Correlation of dose and dose rate information with volume for radiation treatment planning

Abstract

A method for planning radiation treatment accesses (802) information including calculated dose and calculated dose rate for a sub-volume in the treatment target, and also accesses (804) information including a metric of the sub-volume as a function of the calculated dose and calculated dose rate. A graphical user interface includes plotting (806) based on the calculated dose, calculated dose rate, and metric.

Description

[0001] Cross-reference to related applications

[0002] This application claims priority to U.S. Provisional Application Serial No. 63 / 043,027, filed June 23, 2020, by Lansonneur et al., entitled “Correlation of Dose and dose rate information to Volume forradiation treatment planning,” which is incorporated herein by reference in its entirety. Background Technology

[0003] The use of radiation therapy to treat cancer is well-known. Typically, radiation therapy involves directing a beam of high-energy proton, photon, ion, or electron radiation (“therapeutic radiation”) onto a target or volume within a treatment target (e.g., a volume containing a tumor or lesion).

[0004] Before treating a patient with radiation, a patient-specific treatment plan is developed. This plan uses simulations and optimizations that can be based on past experience to define various aspects of the treatment. Typically, the goal of the treatment plan is to deliver sufficient radiation to the unhealthy tissue while minimizing the radiation exposure of the surrounding healthy tissue.

[0005] The planner's goal is to find the optimal solution for multiple clinical objectives, which is contradictory in that improvements toward one objective may have detrimental effects on achieving another. For example, a treatment plan to protect the liver from a certain dose of radiation may result in excessive radiation exposure to the stomach. These types of trade-offs lead to iterative processes, in which the planner creates different plans to find the one best suited to achieve the desired outcome.

[0006] Recent studies in radiation biology have demonstrated the effectiveness of delivering a relatively high therapeutic radiation dose to a target within a single, short timeframe. This type of treatment is generally referred to herein as FLASH radiation therapy (FLASHRT). Evidence to date suggests that FLASH RT advantageously protects normal, healthy tissue from damage when exposed to high radiation doses for only a short period.

[0007] FLASH RT introduces important interdependencies that traditional radiation treatment planning has not captured. Current tools such as dose-volume histograms and dose-rate-volume histograms do not capture the interdependencies between dose and dose rate. For example, from a clinician's perspective, developing a dose rate distribution for high-quality planning is not trivial, because normal tissue may benefit from low dose rates in certain areas if the dose is minimized in those areas. Moreover, for example, a limited number of spots in the irradiation treatment volume can lead to high dose rate delivery but low dose homogeneity at the tumor level, while on the other hand, planning quality can be improved by increasing the number of spots at the expense of reducing the dose rate. Summary of the Invention

[0008] In one aspect, the present invention provides a computer system. In another aspect, the present invention provides a non-transitory computer-readable storage medium having computer-executable instructions for causing the computer system to perform a method for planning radiation processing. In yet another aspect, the present invention provides a non-transitory computer-readable storage medium having computer-executable instructions for causing the computer system to perform another method for planning radiation processing.

[0009] Therefore, according to some embodiments of the present invention, an improved method for generating and evaluating radiation processing plans for FLASH RT and improving radiation processing based on these plans is provided.

[0010] In some embodiments, a computer-implemented method for planning radiation treatment includes accessing information including a calculated dose and a calculated dose rate for a sub-volume in a treatment target (e.g., any number of voxels in any three-dimensional shape constituting the sub-volume), and also accessing information including a metric (e.g., number, percentage, or fraction) of the sub-volume as a function of the calculated dose and the calculated dose rate. A graphical user interface (GUI) is then displayed, including a drawing (e.g., a visual display) based on the calculated dose, calculated dose rate, and metric.

[0011] In some embodiments, drawing includes visualizations of dose-volume histograms (e.g., graphical elements) as a first dimension of the GUI (e.g., visualized elements or aspects, or spatial dimensions in virtual space), visualizations of dose-rate-volume histograms as a second dimension of the GUI, and visualizations of metrics as a third dimension of the GUI. For example, drawing may include visualizations of the calculated dose rate for each sub-volume, visualizations of the calculated dose for each sub-volume, and visualizations of metrics for each sub-volume. In some embodiments, drawing also includes visualizations of the prescribed dose and the prescribed dose rate. In some embodiments, drawing also includes visualizations of the probability of normal tissue complications for each sub-volume. In some embodiments, drawing also includes visualizations of the probability of tumor control for each sub-volume. In some embodiments, different attribute values ​​(e.g., color, pattern, grayscale, alphanumeric text, or brightness) are associated with visualized elements.

[0012] The GUI allows clinicians to better assess the balance between dose rate and dose homogeneity. It visualizes the calculated dose and calculated dose rate for a subvolume within the treated target, along with a metric for the subvolume as a function of the calculated dose and dose rate, in a single scan. Essentially, in a single scan, clinicians can assess the quality of the proposed radiation treatment plan, make changes to the plan, and evaluate the results of those changes.

[0013] In radiation therapy techniques, the intensity of the particle beam is either constant or modulated in the delivery field, such as in intensity-modulated radiation therapy (IMRT) and intensity-modulated particle therapy (IMPT), where the beam intensity varies over each treatment area (volume within the treatment target) of the patient. Depending on the treatment modality, the degrees of freedom available for intensity modulation include beam shaping (collimation), beam weighting (spot scanning), and the angle of incidence (which may be referred to as beam geometry). These degrees of freedom result in a virtually unlimited number of potential treatment plans, making the continuous and efficient generation and evaluation of high-quality treatment plans beyond human capability and reliant on the use of computer systems, especially when considering the time constraints associated with using radiation therapy to treat diseases such as cancer, and the large number of patients undergoing or needing to undergo radiation therapy during any given time period.

[0014] According to some embodiments of the invention, radiation treatment planning and the treatment itself are improved by extending FLASH RT to a wider range of treatment platforms and target sites (e.g., tumors). Treatment plans generated, as described herein, are superior for protecting healthy tissue from radiation by optimizing the balance between the dose rate delivered to unhealthy tissue (e.g., tumor) within the volume of the treatment target and the dose rate delivered to surrounding healthy tissue, compared to conventional techniques for FLASH dose rates. When used with FLASH dose rates, patient movement management is simplified because the dose is administered over a short period (e.g., less than one second). Treatment planning, while still a complex task, is improved relative to conventional treatment planning. In addition to these benefits, the GUI facilitates treatment planning by allowing planners to easily visualize key elements of the proposed treatment plan, easily visualize the impact of changes to those elements on the proposed plan, compare different plans, and define and establish optimization goals.

[0015] In summary, some embodiments of this disclosure relate to generating and implementing processing plans that are the most effective (relative to other plans) and have minimal (or most acceptable) side effects (e.g., lower dose rates outside the treated area). Therefore, some embodiments of the invention specifically improve the field of radiation processing planning and, generally, the field of radiation therapy. Some embodiments of the invention allow for the faster generation of more effective processing plans. Furthermore, some embodiments of the invention contribute to improved computer performance because, for example, by reducing the complexity of generating processing plans, fewer computing resources are needed and consumed, meaning that computer resources are freed up to perform other tasks.

[0016] In addition to radiation therapy techniques such as IMRT and IMPT, embodiments of the present invention can be used for spatially segmented radiation therapy, including high-dose spatially segmented grid radiation therapy, mini-beam radiation therapy, and microbeam radiation therapy.

