Photonic therapy system

Abstract

Provided herein are technologies related to treating cancer, in particular, but not exclusively, to systems and methods for treating a cancer patient in an upright position with photonic radiation. The technologies provide an integrated photonic treatment system comprising a medical imaging system, a patient rotation system, and a photonic beam delivery system.

Description

Cross-reference to related applications

[0001] This application claims priority to U.S. Provisional Patent Application No. 63 / 571,589, filed March 29, 2024, the entire contents of which are incorporated herein by reference. Technical Field

[0002] This article provides techniques relating to the treatment of diseases, and in particular, but not exclusively, systems and methods for treating patients in an upright position with photon radiation. Background Technology

[0003] Cancer treatment typically involves exposing tumors to photon radiation to kill cancer cells. Conventional radiation therapy is delivered to patients in a horizontal position (e.g., supine or prone), partly because treatment planning uses diagnostic imaging data acquired when the patient is in this position. However, treatment of patients in an upright position has offered improvements in cancer treatment. See, for example, Rahim (2020) “Upright radiation therapy – A historical reflection and opportunities for future applications” Frontiers in Oncology 10: 213, incorporated herein by reference. See also Boisbouvier (2022) “Upright patientpositioning for pelvic radiotherapy treatments” Technical Innovations & Patient Support in Radiation Oncology 24: 124–130. While upright radiation therapy offers benefits in terms of patient comfort and improved treatment outcomes, the techniques for imaging and treating patients in an upright position are underdeveloped. Therefore, new upright radiation therapy and imaging techniques are needed for treating patients in an upright position. Summary of the Invention

[0004] Therefore, this document provides techniques relating to treating patients with diseases, and particularly, but not exclusively, systems and methods for treating cancer patients in an upright position (e.g., standing, leaning, sitting, kneeling, or perched) with photon radiation. The system includes a patient rotation system, a medical imaging system, and a beam delivery system. In some embodiments, medical diagnostic images of the patient in an upright position, provided by the medical imaging system, are used to plan radiation therapy for the patient in an upright position using a photon beam generated by the beam delivery system. In some embodiments, the medical diagnostic images of the patient in an upright position, provided by the medical imaging system, are also used to verify the patient's position before treating the patient with the photon beam generated by the beam delivery system. In some embodiments, the medical diagnostic images of the patient in an upright position, provided by the medical imaging system, are used to adjust the patient's position prior to treatment.

[0005] In some implementations, the patient rotation system stabilizes and supports the patient in an upright position, and both medical imaging and radiotherapy procedures are performed using the same patient rotation system to support and position the patient in the same location. Imaging and / or treating patients in an upright position offers benefits such as increased patient comfort and improved patient stability compared to conventional techniques. Furthermore, for many indications (e.g., lung cancer, breast cancer), diagnosis and / or treatment in an upright position offers advantages over conventional diagnosis and / or treatment in a horizontal position.

[0006] Therefore, embodiments of this technology provide a photon beam delivery system for use in photon radiation therapy systems. For example, in some embodiments, the photon beam delivery system includes: a photon generator configured to generate a photon beam (e.g., a high-energy photon beam (e.g., an X-ray beam)); a collimator positioned between the photon generator and a patient; a collimator housing positioned around the collimator, wherein the collimator is coupled to the collimator housing using an interference fit; and a multi-leaf collimator positioned between the collimator and the patient; wherein the photon beam passes through the collimator and the multi-leaf collimator before reaching the patient. In some embodiments, the photon generator includes a waveguide and a waveguide shield positioned around the waveguide. In some embodiments, the waveguide shield is coupled to a rail configured to allow movement of the waveguide shield between a first position and a second position, wherein the waveguide shield is positioned around the waveguide in the first position and positioned at a distance from the waveguide in the second position.

[0007] In some embodiments, the beam delivery system further includes: an adjustment ring coupled to the photon generator; and a mounting plate abutting the adjustment ring, wherein the adjustment ring and the mounting plate are configured to adjust the orientation of the photon generator relative to a collimator. In some embodiments, the adjustment ring and the mounting plate contact along a substantially spherical surface.

[0008] In some embodiments, the beam delivery system includes a noise housing that includes a recess sized and configured to prevent collisions between the beam delivery system, the patient, and the photon radiation therapy system during operation. In some embodiments, the beam delivery system is configured to move between a treatment position and a storage position. In some embodiments, the beam delivery system further includes a shield configured to be in a lowered position when the beam delivery system is in the treatment position and configured to be in an elevated position when the beam delivery system is in the storage position. In some embodiments, the beam delivery system includes a noise configured to move between a treatment position and a storage position. In some embodiments, the beam delivery system further includes a shield configured to be in a lowered position when the treatment head is in the treatment position and configured to be in an elevated position when the treatment head is in the storage position.

[0009] In some embodiments, the multi-leaf collimator is configured to rotate alternately between a first position and a second position about the beam axis while the beam delivery system provides a high-energy photon beam. In some embodiments, the multi-leaf collimator rotates between the first and second positions by approximately 5 to 45 degrees (e.g., 5, 10, 15, 20, 25, 30, 35, 40, or 45 degrees). In some embodiments, the multi-leaf collimator rotates towards either the first or second position by approximately 5 to 25 degrees (e.g., 5, 10, 15, 20, or 25 degrees). In some embodiments, the multi-leaf collimator is rotated approximately 30 degrees (e.g., 25.0, 25.5, 26.0, 26.5, 27.0, 27.5, 28.0, 28.5, 29.0, 29.5, 30.0, 30.5, 31.0, 31.5, 32.0, 32.5, 33.0, 33.5, 34.0, 34.5, or 35.0 degrees) between the first and second positions. In some embodiments, the multi-leaf collimator is rotated approximately 15 degrees (e.g., 12.0, 12.5, 13.0, 13.5, 14.0, 14.5, 15.0, 15.5, 16.0, 16.5, 17.0, 17.5, or 18.0 degrees) towards the first or second position.

[0010] In some embodiments, the multi-leaf collimator rotates between a first position and a second position while the patient rotates about the patient's rotation axis. In some embodiments, the multi-leaf collimator rotates between a first position and a second position while multiple leaves of the multi-leaf collimator translate.

[0011] Furthermore, this technology provides implementations of photon radiation therapy systems. For example, in some implementations, the photon radiation therapy system includes: a beam delivery system, a medical imaging system, and a patient rotation system. In some implementations, the beam delivery system includes: a photon generator configured to generate a photon beam (e.g., a high-energy photon beam (e.g., an X-ray beam)); a collimator positioned between the photon generator and the patient; a collimator housing positioned around the collimator, wherein the collimator is coupled to the collimator housing using an interference fit; and a multi-leaf collimator positioned between the collimator and the patient; wherein the photon beam passes through the collimator and the multi-leaf collimator before reaching the patient. In some implementations, the medical imaging system includes a scanner ring configured to move between an overhead position and an imaging position, and wherein the beam delivery system is configured to move between a treatment position and a storage position. In some embodiments, the scanner ring is in an overhead position when the beam delivery system is in the treatment position, and in an imaging position when the beam delivery system is in the storage position. In some embodiments, movement of the scanner ring between the overhead and imaging positions is coordinated with movement of the beam delivery system between the treatment and storage positions. In some embodiments, the patient rotation system is configured to support a patient in an upright position for imaging and treatment.

