Bioequivalent dose informed FLASH radiation therapy

Abstract

The invention relates to a bioequivalent dose aware FLASH radiation therapy. The control circuit accesses information representative of a radiation dose deposition as a function of time for a particular patient and at least one biological parameter of the particular patient. The control circuit then determines a bioequivalent dose for the particular patient based on both the information representative of the radiation dose deposition as a function of time and the at least one biological parameter to provide the determined bioequivalent dose for the particular patient.

Description

Technical Field

[0001] These teachings relate generally to treating a planned target volume of a patient with energy according to an energy-based treatment plan, and more particularly to FLASH radiation therapy treatment plans. Background Art

[0002] The use of energy to treat medical conditions comprises a known area of ​​prior art effort. For example, radiation therapy forms an important component of many treatment plans for reducing or eliminating unwanted tumors. Unfortunately, the energy applied does not inherently distinguish between unwanted material and adjacent tissues, organs, or the like that are desirable or even critical for the continued survival of the patient. Therefore, energy such as radiation is usually applied in a carefully administered manner to at least attempt to limit the energy to a given target volume. So-called radiation treatment plans usually function in the above-mentioned aspects.

[0003] Many radiation treatment plans specify values ​​for each of the various treatment platform parameters during a single field or during each of a plurality of sequential fields. Treatment plans for radiation treatment sessions are often automatically generated through a so-called optimization process. As used herein, "optimization" will be understood to refer to improving candidate treatment plans without necessarily ensuring that the result of the optimization is in fact a single optimal solution. Such optimization typically involves automatically adjusting one or more physical treatment parameters (typically while complying with one or more corresponding constraints on these aspects), and mathematically calculating the possible corresponding treatment outcomes (such as dose levels) to identify a given set of treatment parameters that represents a good compromise between the desired treatment outcome and avoiding undesirable side effects.

[0004] FLASH energy treatment is a known area of ​​prior art effort, albeit a relatively new area of ​​consideration. FLASH radiotherapy is a technique (at least for photon, electron, and proton treatments) that employs very brief, very high dose rates (utilizing large beam currents). FLASH treatment promises to reduce treatment times to only one to three 1-second sessions, while also potentially significantly reducing side effects. For example, it has been demonstrated that by very brief irradiation at a dose rate of approximately 40 Gy / s, normal tissues are significantly spared, but tumor growth is delayed equivalently. This sparing of normal tissues is known as the FLASH effect.

[0005] Unfortunately, Applicants have determined that many unknowns exist regarding FLASH treatments, including how to consider one or more biological effects associated with a patient when formulating a FLASH treatment, optimizing a FLASH treatment, quality checking a FLASH treatment plan, and / or administering a FLASH treatment plan. Summary of the invention

[0006] In general, according to these various embodiments, the control circuitry accesses information representing radiation dose deposition as a function of time for a particular patient and at least one biological parameter of the particular patient. The control circuitry then determines a biological equivalent dose for the particular patient based on both the information representing radiation dose deposition as a function of time and the at least one biological parameter to provide the determined biological equivalent dose for the particular patient.

[0007] By one approach, the foregoing is suitable for determining multiple bioequivalent doses for a particular patient.

[0008] By one approach, the aforementioned information representing radiation dose deposition as a function of time includes both dose information and dose rate information.

[0009] By one approach, the at least one biological parameter comprises at least one of:

[0010] Normal tissue complication probability information;

[0011] oxygen level information;

[0012] Linear energy transfer information;

[0013] The organization of the logo;

[0014] Organs identified;

[0015] the specified part of the organ identified;

[0016] Time-based parameters;

[0017] the radiation sensitivity of a given tissue / organ;

[0018] Patient image information;

[0019] Organization type;

[0020] Blood oxygen levels;

[0021] blood type;

[0022] Medication;

[0023] chemotherapy information;

[0024] Previous surgical information;

[0025] Immunotherapy information;

[0026] Previous medical treatment information;

[0027] Demographic information;

[0028] Biological age information;

[0029] Genetic marker information;

[0030] time of day;

[0031] Tumor type;

[0032] pH (potential hydrogen) balance information;

[0033] Temperature information;

[0034] Blood pressure information;

[0035] blood panel information; and / or

[0036] Immunization health information.