[0017] After reading the following detailed description illustrated in the various figures, those skilled in the art will recognize these and other objects and advantages according to embodiments of the present invention.

[0018] This overview is provided to introduce some concepts that are further described in the detailed description below. This overview is not intended to identify key or essential features of the claimed subject matter, nor is it intended to limit the scope of the claimed subject matter. Attached Figure Description

[0019] The accompanying drawings, which are incorporated in and form a part of this specification and in which like numbers describe like elements, illustrate embodiments of the present disclosure and, together with the detailed description, serve to explain the principles of the present disclosure.

[0020] Figure 1 This is a block diagram of an example computer system on which the embodiments described herein can be implemented.

[0021] Figure 2 This is a block diagram illustrating an example of an automated radiation therapy treatment planning system according to an embodiment of the present invention.

[0022] Figure 3 The illustration shows a knowledge-based planning system according to an embodiment of the present invention.

[0023] Figure 4 This is a block diagram illustrating selected components of a radiation therapy system according to an embodiment of the present invention that can be implemented thereon.

[0024] Figure 5A and Figure 5B An example of a dose-volume histogram according to one embodiment of the present invention is illustrated.

[0025] Figure 5C The illustration shows a sub-volume within the volume of a processed target according to one embodiment of the present invention.

[0026] Figure 5D An example of an irradiation time-volume histogram according to an embodiment of the present invention is illustrated.

[0027] Figure 6 This is a flowchart illustrating an example of the operation of a computer-implemented radiation treatment plan according to an embodiment of the present invention.

[0028] Figure 7 An example of a dose rate contour line according to an embodiment of the present invention is illustrated.

[0029] Figure 8 , Figure 9 and Figure 10 This is a flowchart illustrating an example of a computer-implemented operation for planning radiation processing according to an embodiment of the present invention.

[0030] Figure 11 , Figure 12 , Figure 13A , Figure 13B , Figure 14-28 , Figure 29A , Figure 29B , Figure 30A , Figure 30B and Figures 31-35 It is an example of a graphical user interface on a display device, and is used for planning radiation processing according to an embodiment of the present invention. Detailed Implementation

[0031] Reference will now be made in detail to various embodiments of the present disclosure, examples of which are illustrated in the accompanying drawings. Although described in conjunction with these embodiments, it should be understood that these embodiments are not intended to limit the present disclosure to these embodiments. Rather, the present disclosure is intended to cover alternatives, modifications, and equivalents that may be included within the spirit and scope of the present disclosure as defined by the appended claims. Furthermore, numerous specific details are set forth in the following detailed description of the present disclosure in order to provide a thorough understanding of the present disclosure. However, it should be understood that the present disclosure may be practiced without these specific details. In other instances, well-known methods, processes, components, and circuits have not been described in detail so as not to unnecessarily obscure aspects of the present disclosure.

[0032] Some parts of the following detailed description are presented using other notations for procedures, logic blocks, processes, and operations on data bits within computer memory. These descriptions and representations are means used by those skilled in the art of data processing to most effectively communicate the substance of their work to others skilled in the art. In this application, procedures, logic blocks, processes, etc., are considered as a self-consistent sequence of steps or instructions that lead to a desired result. A step is a step involving the physical manipulation of physical quantities. Typically, although not strictly necessary, these quantities take the form of electrical or magnetic signals that can be stored, transmitted, combined, compared, and otherwise manipulated in a computer system. Primarily for general reasons, referring to these signals as transactions, bits, values, elements, symbols, characters, samples, pixels, etc., sometimes proves convenient.

[0033] However, it should be remembered that all these and similar terms will be associated with appropriate physical quantities and are merely convenient notations applied to those quantities. Unless specifically stated otherwise, as will be apparent from the following discussion, it should be understood that throughout this disclosure, discussions using terms such as “access,” “generate,” “represent,” “apply,” “indicate,” “store,” “use,” “adjust,” “include,” “calculate,” “operate,” “determine,” “visualize,” “display,” “draw,” “associate,” “interval,” or “round,” refer to computer systems or similar electronic computing devices or processors (e.g., Figure 1 The actions and processes of the computer system 100 (e.g., Figure 6 and Figure 8-10 (Flowchart). A computer system or similar electronic computing device manipulates and converts data that is represented as physical (electronic) quantities within the computer system's memory, registers, or other such information storage, transmission, or display devices.

[0034] The following discussion includes terms such as “dose,” “dose rate,” and “energy.” Unless otherwise stated, a value is associated with each of these terms. For example, a dose has a value and can have different values. For simplicity, the term “dose” may refer to, for example, the value of a dose, unless otherwise stated or obvious from the discussion.

[0035] The following detailed description is presented and discussed according to the methodology. Although the accompanying drawings (e.g.) are not included in this document, Figure 6 and Figure 8-10 The steps and their ordering that describe the operation of these methods are disclosed in the document, but these steps and orderings are merely examples. The embodiments are well-suited for performing various other steps or variations thereof listed in the flowcharts of the accompanying drawings in a sequence different from that depicted and described herein.

[0036] The embodiments described herein can be discussed in the general context of computer-executable instructions residing on some form of computer-readable storage medium (such as a program module) and executed by one or more computers or other devices. By way of example and not limitation, the computer-readable storage medium may include non-transitory computer storage media and communication media. Typically, a program module includes routines, programs, objects, components, data structures, etc., that perform a specific task or implement a specific abstract data type. The functionality of the program module may be combined or distributed across the various embodiments as needed.

[0037] Computer storage media include volatile and non-volatile, removable and non-removable media implemented using any method or technology for storing information such as computer-readable instructions, data structures, program modules or other data. Computer storage media include, but are not limited to, random access memory (RAM), read-only memory (ROM), electrically erasable programmable ROM (EEPROM), flash memory or other memory technologies, optical disc ROM (CD-ROM), digital versatile disc (DVD) or other optical storage, magnetic disk storage, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other medium that can be used to store desired information and can be accessed to retrieve that information.

[0038] Communication media can embody computer-executable instructions, data structures, and program modules, and includes any information transmission medium. By way of example, and not limitation, communication media includes wired media such as wired networks or direct wired connections, and wireless media such as acoustic, radio frequency (RF), infrared, and other wireless media. Any combination of the foregoing may also be included within the scope of computer-readable media.

[0039] Radiation processing plan using different types of histograms

[0040] Figure 1A block diagram of an example computer system 100 on which the embodiments described herein can be implemented is shown. In its most basic configuration, system 100 includes at least one processing unit 102 and memory 104. This most basic configuration in Figure 1 The diagram is illustrated by dashed line 106. System 100 may also have additional features and / or functions. For example, system 100 may also include additional storage devices (removable and / or non-removable), including but not limited to disks, optical discs, or magnetic tapes. Such additional storage devices... Figure 1 The diagram shows a removable storage device 108 and a non-removable storage device 120. The system 100 may also include multiple communication connections 122 that allow the device to communicate with other devices, for example, in a networked environment using logical connections to one or more remote computers.

[0041] System 100 also includes input devices 124, such as keyboards, mice, pens, voice input devices, touch input devices, etc. It also includes output devices 126, such as display devices, speakers, printers, etc. The display devices may be, for example, cathode ray tube displays, light-emitting diode displays, or liquid crystal displays.