[0012] In some embodiments, the medical imaging system includes: a first scanner pillar and a second scanner pillar; a gantry rotatably coupled to the first and second scanner pillars; and a scanner ring translatably coupled to the gantry, wherein the scanner ring includes a photon source and a photon detector on opposite sides of an aperture surrounded by the scanner ring. In some embodiments, a patient rotation system is configured to support a patient in an inclined position. In some embodiments, the photon radiation therapy system further includes a patient supported in an inclined position. In some embodiments, the gantry rotates about a horizontal axis to image the patient in the inclined position. In some embodiments, the patient supported in the inclined position is brought into contact with photon radiation generated by a beam generation system. In some embodiments, the medical imaging system is rotationally oriented such that an angle of approximately 110 to 135 degrees is formed between the beam axis and the long axis of the scanner bridge. In some embodiments, the rotational orientation of the medical imaging system provides an increased ingress / exgress area relative to a non-rotationally oriented medical imaging system.

[0013] In some embodiments, the technology provides a method for treating a patient. In some of the method embodiments described herein, the patient suffers from a disease requiring treatment, such as cancer requiring treatment. For example, in some embodiments, the method includes: providing a photonic radiation therapy system including a beam delivery system, a medical imaging system, and a patient rotation system; positioning the patient in an upright position on the patient rotation system; imaging the patient in the upright position on the patient rotation system; generating a photonic beam through the beam delivery system; and bringing the patient in the upright position into contact with the photonic beam. In some embodiments, the method further includes: rotating the patient rotation system and the patient while bringing the patient into contact with the photonic beam. In some embodiments, the method further includes: rotating a multi-leaf collimator alternately between a first position and a second position about the beam axis while bringing the patient into contact with the photonic beam. In some embodiments, the first position and the second position are separated by approximately 5 to 45 degrees (e.g., 5, 10, 15, 20, 25, 30, 35, 40, or 45 degrees). In some embodiments, the first and second positions are separated by approximately 30 degrees (e.g., 25.0, 25.5, 26.0, 26.5, 27.0, 27.5, 28.0, 28.5, 29.0, 29.5, 30.0, 30.5, 31.0, 31.5, 32.0, 32.5, 33.0, 33.5, 34.0, 34.5, or 35.0 degrees). In some embodiments, the method further includes translating the patient vertically while bringing the patient into contact with the photon beam. In some embodiments, the method further includes translating multiple blades of a multi-leaf collimator while bringing the patient into contact with the photon beam. In some embodiments, the patient's upright position is an inclined position, which positions the patient's head at the rear and the patient's feet at the front.

[0014] In some embodiments, the method includes: providing a photon radiation therapy system including a beam delivery system, a medical imaging system, and a patient rotation system; positioning a patient in an upright position on the patient rotation system; imaging the patient in the upright position on the patient rotation system; generating a photon beam through the beam delivery system; and rotating the patient rotation system and the patient while bringing the patient in the upright position into contact with the photon beam; rotating a multi-leaf collimator alternately between a first position and a second position about a beam axis; translating the patient in a vertical direction; and translating a plurality of blades of the multi-leaf collimator. In some embodiments, the first and second positions are separated by approximately 5 to 45 degrees (e.g., 5, 10, 15, 20, 25, 30, 35, 40, or 45 degrees). In some embodiments, the first and second positions are separated by approximately 30 degrees (e.g., 25.0, 25.5, 26.0, 26.5, 27.0, 27.5, 28.0, 28.5, 29.0, 29.5, 30.0, 30.5, 31.0, 31.5, 32.0, 32.5, 33.0, 33.5, 34.0, 34.5, or 35.0 degrees). In some embodiments, patient imaging provides medical images of the patient for planning treatment, verifying patient position, or adjusting patient position. In some embodiments, the patient has cancer.

[0015] In some embodiments, the method includes: providing a medical imaging system including a scanner ring in a top position; providing a beam delivery system in a storage position; positioning a patient in an upright position on a patient rotation system; translating the scanner ring to an imaging position, in which the patient is located within an aperture of the scanner ring; imaging the patient; translating the scanner ring to the top position; translating the beam delivery system to a treatment position; bringing the patient into contact with a photon beam generated by the beam delivery system; and translating the beam delivery system to a storage position. In some embodiments, the method further includes: rotating the patient rotation system and the patient while bringing the patient into contact with the photon beam. In some embodiments, imaging the patient provides a medical image of the patient for planning treatment, verifying patient position, or adjusting patient position. In some embodiments, the patient has cancer. In some embodiments, the beam delivery system includes a treatment head housing, and the treatment head housing includes a recess to provide clearance for rotation of the patient rotation system and / or the patient when the beam delivery system is in the treatment position. In some embodiments, the beam delivery system in the storage position positions the treatment head housing in a location where the surface of the treatment head housing is flush with the wall. In some embodiments, the beam delivery system further includes a shield that covers gaps in the wall when the beam delivery system is in the storage position.

[0016] In some embodiments, the method includes: providing a photon radiation therapy system including a beam delivery system and a patient rotation system; positioning a patient in an inclined position on the patient rotation system, wherein the patient includes a head and feet; and, while the patient is in the inclined position, bringing the patient into contact with photon radiation generated by the beam delivery system. In some embodiments, positioning the patient in the inclined position on the patient rotation system includes: positioning the patient in an upright position on the patient rotation system and rotating the patient rotation system and the patient about a horizontal axis such that the patient's head moves backward and the patient's feet move forward. In some embodiments, the patient in the inclined position is tilted relative to the Z-axis at approximately 15 degrees (e.g., 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20 degrees).

[0017] Some parts of this description describe implementations of the technique using algorithms and symbolic representations of information operations. These algorithmic descriptions and representations are commonly used by those skilled in the art of data processing to effectively communicate the substance of their work to others skilled in the art. While these operations are described functionally, computationally, or logically, they should be understood as being implemented by computer programs or equivalent circuits, microcode, etc. Furthermore, without loss of generality, it is sometimes convenient to arrange these operations as modules. The described operations and their associated modules can be embodied in software, firmware, hardware, or any combination thereof.

[0018] Some of the steps, operations, or processes described herein may be performed or implemented by one or more hardware or software modules, alone or in combination with other means. In some embodiments, the software modules are implemented as a computer program product comprising a computer-readable medium containing computer program code that can be executed by a computer processor to perform any or all of the described steps, operations, or processes.

[0019] In some implementations, the system includes a virtually provided computer and / or data storage (e.g., as a cloud computing resource). In particular implementations, the technology includes using cloud computing to provide a virtual computer system that includes the components as described herein and / or performs the functions of a computer as described herein. Therefore, in some implementations, cloud computing provides the infrastructure, applications, and software as described herein via a network and / or the Internet. In some implementations, computing resources (e.g., data analytics, computation, data storage, applications, file storage, etc.) are provided remotely via a network (e.g., the Internet; and / or cellular networks).

[0020] Implementations of this technology may also relate to devices for performing the operations described herein. Such devices may be specifically constructed for a desired purpose (e.g., application-specific integrated circuits or field-programmable gate arrays), and / or the devices may include general-purpose computing devices (e.g., microcontrollers, microprocessors, etc.) selectively activated or reconfigured by a computer program stored in a computer. The devices may be configured to perform one or more steps, actions, and / or functions described herein, for example, provided as instructions of a computer program. Such computer programs may be stored in a non-transitory, tangible computer-readable storage medium or any type of medium suitable for storing electronic instructions, which may be coupled to a computer system bus. Furthermore, any computing system mentioned in the specification may include a single processor or may be an architecture employing a multiprocessor design to increase computing power.

[0021] Based on the teachings contained herein, additional implementation methods will be apparent to those skilled in the art. Attached Figure Description

[0022] This patent or application document contains at least one color-drawn drawing. Upon request and payment of the necessary fees, a copy of the published patent or application document with one or more color-drawn drawings will be provided by the Patent Office.

[0023] These and other features, aspects, and advantages of this technology will be better understood with reference to the following figures.

