Systems, methods, and software for magnetic resonance image guided radiation therapy

Abstract

Systems, methods, and computer software are disclosed that may include receiving a treatment prescription for a patient; obtaining, from the workflow library, a diagnosis-driven magnetic resonance imaging guided radiation therapy treatment and planning workflow (MRgRTamp; p workflow), the diagnostic driven MRgRTamp; the P workflow has a parameter list including parameters for MRI guided radiation therapy. An MRgRTamp driven by means of the diagnosis; p working process, which can execute any of the following operations: utilizing the radiation therapy imaging parameters in the parameter list, and using the MRI to guide the radiation therapy system to carry out imaging; generating a radiation therapy treatment plan by using the radiation therapy plan parameters in the parameter list; and / or controlling the MRI guided radiation therapy system using the radiation therapy delivery parameters in the parameter list.

Description

[0001] Related Applications

[0002] This application claims priority and the benefit of U.S. Provisional Application No. 63 / 417,921, filed on October 20, 2022, entitled "SYSTEMS, METHODS AND SOFTWARE FOR MAGNETIC RESONANCE IMAGE GUIDED RADIOTHERAPY", the content of which is incorporated herein by reference. Background Art

[0003] Magnetic resonance imaging (MRI), or nuclear magnetic resonance imaging, is a non-invasive imaging technique that uses the interaction between radiofrequency pulses, a strong magnetic field (modified by applying weak gradient fields thereon to localize, encode, or decode phase and frequency), and body tissues to obtain projection, spectral signals, and planar or volumetric images from within a patient. Magnetic resonance imaging is particularly useful for soft tissue imaging and can be used for disease diagnosis. Real-time or cine MRI can be used to diagnose medical conditions that require imaging of moving structures within a patient. Real-time MRI can also be used in conjunction with interventional procedures such as radiotherapy or image-guided surgery. Summary of the Invention

[0004] In one aspect, systems, methods, and computer software are disclosed that may include at least one programmable processor and a non-transitory machine-readable medium storing instructions that, when executed by the at least one programmable processor, cause the at least one programmable processor to perform operations that include: receiving a treatment prescription for a patient; obtaining from a workflow library a diagnosis-driven magnetic resonance imaging-guided radiotherapy treatment and planning workflow (MRgRT&P workflow) associated with the treatment prescription, the diagnosis-driven MRgRT&P workflow having a parameter list that includes parameters for MRI-guided radiotherapy. With the diagnosis-driven MRgRT&P workflow, any of the following operations can be performed: imaging using an MRI-guided radiotherapy system with radiotherapy imaging parameters from the parameter list; generating a radiotherapy treatment plan with radiotherapy planning parameters from the parameter list; and / or controlling an MRI-guided radiotherapy system with radiotherapy delivery parameters from the parameter list.

[0005] In some variations, the treatment prescription may include disease type, treatment site, stage, total dose, number of fractions, dose per fraction for each structure, minimum / maximum / average dose constraints, and / or dose-volume constraints for targets and organs.

[0006] In some variations, obtaining a diagnosis-driven MRgRT&P workflow can include comparing the treatment prescription to a stored treatment prescription associated with the stored diagnosis-driven MRgRT&P workflow, and returning the stored diagnosis-driven MRgRT&P workflow having a stored treatment prescription that matches the treatment prescription.

[0007] In some variations, radiotherapy imaging parameters can include one or more of the following: volumetric imaging parameters, planar imaging parameters, or tissue tracking parameters.

[0008] In some variations, radiotherapy planning parameters can include one or more of the following: anatomical structure identification parameters, automatic contouring parameters, or relative electron density parameters.

[0009] In some variations, radiotherapy delivery parameters can include one or more of the following: beam energy, MLC position, or couch position.

[0010] In some variations, the operation can include providing a workflow editor configured to facilitate modification of the diagnosis-driven MRgRT&P workflow.

[0011] In some variations, the operation can include obtaining from a workflow library additional diagnosis-driven magnetic resonance imaging-guided radiotherapy treatment and planning workflows (MRgRT&P workflows) associated with the treatment prescription, and presenting a plurality of diagnosis-driven MRgRT&P workflows to a user for selection.

[0012] In a related aspect, a system, method, and computer software can include at least one programmable processor; and a non-transitory machine-readable medium storing instructions that, when executed by the at least one programmable processor, cause the at least one programmable processor to perform operations including: capturing initial parameters of a diagnosis-driven magnetic resonance imaging-guided radiotherapy treatment and planning workflow (MRgRT&P workflow) associated with a treatment prescription, the capturing including recording initial parameters utilized during imaging using an MRI-guided radiotherapy system, during generation of a radiotherapy treatment plan, and during control of the MRI-guided radiotherapy system; generating a diagnosis-driven MRgRT&P workflow based on the initial parameters; and storing the diagnosis-driven MRgRT&P workflow associated with the treatment prescription in a workflow library.

