Systems and methods for adaptive radiotherapy

Abstract

Interstitial brachytherapy is a cancer treatment in which radioactive material is placed directly into the target tissue at the affected site using a afterloading machine. The accuracy of radiation localization is monitored during cancer treatment. During cancer treatment, the radioactive material localization plan can be adjusted based on real-time analysis of the location and dose of radiation measured in, at, and around the target tissue at the affected site.

Description

Background Technology

[0001] The limitations and disadvantages of these conventional methods for data storage will become apparent to those skilled in the art by comparing them with aspects of the present methods and systems set forth in the remainder of this disclosure with reference to the accompanying drawings. Summary of the Invention

[0002] Methods and systems for adaptive radiotherapy are provided, substantially as shown in at least one figure and / or described in conjunction with at least one figure, as set forth more fully in the claims. Attached Figure Description

[0003] Figure 1 An exemplary interstitial brachytherapy treatment for a tumor in a patient's prostate is illustrated according to several aspects of this disclosure.

[0004] Figure 2 Exemplary embodiments of a system for adaptive radiotherapy according to various aspects of this disclosure are shown.

[0005] Figure 3 An exemplary arrangement of radiation sensors in a system for adaptive radiotherapy according to various aspects of this disclosure is shown.

[0006] Figure 4 An exemplary visual display on a treatment controller in a system for adaptive radiotherapy according to various aspects of this disclosure is shown.

[0007] Figure 5 A first placement option for an exemplary surgical robot in a system for adaptive radiotherapy according to several aspects of this disclosure is shown.

[0008] Figure 6 A second placement option for an exemplary surgical robot in a system for adaptive radiotherapy according to several aspects of this disclosure is shown.

[0009] Figure 7 A third placement option for an exemplary surgical robot in a system for adaptive radiotherapy according to various aspects of this disclosure is shown.

[0010] Figure 8 A fourth placement option for an exemplary surgical robot in a system for adaptive radiotherapy according to various aspects of this disclosure is shown.

[0011] Figure 9 An example method for adaptive radiotherapy is shown according to several aspects of this disclosure. Detailed Implementation

[0012] Brachytherapy is commonly used as an effective treatment for cervical cancer, prostate cancer, breast cancer, esophageal cancer, and skin cancer, and can also be used to treat tumors in many other parts of the body. Interstitial brachytherapy is a cancer treatment in which an ionizing radiation source is placed close to the tumor target tissue at the affected site, such as the prostate or breast. Ionizing radiation can be delivered in various ways, from low-activity isotopes (LDR - brachytherapy) to high-activity isotopes (HDR - brachytherapy) or via X-ray emitters (electron brachytherapy).

[0013] The dose rate in brachytherapy refers to the level or intensity of radiation delivered to the surrounding medium and is expressed in glies per hour (Gy / h). In high-dose-rate (HDR) brachytherapy, the dose delivery rate typically exceeds 12 Gy / h. During HDR brachytherapy, the radiation source is left in place for a period of time (usually several minutes or hours) before being withdrawn. The specific duration of treatment will depend on many different factors, including the desired dose delivery rate and the type, size, and location of the cancer.

[0014] A range of imaging techniques, such as X-ray radiography, ultrasound, computed tomography (CT or CAT) scans, and magnetic resonance imaging (MRI), can be used to visualize the shape and size of tumors and their relationship to surrounding tissues and organs. Data from many of these sources can be used to create 3D maps of the tumor and surrounding tissues. Using this information, an optimal distribution plan for the radiation source can be developed. This includes considering how the radiation should be placed and positioned. Incorrect or poor treatment setups can pose safety risks to the patient. Too little or too much radiation must be avoided during treatment, as this can lead to treatment failure and serious side effects.

[0015] Figure 1 An example interstitial brachytherapy 100 for a tumor 101 in a patient's prostate 103 according to several aspects of this disclosure is shown. The size and location of the tumor 101 relative to the patient's urethra 105, bladder 107, and rectum 109 are shown for illustrative purposes. The tumor 101 can be of any size and located anywhere in the prostate 103.

[0016] like Figure 1As shown, afterloading machine 111 is a radiotherapy machine used to irradiate tumor 101. Afterloading machine 111 has the ability to place an ionizing radiation source 119 into the patient's treatment area. The ionizing radiation source may be an isotope fixed to the end of a steel cable 113, which is controlled by afterloading machine 111 and delivered via a delivery tube 115 into a plastic or metal catheter 117 placed inside the patient. The ionizing radiation source may also be a miniaturized X-ray emitter located at the end of a cable 114, which may be small enough to be placed into the plastic or metal catheter 117 via the delivery tube 115. Once positioned, the catheter 117 receives the radiation source 119, and afterloading machine 111 controls the movement, positioning, and residence time of the radiation source 119 within the tumor 101 as specified in the physician's treatment plan.