[0024] Figure 1 This is a schematic diagram showing an orthographic view of the treatment room. Figure 1 The radiation beam (800) generated by the source (100) and the patient's axis of rotation (700) are shown. The isocenter (900) is shown at the intersection of the radiation beam (800) and the patient's axis of rotation (700). Figure 1 The coordinate system used herein is shown, relative to the source (100), the radiation beam (800), and the rotation axis (700). The X-axis and Y-axis lie together in and / or define a horizontal plane, and the Z-axis is and / or defines a vertical axis. The axes described herein may be... Figure 1 The reference axis shown is parallel to, or actually or substantially parallel to, the axis. Figure 1 The axis of the reference axis shown (e.g., relative to) Figure 1 The reference axis shown is the axis that has been translated in space, or relative to... Figure 1 The reference axis shown is the axis of a coordinate system that rotates in space. For example, the vertical axis could be... Figure 1 The Z-axis shown may be parallel to, or actually parallel to, or substantially parallel to. Figure 1The Z-axis is shown in the diagram. Components of the system described herein can be described with reference to the coordinate system associated with that component.

[0025] Figure 2A This is a schematic diagram showing the front view and "beam eye" view of the photon radiation therapy system described in this article.

[0026] Figure 2B This is a schematic diagram showing a rear view of a photon radiation therapy system, which is relative to... Figure 2A The view is taken from the opposite direction.

[0027] Figure 2C This is a schematic diagram showing a planar (top-mounted) view of a photon radiation therapy system.

[0028] Figure 2D This is a schematic diagram showing a side view of a photon radiation therapy system, which is consistent with... Figure 2A , Figure 2B and Figure 2C The views shown are orthogonal.

[0029] Figure 3A This is a schematic diagram showing the front view of a medical imaging system.

[0030] Figure 3B It is shown Figure 3A A schematic diagram of the front view of a medical imaging system, showing the translation of the scanner ring of the medical imaging system.

[0031] Figure 3C This is a schematic diagram showing a plan view of a medical imaging system.

[0032] Figure 3D This is a side view of the medical imaging system and a schematic diagram showing the axis of rotation ρ of the gantry (220) about which it rotates.

[0033] Figure 3E This is a side view of a medical imaging system and a schematic diagram showing the gantry rotating about the axis of rotation ρ to provide a tilted configuration.

[0034] Figure 3F This is a side view of a medical imaging system and a schematic diagram showing the gantry rotating about the axis of rotation ρ to provide a horizontal configuration.

[0035] Figure 3G This is a schematic diagram showing a plan view of a medical imaging system, which is positioned relative to... Figure 2C The orientation shown is set by rotating the orientation about 20 to 45 degrees around the Z-axis.

[0036] Figure 3H It is shown Figure 3GA schematic diagram of the same plan view of the medical imaging system shown. Figure 3H In the diagram, the long axis (231) of the scanner bridge and the beam axis (800) are indicated by dashed lines. For example... Figure 3H As shown, as Figure 3G The rotating medical imaging system shown results in an angle ω of approximately 110 to 135 degrees between the beam axis (800) and the long axis (231) of the scanner bridge.

[0037] Figure 4A This is a schematic diagram showing a plan view of a patient rotation system (300) configured to rotate about a rotation axis (700) relative to a static source (e.g., a beam delivery system) (100).

[0038] Figure 4B It is a schematic plan view showing the patient rotation system (300) and the rotation of the patient rotation system (300) and the patient (500) relative to a static source (e.g., beam delivery system) (100) during treatment with a beam (800) (e.g., to provide rotational treatment to the patient).

[0039] Figure 5 This is a schematic diagram showing a cross-sectional view of a beam delivery system, including a photon generator assembly (110), an adjustment ring assembly (124), a collimator assembly (130), a jaw assembly (140), a multi-leaf collimator (MLC) (150), a treatment head housing (190), and a visor assembly (192). Figure 5 Electron beams (102) and photon beams of various shapes (104, 106, 800) are also depicted.

[0040] Figure 6A This is a schematic diagram showing a cross-sectional view of a photon generator assembly (110), in which a waveguide shield (118) covers the waveguide (114).

[0041] Figure 6B This is a schematic diagram showing a cross-sectional view of a photon generator assembly (110), wherein the waveguide shield (118) is arranged according to... Figure 6A The arrow retracts.

[0042] Figure 7A This is a diagram of the primary collimator (132) and collimator housing (134) in their blank form prior to final machining. The primary collimator (132) and housing (134) are not shown to scale.

[0043] Figure 7B This is a diagram of the collimator assembly (130), in which the collimator (132) has been pressed into the housing (134) and finalized.

[0044] Figure 8A This is a schematic diagram showing a side view of a medical imaging system, which includes a scanner ring and a static source (e.g., a beam delivery system) (100). Figure 8A The wall (620) of the treatment room is shown. The source is in a storage position along the Y-axis away from the patient rotation system (not shown) and the isocenter. The scanner ring is in an overhead position along the Z-axis away from the patient rotation system (not shown) and the isocenter.

[0045] Figure 8B This is a schematic side view showing a medical imaging system and its scanner ring (250) translated from a top position to an imaging position. The medical imaging system, including the scanner ring in the imaging position, is used to image a patient to acquire medical images of the patient's treatment volume, including the isocenter (900).

[0046] Figure 8C This is a schematic diagram showing a side view of a medical imaging system and its scanner ring, translated from the imaging position to the top position.

[0047] Figure 8D This is a schematic diagram showing a side view of a medical imaging system, with the scanner ring in a top position and the source (e.g., a beam delivery system) translated from a storage position to a treatment position close to the patient rotation system (not shown) and the isocenter.

[0048] Figure 8E This is a schematic diagram of a side view showing a medical imaging system and a beam delivery system generating a beam (800) so that the isocenter (900) contacts the beam (800).

[0049] Figure 8F It is shown Figure 8E The diagram shows a side view of a medical imaging system, in which the beam generation system has been deactivated.

[0050] Figure 8G This is a schematic diagram showing a medical imaging system and a source translated from a treatment position to a storage position away from the patient.

[0051] Figure 8H This is an isometric view showing the beam delivery system in the treatment position.

[0052] Figure 8I This is an isometric view showing the beam delivery system in its storage location.

[0053] Figure 9A This is an isometric view of a beam delivery system with the collimator at the 0-degree position.

[0054] Figure 9BThis is an isometric view of a beam delivery system with the collimator rotated 15 degrees.

[0055] Figure 9C This is a schematic diagram illustrating the method steps for oscillating a multi-leaf collimator between a first position (I) and a second position (II).

[0056] Figure 10A This is a schematic side view showing a medical imaging system and a patient rotation system (partially obscured and not visible), wherein the gantry of the medical imaging system and the patient rotation system are tilted to image and / or treat a patient in an tilted position. Figure 10A In the image, the scanner ring is shown in the top position.

[0057] Figure 10B It is shown Figure 10A A schematic diagram of the side view of a medical imaging system, in which the scanner ring has been translated to the imaging position.