[0013] Embodiments of the present subject matter may include, but are not limited to, methods consistent with the description provided herein and articles including tangible, machine-readable media operable to cause one or more machines (e.g., computers, etc.) to perform operations implementing one or more of the features. Similarly, computer systems are also contemplated, which may include one or more processors and one or more memories coupled to the one or more processors. The memory may include computer-readable storage media that may contain, encode, store, or otherwise process one or more programs that cause the one or more processors to perform one or more of the operations described herein. Computer-implemented methods consistent with one or more embodiments of the present subject matter may be implemented by one or more data processors residing in a single computing system or across multiple computing systems. Such multiple computing systems may be connected and may exchange data and / or commands or other instructions, etc., including but not limited to connections via a network (e.g., the Internet, wireless wide area network, local area network, wide area network, wired network, etc.), direct connections between one or more of the multiple computing systems, etc.

[0014] Details of one or more variations of the subject matter described herein are set forth in the accompanying drawings and the following description. Other features and advantages of the subject matter described herein will be apparent from the specification, the drawings, and the claims. Although certain features of the presently disclosed subject matter are shown only for particular embodiments, it should be understood that these features are not intended to limit the invention. The appended claims of this disclosure are intended to define the scope of the protected subject matter. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] The drawings are incorporated into and form a part of this specification, illustrate certain aspects of the subject matter disclosed herein, and together with the description, help to explain some of the principles associated with the disclosed embodiments. In the drawings:

[0016] Figure 1 is a schematic diagram showing an exemplary list of parameters that can be used for magnetic resonance image-guided radiotherapy (MRgRT) imaging, planning, or delivery, according to certain aspects of the present disclosure,

[0017] Figure 2 is a schematic diagram showing the creation and storage of a diagnosis-driven magnetic resonance-guided radiotherapy treatment and planning (MRgRT&P) workflow, according to certain aspects of the present disclosure, and

[0018] Figure 3 is a schematic diagram showing the use of a diagnosis-driven MRgRT&P workflow, according to certain aspects of the present disclosure. DETAILED DESCRIPTION

[0019] Figure 1FIG. 0 is a schematic diagram showing an exemplary list of parameters that can be used for magnetic resonance image-guided radiotherapy (MRgRT) imaging, planning, or delivery. MRgRT is an extremely complex and precise process that may involve dozens (or even hundreds) of decisions during the planning and execution of the imaging / planning / treatment workflow. Planning a patient's treatment not only includes determining the radiotherapy plan, but also determining the machine parameters used during treatment (e.g., parameters of the MRI and radiation source). The present disclosure generally divides such parameters (e.g., in the form of parameter list 100) into three categories: imaging parameters 110, planning parameters 130, and delivery parameters 150. However, a particular parameter can be used in more than one category. For example, certain imaging parameters can be determined as part of the imaging performed during the planning process and can also be used during imaging in the delivery process. Thus, in various embodiments, parameter list 100 can include any combination of the parameters described herein. However, the parameters disclosed herein are not intended to be an exhaustive list, and other parameters used in planning, imaging, and delivery can also be included and should be considered within the scope of the present disclosure.

[0020] Radiotherapy imaging parameters 110 can include volumetric imaging parameters 112 (shown separately in Figure 1 but similar or identical to the volumetric imaging parameters 132 used in planning). Other parameters can include planar imaging parameters 114 for cine imaging, e.g., which cine is enabled for treatment, cine label, cine annotation, number of planes, plane orientation (axial, sagittal, coronal, oblique), contrast, frame rate, slice thickness, in-plane resolution, cine origin, cine field of view, etc. Additional parameters can include tissue tracking parameters 116, e.g., the structures to be tracked for each plane, the method for creating tracking boundaries for each tracked structure (including isodose level thresholds (> or < dose level)), boundary structures, or structure edge expansion in each specified direction (+x, -x, +y, -y, +z, -z). The gating parameter for each plane can include soft tissue tracking algorithms (e.g., standard, large deformation, small motion, etc.), allowed percentage area violation, confidence value in percentage, display settings for the patient (e.g., hidden, only contours, image and contours), k-space mixing on / off, noise filtering on / off with noise parameters, motion correction on / off, number of frames with tracking off (e.g., 0 - 5), number of frames with tracking on (e.g., 0 - 5), etc.