[0042] exist Figure 1 In the example, memory 104 includes computer-readable instructions, data structures, program modules, etc., associated with the "optimizer" model 150. However, the optimizer model 150 may alternatively reside in any computer storage medium used by system 100, or may be distributed across some combination of computer storage media, or may be distributed across some combination of networked computers. The functionality of the optimizer model 150 is described below.

[0043] Figure 2 This is a block diagram illustrating an example of an automated radiation therapy treatment planning system 200 according to an embodiment of the present invention. System 200 includes an input interface 210 for receiving patient-specific information (data) 201, a data processing unit 220 for implementing an optimizer model 150, and an output interface 230. System 200 can be wholly or partially integrated into a computer system 100 (… Figure 1 On or using computer system 100 ( Figure 1 It is implemented as a software program, hardware logic, or a combination thereof.

[0044] exist Figure 2 In this example, patient-specific information is provided to and processed by the optimizer model 150. In this embodiment, the optimizer model 150 generates a prediction, and a treatment plan based on the prediction can then be generated.

[0045] Figure 3A knowledge-based planning system 300 according to an embodiment of the present invention is illustrated. Figure 3 In the example, system 300 includes a knowledge base 302 and a treatment planning toolset 310. The knowledge base 302 includes patient records 304 (e.g., radiation treatment plans), treatment types 306, and statistical models 308. Figure 3 The example processing planning toolset 310 includes the current patient record 312, processing type 314, medical image processing module 316, optimizer model (module) 150, dose distribution module 320, and final radiation treatment plan 322.

[0046] The treatment planning toolset 310 searches the knowledge base 302 (via patient records 304) for previous patient records similar to the current patient record 312. The statistical model 308 can be used to compare the predictions for the current patient record 312 with statistical patient data. Using the current patient record 312, the selected treatment type 306, and the selected statistical model 308, the toolset 310 generates a radiation treatment plan 322.

[0047] More specifically, based on past clinical experience, the most frequently used treatment type may exist when a patient exhibits a specific diagnosis, stage, age, weight, sex, comorbidities, etc. The first-step treatment type 314 can be selected by choosing a treatment type that the planner has already used for similar patients in the past. Treatment planning may include patient outcomes, which may include the probability of normal tissue complications (e.g., local recurrence failure, and overall survival as a function of dose rate and patient-specific treatment type outcome) as a function of dose rate and / or dose rate. The medical image processing module 316 provides automatic contour drawing and automatic segmentation of two-dimensional cross-sectional slices (e.g., from any imaging modality such as, but not limited to, computed tomography (CT), positron emission tomography-CT, magnetic resonance imaging, and ultrasound) to form a three-dimensional (3D) image using medical images from the current patient record 312. Dose distribution maps and dose rate distribution maps are calculated by the dose and dose rate distribution module 320, which may utilize optimizer model 150.

[0048] In an embodiment of the invention, optimizer model 150 uses a dose prediction model to provide, for example, 3D dose distribution, dose and dose rate, and associated dose-volume histograms (DVH) and dose-rate-volume histograms (DRVH).

[0049] The following discussion involves beam, volume, dose, dose rate, and other elements or values. The discussion below is based on the planning toolset 310 and optimizer model 150 (…). Figure 3 In the context of modeling elements and calculated values, unless otherwise stated or explicitly stated in the discussion.

[0050] Figure 4 This is a block diagram illustrating selected components on which a radiation therapy system 400 according to an embodiment of the present invention can be implemented. Figure 4 In the example, system 400 includes beam system 404 and nozzle 406.

[0051] Beam system 404 generates and transmits beam 401. Beam 401 may be a proton beam, electron beam, photon beam, ion beam, or nuclear beam (e.g., carbon, helium, and lithium). In embodiments, depending on the type of beam, beam system 404 includes components that guide (e.g., bend, direct, or direct) the beam system in a direction toward nozzle 406 and direct it into nozzle 406. In embodiments, the radiation therapy system may include one or more multi-leaf collimators (MLCs); each MLC leaf may be independently moved back and forth by control system 410 to dynamically shape the aperture through which the beam can pass, to block or not block portions of the beam, thereby controlling the beam shape and exposure time. Beam system 404 may also include components for adjusting (e.g., reducing) the beam energy entering nozzle 406.

[0052] Nozzle 406 is used to direct the beam at various locations within the treatment chamber supported on a patient support device 408 (e.g., a chair or table) (volumes within the treatment target, such as volumes within a patient). Volumes within the treatment target can be organs, portions of organs (e.g., volumes or regions within an organ), tumors, diseased tissue, or patient contours. Volumes within the treatment target can include unhealthy tissue (e.g., tumors) and healthy tissue. Volumes within the treatment target can be (virtually) divided into multiple voxels. Sub-volumes can include single voxels or multiple voxels.

[0053] Nozzle 406 may be mounted on or part of a gantry, which may be movable relative to patient support device 408, which may also be movable. In one embodiment, beam system 404 is also mounted on or part of the gantry. In another embodiment, beam system is separate from (but in communication with) the gantry.

[0054] Figure 4 The control system 410 receives and implements a prescribed radiation treatment plan. In an embodiment, the control system 410 includes a computer system having a processor, memory, input devices (e.g., a keyboard), and a display, possibly in a known manner. The control system 410 can receive data regarding the operation of the system 400. The control system 410 can control parameters of the beam system 404, nozzle 406, and patient support device 408, including parameters such as beam energy, intensity, direction, size, and / or shape, based on the received data and the prescribed radiation treatment plan.

[0055] As described above, the beam 401 entering the nozzle 406 has a specific energy. Therefore, in embodiments according to this disclosure, the nozzle 406 includes one or more components that influence (e.g., reduce, modulate) the beam energy. The term "beam energy modulator" is used herein as a general term for one or more components that influence the beam energy in order to control the beam range (e.g., the extent to which the beam penetrates into the target), control the dose delivered by the beam, and / or control the depth-dose profile of the beam, depending on the type of beam. For example, for a proton or ion beam with a Bragg peak, the beam energy modulator may control the position of the Bragg peak within the volume of the target being processed. In various embodiments, the beam energy modulator 407 includes a range modulator, a range shifter, or both.

[0056] In radiation therapy techniques, where the intensity of the particle beam is constant or modulated in the delivery field, such as intensity-modulated radiation therapy (IMRT) and intensity-modulated particle therapy (IMPT), the beam intensity varies over each treatment area (volume within the treatment target) in the patient. Depending on the treatment modality, the degrees of freedom available for intensity modulation include beam shaping (collimation), beam weighting (spot scanning), and the angle of incidence (which may be referred to as beam geometry). These degrees of freedom result in a virtually unlimited number of potential treatment plans, and therefore the ability to consistently and effectively generate and evaluate high-quality treatment plans is beyond human capability and relies on the use of computer systems, especially when considering the time constraints associated with using radiation therapy to treat diseases such as cancer, and the large number of patients who undergo or need to undergo radiation therapy during any given time period.

[0057] Beam 401 can actually have any regular or irregular cross-sectional shape (e.g., an eye view of the beam). For example, the shape of beam 401 can be defined using an MLC that blocks part or more of the beam. Different beams can have different shapes.