[0058] It should be understood that the accompanying drawings are not necessarily drawn to scale, and the objects in the drawings are not necessarily drawn relative to each other. The drawings are intended to provide clear and understandable depictions of various embodiments of the devices, systems, and methods disclosed herein. Where possible, the same reference numerals will be used throughout the drawings to refer to the same or similar parts. Furthermore, it should be understood that the drawings are not intended to limit the scope of this teaching in any way. Embodiments of this technology are described using the following numbering features: 100-beam delivery system (source) 102 electron beam 104 photon beam 106 photon beam 110 photon generator assembly 112 electron gun 113 cathode 114 waveguide 116 Excitation Target 118 waveguide shielding 120 linear bearing guide rail 124 Adjusting Ring Assembly 126 Adjusting Ring 128 mounting plate 130 collimator assembly 132 Primary Collimator 134 Collimator Housing 136 incisions 140 jaw assembly 142 Upper Jaw 144 lower jaws 150+ leaf collimator 152-blade collimator blades 190 Treatment Head Shell 191 Treatment of the concave part of the head shell 192 baffle assembly 194 shield 196 pulley mechanism 200 Medical Imaging System 211 First Pillar 212 Second Pillar 220 racks 221 First Scanner Arm 222 Second Scanner Arm 230 Scanner Bridge The long axis of the 231 scanner bridge 250 Scanner Ring 255 holes 290 Entry / Exit Area 291 In / Out Path 300 Patient Rotation System 500 patients 600 treatment rooms 610 flooring 620 wall 700 rotation axis 800 radiation beam 900 and other centers Detailed Implementation This document provides techniques relating to the treatment of patients with diseases, and particularly, but not exclusively, systems and methods for treating cancer patients in an upright position with photon radiation. Embodiments of this technique provide a photon radiation therapy system comprising a medical imaging system, a patient rotation system, and a photon beam delivery system.

[0059] In this detailed description of various embodiments, numerous specific details are set forth for illustrative purposes to provide a thorough understanding of the disclosed embodiments. However, those skilled in the art will understand that these various embodiments can be practiced with or without these specific details. In other instances, structures and apparatus are shown in block diagram form. Furthermore, those skilled in the art will readily understand that the specific order in which the methods are proposed and performed is illustrative, and that the order is expected to vary while still remaining within the spirit and scope of the various embodiments disclosed herein.

[0060] All references and similar materials cited in this application, including but not limited to patents, patent applications, articles, books, papers, and internet web pages, are expressly incorporated herein by reference in their entirety, regardless of their purpose. Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the various embodiments described herein pertain. Where the definitions of terms in the incorporated references differ from those provided in this teaching, the definitions provided in this teaching shall prevail. Section headings used herein are for organizational purposes only and should not be construed as limiting the subject matter in any way.

[0061] definition To facilitate understanding of this technology, several terms and phrases are defined below. Additional definitions are set forth throughout the detailed description.

[0062] Throughout the specification and claims, unless the context clearly specifies otherwise, the following terms shall take on the meaning explicitly relevant herein. The phrase "in one embodiment" as used herein does not necessarily refer to the same embodiment, although it may refer to the same embodiment. Similarly, the phrase "in another embodiment" as used herein does not necessarily refer to different embodiments, although it may refer to different embodiments. Therefore, as described below, various embodiments of the invention can be readily combined without departing from the scope or spirit of the invention.

[0063] Additionally, as used herein, unless the context explicitly states otherwise, the term "or" is an inclusive "or" operator and is equivalent to the term "and / or". Unless the context explicitly states otherwise, the term "based on" is not exclusive and allows for basing on additional factors not described. Furthermore, throughout the specification, "a / an" and "the" include plural references. "In" means both "in" and "on".

[0064] As used herein, the terms “about,” “approximately,” “substantially,” and “significantly” are understood by those skilled in the art and will vary to some extent depending on the context in which they are used. If the use of these terms is unclear to those skilled in the art when considering the context in which they are used, “about” and “approximately” mean less than or equal to 10% plus or minus the particular term, and “substantially” and “significantly” mean greater than 10% plus or minus the particular term.

[0065] As used herein, the disclosure of a range includes the disclosure of all values ​​within the entire range and further subdivisions of the range (including endpoints and subranges given for the range). As used herein, the disclosure of a numerical range includes the endpoints and each intermediate number therebetween having the same precision. For example, for the range 6–9, the numbers 7 and 8 are expected in addition to 6 and 9, and for the range 6.0–7.0, the numbers 6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6.9, and 7.0 are explicitly expected.

[0066] As used herein, the suffix "without..." refers to a technical implementation that omits the features of the basic root word of the word with "without..." appended. That is, as used herein, the term "without X" means "without X," where X is a technical feature omitted in the "without X" technology. For example, a "calcium-free" composition does not contain calcium, and a "mixing-free" method does not include a mixing step, etc.

[0067] Although the terms “first,” “second,” “third,” etc., may be used herein to describe various steps, elements, compositions, parts, regions, layers, and / or portions, these steps, elements, compositions, parts, regions, layers, and / or portions should not be limited by these terms unless otherwise stated. These terms are used to distinguish one step, element, composition, part, region, layer, and / or portion from another step, element, composition, part, region, layer, and / or portion. Unless the context clearly indicates otherwise, terms such as “first,” “second,” and other numerical terms used herein do not imply order or sequence. Therefore, without departing from the art, a first step, element, composition, part, region, layer, or portion discussed herein may be referred to as a second step, element, composition, part, region, layer, or portion.

[0068] As used herein, the terms “existence” or “non-existence” (or alternatively, “existing” or “non-existent”) are used in a relative sense to describe the quantity or level of a particular entity (e.g., a part, action, element). For example, when an entity is said to be “existing,” it means that the level or quantity of that entity is above a predetermined threshold; conversely, when an entity is said to be “non-existent,” it means that the level or quantity of that entity is below a predetermined threshold. The predetermined threshold can be a detectability threshold or any other threshold associated with a specific test used to detect the entity. When an entity is “detected,” it is “existing”; when an entity is “not detected,” it is “non-existent.”

[0069] As used herein, “increase” or “decrease” refers to a detectable (e.g., measurable) positive or negative change in the value of a variable relative to a previously measured value, a predetermined value, and / or a standard control, respectively. An increase is a positive change relative to a previously measured value, a predetermined value, and / or a standard control, preferably at least 10%, more preferably 50%, even more preferably 2 times, even more preferably at least 5 times, and most preferably at least 10 times. Similarly, a decrease is a negative change relative to a previously measured value, a predetermined value, and / or a standard control, preferably at least 10%, more preferably 50%, even more preferably at least 80%, and most preferably at least 90%. Other terms indicating quantitative changes or differences, such as “more” or “less”, are used herein in the same manner as described above.

[0070] As used herein, "system" refers to a plurality of real and / or abstract components that operate together for a common purpose. In some embodiments, "system" is an integrated collection of hardware and / or software components. In some embodiments, each component of the system interacts with and / or is associated with one or more other components. In some embodiments, system refers to a combination of components and software used to control and direct methods. For example, a "system" or "subsystem" may include one or more of the following or any combination thereof: mechanical devices, hardware, hardware components, circuits, lines, logic designs, logic components, software, software modules, components of software or software modules, software processes, software instructions, software routines, software objects, software functions, software classes, software programs, files containing software, etc., to perform the functions of the system or subsystem. Therefore, methods, systems, components and devices of systems, or certain aspects or portions thereof, of the embodiments may take the form of program code (e.g., instructions) embodied in tangible media such as floppy disks, CD-ROMs, hard disk drives, flash memory, or any other machine-readable storage media, wherein the machine becomes the device of the practical embodiment when the program code is loaded into and executed by the machine such as a computer. When the program code executes on a programmable computer, the computing device typically includes a processor, a processor-readable storage medium (e.g., volatile and non-volatile memory and / or storage elements), at least one input device, and at least one output device. One or more programs may implement or utilize the processes described in conjunction with the embodiments, for example, by using application programming interfaces (APIs), reusable controls, etc. Such programs are preferably implemented in a high-level procedural or object-oriented programming language to communicate with the computer system. However, if desired, one or more programs may be implemented in assembly language or machine language. In any case, the language may be a compiled or interpreted language and combined with the hardware implementation.