[0021] The radiotherapy planning parameters 130 may include one or more of the following: volumetric imaging parameters 132, image registration parameters 134, anatomical structure segmentation parameters 136, treatment planning parameters 138, treatment planning dose parameters 140, treatment planning optimization parameters 142, dose display parameters 144, treatment option parameters 146, etc.

[0022] The volumetric imaging parameters 132 for initial treatment planning and daily setup may include, for example, the following parameters. The planned patient orientation may specify, for example, head first or feet first and prone or supine. Parameters for the couch position may be used to set the imaging volume. Parameters for one or more anatomical sites (e.g., known treatment locations (e.g., tumors) and / or organs at risk) may be used for volume constraints or default values (e.g., approximate sizes of tumors, lungs, heart, etc.). The number of scans and the scan contrast (pulse sequence) for each scan may be set, as well as which scans are required during treatment. Parameters related to the skin mask algorithm may be used (e.g., to detect and define the skin surface outside of which volumetric imaging need not be performed), or parameters related to the threshold used to determine the skin surface may be used (e.g., a given intensity value or image gradient, noise floor, etc.). In some embodiments, the imaging parameters determined from pre-treatment imaging may also be used during treatment (e.g., for real-time magnetic resonance imaging radiotherapy (MRgRT)).

[0023] Some embodiments may include volumetric imaging parameters that may be set for each scan. For example, scan tags, scan notes, and scan locations may be set. The field of view (FOV) may be set. The system may also accept or reject such settings based on the skin mask. For example, if the skin mask extends inward by more than 1 cm and not more than 2 cm, the FOV may be accepted, otherwise the FOV may be enlarged or shrunk such that if it is smaller, a 1-cm margin is added, and if it is larger, a 2-cm margin is set. The configuration for parallel imaging may be set, such as parallel imaging along 0, 1, or 2 axes. The scan resolution may be set, e.g., a higher resolution may be set for critical features or features with small sizes, while a lower resolution may be used in less critical areas. Other parameters may include planned breath-holding, e.g., to acquire images during inhalation, exhalation, or not to hold the breath if breath-holding is not used.

[0024] The image registration parameters 134 may include parameters for defining an auxiliary image set for deformable image registration to assist in planning, the definition of an optional X-ray CT scan to produce a relative electron density (RED) map, or a previously delivered dose defined for deformable image registration, etc.

[0025] The anatomical structure segmentation parameters 136 may include the definition of targets and organs at risk (OARs) for treatment planning, Boolean operators and rules for generating contours, automatic contouring templates, the definition for synthetic CT generation, RED density override, the color for each target or organ at risk, displaying the segmentation as lines, with line thickness and / or having the color wash with opacity percentage turned on / off, etc.

[0026] The treatment planning parameters 138 may include the number of isocenters, the positions of the isocenters, the couch position relative to the planned isocenters, the number of beams at each isocenter, the angle of each beam, the type of each beam (e.g., conformal or intensity modulated radiotherapy (IMRT)), the beam aperture creation rules for each conformal beam (e.g., the structures and edges in each beam direction), etc.

[0027] The treatment planning dose parameters 140 may include the beam pixel (bixel) size (e.g., 4mm x 4mm or 3mm or 2mm), the dose grid resolution, the IMRT efficiency (e.g., 0.2 to 20), the beam pixel histories / cm 2 (e.g., 15000), the total segment histories (e.g., 4800000) for Monte Carlo dose calculation, the option of using magnetic fields in beam pixel dose calculation or in segment dose calculation, etc.

[0028] The treatment planning optimization parameters 142 may include the IMRT leaf sequencer type (e.g., fixed segment, accuracy target, or fixed discretization), the maximum leaf sequencer discretization (e.g., 1 to 16), the leaf sequencer accuracy target (e.g., 0.1 to 0.01), the maximum number of segments, the type of optimization objective function (simple or advanced), etc. For targets and OARs in the advanced objective function, other parameters may include target importance, objective power, whether to increase or decrease, etc. For targets and OARs in the simple objective function, other parameters may include target upper limit importance, target lower limit importance, target upper limit power, target lower limit power, threshold dose, etc. For each target or OAR, other parameters may also include constraints such as minimum dose greater than or equal to, maximum dose less than or equal to, average dose greater than or equal to, average dose less than or equal to, etc. The dose volume histogram constraint parameters for the advanced objective function of each target or OAR may include percentage or cc volume, greater than or equal to or less than or equal to, dose, etc.

[0029] The dose display parameter 144 may include the number of isodose lines, the dose level of each isodose line, the display of isodose lines in Gy or percentage, the color of each isodose line, the thickness of the isodose lines, the opacity of the isodose lines, the on or off of dose color wash, the color map of the color wash, the opacity of the color wash, the display of the color wash in Gy or percentage, the minimum color wash value, the maximum color wash value, etc.