[0017] Interstitial brachytherapy requires the direct and precise placement of a short-range radiation source 119 (such as radioactive isotopes like cobalt-60, iodine-125, diatom-131, iridium-192, or an electron source such as a miniaturized X-ray source) at the site of the cancerous tumor 101. The radiation therapy aims to kill cancerous tissue while minimizing exposure to healthy tissue. The radiation source 119 can travel the entire length of the catheter 117 while stopping at specific locations for predetermined time periods, thus providing isotropic irradiation of the tissue surrounding the tumor 101. However, if the brachytherapy unit is not properly calibrated, healthy (e.g., non-cancerous) tissue may be irradiated incorrectly.

[0018] Several aspects of this disclosure provide a tool for real-time adjustment of an afterloading radiotherapy machine during brachytherapy to provide and maintain accurate radiation placement and dose. The intensity, location, and velocity of the detected radiation can be used as feedback to recalibrate the afterloading machine in real time. Figure 2 Exemplary embodiments of a system for adaptive radiotherapy according to various aspects of this disclosure are shown.

[0019] The treatment controller 207 can receive in vivo dosimetry (IVD) data 205 and generate afterloading adjustment signals 213. The treatment controller 207 can be implemented in various forms. For example, the treatment controller 207 can be software on a dedicated system or a mobile device such as an iPad or iPhone. The treatment controller 207 can be programmed with the physician's treatment plan 211 and MRI data 209. During radiotherapy, the IVD data 205 and the afterloading adjustment signals 213 can be transmitted wirelessly (or directly via wired connection) to the afterloading machine 111 and / or the IVD detector 201. Wireless communication can be achieved through various protocols, such as WiFi, cellular, 5G, or Bluetooth. For example, cellular connectivity would allow one (or more) physicians to monitor radiotherapy from a remote location. The processing controller 207 can also be a feature added to the afterloading machine 111.

[0020] IVD data 205 can be generated based on light received by multiple optical detection units (e.g., photodetectors, photodiodes, etc.). The optical detection units typically have fast signal response times to allow for the identification of radiation source locations. The optical detection units may be located in the radiation source detector 203 at the patient's location. Alternatively, the optical detection units may be coupled to an optical fiber and located in the IVD detector 201. The IVD detector 201 may be a standalone device, or it may be added to the aftermarket unit 111.

[0021] The light received by the multiple light detection units is generated by multiple scintillators in the radiation source detector 203. Each of the multiple scintillators is configured to generate light in the presence of ionizing radiation from the radiation source 119.

[0022] The position and velocity of the radiation source 119 can be calculated based on electrical signals (e.g., voltage or current) from multiple optical detection units. This calculation can be performed in the IVD detector 201 or the treatment controller 207.

[0023] The treatment controller 207 can map the progress of radiotherapy and compare such mapping with MRI data 209 and the physician's treatment plan 211 determined prior to radiotherapy. The treatment controller 207 can identify errors between the desired radiation dose and the current radiation dose based on the IVD data. Similarly, the treatment controller 207 can identify errors between the desired radiation location and the current radiation location. The afterload adjustment signal 213 is determined based on the identified locations where the current treatment does not match the physician's treatment plan 211.

[0024] According to an example implementation, radiation source detector 203 may include multiple radiation sensors / detectors. Figure 3 An exemplary arrangement of radiation sensors in a system for adaptive radiotherapy according to various aspects of this disclosure is shown. Figure 3 An exemplary arrangement includes radiation probe #1 301, radiation probe #2 303, and radiation probe #3 305.

[0025] The radiation probe #1 301 is described in more detail. The radiation probe #1 301 includes a scintillator 309 and may include a photodetector 313 (e.g., a photodiode). Additionally, the radiation probe #1 301 may include a reference marker 307 and / or an optical fiber 311. The reference marker 307 may include a gold tip that allows the radiation probe #1 301 to be positioned using an MRI scanner. The optical fiber 311 allows the photodetector 313 to be positioned at a distance from the scintillator 309. The photodetector 313 may also include a built-in lens and / or filter to select the wavelength emitted from a particular scintillator 309.