[0071] As used herein, the term "constructed as [verb]" means that the identified element or component has a structure that is shaped, sized, set, connected, and / or configured to perform the identified verb. For example, a component "constructed to move" is movably connected to another element and includes an element that causes the component to move, or the component is otherwise configured to move in response to other elements or components. Thus, as used herein, "constructed as [verb]" describes structure rather than function. Furthermore, as used herein, "constructed as [verb]" means that the identified element or component is intended and designed to perform the identified verb.

[0072] As used herein, the term "associated" means that elements are part of the same component and / or operate together or interact with each other in some way. For example, a car has four tires and four wheel covers. While all elements are connected as part of the car, it is understood that each wheel cover is "associated" with a specific tire.

[0073] As used herein, the term "link" refers to two or more components that are fixed together by any suitable means. Thus, in some embodiments, the expression "link" of two or more parts or components should mean that these parts are directly or indirectly connected or operate together, for example, through one or more intermediate parts or components.

[0074] As used herein, "direct connection" means that two elements are in direct contact with each other. As used herein, "fixed connection" or "fixed" means that two parts are connected so as to move as a whole while maintaining a constant orientation relative to each other. Therefore, when two elements are connected, all parts of these elements are connected. However, when describing the connection of a specific part of a first element to a second element, for example, the connection of the first end of an axle to a first wheel, it means that a specific part of the first element is positioned closer to the second element than its other parts. Furthermore, unless the upper object is otherwise substantially held in place, an object resting on another object held in place solely by gravity is not "connected" to the lower object. That is, for example, a book on a table is not connected to it, but a book stuck to the table is connected to it.

[0075] As used herein, the terms "removable connection" or "temporary connection" mean that one component is connected to another component in a substantially temporary manner. That is, the two components are connected in a way that allows for easy connection or separation of the components without damaging them. Therefore, components with a "removable connection" can be easily disconnected and reconnected without causing damage to the components.

[0076] As used herein, the term "operably coupled" means that multiple elements or components are coupled such that when a first element moves from one location / configuration to another, a second element also moves between locations / configurations, wherein each of the multiple elements or components is movable between the first and second locations, or between the first and second configurations. It is important to note that a first element can be "operably coupled" to another element, but the reverse is not necessarily true.

[0077] As used herein, the term “rotatably coupled” refers to two or more components coupled in such a way that at least one component can rotate relative to the other component.

[0078] As used herein, the term “translationally coupled” refers to two or more components coupled in such a manner that at least one component can be translated relative to the other component.

[0079] As used herein, the term "interference fit" refers to a fit between two parts in which the external dimensions of the first part slightly exceed the internal dimensions of the second part that mates with the first part. Therefore, an interference fit can be used to connect two parts using friction.

[0080] As used herein, the term "temporarily set" means that a first element or component is placed on a second element or component in a manner that allows the first element / component to move without disengaging or otherwise manipulating it. For example, a book is simply placed on a table, for instance, without being glued or secured to the table, but is "temporarily set" on the table.

[0081] As used herein, the term "corresponding" means that two structural components are similar in size and shape to each other and can be joined with minimal friction. Therefore, the opening "corresponding" to a component is slightly larger than the component, allowing the component to pass through the opening with minimal friction. This definition can be modified if the two components fit together "closely." In this case, the difference in component size is even smaller, thus increasing the amount of friction. If the element defining the opening and / or the component inserted into the opening is made of a deformable or compressible material, the opening can even be slightly smaller than the component inserted into the opening. Regarding surfaces, shapes, and lines, two or more "corresponding" surfaces, shapes, or lines generally have the same size, shape, and profile.

[0082] As used herein, the term "travel path" or "path" when used in association with a moving element includes the space through which the element moves during its motion. Therefore, all inherently moving elements have a "travel path" or "path".

[0083] As used herein, the expression “engages” two or more parts or components with each other shall mean that the elements apply force or bias to each other directly or through one or more intermediate elements or components. Furthermore, as used herein with regard to a moving part, the moving part may “engage” another element during movement from one position to another and / or may “engage” another element once it is in the described position. Therefore, it is understood that the expressions “when element A moves to the first position, element A engages element B” and “when element A is in the first position, element A engages element B” are equivalent expressions and mean that element A engages element B either when it moves to the first position and / or when element A is in the first position.

[0084] As used herein, the term "operably engaged" means "engaged and movable." That is, when used relative to a first component that is configured to move or rotate, "operably engaged" means that the first component applies a force sufficient to cause the second component to move. For example, a screwdriver can be placed where it contacts a screw. When no force is applied to the screwdriver, the screwdriver is merely "attached" to the screw. If an axial force is applied to the screwdriver, the screwdriver presses against the screw and "engages" it. However, when a rotational force is applied to the screwdriver, the screwdriver "operably engages" the screw and causes the screw to rotate. Furthermore, for electronic components, "operably engaged" means that one component controls another component via a control signal or current.

[0085] As used herein, the term “quantity” should refer to an integer of one or more (e.g., multiple).

[0086] As used herein, in the phrases “[x] moves between its first and second positions” or “[y] is constructed to move [x] between its first and second positions,” “[x]” is the name of the element or component. Furthermore, when [x] is an element or component that moves between multiple positions, the pronoun “its” refers to “[x]”, i.e., the named element or component preceding the pronoun “its.”

[0087] As used herein, the “radial side / surface” of a circular or cylindrical body is a side / surface that extends around or through a height line at its center. As used herein, the “axial side / surface” of a circular or cylindrical body is a side extending in a plane substantially perpendicular to the height line at its center. That is, generally speaking, for a cylindrical soup pot, the “radial side / surface” is the substantially circular sidewall, and “one or more axial side / surfaces” are the top and bottom of the soup pot.

[0088] As used in this article, the term "single" means that a component is created as a single piece or unit. That is to say, a component that includes pieces created separately and then joined together as units is not a "single" component or body.

[0089] As used herein, a “connecting assembly” includes two or more connecting elements or connecting parts. The parts of a connecting element or connecting assembly are not typically part of the same element or other component. Therefore, the parts of a “connecting assembly” may not be described simultaneously in the following description.

[0090] As used herein, "connector" or "one or more connecting parts" refers to one or more parts of a connecting assembly. That is, a connecting assembly includes at least two parts configured to be connected together. It is understood that the parts of a connecting assembly are compatible with each other. For example, in a connecting assembly, if one connecting part is a snap-on socket, the other connecting parts are snap-on plugs, or if one connecting part is a bolt, the other connecting parts are nuts.

[0091] As used herein, a “planar body” or “planar component” is a typically thin element comprising opposing, wide, generally flat surfaces and thinner edge surfaces extending between the wide, flat surfaces. The edge surfaces may include generally flat portions, such as on a rectangular planar component, or curved, such as on a disc, or have any other shape.

[0092] As used herein, and when used in relation to the transmission of data or signals, “electronic communication” includes both hard-wired and wireless forms of communication.

[0093] As used herein, “electrically connected” or “powered connection” means that current flows or can flow between the identified components. “Electrically connected” further depends on the location or configuration of the components. For example, in a circuit breaker, when the contacts are in the closed position, the moving contact is “electrically connected” to the stationary contact. When the contacts are in the open position, the same moving contact is not “electrically connected” to the stationary contact.

[0094] As used herein, the term "radiation source" or "source" refers to a device that generates radiation (e.g., ionizing radiation) in the form of photons (e.g., described as particles or waves), such as the photon beam delivery system described herein. In some embodiments, the radiation source includes a linear accelerator ("linac") that generates a beam of photons or electrons for treating cancer patients by exposing a tumor to the photon or electron beam. In some embodiments, the source generates electromagnetic waves, such as in the form of X-rays or gamma rays with wavelengths in the range of about 1 pm to about 1 nm. Although it is understood that radiation can be described as having wave-particle duality, it is sometimes convenient to refer to radiation as a wave and sometimes as a particle. Therefore, without limiting the technique and understanding the quantum mechanical laws that stipulate that every particle or quantum entity is described as a particle or wave, both descriptions are used throughout.