[0030] The treatment option parameter 146 may include adaptive or non - adaptive, filling the fractionation delivery calendar with an approved treatment plan, setting subsequent adaptive fractions to a new online adaptation plan or the original plan, etc.

[0031] In some embodiments, the radiotherapy planning parameters that can be used to generate relative electron density (RED) settings or maps may further include anatomical structure identification parameters (e.g., coordinates or labels of structures or components within a patient), automatic contouring parameters (e.g., similar to the anatomical structure segmentation parameter 116), relative electron density parameters (e.g., RED values assigned to the identified anatomical structures), etc.

[0032] The radiotherapy delivery parameter 150 may include one or more of the following: beam energy 152, MLC position 154, or couch position 156. Such radiotherapy delivery parameters can thus provide the physical settings of a radiotherapy delivery device (e.g., power engagement, MLC leaves in a specific position, the treatment couch at a specific height / orientation, etc.).

[0033] The present disclosure contemplates automating certain aspects of radiotherapy planning, imaging, and / or treatment. This can be achieved by leveraging parameters previously determined during the imaging, planning, and / or treatment processes for patients with a specific diagnosis according to a specific treatment prescription. The parameters associated with the treatment prescription may constitute what is herein referred to as a diagnosis - driven magnetic resonance - guided radiotherapy treatment and planning (MRgRT&P) workflow (note that when the present disclosure uses this term, even though the acronym does not explicitly include "I", it is contemplated that imaging parameters can be included in the workflow as described herein).

[0034] Figure 2 is a simplified schematic diagram showing the creation of a diagnosis - driven magnetic resonance - guided radiotherapy treatment and planning (MRgRT&P) workflow according to certain aspects of the present disclosure. In some embodiments, a diagnosis - driven MRgRT&P workflow can be created by manual data entry of parameters (such as the aforementioned parameters). In other embodiments, a diagnosis - driven MRgRT&P workflow can be created partially or fully by capturing the parameters used during an actual session of imaging, planning, and / or treatment (e.g., performed by an expert or experienced clinician).

[0035] InFigure 2 In an exemplary process 200, initial parameters of a diagnosis-driven MRgRT&P workflow associated with a treatment prescription can be captured at 210. The capture can include recording initial parameters used during imaging using an MRI-guided radiotherapy system (e.g., any imaging parameter 110), initial parameters used during radiotherapy plan generation (e.g., any plan parameter 130), and / or initial parameters used during controlling the MRI-guided radiotherapy system (e.g., any delivery parameter 150). In one embodiment, the capture can be performed by the system automatically capturing data input fields, keystrokes, or other manual computer inputs, etc.

[0036] At 220, a diagnosis-driven MRgRT&P workflow can be generated based on the captured parameters by associating a set of initial parameters 224 with the diagnosis-driven MRgRT&P workflow. Any sub-combination of the captured initial parameters can be used. For example, it can include only certain parameters related to planning, imaging, delivery, planning and imaging, planning and delivery, or planning, imaging, and delivery. In a preferred embodiment, the diagnosis-driven MRgRT&P workflow contains parameters related to imaging, planning, and treatment, but the present disclosure contemplates that the diagnosis-driven MRgRT&P workflow may contain only parameters related to a subset of these MRgRT operations.

[0037] The present disclosure also contemplates that the system and software provide a workflow editor configured to facilitate modifying the diagnosis-driven MRgRT&P workflow. This can include using a graphical user interface (GUI) to, for example, change numerical parameter values, modify anatomical contours, update labels, modify treatment goals and constraints, modify imaging or radiotherapy machine settings, etc.

[0038] The diagnosis-driven MRgRT&P workflow can be associated with a treatment prescription 222. As used herein, the term "treatment prescription" broadly describes a patient diagnosis and / or specific treatment parameters of a patient. For example, a treatment prescription can include any of the following: disease type (e.g., malignant or benign), treatment site, stage (T, N, M), grade, primary reference target, intent (curative, palliative, other), total dose, number of fractions, dose per fraction, dose-volume constraints of the target, including the specification of the target prescription dose-volume coverage (e.g., the prescription dose (Drx) covers 95% or more of the target volume), target hot spot dose-volume margin (e.g., less than 1% of the target volume is covered by more than 107% of the Drx), target cold spot dose-volume margin (e.g., 95% of the Drx covers more than 99% of the target volume), and dose-volume constraints of the health-threatening organs involved in a given diagnostic treatment (e.g., dose-volume constraints of the bladder, rectum, and femur in prostate cancer treatment), minimum dose constraint of the target, average dose constraint of the target and health-threatening organs, maximum dose constraint of the target and health-threatening organs, etc. In addition, the "dose" used herein can be a physical dose (unit: Gy) or a biologically effective dose (BED).