[0058] In this embodiment, beam 401 comprises a number of beam segments or sub-beams (also referred to as light spots). A maximum energy (e.g., 80 MeV) is assigned to beam 401, and the energy level of each beam segment is defined as a percentage or fraction of the maximum energy. Essentially, each beam segment is weighted according to its energy level; some beam segments are weighted to have higher energy levels than others. By weighting the energy of each beam segment, the intensity of each beam segment is also effectively weighted. The defined energy level or intensity can be achieved for each beam segment using beam energy modulator 407.

[0059] Each beam segment can deliver a relatively high dose rate (a relatively high dose over a relatively short period of time). For example, each beam segment can deliver at least 40 grays (Gy) in less than one second and up to 120 Gy or more per second.

[0060] In operation, in this embodiment, beam segments are delivered sequentially. For example, a first beam segment is delivered to a volume in the target being processed (on), and then turned off, then a second beam segment is turned on, then turned off, and so on. Each beam segment may be turned on for only a fraction of a second (e.g., on the order of milliseconds).

[0061] A single beam can be used and applied from different directions and in the same or different planes. Alternatively, multiple beams can be used in the same or different planes. The direction and / or number of beams can be varied over multiple treatment sessions (i.e., time-segmented) to deliver a uniform dose over the volume of the target being treated. The number of beams delivered at any given time depends on the radiation treatment system (e.g., Figure 4 The number of gantry or nozzles and the treatment plan in the radiation treatment system 400.

[0062] In embodiments of the invention, a DRVH (different from a DVH) is generated for the volume within the treatment target. The DRVH can be generated based on a proposed radiation treatment plan. The DRVH can be stored in a computer system memory and used to generate a final radiation treatment plan to be used to treat the patient. Parameter values ​​affecting the dose rate can be adjusted until the DRVH meets or is related to the patient's treatment goals.

[0063] Figure 5A An example of a DRVH 500 according to an embodiment of the invention is illustrated. The DRVH plots the cumulative dose rate-volume distribution in the treatment target frequency distribution, which summarizes the simulated dose rate distribution within the treatment target volume of interest, generated by the proposed radiation treatment plan. It can be used... Figure 1 The optimizer model 150 determines the simulated dose rate distribution. DRVH indicates the dose rate and the percentage of the volume of the treated target receiving that dose rate. For example, as... Figure 5A As shown, the DRVH 500 can be processed to receive a dose rate of X or greater (at least X) at 100% volumetric reception in the target, a dose rate of Y or greater (at least Y) at 50% volumetric reception in the target, and so on. The DRVH 500 can be displayed as a graphical user interface (GUI) or a part thereof (see discussion below).

[0064] For example, the volume within the target being treated can include different organs, or it can include both healthy and unhealthy tissue (e.g., a tumor). Accordingly, refer to Figure 5B and Figure 5C DRVH 510 includes multiple curves 512 and 514, which respectively illustrate the simulated dose rate distribution for a first sub-volume 522 (e.g., for an organ or for healthy tissue) and a second sub-volume 524 (e.g., for a second organ or for unhealthy tissue) within a volume 504 of the treatment target. DRVH may include more than two simulated dose rate distributions. DRVH 510 may be displayed as or as part of a GUI.

[0065] In an embodiment of the invention, an irradiation time-volume histogram (which is different from DVH and / or DRVH, but can be used with DVH and / or DRVH) is generated for the volume in the treated target. The irradiation time-volume histogram can be stored in a computer system memory and used in conjunction with or in place of DVH and / or DRVH to generate a radiation treatment plan.

[0066] Figure 5D An example of an irradiation time-volume histogram 550 according to an embodiment of the invention is illustrated. The irradiation time-volume histogram plots the cumulative irradiation time-volume distribution across the frequency distribution of the treated target, summarizing the simulated irradiation time distribution within the volume of the treated target, which will be generated by the proposed radiation treatment plan. Figure 1 The optimizer model 150 can determine the simulated irradiation time distribution. The irradiation time-volume histogram indicates the irradiation time (duration) and the percentage of volume irradiated for those durations. The DRVH 550 can be displayed as a GUI or as part of a GUI.

[0067] Figure 6 Flowchart 600 is an example of a computer-implemented operation for a radiation treatment plan, which includes generating a DVH, DRVH, or irradiation time-volume histogram according to some embodiments of the invention. Flowchart 600 may be implemented residing on some form of computer-readable storage medium (e.g., on...). Figure 1 Computer-executable instructions (e.g., in the memory of the computer system 100) Figure 1 Optimizer model 150).

[0068] exist Figure 6 In box 602, define (for example, using) Figure 1 and Figure 2The radiation treatment plan proposed by the optimizer model 150 is stored in and accessed from the computer system memory. The proposed radiation treatment plan includes parameter values ​​that may affect the dose and dose rate, as well as other parameters. Parameters that may affect the dose and dose rate include, but are not limited to, the number of irradiations of the volume in the treated target, the duration of each irradiation (irradiation time), and the dose deposited in each irradiation. Parameters may also include the direction of the beam to be directed into the volume of the treated target, and the beam energy of each beam. Parameters may also include the time period during which irradiation is applied (e.g., multiple irradiations applied over a time period such as one hour, where each irradiation within that time period is separated from the next irradiation by another time period) and the time interval between each irradiation time period (e.g., each hour-long time period is separated from the next time period by one day). If the volume in the treated target is divided into sub-volumes or voxels, the parameter values ​​may be based on each sub-volume or each voxel (e.g., values ​​per sub-volume or voxel).

[0069] In optimizing model 150 ( Figure 3 In radiation treatment planning, appropriate dose threshold curves (e.g., the relationship between normal tissue retention dose and dose rate or irradiation time) can be used to establish dose limits for the radiation treatment plan. For example, appropriate (e.g., tissue-dependent) dose threshold curves can be used to determine beam orientation (gantry angle) and beam segment weights. That is, parameters affecting the dose can be adjusted during radiation treatment planning so that the limits in the dose threshold curves are met. Dose threshold curves can be tissue-dependent. For example, the dose threshold curve for the lungs may differ from the dose threshold curve for the brain.

[0070] Dosage limitations may include, but are not limited to: a maximum limit on the irradiation time for each sub-volume (voxel) within the target (e.g., treatment time less than x1 seconds for each voxel in the target tissue); a maximum limit on the irradiation time for each sub-volume (voxel) outside the target (e.g., treatment time less than x2 seconds for each voxel in normal tissue; x1 and x2 may be the same or different); a minimum limit on the dose rate for each sub-volume (voxel) within the target (e.g., dose rate greater than y1 Gy / sec for each voxel in the target tissue); and / or a minimum limit on the dose rate for each sub-volume (voxel) outside the target (e.g., dose rate greater than y2 Gy / sec for each voxel in normal tissue; y1 and y2 may be the same or different). Typically, the limitations aim to minimize the amount of time normal tissue is irradiated.