[0026] When radiation source 119 is within tumor 101, radiation probes #1 301, #2 303, and #3 305 each generate an electrical signal inversely proportional to the respective distances R1, R2, and R3 between radiation source 119 and the scintillator of each corresponding radiation probe 301, 303, and 305. For example, the resulting electrical signal can be inversely proportional to the square of the distance between radiation source 119 and the point 309 where the radiation is converted into light. Each calculated distance R1, R2, and R3 generates spheres 341, 343, and 345 representing possible locations of radiation source 119. The intersection of spheres 341, 343, and 345 identifies the location of radiation source 119. Therefore, the electrical signals from radiation probes #1 301, #2 303, and #3 305 are used to triangulate the location of radiation source 119.

[0027] Each scintillator 309, 319, 329 is configured to generate light in the presence of radiation 119 from the radiation source. The level of light generated by each scintillator 309, 319, 329 is proportional to the level of radiation incident on each scintillator 309, 319, 329. Each light detection unit 313, 323, 333 is configured to generate an electrical signal in the presence of light from one of the scintillators 309, 319, 329. The level of the electrical signal generated by each light detection unit 313, 323, 333 is proportional to the level of light incident on each light detection unit 313, 323, 333. Therefore, the level of the electrical signal generated by each light detection unit 313, 323, 333 is proportional to the level and properties (e.g., spectral characteristics) of the radiation incident on each scintillator 309, 319, 329. Each of the multiple optical detection units 313, 323, 333 can be coupled to one of the multiple scintillators 309, 319, 329 via an optical fiber.

[0028] For example, Figure 4 It shows how to use such Figure 2 An exemplary visual display 411 is shown on the treatment controller 207 in the adaptive radiotherapy system. The visual display 411 is capable of mapping radiation dose. For example, the visual display 411 can be 3D and can use different colors and textures to identify gradients of different radiation levels.

[0029] The visual display 411 can combine MRI images of the target tumor 101 with the physician's treatment plan and real-time feedback from radiation monitoring. For example, the current location of the radiation source 401 can be overlaid on the MRI image of the target tumor 101, as shown. The physician's treatment plan can be illustrated using images of the current afterloading catheter placement 403 and the planned afterloading catheter placement 405. Based on the detected radiation 405 and the planned radiation 407, the treatment controller 207 can calculate whether corrective measures should be taken to the physician's treatment plan. For example, the radiation could be targeted to an area other than the area initially planned before radiation therapy begins. Such corrective measures can be sent to change the current afterloading settings. Before the treatment controller changes the afterloading settings, the physician can choose to override the adaptive response of the treatment controller.

[0030] Figure 5 A first placement option for an exemplary surgical robot 501 in a system for adaptive radiotherapy according to various aspects of this disclosure is illustrated. The surgical robot 501 can be configured to control the placement of one or more catheters according to adjustment instructions from a treatment controller. For example, the surgical robot 501 may include multiple interstitial catheters pointing to different locations within the patient's body. Alternatively, the surgical robot 501 may be configured to change the orientation of one or more interstitial catheters. Based on control signals for real-time adjustment from the treatment controller 207 to the afterloading device 111, the surgical robot 501 can be configured to control the duration for which the radiation source is positioned at a target location. This duration can be adjusted during radiotherapy based on IVD data received by the treatment controller 207. Similarly, the target location can be adjusted during radiotherapy based on IVD data received by the treatment controller 207.

[0031] Figure 6 A second placement option for an exemplary surgical robot 501 in a system for adaptive radiotherapy according to several aspects of this disclosure is shown. Figure 6 In the process, radiation probes #1 301, #2 303, and #3 305 were placed in the target tumor 101, while the surgical robot 501 administered radiation therapy.

[0032] Figure 7 A third placement option for an exemplary surgical robot 501 in a system for adaptive radiotherapy according to various aspects of this disclosure is shown. Figure 7 In this procedure, radiation probes #1 301, #2 303, and #3 305 are placed in the patient's urethra 105, while the surgical robot 501 administers radiation therapy. Radiation probes 301, 303, and 305 may be located within or integrated into a urinary catheter.

[0033] Figure 8A fourth placement option is shown for an exemplary surgical robot 501 in a system for adaptive radiotherapy according to several aspects of this disclosure. Figure 8 In the process, surgical robot 501 simultaneously delivers radiation therapy to tumor 101 located in the patient's rectum 109.

[0034] Figure 9 An example method for adaptive radiotherapy according to several aspects of this disclosure is illustrated. At 901, light is generated by a plurality of scintillators. The level of light generated by each scintillator is proportional to the level of radiation incident on each scintillator and the nature of the radiation source. At 903, a plurality of electrical signals are generated by a plurality of photodetectors. The level of the electrical signal generated by each photodetector is proportional to the light from each corresponding scintillator. The current position and current velocity of the radiation source can be determined by triangulation based on the electrical signals from the plurality of photodetectors.