[0039] In some embodiments, for a specific diagnosis, there can be different (i.e., multiple) diagnosis-driven MRgRT&P workflows. For example, in treating prostate cancer, a diagnosis-driven MRgRT&P workflow can provide the parameters for a single-fraction treatment of 24 Gy, while other diagnosis-driven MRgRT&P workflows can treat in, for example, 5 fractions of 8 Gy or 39 fractions of 2 Gy, since each of these treatment plans will deliver a similar biologically effective dose.

[0040] It is also contemplated that for a given treatment regimen, there can be different (i.e., multiple) diagnosis-driven MRgRT&P workflows. For example, different workflows for the same prescription can include different plan optimization parameters (e.g., treatment plan optimization parameter 142, etc.). Different optimization settings can then provide different plans, which can result in slightly different aspects such as target dose, organ protection, etc., and the user can use more than one workflow to compare similar plans and select the desired plan.

[0041] At 230, the diagnostic-driven MRgRT&P workflow can be stored in a workflow library associated with a treatment prescription. The workflow library can be any data store and can contain other diagnostic-driven MRgRT&P workflows created for other treatment prescriptions. In other embodiments, the diagnostic-driven MRgRT&P workflow can be stored in a database 240 (e.g., a local server or other computer memory) that can be accessed by the workflow library 230 to introduce any number of diagnostic-driven MRgRT&P workflows 220.

[0042] Figure 3 is a schematic diagram showing an exemplary use of a diagnostic-driven MRgRT&P workflow in accordance with certain aspects of the present disclosure. Process 300 can include receiving a patient's treatment prescription at 310, e.g., by the system interpreting input clinician text or fields, selecting a pre-established treatment prescription (e.g., from a list), etc. For example, the treatment prescription can include disease type, treatment site, stage, total dose, number of fractions, dose per fraction for each structure, minimum / maximum / average dose constraints and / or dose volume constraints for targets and organs, etc.

[0043] At 320, a diagnostic-driven MRgRT&P workflow 330 associated with the treatment prescription 332 can be obtained from the workflow library 320. The diagnostic-driven MRgRT&P workflow 330 can include a parameter list 334 having parameters for MRI-guided radiotherapy. For example, given the treatment prescription input at 310, a suitable diagnostic-driven MRgRT&P workflow can be found in the workflow library 320, e.g., by comparing the treatment prescription with a stored treatment prescription associated with the stored diagnostic-driven MRgRT&P workflow. The system can then return the stored diagnostic-driven MRgRT&P workflow having a stored treatment prescription that matches the treatment prescription. The parameter list 334 can contain parameters previously created and stored during the creation process (e.g., as referenced Figure 2 as described).

[0044] In some cases, the system can return multiple different diagnostic-driven MRgRT&P workflows to the user for selection. For example, the workflows for a particular treatment prescription can contain different plan optimization parameters, and multiple workflows can be presented to the user, and the user can use / select the workflow that is considered most ideal among them. Thus, the system can be configured to obtain additional diagnostic-driven magnetic resonance imaging-guided radiotherapy treatment and planning workflows (MRgRT&P workflows) associated with a treatment prescription from the workflow library and present multiple diagnostic-driven MRgRT&P workflows to the user for selection.

[0045] The diagnostic-driven MRgRT&P workflow 330 can be used for planning, imaging, treatment, etc., but some embodiments allow the diagnostic-driven MRgRT&P workflow to be edited at 340 before use. For example, a doctor or technician can modify various parameters based on the specific needs of the patient or the imaging / planning / delivery system configuration. However, since the present disclosure automatically invokes and applies previously determined parameters in the diagnostic-driven (MRgRT&P) workflow, such manual requirements are greatly reduced.

[0046] Via the invoked diagnostic-driven MRgRT&P workflow 330, the system can then perform any combination of the following: image using the MRI-guided radiotherapy system 360 with the radiotherapy imaging parameters in the parameter list 334; generate a radiotherapy treatment plan using the radiotherapy planning parameters in the parameter list 334 ( Figure 3 at 350 in); and control the MRI-guided radiotherapy system using the radiotherapy delivery parameters in the parameter list 334 ( Figure 3 at 370 in, represented by an exemplary gantry-mounted radiotherapy system within a split MRI).