[0071] In box 604, in one embodiment, the DVH and DRVH are generated based on parameter values ​​in the proposed radiation treatment plan. The dose and dose rate for each sub-volume or voxel can be determined. The dose rate is the sum of the doses deposited in each irradiation divided by the sum of the irradiation durations. The dose rate can be determined and recorded using a fine time index (e.g., time increments on the order of milliseconds); that is, for example, the dose for each sub-volume or voxel can be recorded in time increments on the order of milliseconds per beam and per portion. The dose and dose rate are cumulative. For example, depending on the beam direction and energy, the cumulative dose and dose rate for some portions (e.g., sub-volumes or voxels) of a volume in the treated target can be higher than for other portions. The dose and dose rate for each sub-volume or voxel can be calculated to include ray tracing (and Monte Carlo simulations), where each beam particle is traced to determine the first scattering, second scattering, etc., of each particle to obtain a true voxel-based or sub-volume-based dose rate over each irradiation.

[0072] In one embodiment, an irradiation time-volume histogram is generated. The irradiation time-volume histogram can be generated in essentially the same manner as that just described for generating a DRVH.

[0073] In box 606, DVH, DRVH, and / or irradiation time-volume histograms can be assessed by determining whether the proposed radiation treatment plan meets the objectives (e.g., clinical goals) specified for the patient's treatment. Clinical goals or objectives can be represented by a set of quality metrics (such as target homogeneity, vital organ preservation, etc.) with corresponding target values. Another way to evaluate histograms is through a knowledge-based approach that incorporates and reflects current best practices gathered from multiple previous similar treatments of other patients. Yet another way to assist planners is to use a multi-criteria optimization (MCO) approach for treatment planning. Pareto surface navigation is an MCO technique that facilitates exploring trade-offs between clinical goals. For a given set of clinical goals, a treatment plan is considered Pareto optimal if it meets these goals and if no metric can be improved without worsening at least one other metric.

[0074] As mentioned above, for FLASH RT, dose rates of at least 40 Gy per second (less than 1 second) and dose rates of up to 120 Gy per second or more can be used. Therefore, another way to evaluate DVH and DRVH is to define dose and dose rate thresholds based on FLASH RT dose rates, and also specify thresholds for dose and dose rate within the treated target. DVH and DRVH can be evaluated by determining whether a metric of volume within the treated target (e.g., fraction, number, or percentage of sub-volumes or voxels) meets the dose and dose rate thresholds. For example, a dose rate-volume histogram can be considered satisfactory if 60% of the volume within the treated target (specifically, the volume portion of the treated target includes unhealthy tissue) receives a dose rate of at least 50 Gy per second.

[0075] exist Figure 6 In box 608, some or all of the parameter values ​​in the proposed radiation treatment plan can be iteratively adjusted to generate different DVH, DRVH, and / or irradiation time-volume histograms to determine the final set of parameter values ​​that produce a histogram (or multiple histograms) that optimally meets the patient treatment objectives (clinical objectives) or the prescribed (final) radiation treatment plan that meets the aforementioned thresholds.

[0076] In box 610, the final set of parameter values ​​is then included in the prescribed radiation treatment plan for treating the patient.

[0077] Generally, embodiments of the invention optimize radiation treatment plans based on dose, dose rate, and / or exposure time. This does not mean that treatment plan optimization is based solely on dose, dose rate, and / or exposure time.

[0078] Correlation between dose, dose rate, and volume in the treatment plan

[0079] Figure 8 , Figure 9 and Figure 10 Flowcharts 800, 900, and 1000 (800-1000) are examples of a computer-implemented method for planning radiation processing according to embodiments of the present invention. Flowcharts 800-1000 can be implemented residing on some form of computer-readable storage medium (e.g., Figure 1 Computer-executable instructions (e.g., in the memory of the computer system 100) are stored in the computer's memory. Figure 1 The optimizer model 150). In these embodiments, as a result of the disclosed method, a GUI is generated and displayed. For example, the GUI visualizes, in a single render, the calculated dose (e.g., total calculated dose) and calculated dose rate of a sub-volume within the target being processed, as well as a metric of the sub-volume as a function of the calculated dose and calculated dose rate. Figure 11 , Figure 12 , Figure 13A , Figure 13B and Figure 14-28 , Figure 29A , Figure 29B , Figure 30A , Figure 30B and Figures 31-35 An example of a GUI according to the present invention is provided.

[0080] exist Figure 8 In box 802, information is accessed from computer system memory including the calculated dose (e.g., total calculated dose) and calculated dose rate for a sub-volume in the processing target (e.g., any number of voxels of any three-dimensional shape constituting the sub-volume), as well as information including the sub-volume as a metric (e.g., number, percentage, or fraction) as a function of the calculated dose and calculated dose rate.

[0081] In box 804, information including subvolume as a function of the calculated dose (e.g., total calculated dose) and the calculated dose rate is also accessed from the computer system memory.

[0082] In box 806, in the display device 126 of the computer system ( Figure 1 The GUI displays plots (e.g., visual displays) based on calculated dose, calculated dose rate, and metrics.

[0083] exist Figure 8 In box 808, different attribute values ​​(such as color, pattern, grayscale, alphanumeric text, or brightness) are associated with visual elements in the GUI.

[0084] Now for reference Figure 9 In box 902, the radiation processing plan is accessed from the computer system memory. The radiation processing plan includes, for example, the number of beams to be directed to and enter the volume of the processing target, the direction of the beams, and the dose rate range for each beam.

[0085] In box 904, the dose (e.g., total dose) for each sub-volume is calculated using the number and direction of the beams and the range of dose rates.

[0086] In box 906, the dose rate for each sub-volume is calculated using the number and direction of the beams and the range of dose rates.

[0087] In box 908, for different levels or ranges (e.g., intervals) of dose (e.g., total dose) and different levels or ranges (e.g., intervals) of dose rate, a metric (e.g., number, fraction, or percentage) is determined for receiving at least the corresponding dose level (e.g., total dose) and at least the corresponding dose rate level.

[0088] In frame 910, in display device 126 ( Figure 1 The GUI displays plots (e.g., visual displays) based on calculated dose, calculated dose rate, and metrics.

[0089] Now for reference Figure 10 In box 1002, the DVH of the volume in the processing target is generated.

[0090] In box 1004, the volume DRVH is generated.

[0091] In box 1006, the display device 126 of the computer system ( Figure 1 The GUI displays a combined plot of DVH and DRVH. The combined plot is visualized as a function of dose rate, representing a measure of the volume received at a given dose, and is also visualized as a function of dose, representing a measure of the volume received at a given dose rate.

[0092] In embodiments, the drawing in the GUI generated and displayed as described above includes visualizations of DVH (e.g., graphical elements) as a first dimension of the GUI (e.g., visualized elements or aspects, or spatial dimensions in virtual space), visualizations of DVH as a second dimension of the GUI, and visualizations of metrics as a third dimension of the GUI. For example, the drawing may include visualizations of the calculated dose rate for each sub-volume, visualizations of the calculated dose for each sub-volume (e.g., the calculated total dose), and visualizations of metrics for each sub-volume. In embodiments, the drawing also includes visualizations of the prescribed dose and the prescribed dose rate. In embodiments, the drawing also includes visualizations of the normal tissue complication probability (NTCP) for each sub-volume. In embodiments, the drawing also includes visualizations of the tumor control probability (TCP) for each sub-volume.

[0093] Although Figure 6 and Figure 8-10 The operations in the system are presented in a series and specific order, but the invention is not limited thereto. These operations can be performed in different orders and / or in parallel, and operations can also be performed iteratively. As mentioned above, due to the different parameters that need to be considered, the range of values ​​of these parameters, the interrelationships of these parameters, the need for an effective treatment plan that minimizes the risk to the patient, and the need for rapidly generating high-quality treatment plans, the use of computer system 100 ( Figure 1 It is important that the optimizer model 150, which is consistently executed on the radiation treatment scheme as disclosed herein, is used.