[0095] As used herein, the term "static source" refers to a source that does not rotate about the patient's axis of rotation during treatment. Some embodiments provide that the "static source" remains substantially fixed relative to an axis through which the patient rotates while the patient is treated with a photon beam generated by the static source. Although the patient may rotate about said axis to produce a relative motion between the static source and the rotating patient equivalent to the relative motion of the source rotating about the static patient, during treatment, the static source does not rotate about the patient's axis of rotation relative to a third object or frame of reference (e.g., the treatment room where the patient is positioned), even though the patient rotates about the patient's axis of rotation relative to said third object or frame of reference (e.g., the treatment room where the patient is positioned) during treatment.

[0096] The static source can be translated along one or more axes and / or rotated or rotated about one or more axes during installation, maintenance, or for beam alignment and adjustment. As described herein, the static source can be translated away from the patient to accommodate components of the imaging system for imaging the patient, and the static source can be translated toward the patient to position the static source for treating the patient.

[0097] As described herein, in some embodiments, the static source may translate (e.g., along an axis parallel to or substantially parallel to the patient's axis of rotation (e.g., in the Z direction)) and / or rotate or rotate about an axis orthogonal to the patient's axis of rotation (e.g., in the X or Y direction) during patient treatment. For example, as described herein, the static source or a component thereof may rotate about a beam axis, for example, during patient treatment. Furthermore, the static source may translate, rotate, and / or rotate about the patient to position the static source before or after patient treatment. In some embodiments, the "static source" is a photon source and may therefore be referred to as a "static photon source."

[0098] A static source can be mounted on a mobile platform, so that the static source can move relative to the ground and fixed objects on the ground as the mobile platform moves to transport the static source. Therefore, the term "static source" can refer to a mobile "static source" provided that the mobile "static source" does not rotate about an axis passing through the patient, and that the patient rotates about that axis when the patient is treated with a photon beam generated by the static source.

[0099] As used herein, the term “computed tomography” is abbreviated as “CT” and refers to both tomographic and non-tomographic radiography. For example, the term “CT” refers to various forms of CT, including but not limited to x-ray CT, positron emission tomography (PET), single-photon emission computed tomography (SPECT), and photon-counting computed tomography. Generally, computed tomography (CT) involves using opposing x-ray sources and detectors that rotate around the patient and subsequently reconstructing images onto different planes. In embodiments of CT described herein (e.g., apparatus, devices, and methods provided for CT), the x-ray source is a static source and the patient rotates relative to the static source. The x-ray current used in CT describes the current flow from the cathode to the anode and is typically measured in milliamperes (mA).

[0100] As used herein, the term "beam" refers to a stream of radiation (e.g., electromagnetic waves and / or particle radiation). In some embodiments, the beam is generated by a source and confined to a small solid angle. In some embodiments, the beam is collimated. In some embodiments, the beam is generally unidirectional. In some embodiments, the beam is divergent. In some embodiments, the beam is a photon beam, and in some embodiments, the beam is an X-ray beam.

[0101] As used herein, the terms "patient" or "subject" refer to a mammal identified and / or selected for imaging and / or treatment with radiation. Thus, in some embodiments, the patient or subject is exposed to a beam of radiation, such as a primary beam generated by a radiation source. In some embodiments, the patient or subject is a human. In some embodiments, the patient or subject is a veterinary or farm animal, livestock or pet, or an animal used for clinical research. In some embodiments, the subject or patient has a disease (e.g., cancer) and / or the subject or patient has been identified as having or at risk of having a disease (e.g., cancer).

[0102] As used herein, the terms "imaging volume" or "treatment volume" refer to the volume (e.g., tissue) of a patient selected for imaging and / or treatment with radiation. For example, in some embodiments, the "treatment volume" or "imaging volume" includes a tumor within the patient (e.g., the patient's body). As used herein, the term "healthy tissue" refers to a patient volume (e.g., tissue) that is not and / or does not include the treatment volume. In some embodiments, the imaging volume is larger than and includes the treatment volume.

[0103] The technical implementation described herein relates to a coordinate system, which includes X, Y, and Z axes defined relative to the rotational axes of the radiation beam and the patient and / or patient rotation system. See also Figure 1 A diagram of a treatment room (600) is shown, comprising a floor (610), walls (620), a radiation beam (800) generated by a source (100), and a patient's axis of rotation (700). An isocenter (900) is shown at the intersection of the radiation beam (800) and the patient's axis of rotation (700). Figure 1 As shown, the implementation uses a coordinate system in which the X-axis and Y-axis lie together in and / or define a horizontal plane, and the Z-axis is and / or defines a vertical axis. For patients positioned on a PRS, the X-axis is a left-right axis, a horizontal axis, or a frontal axis; the Y-axis is an anterior-posterior axis, a dorsal-ventral axis, or a sagittal axis; and the Z-axis is a sagittal axis or a longitudinal axis. The X-axis and Y-axis lie together in and / or define a horizontal, transverse, and / or axial plane. The Y-axis and Z-axis lie together in and / or define a sagittal or longitudinal plane. The X-axis and Z-axis lie together in and / or define a frontal or coronal plane.

[0104] Therefore, in some embodiments, describing movement as "forward" or "backward" is movement along the Y-axis; describing movement as "left" or "right" is movement along the X-axis; and describing movement as "up" and "down" is movement along the Z-axis. Furthermore, rotation described as "roll" is rotation about the Y-axis (e.g., by angle φ); rotation described as "pitch" is rotation about the X-axis (e.g., by angle ψ); and rotation described as "yaw" is rotation about the Z-axis (e.g., by angle θ). Thus, in some embodiments, the technique is described as having six degrees of freedom, e.g., translation along one or more of the X, Y, and / or Z axes; and rotation about one or more of the X, Y, and / or Z axes.

[0105] The patient rotation axis (700) and the radiation beam (800), and therefore the coordinate system, can be spatially rotated relative to the treatment room, for example, to treat patients leaning back relative to the treatment room or in other treatment postures that are not necessarily aligned with the walls and corners of the treatment room.

[0106] As used in this article, the term "perching position" refers to a patient in a roughly standing position with the trunk tilted back relative to the vertical axis, and optionally with the knees bent.

[0107] Photon radiation therapy system This technology provides a photonic radiation therapy system, including a photonic beam delivery system (100), a medical imaging system (200), and a patient rotation system (300). The patient rotation system (300) supports a patient in an upright position. The beam delivery system (100) is a static source. In some embodiments, the beam delivery system (100) can be translated away from the patient to a storage location to provide clearance for positioning the scanner ring of the medical imaging system at the imaging position to image the patient. Figure 2A This is a front view (“beam eye view”) of the photon radiation therapy system as seen from the photon beam delivery system (100), which shows the medical imaging system (200) and the patient rotation system (300). Figure 2B It shows relative to Figure 2A The view in the image is the rear view as seen from a relative direction. Figure 2B The photon beam delivery system (100), medical imaging system (200), and patient rotation system (300) are shown. Figure 2C This is a planar (top-down) view showing the photon beam delivery system (100), the medical imaging system (200), and the patient rotation system (300), which is obscured by a portion of the medical imaging system (200). Figure 2D Is with Figure 2A , Figure 2B and Figure 2C The view shown is an orthogonal side view. Figure 2D A photon beam delivery system (100), a medical imaging system (200), and a patient rotation system (300) are shown, the patient rotation system being obscured by a portion of the medical imaging system (200).