[0037] By one approach, these teachings will further apply to any one or more of the following:

[0038] generating a radiation treatment prescription based at least in part on the determined biological equivalent dose for a particular patient;

[0039] optimizing the FLASH radiation therapy treatment based at least in part on the determined biological equivalent dose for the particular patient to provide an optimized FLASH radiation therapy treatment;

[0040] evaluating the quality of an optimized FLASH radiation therapy treatment plan based at least in part on the determined biological equivalent dose for a particular patient; and / or

[0041] According to the aforementioned optimized FLASH radiation therapy treatment plan, radiation is administered to a particular patient.

[0042] So configured, these teachings can capture the combined effects of dose distribution, dose rate distribution, and one or more related biological data into one metric that is related to the effects observed at the biological level. BRIEF DESCRIPTION OF THE DRAWINGS

[0043] The above needs are at least partially met by providing a biologically equivalent dose-informed FLASH radiation therapy as described in the following detailed description, particularly when studied in conjunction with the accompanying drawings, wherein:

[0044] Figure 1 Includes block diagrams of various embodiment configurations according to these teachings;

[0045] Figure 2 including flow charts configured according to various embodiments of these teachings;

[0046] Figure 3 includes diagrams of various embodiment configurations according to these teachings; and

[0047] Figure 4 Included are diagrams of various embodiment configurations according to these teachings.

[0048] The elements in the drawings are shown for simplicity and clarity, and are not necessarily drawn to scale. For example, the size and / or relative position of some elements in the drawings may be enlarged relative to other elements to help improve the understanding of the various embodiments of this teaching. In addition, the elements that are useful or necessary, common but well understood in commercially feasible embodiments are usually not depicted, so as to facilitate the viewing of these various embodiments of this teaching with less obstruction. Certain actions and / or steps may be described or depicted in a specific order of occurrence, and those skilled in the art will understand that this specificity about the order is not actually required. The terms and expressions used herein have the usual technical meanings given to such terms and expressions by those skilled in the art in the above-mentioned technical field, unless different specific meanings are set forth in addition herein. Unless otherwise specifically noted, the word "or" when used in this article should be interpreted as having a disjunctive structure rather than a conjunctive structure. DETAILED DESCRIPTION

[0049] These and other benefits may become more apparent upon a thorough review and study of the following detailed description. Figure 1 , an illustrative device 100 compatible with many of these teachings will first be presented.

[0050] In this particular example, enabling device 100 includes control circuit 101. As a "circuit," control circuit 101 thus includes a structure that includes at least one (and typically many) conductive paths (such as paths including conductive metals such as copper or silver) that transmit electricity in an orderly manner, which paths will typically also include corresponding electrical components (both passive (such as resistors and capacitors) and active (such as any of a variety of semiconductor-based devices), as appropriate) to allow the circuit to implement the control aspects of these teachings.

[0051] Such control circuit 101 may include a fixed-purpose hardwired hardware platform (including but not limited to an application-specific integrated circuit (ASIC) (which is an integrated circuit customized by design for a specific purpose rather than intended for general use), a field programmable gate array (FPGA), etc.), or may include a partially or fully programmable hardware platform (including but not limited to a microcontroller, a microprocessor, etc.). These architectural options for such structures are well known and well understood in the art and need not be further described herein. This control circuit 101 is configured (e.g., by using corresponding programming that will be well understood by those skilled in the art) to perform one or more of the steps, actions, and / or functions described herein.

[0052] The control circuit 101 is operably coupled to a memory 102. The memory 102 may be integrated into the control circuit 101, or may be physically separate (in whole or in part) from the control circuit 101, as desired. The memory 102 may also be local to the control circuit 101 (where, for example, the two share a common circuit board, chassis, power supply, and / or housing), or may be partially or fully remote to the control circuit 101 (where, for example, the memory 102 is physically located in another facility, another urban area, or even another country compared to the control circuit 101).

[0053] In addition to information such as optimization information for a particular patient, information about a particular radiation treatment platform, information representing radiation dose deposition as a function of time for a particular patient, and at least one biological parameter for a particular patient as described herein, the memory 102 may also be used to, for example, non-transitorily store computer instructions that, when executed by the control circuit 101, cause the control circuit 101 to operate as described herein. (As used herein, this reference to "non-transitorily" will be understood to refer to the non-transitory state of the stored content (and thus excludes the situation where the stored content merely constitutes a signal or wave), rather than the volatility of the storage medium itself, and thus includes both non-volatile memory (such as read-only memory (ROM)) and volatile memory (such as dynamic random access memory (DRAM)).

