The OGTS of claim 13, further comprising a database, the database including saved scenes.

22. The OGTS according to claim 21, wherein, The saved scene includes the image, information identifying the camera that provided the image, and the region of interest of the image.

23. The OGTS according to claim 1, wherein, The first peripheral camera is located on the main Y-axis of the OGTS.

24. The OGTS according to claim 2, wherein, The first peripheral camera is located on the main Y-axis of the OGTS, and the second peripheral camera is located on the main X-axis of the OGTS.

25. The OGTS according to claim 1, wherein, The top-mounted camera is located on the main Z-axis of the OGTS.

26. A method for positioning a patient, the method comprising: Obtain a first reference image of the patient support and / or the patient; Superimpose a first live image of the patient support and / or the patient onto the reference image; Align the first live image with the first reference image to determine the displacement; and The patient support and / or the patient are moved according to the displacement.

27. The method according to claim 26, wherein, The first reference image is provided by the first camera, and the first live image is provided by the first camera.

28. The method of claim 26, further comprising obtaining a second reference image of the patient support and / or the patient; and superimposing a second live image of the patient support and / or the patient onto the second reference image.

29. The method according to claim 28, wherein, The second reference image is provided by the second camera, and the second live image is provided by the second camera; and wherein the field of view of the second camera is orthogonal to the field of view of the first camera.

30. The method according to claim 26, wherein, The first camera is a top-mounted camera.

31. The method according to claim 26, wherein, The first camera is an external camera.

32. The method according to claim 26, wherein, Aligning the first live image and the first reference image includes user interaction with a graphical user interface to align the first live image and the first reference image.

33. The method according to claim 26, wherein, Aligning the first live image and the first reference image includes using image alignment software to align the first live image and the first reference image.

34. The method according to claim 26, wherein, The saved scene includes the first reference image.

35. The method according to claim 34, wherein, The saved scene includes the first reference image, information identifying the camera that provided the first reference image, and the region of interest of the first reference image.

36. The method according to claim 26, wherein, The displacement includes translation in the X, Y and / or Z directions and / or rotation about the X-axis, Y-axis and / or Z-axis.

37. The method of claim 26, further comprising determining a relationship between the pixel size of the first camera and the distance in actual space.

38. The method of claim 26, further comprising exposing the patient to radiation.

39. The method of claim 26, further comprising imaging the patient using computed tomography.

40. A method for positioning a patient, the method comprising: Obtain a first reference image of the patient support and / or the patient; Superimpose a first live image of the patient support and / or the patient onto the reference image; The reference image is based on the correction vector displacement; Apply the corrective vector to the patient support and / or the patient; and The correct application of the correction vector is verified by aligning the first live image and the first reference image.

41. The method according to claim 40, wherein, The application of the correction vector is correct when the first live image and the first reference image are substantially, to the greatest extent or substantially aligned.

Images