[0035] In step 905, IVD data is generated based on multiple electrical signals. This IVD data can be wirelessly transmitted from the IVD detector to the treatment controller. The error between the target location of the radiation source (i.e., the location determined before radiotherapy) and the current location of the radiation source can be calculated from the IVD data. The error between the desired radiation dose and the current radiation dose can also be determined based on electrical signals from multiple light detection units.

[0036] In step 907, an afterloading adjustment signal is generated based on IVD data. This signal can be used to control and adjust the duration of the radiation source's position at the target location. The surgical robot can be controlled based on this signal. Therefore, the surgical robot can control the placement of one or more interstitial catheters based on real-time feedback regarding the effectiveness and accuracy of the current radiotherapy, thereby reducing errors and the need for retreatment.

[0037] Although the method and / or system have been described with reference to certain embodiments, those skilled in the art will understand that various changes and equivalents can be made without departing from the scope of the method and / or system. Furthermore, many modifications can be made to adapt particular situations or materials to the teachings of this disclosure without departing from its scope. Therefore, it is intended that the method and / or system be limited to the specific embodiments disclosed, but rather that the method and / or system encompass all embodiments falling within the scope of the appended claims.

[0038] As used herein, the terms “circuits” and “circuitry” refer to physical electronic components (i.e., hardware) and any software and / or firmware (“code”) that can configure, be executed by, and / or otherwise associate with the hardware. As used herein, for example, a particular processor and memory may include a first “circuit” when executing the first one or more lines of code and a second “circuit” when executing the second one or more lines of code. As used herein, “and / or” means any one or more items in a list connected by “and / or”. For example, “x and / or y” means any element in the three-element set {(x),(y),(x,y)}. In other words, “x and / or y” means “one or both of x and y”. As another example, “x, y, and / or z” means any element in the seven-element set {(x),(y),(z),(x,y),(x,z),(y,z),(x,y,z)}. In other words, “x, y, and / or z” means “one or more of x, y, and z”. As used herein, the term "exemplary" means serving as a non-limiting example, instance, or illustration. As used herein, the terms "e.g." and "for example" list one or more non-limiting examples, instances, or illustrations. As used herein, the circuit is "operable" to execute the function, provided that the circuit contains the hardware and code (if necessary) required to execute the function, regardless of whether the execution of the function is disabled or not enabled (e.g., by user-configurable settings, factory tuning, etc.).

Claims

1. A system for adaptive radiotherapy, comprising: The treatment controller is operable to receive in vivo dosing (IVD) data and generate afterloading adjustment signals, wherein: IVD data is generated based on the light received by multiple optical detection units. Light received by the plurality of light detection units is generated by a plurality of scintillators. Each of the plurality of scintillators is configured to produce light in the presence of radiation from a radiation source. The level of light produced by each scintillator is proportional to the level and nature of the radiation incident on each scintillator. Each of the plurality of optical detection units is configured to generate an electrical signal in the presence of light from one of the plurality of scintillators, and The level of the electrical signal generated by each optical detection unit is proportional to the light incident on each optical detection unit; Visual display, configured to combine MRI images with treatment plans and real-time feedback from radiation monitoring, The visual display maps the radiation dose, and in the visual display, the current location of the radiation source is overlaid on the MRI image. The system includes a surgical robot configured to control the placement of one or more interstitial catheters according to a treatment controller adjustment signal, and the afterloading device is configured to control the time period during which the radiation source is located at the target position according to the treatment controller adjustment signal.

2. The system according to claim 1, wherein, The system includes an IVD detector configured to calculate the location of the radiation source based on electrical signals from the plurality of optical detection units.

3. The system according to claim 2, wherein, The IVD detector is configured to calculate the location of the radiation source by triangulation based on electrical signals from the plurality of optical detection units.

4. The system according to claim 2, wherein, The IVD detector is configured to calculate the velocity of the radiation source based on electrical signals from the plurality of optical detection units.

5. The system according to claim 1, wherein, The treatment controller is operable to calculate the error between a desired radiation dose and a current radiation dose, wherein the desired radiation dose is determined prior to radiotherapy, and wherein the current radiation dose is determined based on the IVD data.

6. The system according to claim 1, wherein, The length of the time period is configured to be adjusted during radiotherapy based on IVD data received by the treatment controller.

7. The system according to claim 1, wherein, The target location is configured to be adjusted by the surgical robot and the afterloading machine during radiotherapy based on IVD data received by the treatment controller.

8. The system according to claim 2, wherein, The IVD detector is configured to wirelessly transmit the IVD data to the treatment controller.

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