[0094] Figure 11 , Figure 12 , Figure 13A , Figure 13B and Figure 14-28 , Figure 29A , Figure 29B , Figure 30A , Figure 30B and Figures 31-35 An example of a GUI (User-Guided Interface) for displaying information associated with planned radiation treatment, according to an embodiment of the invention, is illustrated. The GUI can be generated using the methods described above and uses some form of computer-readable storage medium (e.g., Figure 1 Computer-executable instructions (e.g., in the memory of the computer system 100) are stored in the computer system 100. Figure 1 The optimizer model 150 is implemented and can be displayed on the output device 126 of the computer system.

[0095] Embodiments of the present invention are not limited to Figure 11 , Figure 12 , Figure 13A , Figure 13B and Figure 14-28 , Figure 29A , Figure 29B , Figure 30A , Figure 30B and Figures 31-35 The illustrated GUI. Typically, the GUI in embodiments of the invention allows for easy visualization of the interdependencies between dose, dose rate, dose and dose rate per volume, and volume measures as functions of dose and dose rate, for use in radiation treatment planning. In the following discussion, dose, dose rate, etc., are calculated values.

[0096] Furthermore, the disclosed GUI may include information beyond that included in the examples. For instance, the GUI may also be used to present information such as the direction of the beam to be directed into each sub-volume and the beam energy of each beam.

[0097] In an embodiment, drop-down menus or other types of GUI elements (not shown in the figure) can be used to select and establish GUI settings (e.g., attributes, thresholds, etc.) and the types of information(s) that will be displayed at any given time.

[0098] Furthermore, the GUI is not necessarily a static display. For example, the information presented in the GUI can be programmed to change over time or in response to user input to illustrate the relationship between cumulative dose or dose rate and time. Additionally, for example, the GUI can be programmed to sequentially present different cross-sectional slices of the volume within the treated target to provide a depth dimension to a two-dimensional representation, or to manipulate (e.g., rotate) a virtual three-dimensional representation so that it can be viewed from different perspectives.

[0099] exist Figure 11In the example, GUI 1100 includes a two-dimensional plot of the dose-rate relationship. The dose and dose rate for each sub-volume (e.g., voxel) are plotted in two dimensions. The distribution (metric) of the sub-volumes is projected onto the dose axis to generate the DVH, and also onto the dose rate axis to generate the DRVH.

[0100] exist Figure 12 In the example, GUI 1200 includes two-dimensional plots of dose-rate relationships for normal tissue and for tumors. The dose and dose rate for each subvolume (e.g., voxel) are visualized (plotted) in two dimensions. Tissue-specific filters are defined in the plots for normal tissue and tumor-specific filters are defined in the plots for tumor tissue. Different filters can be defined to illustrate the different tissue responses to dose and dose rate. Voxels can be color-coded to indicate the relative values ​​of NTCP and TCP. Figure 12 In the example, color keys are included in GUI 1200 and are associated with each graph as shown. The colors of voxels in the graphs can be compared to the keys to indicate relative values ​​of NTCP or TCP.

[0101] exist Figure 13A and Figure 13B In the example, GUI 1300 includes visualization of dose and dose rate. GUI 1300 includes plotting a plane at the isocenter of the volume of the target being processed. The total area of ​​the plane is divided into different smaller regions, where the size of each smaller region indicates (e.g., proportionally) the dose level received. Figure 13A ) or dose rate ( Figure 13B The volume of the target. Smaller areas can be color-coded to indicate dose levels. Figure 13A and Figure 13B In the example, color keys are included in GUI 1300 to associate the colors in the drawing with different dose levels and different dose rate levels, respectively. The color of each smaller region can be compared with the color in the key to determine the dose / dose rate level of each smaller region.

[0102] exist Figure 14 In the example, GUI 1400 includes plots of dose along one axis and a measure (percentage) of the volume receiving a given dose along the corresponding axis, and plots of dose rate along the other axis and a percentage of the volume receiving a given dose rate along the corresponding axis. GUI 1400 is useful for visualizing and identifying qualitative trends. In this plot, each "X" represents a voxel with dose and dose rate. Each "X" has a certain degree of transparency, allowing the density of points in the plot to be visualized.

[0103] exist Figure 15In the example, GUI 1500 includes a two-dimensional plot of dose rate levels (ranges or intervals) on one axis and dose levels (ranges or intervals) on another axis. A measure (percentage) of the volume of a given combination of received dose and dose rate is projected into the plot. Figure 15 In the example, approximately 9% of the volume receives at least approximately 17.5 Gy of dose at a dose rate of approximately 250 Gy per second. The projection of the volume can be color-coded to indicate a measure of the volume receiving a given dose and dose rate. Figure 15 In the example, color keys are included in GUI 1500 to associate colors in the drawing with different measures of volume. One or more colors of the volume projection can be compared with colors in the keys to determine the dose / dose rate level for each smaller region.

[0104] The GUI 1500 allows for easy visualization and identification of total quantitative characteristics. For example, such as... Figure 16 , Figure 17 and Figure 18 As shown in the circled areas, the intrafield dose rate gradients with peak values ​​of 18 Gy and 260 Gy per second, and the field edges are easily visualized.

[0105] exist Figure 19 In the example, GUI 1900 includes a two-dimensional plot of dose rate levels (ranges or intervals) on one axis and dose levels (ranges or intervals) on another axis. In this example, for each point in the plot, a measure (e.g., percentage) of the volume at or above the dose level and dose rate is represented by color. Figure 19 In the example, color keys are included in GUI 1900 to associate colors in a drawing with different measures of volume. Furthermore, in this example, horizontal slices (made by...) Figure 19 The dashed line in the figure indicates the volume region DVH above a given dose rate.

[0106] exist Figure 20 In the example, GUI 2000 includes a two-dimensional plot of dose rate levels (ranges or intervals) on one axis and dose levels (ranges or intervals) on another axis. In this example, each line in the plot represents a measure (e.g., a percentage) of the volume at or above a given dose level and dose rate. Figure 20 In the example, each line is a different color, and color keys are included in GUI 2000 to associate the color of the lines being drawn with different measures of volume. For example, in Figure 21 In the example, approximately 60% of the volume received at least 17.5 Gy at a dose rate of at least 250 Gy per second.

[0107] exist Figure 22 In this example, GUI 2000 also includes a region 2010 representing the prescribed dose and dose rate. In this example, the prescription is at least 150 Gy per second to 90% of the volume, with that 90% of the volume receiving more than 10 Gy. In this example, the prescription is satisfied because region 2010 is surrounded by lines corresponding to 90% of the volume.

[0108] exist Figure 23 In the example, for a given dose rate (e.g., at least 40 Gy per second), the GUI 2300 includes a two-dimensional plot of dose rate levels (ranges or intervals) on one axis and a measure (fraction) of the volume receiving the given dose on the other axis. In this example, each line in the plot represents a different sub-volume (e.g., planned target volume (PTV), right lung, and spinal cord). Figure 23 In the example, each line is a different color, and color keys are included in the GUI 2300 to associate the color of the lines being drawn with the associated sub-volumes. In this example, 80% of the PTVs receive doses higher than 60 Gy and a dose rate of 40 Gy per second.