[0047] While the above embodiments can be used for imaging, planning, and treatment, other embodiments can include embodiments where the diagnostic-driven MRgRT&P workflow 330 is used in a sub-combination with any one or any two of these stages. In one embodiment, the system can generate a radiotherapy treatment plan using the radiotherapy planning parameters in the parameter list 334 and control the MRI-guided radiotherapy system using the radiotherapy delivery parameters in the parameter list. In another embodiment, the system can image using the MRI-guided radiotherapy system with the radiotherapy imaging parameters in the parameter list 334 and generate a radiotherapy treatment plan using the radiotherapy planning parameters in the parameter list 334. In yet another embodiment, the system can image using the MRI-guided radiotherapy system with the radiotherapy imaging parameters in the parameter list 334 and control the MRI-guided radiotherapy system using the radiotherapy delivery parameters in the parameter list 334. In other embodiments, the system can be configured to perform any one of the following: image using the MRI-guided radiotherapy system with the radiotherapy imaging parameters in the parameter list 334; generate a radiotherapy treatment plan using the radiotherapy planning parameters in the parameter list 334; or control the MRI-guided radiotherapy system using the radiotherapy delivery parameters in the parameter list 334.

[0048] In some embodiments, the processes described herein may also include requesting user confirmation related to the generation, imaging, and / or control based on parameter list 334. For example, the system may request confirmation of the parameters in the diagnosis-driven MRgRT&P workflow at various steps of the process to ensure that the user wishes to proceed in the specified manner.

[0049] Next, further features, characteristics, and exemplary aspects of the present disclosure will be described in the form of items that may optionally be claimed in any combination:

[0050] Item 1: A system comprising at least one programmable processor and a non-transitory machine-readable medium storing instructions that, when executed by the at least one programmable processor, cause the at least one programmable processor to perform operations including: receiving a treatment prescription for a patient; obtaining from a workflow library a diagnosis-driven magnetic resonance imaging-guided radiotherapy treatment and planning workflow (MRgRT&P workflow) associated with the treatment prescription, the diagnosis-driven MRgRT&P workflow having a parameter list including parameters for MRI-guided radiotherapy; using the radiotherapy imaging parameters in the parameter list to perform imaging using an MRI-guided radiotherapy system; generating a radiotherapy treatment plan using the radiotherapy planning parameters in the parameter list; and / or controlling the MRI-guided radiotherapy system using the radiotherapy delivery parameters in the parameter list.

[0051] Item 2: The system according to Item 1, wherein the treatment prescription includes a disease type, treatment site, stage, total dose, number of fractions, dose per fraction for each structure, minimum / maximum / average dose constraints, and / or dose volume constraints for targets and organs.

[0052] Item 3: The system according to any one of the preceding items, wherein obtaining the diagnosis-driven MRgRT&P workflow includes comparing the treatment prescription with stored treatment prescriptions associated with stored diagnosis-driven MRgRT&P workflows, and returning a stored diagnosis-driven MRgRT&P workflow having a stored treatment prescription that matches the treatment prescription.

[0053] Item 4: The system according to any one of the preceding items, wherein the radiotherapy planning parameters include one or more of the following: anatomical structure identification parameters, automatic contouring parameters, or relative electron density parameters.

[0054] Item 5: The system according to any one of the preceding items, wherein the radiotherapy planning parameters include one or more of the following: volume imaging parameters, image registration parameters, anatomical structure segmentation parameters, treatment planning parameters, treatment plan dose calculation parameters, treatment plan optimization parameters, dose display parameters, or treatment option parameters.

[0055] Item 6: The system according to any one of the preceding items, wherein the radiotherapy imaging parameters include one or more of the following: volumetric imaging parameters, planar imaging parameters, or tissue tracking parameters.

[0056] Item 7: The system according to any one of the preceding items, wherein the radiotherapy delivery parameters include one or more of the following: beam energy, MLC position, or couch position.

[0057] Item 8: The system according to any one of the preceding items, the operation further includes requesting user confirmation related to generation, imaging, and / or control based on a list of parameters.

[0058] Item 9: The system according to any one of the preceding items, the operation further includes providing a workflow editor configured to facilitate modification of a diagnosis-driven MRgRT&P workflow.

[0059] Item 10: The system according to any one of the preceding items, the operation further includes obtaining additional diagnosis-driven magnetic resonance imaging-guided radiotherapy treatment and planning workflows (MRgRT&P workflows) associated with a treatment prescription from a workflow library, and presenting multiple diagnosis-driven MRgRT&P workflows to a user for selection.