[0054] By an optional approach, the control circuit 101 is also operatively coupled to a user interface 103. The user interface 103 may include any of a variety of user input mechanisms (such as but not limited to a keyboard and keypad, a cursor control device, a touch-sensitive display, a voice recognition interface, a gesture recognition interface, etc.) and / or user output mechanisms (such as but not limited to a visual display, an audio transducer, a printer, etc.) to facilitate receiving information and / or instructions from a user and / or providing information to a user.

[0055] If desired, the control circuit 101 may also be operably coupled to a network interface (not shown). So configured, the control circuit 101 may communicate with other components (both within the device 100 and external to the device 100) via the network interface. Network interfaces, including both wireless and non-wireless platforms, are well understood in the art and need not be specifically elaborated upon herein.

[0056] By one approach, a computed tomography device 106 and / or other imaging device 107 as known in the art may obtain some or all of any desired patient-related imaging information.

[0057] In this illustrative example, the control circuit 101 is configured to ultimately output an optimized energy-based treatment plan (such as, for example, the optimized radiation treatment plan 113). The energy-based treatment plan typically includes specified values ​​for each of the various treatment platform parameters during each of a plurality of sequential exposure fields. (It should be noted that these teachings may also be applicable to plans that use only a single "field", such as when the gantry is constantly in motion and radiation is constantly being applied.) In this case, the energy-based treatment plan is generated by an optimization process, examples of which are provided further herein.

[0058] By one approach, the control circuit 101 may be operably coupled to an energy-based treatment platform 114 configured to deliver therapeutic energy 112 to a corresponding patient 104 having at least one treatment volume 105 and also having one or more organs at risk (at least one organ at risk) according to an optimized energy-based treatment plan 113. Figure 1 108 to the Nth organ at risk 109). These teachings are generally applicable to use with any of a variety of energy-based treatment platforms / devices. In a typical application scenario, the energy-based treatment platform 114 will include an energy source, such as a radiation source 115 of ionizing radiation 116. By one approach, the energy-based treatment platform 114 is specifically configured to deliver FLASH radiation therapy.

[0059] By one approach, the radiation source 115 can selectively move along an arcuate path via the gantry (wherein the path includes the patient itself, at least to some extent, during treatment administration). The arcuate path can include a complete or nearly complete circle, as desired. By one approach, the control circuit 101 controls the movement of the radiation source 115 along the arcuate path, and can accordingly control when the radiation source 115 starts moving, stops moving, speeds up, slows down, and / or the speed at which the radiation source 115 travels along the arcuate path.

[0060] As an illustrative example, radiation source 115 may include, for example, a radio frequency (RF) x-ray source based on a linear particle accelerator (linac-based). A linac is a particle accelerator that greatly increases the kinetic energy of charged subatomic particles or ions by subjecting the charged particles to a series of oscillating electric potentials along a linear beamline, which can be used to produce ionizing radiation (e.g., x-rays) 116 and high-energy electrons.

[0061] A typical energy-based treatment platform 114 may also include: one or more support devices 110 (such as a couch) for supporting the patient 104 during a treatment session, one or more patient fixation devices 111, a gantry or other movable mechanism that allows selective movement of the radiation source 115, and one or more energy shaping devices (e.g., beam shaping devices 117, such as jaws, multi-leaf collimators, etc.) for providing selective energy shaping and / or energy modulation as needed.

[0062] In a typical application scenario, it is assumed herein that during an energy-based treatment session, the patient support device 110 can be selectively controlled by the control circuit 101 to move in any direction (i.e., any X, Y, or Z direction). Because the aforementioned elements and systems are well understood in the art, further elaboration of these aspects is not provided herein unless otherwise relevant to the description.

[0063] Reference now Figure 2 , a process 200 that can be performed, for example, in conjunction with the above-described application scenario (and more particularly via the aforementioned control circuit 101) will be described. In general, the process 200 can be used to facilitate generating an optimized radiation treatment plan 113, thereby facilitating treating a specific patient with therapeutic radiation (and particularly FLASH radiation therapy) using a specific radiation treatment platform according to the optimized radiation treatment plan.