[0109] exist Figure 24 In the example, GUI 2400 includes a two-dimensional plot of dose rate levels (ranges or intervals) on one axis and a measure (percentage) of the volume received with a given dose on the other axis. GUI 2400 represents a DVH curve for the region at or above a certain dose rate. In this example, each line in the plot represents a different dose rate. Figure 24 In the example, each line is a different color, and color keys are included in the GUI 2400 to associate the color of the lines being drawn with different dose rates.

[0110] exist Figure 25 In the example, for a given dose rate (e.g., 150 Gy per second), GUI 2500 includes a two-dimensional plot of the dose rate level (range or interval) on one axis and a measure (percentage) of the volume receiving the given dose on the other axis. GUI 2500 represents a visualization (graph) of the DVH at or above a given dose rate. Figure 25 In this example, GUI 2500 also includes a region 2502 representing the prescribed dose and dose rate. In this example, the prescription is at least 150 Gy per second to 90% of the volume, and that 90% of the volume receives more than 10 Gy.

[0111] exist Figure 26In the example, GUI 2600 includes plots of dose rate levels (ranges or intervals) on one axis and dose levels (ranges or intervals) on another axis, showing the dose and dose rate distributions for different sub-volumes (e.g., spinal cord, right lung, and PTV). In this example, each sub-volume is represented by a different color, and color keys are included in GUI 2600 to associate the colors in the plot with the different sub-volumes.

[0112] exist Figure 27 and Figure 28 In the examples, GUIs 2700 and 2800 include volume rendering (e.g., CT images). In these examples, contour lines of different colors are used to delineate portions of the volume having doses and dose rates above, below, or within specific ranges (e.g., voxels). Color keys are included in GUIs 2700 and 2800 to associate colors in the rendering with, for example, dose levels. Figure 27 In the example, the dose distribution is shown in the depicted rectangular region only for sub-volumes (voxels) with dose rates between 40 Gy and 120 Gy per second. Figure 28 In the example, the depicted rectangular region contains voxels with doses greater than 10 Gy and dose rates greater than 10 Gy per second.

[0113] exist Figure 29A In the example, GUI 2900 includes a plot of the cumulative dose versus time. GUI 2900 is useful for determining the time interval (dt) required to deliver a given dose level (e.g., 90%).

[0114] Figure 29B The illustration shows an example of GUI 2910, where more than one dose rate is specified for each voxel. When a specific dose or dose rate range is specified, the corresponding dose is displayed. Figure 29B In the example, the lower line in the graph (which can be displayed using the first color) represents the dose rate as a function of time, and the upper line in the graph (which can be displayed using a second, different color) represents the cumulative dose as a function of time. The slope of the upper line is the dose rate as a function of time. For the voxel illustrated, GUI 2910 provides a visualization of the dose, average dose rate, and the dose delivered against a dose rate or dose rate range. In this example, GUI 2910 shows a dose of 60 Gy, an average dose rate of approximately 40 Gy per second, and a dose of approximately 40 Gy delivered at a dose rate ranging from 150 Gy to 200 Gy per second.

[0115] exist Figure 30A In the example, GUI 3000 includes drawing the isodose contour overlay on the dose rate distribution in a volume (e.g., a CT image). Figure 30AIn the example, different colors are used to indicate different dose levels and different dose rates. Color keys are included in the GUI 3000 to associate colors in the drawing with dose levels and dose rates. The drawing can be manipulated using keys by selecting the different dose levels and dose rates to be drawn in the GUI 3000 using the pointers shown in the diagram. For example, one color can be used to represent a dose in the range of 5-11 Gy, and different shades of that color can be used to represent different dose rate ranges corresponding to that dose range (e.g., 151-201 Gy per second, 201-252 Gy per second, and 252-303 Gy per second). The user can interactively change the position of the pointers on one or both of the vertical and horizontal axes. By changing the position of these pointers, the corresponding ranges of dose and dose rate associated with a particular color or shade are also changed, and the isodose contours in the GUI 3000 will be changed accordingly.

[0116] Figure 30B The illustration shows an example of GUI 3010, where doses corresponding to a specific dose rate range are plotted on a CT image (e.g., also in...). Figure 30A The top of the CT image shown. In this example, dose rate range limits are applied individually for each voxel, and the corresponding portion of the dose is visualized. Alternatively, the dose rate distribution limited by the cumulative dose in each voxel can be visualized; for example, the GUI can display the dose rate in each voxel at which X percent of the dose has accumulated. The user can select the percentage of dose for selecting the dose rate displayed for each voxel. Similarly, the user can interactively select and adjust the pointer position to associate color with dose range. In this example, the user can also adjust the pointer position to select the dose rate range. Only the dose to be delivered at the selected dose rate is plotted in GUI 3010. Figure 30B The example shows an isodose profile for a dose that will be delivered at a dose rate range of 201-252 Gy per second.

[0117] exist Figure 31 In this example, for a given volume or sub-volume (e.g., structure "S1"), the GUI 3100 includes a two-dimensional plot of the dose rate level (range or interval) on one axis of the graph and a measure (percentage) of the volume receiving the given dose on the other axis of the graph. Lines in the graph depict different regions of the visualization. These lines define regions representing different DVHs corresponding to different dose rates. In this example, each region is represented by a different coloring level, and keys are included in the GUI 3100 to associate the coloring level in the visualization with the dose level and dose rate. Furthermore, in this example, different pointers are included in the plot to indicate different purposes (e.g., prescribed dose and dose rate).

[0118] exist Figure 32 In the example, GUI 3200 includes the rendering of the region where the beams are superimposed in three dimensions. The number of times a voxel is traversed by the beam is color-coded. GUI 3200 includes x and y coordinates in a plane representing the volume shown in the visualization, and also includes a z coordinate indicating the depth of the plane within the volume. Figure 32 The example outlines a specific target within the volume. In this example, five beams are shown, and a key is included in the GUI 3200 to associate the color of a voxel with the number of beams reaching that voxel.

[0119] exist Figure 33 In the example, GUI 3300 includes plotting the cumulative dose delivered above a certain dose rate threshold (e.g., above 40 Gy per second). Figure 33 In the example, different colors are used to indicate different cumulative doses. Color keys are included in the GUI 3300 to associate colors in the drawing with dose levels and dose rates. Figure 33 The example outlines a specific target within the volume.

[0120] exist Figure 34 In the example, GUI 3400 includes plotting the cumulative dose delivered below a certain dose rate threshold (e.g., below 40 Gy per second). Figure 34 In the example, different colors are used to indicate different cumulative doses. Color keys are included in the GUI 3400 to associate colors in the drawing with dose levels and dose rates. Figure 34 The example outlines a specific target within the volume.

[0121] exist Figure 35 In the example, GUI 3500 includes a plot of DVH for doses delivered above a certain dose rate threshold (e.g., above 40 Gy per second). In this example, dashed lines represent total DVH, and solid lines represent DVH above a certain dose rate threshold (e.g., above 40 Gy per second). The difference between each pair of solid and dashed lines indicates organ portions in danger volumes that were not delivered at a sufficiently high dose rate. Figure 35 In the example, different colors are used to indicate different organs or structures. Color keys are included in GUI 3500 to associate colors in drawing with different organs or structures.