[0060] Item 11: A system, comprising: at least one programmable processor; and a non-transitory machine-readable medium storing instructions that, when executed by the at least one programmable processor, cause the at least one programmable processor to perform operations including the following: capturing initial parameters of a diagnosis-driven magnetic resonance imaging-guided radiotherapy treatment and planning workflow (MRgRT&P workflow) associated with a treatment prescription, the capturing including recording the initial parameters utilized during imaging using an MRI-guided radiotherapy system, during generation of a radiotherapy treatment plan, and during control of the MRI-guided radiotherapy system; generating a diagnosis-driven MRgRT&P workflow based on the initial parameters; and storing the diagnosis-driven MRgRT&P workflow associated with the treatment prescription in a workflow library.

[0061] Item 12: The system according to Item 11, the operation further includes providing a workflow editor configured to facilitate modification of a diagnosis-driven MRgRT&P workflow.

[0062] The present disclosure anticipates that the calculations disclosed in the embodiments herein can be performed in a variety of ways applying the same concepts taught herein, and such calculations are equivalent to the disclosed embodiments.

[0063] One or more aspects or features of the subject matter described herein can be implemented in digital electronic circuitry, integrated circuitry, specially designed application specific integrated circuits (ASICs), field programmable gate arrays (FPGAs), computer hardware, firmware, software, and / or combinations thereof. These various aspects or features can include implementation in one or more computer programs that are executable and / or interpretable on a programmable system including at least one programmable processor, a storage system, at least one input device, and at least one output device, the programmable processor may be special purpose or general purpose and is coupled to receive data and instructions from, and to send data and instructions to, the programmable processor. The programmable system or computing system may include clients and servers. The clients and servers are typically remote from each other and typically interact via a communication network. The relationship of client and server arises by virtue of computer programs running on respective computers and having a client-server relationship to each other.

[0064] These computer programs may also be referred to as programs, software, software applications, applications, components, or code, include machine instructions for a programmable processor, and can be implemented in a high-level procedural language, an object-oriented programming language, a functional programming language, a logical programming language, and / or assembly / machine language. As used herein, the term “machine-readable medium” (or “computer-readable medium”) refers to any computer program product, apparatus, and / or device, such as a disk, optical disk, memory, and programmable logic device (PLD), for providing machine instructions and / or data to a programmable processor, including a machine-readable medium that receives machine instructions as a machine-readable signal. The term “machine-readable signal” (or “computer-readable signal”) refers to any signal for providing machine instructions and / or data to a programmable processor. The machine-readable medium can non-transitorily store such machine instructions, such as, for example, non-transitory solid state memory or a magnetic hard disk drive or any equivalent storage medium. The machine-readable medium can alternatively or additionally store such machine instructions in transient fashion, such as, for example, a processor cache or other random access memory associated with one or more physical processor cores.

[0065] To provide for interaction with a user, one or more aspects or features of the subject matter described in this document can be implemented on a computer having a display device such as, for example, a cathode ray tube (CRT), or a liquid crystal display (LCD), or a light emitting diode (LED) monitor for displaying information to the user, as well as a keyboard and a pointing device such as, for example, a mouse or a trackball, by which the user can provide input to the computer. Other types of devices can also be used to provide for interaction with the user. For example, the feedback provided to the user can be any form of sensory feedback such as, for example, visual feedback, auditory feedback, or tactile feedback; and the input received from the user can be in any form, including but not limited to acoustic, speech, or tactile input. Other possible input devices include but are not limited to a touch screen or other touch-sensitive devices such as, for example, a single-point or multi-point resistive or capacitive touchpad, voice recognition hardware and software, optical scanners, optical pointers, digital image capture devices and associated interpretation software, and the like.

[0066] In the foregoing description and claims, phrases such as “at least one” or “one or more” can occur after a list of elements or features in a conjunction. The term “and / or” can also occur in a list of two or more elements or features. Such phrases are intended to mean any element or feature individually listed or any combination of any listed element or feature with any other listed element or feature, unless implicitly or explicitly contradicted by the context in which it is used. For example, the phrases “at least one of A and B;” “one or more of A and B;” “A and / or B” each mean “A alone, B alone, or A and B together.” Similar interpretations apply to lists containing three or more items. For example, the phrases “at least one of A, B, and C;” “one or more of A, B, and C;” “A, B, and / or C” each mean “A alone, B alone, C alone, A and B together, A and C together, B and C together, or A and B and C together.” The term “based on” as used above and in the claims is intended to mean “at least partially based on,” such that an unrecited feature or element is also permissible.