[0064] At block 201, the process 200 provides access to information representing radiation dose deposition as a function of time for a particular patient. By one approach, the information includes both dose information and dose rate information.

[0065] At block 202, the control circuit 101 accesses at least one biological parameter of a particular patient. These teachings are highly flexible in practice and will be adapted to a wide variety of biological parameters. Examples of biological parameters that may be of benefit include, but are not limited to, any one or more of the following:

[0066] Information on the probability of normal tissue complications (corresponding to, for example, the effect being measured, but which is not necessarily an input to the bioequivalent dose);

[0067] Oxygen level information (including, for example, overall oxygen levels in a given tissue or anatomical structure, oxygen levels in a patient's blood, and / or even specific oxygen levels at a per-voxel or voxel subgroup level);

[0068] Linear energy transfer information;

[0069] The organization of the logo;

[0070] Organs identified;

[0071] the specified part of the organ identified;

[0072] Time-based parameters;

[0073] The radiation sensitivity of a given tissue / organ (this information captures, for example, the alpha / beta ratio of a given organ);

[0074] Patient image information (including but not limited to imaging derived from computed tomography, magnetic resonance imaging, and / or positron emission tomography, and imaging presenting segmentation information about the patient);

[0075] Organization type;

[0076] Blood oxygen levels;

[0077] blood type;

[0078] Medication (including one or more prescription or over-the-counter medications and / or supplements);

[0079] Chemotherapy information (including previous chemotherapy treatments, current chemotherapy treatments, and / or planned / scheduled chemotherapy treatments);

[0080] Previous surgical information;

[0081] Immunotherapy information;

[0082] Previous medical treatment information (including, for example, radiotherapy, ultrasound, etc.);

[0083] Demographic information (such as, but not limited to, age, gender, ethnicity, health factors (such as body mass index, autoimmune conditions, blood sugar levels, hemophilia, hypertension, etc.), lifestyle factors (such as smoking and drinking history and habits), stress factors, blood test information (such as white blood cell count, cholesterol levels, etc.), and even DNA information);

[0084] Biological age information;

[0085] Genetic marker information;

[0086] time of day;

[0087] Tumor type;

[0088] pH (potential hydrogen) balance information;

[0089] Temperature information;

[0090] Blood pressure information;

[0091] Blood test information; and / or

[0092] Immunization health information.

[0093] At block 203, the control circuit 101 then determines a biological equivalent dose for the specific patient based on both the information representing the radiation dose deposition as a function of time and the at least one biological parameter, thereby providing the determined biological equivalent dose for the specific patient. By one approach, this may include determining a plurality of biological equivalent doses for the specific patient, thereby providing a plurality of determined biological equivalent doses for the specific patient.

[0094] By one approach, the foregoing includes determining at least one biological equivalent dose on a per-voxel basis (e.g., for voxels within a patient target volume and / or within an organ at risk). The latter may be useful, for example, when the dose relative to time information includes a set of three-dimensional points within a patient image. By another approach, the foregoing may include determining at least one biological equivalent dose on a per-patient structure basis.

[0095] Figure 3 An illustrative example in these regards is presented with the understanding that the details of the example are intended for illustrative purposes and are not intended to suggest any limitations with respect to these teachings.

[0096] In this example, the dose 301 and dose rate 302 distributions are combined into a biological equivalent dose (BED) 303 that is related to a normal tissue complication probability (NTCP) 304. The relationship between dose (D) 301, dose rate (DR) 302, and normal tissue complication probability (NTCP) 304 is complex and not necessarily intuitive. It should be appreciated that combining dose and dose rate into one distribution BED=f(D, DR) allows for better visualization of their correlation with NTCP.

[0097] As described above, these teachings will be applicable using any of a variety of biological inputs. As just one illustrative example, oxygen levels within tissue can be used in conjunction with dose rate information to produce an oxygen enhancement ratio weighted biological dose.

[0098] By an optional method, referring to optional block 204, these teachings will be adapted to generate a radiation treatment prescription based at least in part on the above-described biological equivalent dose for a particular patient. Those skilled in the art will appreciate that a radiation treatment prescription represents an overall dose target envisioned and anticipated by the prescribing oncologist. Thus, the radiation treatment prescription does not involve matters such as the geometry of the treatment machine, control points, treatment field, etc. (For clarity, it should be understood that a radiation treatment prescription is distinct from optimization purposes, which are very specifically designed to reflect and be adapted to the technical details and specifications of a particular radiation treatment platform, specific details about the patient presentation, and / or other physical details about the specific application of setting up the geometry of the treatment machine, control points, treatment field, etc.)