[0122] In summary, embodiments of the invention improve radiation treatment planning and the treatment itself by extending FLASH RT to a wider range of treatment platforms and target sites. Even for non-FLASH dose rates, treatment plans generated as described herein are superior for protecting normal tissue from radiation, even for conventional techniques, by reducing (if not minimizing) the dose to normal tissue (outside the target) by the magnitude (and, in some cases, the integral) as designed. When used with FLASH dose rates, patient movement management is simplified because the dose is administered over a short period (e.g., less than one second). Treatment planning, while still a complex task of finding a balance between competing and relevant parameters, is simplified compared to conventional planning. The techniques described herein can be used in stereotactic radiation surgery and stereotactic body radiation therapy with single or multiple metastases.

[0123] In addition to these benefits, the GUI facilitates treatment planning by allowing planners to easily visualize key elements of the proposed treatment plan (e.g., dose rate per subvolume), easily visualize the impact of changes to the proposed plan on those elements, and easily visualize comparisons between different plans.

[0124] In addition to radiation treatment techniques in which the intensity of the particle beam is constant or modulated in the delivery field (such as IMRT and IMPT), embodiments of the invention can be used for spatially segmented radiation treatment, including high-dose spatially segmented grid radiation treatment, mini-beam radiation therapy, and microbeam radiation treatment.

[0125] Although the subject matter has been described in language specific to structural features and / or methodological actions, it should be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or actions described above. Rather, the specific features and actions described above are disclosed as exemplary forms of implementing the claims.

Claims

1. A computer system, comprising: processor; A display device is coupled to the processor; as well as A memory, coupled to the processor and including instructions, which, when executed, cause the processor to perform a method for planning a radiation process, the method comprising: Access includes information on calculated dose and calculated dose rate for multiple sub-volumes within a volume of the target being processed; Access information including the plurality of sub-volumes, as a function of the calculated dose and the calculated dose rate; and A graphical user interface (GUI) is displayed on the display device, the GUI including, in a single drawing, a representation of the calculated dose, the calculated dose rate, and the metric value.

2. The computer system of claim 1, wherein the single drawing includes visualization of a dose-volume histogram as a first dimension of the GUI, visualization of a dose-rate-volume histogram as a second dimension of the GUI, and visualization of the metric as a third dimension of the GUI.

3. The computer system of claim 1 or 2, wherein the single drawing comprises a visualization of the calculated dose of each of the plurality of sub-volumes.

4. The computer system of claim 1 or 2, wherein the single drawing comprises a visualization of the calculated dose rate of each of the plurality of sub-volumes.

5. The computer system of claim 1 or 2, wherein the single drawing comprises a visualization of the metric value of each of the plurality of sub-volumes.

6. The computer system of claim 1 or 2, wherein the single drawing further includes visualization of prescription dosage and prescription dosage rate.

7. The computer system of claim 1 or 2, wherein the GUI further includes visualization of the probability of normal tissue complications for each of the plurality of sub-volumes.

8. The computer system of claim 1 or 2, wherein the GUI further includes visualization of the tumor control probability of each of the plurality of sub-volumes.

9. The computer system according to claim 1 or 2, wherein the method further comprises: Associate the attribute values ​​with the individual drawn elements corresponding to the calculated dose, the calculated dose rate, and the metric value; as well as Display the element based on the attribute value.

10. The computer system of claim 9, wherein the attribute value is a value of an attribute selected from the group consisting of: color, pattern, grayscale, alphanumeric text, and brightness.

11. The computer system according to any one of claims 1, 2 and 10, wherein the single drawing further comprises isodose contour lines and isodose rate contour lines.

12. A non-transitory computer-readable storage medium having computer-executable instructions for causing a computer system to execute a method for planning radiation processing, the method comprising: Access to a radiation treatment plan, the radiation treatment plan including the number of beams to be directed to and enter a volume in a treatment target, the direction of the beams, and the dose rate range for each of the beams, wherein the volume comprises multiple sub-volumes; The dose of each of the plurality of sub-volumes is calculated using the number and direction of the beams and the dose rate range; The dose rate of each of the plurality of sub-volumes is calculated using the number and direction of the beams and the dose rate range. For different dose levels and different dose rate levels, determine the metric value of the sub-volume calculated to receive at least the corresponding dose level and at least the corresponding dose rate level; and A graphical user interface (GUI) is displayed on the display device of the computer system. The GUI includes a drawing of representations of the following: the calculated dose of each of the plurality of sub-volumes, the calculated dose rate of each of the plurality of sub-volumes, and the metric value of the sub-volume calculated to receive at least the corresponding dose level and at least the corresponding dose rate level.

13. The non-transitory computer-readable storage medium of claim 12, wherein the drawing includes visualization of a dose-volume histogram as a first dimension of the GUI, visualization of a dose-rate-volume histogram as a second dimension of the GUI, and visualization of the metric as a third dimension of the GUI.

14. The non-transitory computer-readable storage medium according to claim 12 or 13, wherein the drawing is a single drawing.

15. The non-transitory computer-readable storage medium of claim 12 or 13, wherein the drawing further comprises one or more visualizations selected from the group consisting of: visualizations of prescription dose and prescription dose rate, visualizations of the probability of normal tissue complications in each of the plurality of sub-volumes, and visualizations of the probability of tumor control in each of the plurality of sub-volumes.

16. The non-transitory computer-readable storage medium according to claim 12 or 13, wherein the method further comprises: Associate the attribute values ​​with the drawn elements corresponding to the calculated dose, the calculated dose rate, and the metric value; as well as Display the element based on the attribute value.

17. A non-transitory computer-readable storage medium having computer-executable instructions for causing a computer system to execute a method for planning radiation processing, the method comprising: Generate a dose-volume histogram (DVH) for the volume in the treated target, wherein the DVH indicates a measure of the volume in which the dose is received; Generate a dose rate-volume histogram (DRVH) for the volume in the processing target, wherein the DRVH indicates a measure of the volume at which the received dose rate is received; and A graphical user interface (GUI) is displayed on the display device of the computer system. The GUI includes a combined rendering of the DVH and the DRVH, wherein the combined rendering is calculated as a measure of the volume receiving a given dose and visualized as a function of dose rate, and is also calculated as a measure of the volume receiving a given dose rate and visualized as a function of dose.

18. The non-transitory computer-readable storage medium of claim 17, wherein the GUI includes a visualization of the DVH as a first dimension of the GUI, a visualization of the DRVH as a second dimension of the GUI, and a visualization of the value of the metric as a third dimension of the GUI.

19. The non-transitory computer-readable storage medium of claim 17 or 18, wherein the combined rendering comprises one or more visualizations selected from the group consisting of: visualization of the calculated dose of each sub-volume of a plurality of sub-volumes of the volume, visualization of the calculated dose rate of each sub-volume of the plurality of sub-volumes, and visualization of the value of the metric of each sub-volume of the plurality of sub-volumes.

20. The nontransitory computer-readable storage medium of claim 17 or 18, wherein the combined rendering further comprises one or more visualizations selected from the group consisting of: visualization of prescription dose and prescription dose rate, visualization of the probability of normal tissue complications in each of the plurality of sub-volumes of the volume, and visualization of the probability of tumor control in each of the plurality of sub-volumes.

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