[0108] Some embodiments and aspects of a medical imaging system (200) are described in U.S. Patent No. 11,918,397 (“Multi-axis Medical Imaging”), which is expressly incorporated herein by reference. Some embodiments and aspects of a patient rotation system (300) are described in U.S. Patent No. 11,529,109 (“Patient Positioning Device”) and U.S. Patent Application No. 20230172566 (“Patient Positioning System”), each of which is expressly incorporated herein by reference.

[0109] Medical imaging system The implementation of a photon radiation therapy system includes a medical imaging system (200). For example... Figures 3A to 3C As shown, the medical imaging system (200) includes a first scanner pillar (211) and a second scanner pillar (212). The gantry (220) includes a first scanner arm (221), a second scanner arm (222), and a scanner bridge (230). The gantry (220) is rotatably connected to the first scanner pillar (211) and the second scanner pillar (212). Specifically, the first scanner arm (221) is rotatably connected to the first scanner pillar (211), and the second scanner arm (222) is rotatably connected to the second scanner pillar (212). The gantry (220) can rotate as a unit about a rotation axis rho (ρ) (see discussion below). Figures 3D to 3F ).

[0110] The medical imaging system (200) includes a scanner ring (250) translatably coupled to a first scanner arm (221) and a second scanner arm (222). The scanner ring (250) includes photon (e.g., X-ray) sources and photon detectors on opposite sides of an aperture (255) surrounded by the scanner ring (250), for example, to provide a computed tomography (CT) imaging system. Figure 3BAs shown, the scanner ring (250) is translatable along the first scanner arm (221) and the second scanner arm (222). In a particular embodiment, when the first scanner arm (221) and the second scanner arm (222) are positioned in an upright (vertical) position, the scanner ring (250) is translatable along the first scanner arm (221) and the second scanner arm (222) in the Z direction (e.g., "up" and "down"), for example, to position the scanner ring (250) such that an upright patient is located within the aperture (255) of the scanner ring (250). The scanner ring (250) is also rotated by rotating the gantry (220) about the axis of rotation rho (ρ), allowing the patient to be imaged in upright, horizontal, tilted, and other positions. When the first scanner arm (221) and the second scanner arm are vertical, horizontal, or in an inclined position between the vertical and horizontal positions, the scanner ring (250) can translate along the first scanner arm (221) and the second scanner arm (222).

[0111] For example, such as Figures 3D to 3F As shown, the frame (220) (including a first scanner arm (221), a second scanner arm (222), and a scanner bridge (230)) and the scanner ring (250) are rotatable about a rotation axis rho (ρ). The frame (220) can rotate by an angle of approximately 5 to 100 degrees (e.g., 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, or 100 degrees) to position the scanner ring (250) and the holes (255) of the scanner ring relative to the Z-axis to acquire images in an inclined posture relative to the Z-axis (e.g., as shown). Figure 3E (as shown) and in a horizontal (e.g., substantially or actually horizontal) posture, such as a prone or supine position (e.g., as shown) Figure 3F The image shows a patient's medical image. As the gantry (220) has been rotated as described above, the scanner ring (250) can be translated along the first scanner arm (221) and the second scanner arm (222), for example, translated to... Figure 3D , Figure 3E and Figure 3F The example is shown in the text.

[0112] Therefore, medical imaging systems can be tilted (e.g., as shown in the image). Figure 3E(as shown in the diagram) to obtain medical images of a patient in a tilted position, which can be used to plan radiation therapy treatment of the patient in the same tilted position (e.g., as described herein). In some embodiments, the method includes treating the patient in a tilted position, wherein the patient is tilted backward at approximately 15 degrees (e.g., 12.0, 12.1, 12.2, 12.3, 12.4, 12.5, 12.6, 12.7, 12.8, 12.9, 13.0, 13.1, 13.2, 13.3, 13.4, 13.5, 13.6, 13.7, 13.8, 13.9, 14.0, 14.1, 14.2, 14.3, 14.4, 14.5, 14.6, 14.7, 14.8). An angle of 14.9, 15.0, 15.1, 15.2, 15.3, 15.4, 15.5, 15.6, 15.7, 15.8, 15.9, 16.0, 16.1, 16.2, 16.3, 16.4, 16.5, 16.6, 16.7, 16.8, 16.9, 17.0, 17.1, 17.2, 17.3, 17.4, 17.5, 17.6, 17.7, 17.8, 17.9, or 18.0 degrees is provided, for example, tilting the head further back and the feet further forward relative to the patient's body. Therefore, an implementation of the method is provided that includes imaging a patient in an inclined position, wherein the angle at which the patient is tilted backward during imaging is the same as the angle at which treatment will be performed on the patient. Providing a patient in an inclined position is more stable than providing a patient in an upright, non-inclined position (i.e., a position aligned with or substantially aligned with the Z-axis, or a position in which the patient is tilted less than 5 to 10 degrees relative to the Z-axis).

[0113] The beam delivery system (100) can be translated along the Y-axis to position it near the patient rotation system (300), the patient (500), and / or the isocenter (900) during patient (500) treatment. When not used for patient (500) treatment, the beam delivery system (100) can be translated along the Y-axis to position it in a storage location away from the patient rotation system (300). In some embodiments, the storage location is behind the wall (620) of the treatment room (600), such as... Figure 1 As shown in the figures, and illustrated in more detail in Figures 6H and 6I. In some embodiments, the treatment method includes coordinated movement of the beam delivery system (100) and the scanner ring (500), as described below and in... Figure 6A As shown in Figure 6G.

[0114] In some implementations, for example, such as Figure 3G As shown, the medical imaging system (200) is provided in the following orientation: wherein relative to Figure 2CAs shown in the diagram, the medical imaging system (200) is rotated approximately 20 to 45 degrees ζ around the Z-axis. In other words, as... Figure 3H As shown, the embodiment provides a medical imaging system (200) that rotates about a Z-axis such that the long axis (231) of the scanner bridge (e.g., the line connecting the first and second scanner supports) forms an angle ω (e.g., 100, 105, 110, 115, 120, 125, 130, 135, 140, or 145 degrees) with the beam axis (800) of approximately 110 to 135 degrees. For reference, Figure 2C The embodiment shown provides a medical imaging system (200) at an angle ω of approximately 90 degrees.

[0115] like Figure 3G and Figure 3H As shown, the medical imaging system (200) provided with this rotational orientation is relative to Figure 2C The embodiment shown creates an enlarged patient entry / exit area (290). The enlarged patient entry / exit area (290) provides the patient with an improved pathway to the patient rotation system (300), for example, along an unobstructed entry / exit path (291). Thus, in some embodiments, the rotationally oriented medical imaging system (200) provides the patient entry / exit area (290) and / or an unobstructed entry / exit path (291) for patient movement along which the patient can effectively enter and exit the patient rotation system (300) and / or the medical imaging system (200) for imaging and / or treatment.

[0116] Patient rotation system The implementation of the photon radiation therapy system includes a patient rotation system (300). For example... Figure 4A As shown, the patient rotation system (300) is configured to rotate about a rotation axis (700). In some embodiments, the rotation axis (700) passes through an isocenter (900) associated with the patient's treatment and target volume. The patient rotation system (300) rotates relative to a source (e.g., a static source) (100). Figure 4B As shown, a patient (500) positioned on a patient rotation system (300) rotates around a rotation axis during treatment with a beam (800) generated by a source (100).