[0099] As an alternative to or in combination with the foregoing, by another optional method and as represented by optional box 205, these teachings will be suitable for optimizing the FLASH radiation therapy treatment plan at least in part based on the determined biological equivalent dose for a specific patient to provide an optimized FLASH radiation therapy treatment plan. By one method, the foregoing can include calculating multiple biological equivalent dose values ​​as part of an optimization cycle. These different biological equivalent dose values ​​can correspond to different patient structures, patient substructures and / or voxels, and can be included as part of a cost function that is iteratively reduced to a local minimum (if not a global minimum). For example, biological equivalent dose values ​​AB can be iteratively generated until a seemingly optimal value is found.

[0100] When optimizing a FLASH plan, better performance can be expected when the analytical expression for the gradient (i.e., the derivative of the distribution used for optimization with respect to the optimization variable) is known. In general, the variables used for optimization include the beamlet intensities for intensity-modulated radiotherapy or the weights of the individual pencil beams for intensity-modulated proton therapy. In both cases, the optimization variables can be expressed in monitoring units (MU). For a model where the BED depends only on the dose rate DR and the dose D, the gradient with respect to the optimization variable MU can be expressed as:

[0101]

[0102] For a model where BED depends on the dose rate DR, the dose D, and any other biometric X (e.g., oxygen enhancement ratio or linear energy transfer), the gradient with respect to the optimization variable MU can be expressed as:

[0103]

[0104] These teachings will also be adapted to allow BED to be a function of the dose versus delivery time curve, in which case the effect of a given dose delivery sequence on BED can be assessed with the aid of detailed treatment delivery modeling. Likewise, the chain rule still applies and includes the proton pencil beam spot list (scan pattern) as a variable that can be manipulated by the optimizer to achieve the BED target.

[0105] As an alternative to the foregoing, or any permutation or combination thereof, at optional block 206, the process 200 is adapted to evaluate the quality of the optimized FLASH radiation therapy treatment plan based at least in part on the determined biological equivalent dose for a particular patient. Such an approach may be beneficial, for example, when the biological equivalent dose corresponds to a three-dimensional distribution and the quality is evaluated at least in part using the distribution as input.

[0106] Also as an alternative to the foregoing, or in any permutation or combination therewith, at optional block 207, these teachings are adapted to administer radiation to a particular patient according to the foregoing optimized FLASH radiation therapy treatment plan using, for example, the radiation treatment platform 114 described above.

[0107] To assist the treatment planner, these teachings will also be adapted to provide one or more corresponding assessment tools. Examples include, but are not limited to, BED volume histograms, BED distributions displayed on top of computed tomography images, BED distributions displayed by field, BED impact matrices, etc.

[0108] By way of illustration and reference Figure 4 , standard dose volume histograms (DVH) 401, 402 and biological equivalent dose volume histograms (BEDVH) 403, 404 for risk organs and target volumes can be presented respectively. Target coverage is relatively unchanged, but risk organs receive significantly lower BED compared to physical dose. This interface facilitates clinical decision making regarding treatment mode (FLASH versus conventional).

[0109] It should be appreciated that while existing FLASH radiation therapy treatment plan optimization techniques tend to focus solely on improving the physical dose rate, such existing approaches also tend to ignore consideration of any FLASH-based biological effects; however, the present teachings successfully balance these two considerations.

[0110] Those skilled in the art will appreciate that various modifications, substitutions and combinations may be made with respect to the above-described embodiments without departing from the scope of the present invention, and such modifications, substitutions and combinations are to be considered within the scope of the inventive concept.

Claims

1. A method comprising: Through the control circuit: accessing information representing radiation dose deposition as a function of time for a particular patient; accessing at least one biological parameter of the specific patient; A biological equivalent dose is determined for the specific patient based on both the information representing radiation dose deposition as a function of time and the at least one biological parameter to provide a determined biological equivalent dose for the specific patient.