[0067] Depending on the desired configuration, the subject matter described herein can be embodied in a system, apparatus, method, computer program, and / or article. Any method or logical flow depicted in the figures and / or described herein need not be in the particular order or sequential order shown to achieve the desired result. The embodiments set forth in the foregoing description do not represent all embodiments consistent with the subject matter described herein. Instead, they are merely some examples consistent with aspects of the described subject matter. Although some variations have been described in detail above, other modifications or additions are possible. In particular, additional features and / or variations can be provided in addition to those features and / or variations set forth herein. The foregoing embodiments can be directed to various combinations and sub-combinations of the disclosed features and / or to combinations and sub-combinations of the foregoing other features. Moreover, the foregoing advantages are not intended to limit the application of any of the issued claims to processes and structures that achieve any or all of such advantages.

[0068] Furthermore, section headings should not limit or characterize the invention set forth in any claims that may be derived from the present disclosure. Also, the technical descriptions in the "Background" should not be construed as an admission that the technology is prior art to any invention in the present disclosure. The "Summary" should not be regarded as a characterization of the invention set forth in the issued claims. Moreover, any general reference to the present disclosure or use of the singular term "invention" is not intended to imply any limitation on the scope of the claims presented below. Multiple inventions can be claimed by limitations in multiple claims issued in accordance with the present disclosure, and those claims accordingly define the (one or more) inventions protected thereby and their equivalents.

Claims

1. A system comprising: at least one programmable processor; and a non - transitory machine - readable medium storing instructions which, when executed by the at least one programmable processor, cause the at least one programmable processor to perform operations, the operations including: receiving a treatment prescription of a patient; obtaining from a workflow library a diagnosis - driven magnetic resonance imaging - guided radiotherapy treatment and planning workflow (MRgRT&P workflow) associated with the treatment prescription, the diagnosis - driven MRgRT&P workflow having a parameter list including parameters for MRI - guided radiotherapy; using the radiotherapy imaging parameters in the parameter list to perform imaging using an MRI - guided radiotherapy system; generating a radiotherapy treatment plan using the radiotherapy planning parameters in the parameter list; and controlling the MRI - guided radiotherapy system using the radiotherapy delivery parameters in the parameter list.

2. The system according to claim 1, wherein the treatment prescription includes disease type, treatment site, stage, total dose, number of fractions, dose per fraction for each structure, minimum / maximum / average dose constraints, and / or dose - volume constraints for targets and organs.

3. The system according to claim 1, obtaining the diagnosis - driven MRgRT&P workflow comprising: comparing the treatment prescription with stored treatment prescriptions associated with stored diagnosis - driven MRgRT&P workflows; and returning a stored diagnosis - driven MRgRT&P workflow having a stored treatment prescription that matches the treatment prescription.

4. The system according to claim 1, wherein the radiotherapy planning parameters include one or more of the following: anatomical structure identification parameters, automatic contouring parameters, or relative electron density parameters.

5. The system according to claim 1, wherein the radiotherapy planning parameters include one or more of the following: volume imaging parameters, image registration parameters, anatomical structure segmentation parameters, treatment planning parameters, treatment planning dose calculation parameters, treatment planning optimization parameters, dose display parameters, or treatment option parameters.

6. The system according to claim 1, wherein the radiotherapy imaging parameters include one or more of the following: volume imaging parameters, planar imaging parameters, or tissue tracking parameters.

7. The system according to claim 1, wherein the radiotherapy delivery parameters include one or more of the following: beam energy, MLC position, or couch position.

8. The operation of the system according to claim 1 further includes requesting user confirmation related to generation, imaging, and / or control based on the parameter list.

9. The operation of the system according to claim 1 further includes providing a workflow editor configured to facilitate modification of the diagnosis - driven MRgRT&P workflow.

10. The operation of the system according to claim 1 further comprising: obtaining from the workflow library an additional diagnosis - driven magnetic resonance imaging - guided radiotherapy treatment and planning workflow (MRgRT&P workflow) associated with the treatment prescription; and Present multiple diagnostic-driven MRgRT&P workflows to a user for selection therefrom.

11. A system, comprising: at least one programmable processor; and a non-transitory machine-readable medium storing instructions that, when executed by the at least one programmable processor, cause the at least one programmable processor to perform operations, the operations including: capturing initial parameters of a diagnostic-driven magnetic resonance imaging-guided radiotherapy treatment and planning workflow (MRgRT&P workflow) associated with a treatment prescription, the capturing including recording initial parameters utilized during imaging using an MRI-guided radiotherapy system, during generation of a radiotherapy treatment plan, and during controlling the MRI-guided radiotherapy system; generating the diagnostic-driven MRgRT&P workflow based on the initial parameters; and storing the diagnostic-driven MRgRT&P workflow associated with the treatment prescription in a workflow library.

12. The system of claim 11, wherein the operations further include providing a workflow editor configured to facilitate modification of the diagnostic-driven MRgRT&P workflow.

Images