2. The method of claim 1 , wherein determining the bioequivalent dose for the specific patient comprises: A plurality of biological equivalent doses for the specific patient is determined based on both the information representing radiation dose deposition as a function of time and the at least one biological parameter to provide a plurality of determined biological equivalent doses for the specific patient. 3 . The method of claim 1 , wherein the information representing radiation dose deposition as a function of time comprises both dose information and dose rate information. The method according to claim 1 , wherein the at least one biological parameter includes normal tissue complication probability information. The method of claim 1 , wherein the at least one biological parameter comprises oxygen level information. The method of claim 1 , wherein the at least one biological parameter comprises linear energy transfer information.

7. The method of claim 1 , wherein the at least one biological parameter comprises at least one of: the organization identified; the organs identified; the designated part of the organ identified; Time-based parameters; the radiosensitivity of a given tissue / organ; Patient image information; Organization type; Blood oxygen levels; blood type; Medication; chemotherapy information; Previous surgical information; Immunotherapy information; Previous medical treatment information; demographic information; Biological age information; genetic marker information; time of day; Tumor type; pH (potential hydrogen) balance information; Temperature information; Blood pressure information; blood test information; Immunization health information.

8. The method according to claim 1, further comprising: A FLASH radiation therapy treatment plan is optimized based at least in part on the determined biological equivalent dose for the specific patient to provide an optimized FLASH radiation therapy treatment plan.

9. The method according to claim 8, further comprising: Radiation is administered to the specific patient according to the optimized FLASH radiation therapy treatment plan.

10. The method according to claim 8, further comprising: The quality of the optimized FLASH radiation therapy treatment plan is evaluated based at least in part on the determined biological equivalent dose for the specific patient.

11. The method according to claim 1 , further comprising: A radiation treatment prescription is generated based at least in part on the determined biological equivalent dose for the particular patient.

12. A device comprising: a memory having stored therein information representing radiation dose deposition as a function of time for a specific patient and at least one biological parameter of the specific patient; a control circuit operatively coupled to the memory and configured to: accessing said information representing radiation dose deposition as a function of time for a particular patient; accessing the at least one biological parameter of the specific patient; A biological equivalent dose is determined for the specific patient based on both the information representing radiation dose deposition as a function of time and the at least one biological parameter to provide a determined biological equivalent dose for the specific patient.

13. The apparatus of claim 12 , wherein the control circuit is configured to generate the biological equivalent dose for the specific patient by determining a plurality of biological equivalent doses for the specific patient based on both the information representing radiation dose deposition as a function of time and the at least one biological parameter, thereby providing a plurality of determined biological equivalent doses for the specific patient.

14. The apparatus of claim 12, wherein the information indicative of radiation dose deposition as a function of time comprises at least in part dose rate information.

15. The apparatus of claim 12, wherein the information representative of radiation dose deposition as a function of time comprises both dose information and dose rate information.

16. The apparatus of claim 12, wherein the at least one biological parameter comprises normal tissue complication probability information.

17. The apparatus of claim 12, wherein the at least one biological parameter comprises oxygen level information.

18. The apparatus of claim 12, wherein the at least one biological parameter comprises linear energy transfer information.

19. The apparatus of claim 12, wherein the at least one biological parameter comprises at least one of: the organization identified; the organs identified; the designated part of the organ identified; Time-based parameters; the radiosensitivity of a given tissue / organ; Patient image information; Organization type; Blood oxygen levels; blood type; Medication; chemotherapy information; Previous surgical information; Immunotherapy information; Previous medical treatment information; demographic information; Biological age information; genetic marker information; time of day; Tumor type; pH (potential hydrogen) balance information; Temperature information; Blood pressure information; blood test information; Immunization health information.

20. The apparatus of claim 12, wherein the control circuit is further configured to: A FLASH radiation therapy treatment plan is optimized based at least in part on the determined biological equivalent dose for the specific patient to provide an optimized FLASH radiation therapy treatment plan.

21. The apparatus of claim 20, wherein the control circuit is further configured to: Radiation is administered to the specific patient according to the optimized FLASH radiation therapy treatment plan.

22. The apparatus of claim 20, wherein the control circuit is further configured to: The quality of the optimized FLASH radiation therapy treatment plan is evaluated based at least in part on the determined biological equivalent dose for the specific patient.

23. The apparatus of claim 12, wherein the control circuit is further configured to: A radiation treatment prescription is generated based at least in part on the determined biological equivalent dose for the particular patient.

Images