[0117] Beam delivery system Implementations of the photon radiation system include a beam delivery system (100). For example... Figure 5As shown in the cross-sectional view, the beam delivery system is configured to provide a controlled photon radiation beam aimed at the treatment volume within the patient, while also providing sufficient shielding and beam shaping systems to mitigate the beam's impact on healthy tissue. In some embodiments, the beam delivery system (100) includes a photon generator assembly (110), an adjustment ring assembly (124), a collimator assembly (130), a jaw assembly (140), a multi-leaf collimator (MLC) (150), a treatment head housing (190), and a shield assembly (192).

[0118] In some embodiments, the photon generator assembly (110) includes an electron gun (112), a waveguide (114), an excitation target disk (116), and a waveguide shield (118). The photon generator assembly first generates a narrow electron beam (102) by heating a cathode (113) positioned at the distal end of the waveguide (114). The waveguide (114) then focuses the electron beam and guides it along the negative Y direction to the target disk (116) at the proximal end of the waveguide (114). In some embodiments, the target disk (116) is made of a tungsten alloy or other heavy metal. When the electron beam (102) collides with the target disk (116), it excites and generates a high-energy photon beam (104) (i.e., X-rays). The beam (104) is substantially conical and increases radially as it moves toward the patient in the negative Y direction. In some embodiments, the photon generator assembly (110) further includes a waveguide shield (118) which is sized and configured to mount on the waveguide (114) and provide shielding against stray high-energy particles (i.e., scattered radiation). Figure 6A and Figure 6B As shown in more detail below, in some embodiments, the waveguide shield (118) is configured to run along a pair of linear bearing rails (120). In some embodiments, the waveguide shield (118) is movable in the positive Y direction away from the rest of the system (100), exposing the internal waveguide (114). This allows for easier installation and access to the waveguide (114) during maintenance.

[0119] Refer again Figure 5In some embodiments, the waveguide (114) is coupled to an adjustment ring assembly (124), which allows for fine adjustment of the position and orientation of the photon generator assembly to provide proper alignment of the photon beam (800) with the rest of the system (100). The adjustment ring assembly includes a convex adjustment ring (126) and a concave mounting plate (128). The adjustment ring (126) is coupled to the waveguide (114), its spherical surface abutting against the corresponding surface of the mounting plate (128). The two abutting surfaces follow the same spherical profile, allowing them to remain in contact as they slide relative to each other. This degree of freedom of motion allows for fine adjustment of the orientation of the beam (102) relative to the rest of the system (100) about the Z-axis and X-axis, similar to a ball-and-socket joint. In some embodiments, the adjustment ring assembly (124) includes fasteners that secure the adjustment ring (126) to the mounting plate (128) in the desired orientation.

[0120] In some embodiments, the photon beam (104) passes through a collimator assembly (130). In some embodiments, the primary collimator assembly (130) includes a primary collimator (132), a collimator housing (134), and a notch (136) formed in the primary collimator (132). The function of the primary collimator is, among other things, to shape the beam (104) into a desired shape and minimize scattered radiation. In some embodiments, the primary collimator (132) is a cylinder formed of tungsten with a truncated square pyramidal notch (136) oriented with its apex positioned distal to its square base, sized and configured to shape the substantially conical beam (104) into a substantially pyramidal beam (106). In some embodiments, the housing (134) is formed of stainless steel as a blank with a central hole. See also Figure 7A The collimator (132) is then pressed into the center hole (creating an interference fit), and the surrounding housing is then machined into its final shape using the features of the collimator (132) as a reference. See also Figure 7B This technology allows for the manufacture and implementation of simplified composite parts without the need for additional tolerance correction components (i.e., tolerance accumulation), thereby reducing the overall size of the system (100).

[0121] Refer again Figure 5In some embodiments, the beam (106) passes through a jaw assembly (140), which includes an upper jaw (142) and a lower jaw (144). The jaw assembly (140) functions to further shape the photon beam (106) and shield scattered radiation. In some embodiments, the upper and lower jaws (142, 144) are sized and configured to open and close to further shape the photon beam (106). In some embodiments, the upper jaw (142) is lowered such that the upper edge of the photon beam (106) (i.e., furthest in the positive Z direction) is aligned with the uppermost open leaf of the multi-leaf collimator (150), and similarly, the lower jaw (144) is raised such that the lower edge of the photon beam (106) (i.e., furthest in the negative Z direction) is aligned with the lowermost open leaf of the multi-leaf collimator (150).

[0122] In some embodiments, the photon beam (106) passes through the MLC (150). In some embodiments, the MLC (150) includes a plurality of blades (152), each blade being translatably coupled to a motor that translates the blades to a position to shape the beam (106) into a final shaped beam (800). Multileaf collimators are discussed in Boyer’s “Basic applications of multileaf collimators,” published by Medical Physics Publishing for the American Association of Physicists (July 2001), AAPM Report No. 72 (Report of Task Group 50 of the Radiation Therapy Committee), which is incorporated herein by reference. Embodiments of this technique provide an MLC with a blade velocity of approximately 10 cm / s for a field projected onto an isocentric field (e.g., provided by the physical movement of a single blade at a velocity of approximately 5 cm / s). In some embodiments, the MLC (150) is positioned within the treatment head housing (190). As discussed further herein, in some embodiments, the treatment head housing includes a recess (191) that allows clearance for the patient and / or the patient rotation system.

[0123] As further discussed herein, in some embodiments, system 100 includes a shield assembly (192) comprising a shield (194) and a pulley mechanism (196). In some embodiments, the pulley mechanism (196) is configured to automatically lower the shield (194) when the treatment head housing (190) extends and to automatically raise the shield (194) when the treatment head housing (190) retracts.

[0124] method The techniques provided herein relate to various methods for imaging and / or treating patients. In some embodiments, the techniques described herein provide a method for treating a patient with photon radiation. Medical diagnostic images of a patient (e.g., in an upright position) provided by a medical imaging system are used to plan radiotherapy of the patient (e.g., in an upright position) using a photon beam generated by a beam delivery system. In some embodiments, a patient rotation system stabilizes and supports the patient in an upright position, and both the medical imaging process and the radiotherapy process are performed using the same patient rotation system to support and position the patient.

[0125] Treatment Implementations of this technology relate to methods of treating a patient. For example, in some embodiments, the method includes selecting a patient who requires treatment with radiation. In some embodiments, the patient is a cancer patient, such as a patient with a tumor. In some embodiments, the patient has an arteriovenous malformation. In some embodiments, the radiation is a photon beam (e.g., an X-ray beam). Therefore, in some embodiments, the method includes contacting the patient's tumor (i.e., the treatment volume) with the photon radiation. In some embodiments, the patient is positioned on a patient rotation system as described herein, and the photon radiation is provided by a photon beam generation system as described herein.

[0126] In some embodiments, the method of treating a patient includes imaging the patient. In some embodiments, imaging the patient is performed to provide medical images of the patient for planning photon radiation therapy. In some embodiments, imaging the patient is performed to provide medical images of the patient for verifying that the patient is correctly positioned for photon radiation therapy. In some embodiments, imaging the patient is performed to provide medical images of the patient for adjusting the patient's position prior to photon radiation therapy. In some embodiments, imaging the patient is performed after photon radiation therapy, for example, to provide medical images of the patient for monitoring the effectiveness of the treatment. In some embodiments, the method of treating a patient includes multiple treatment phases of radiation therapy and multiple imaging phases of imaging the patient to provide images for monitoring treatment progress, for modifying the treatment plan, or for providing information to determine if alternative or additional treatments for the patient may be effective (e.g., surgery, chemotherapy, etc.). In some embodiments, the patient is imaged using a medical imaging system as described herein.

[0127] In some implementations, treatment is performed using a photon radiation therapy system as described herein, which includes a photon beam delivery system, a medical imaging system, and a patient rotation system.

[0128] In some implementations, the patient is treated with a photon beam while in an upright position (e.g., standing, sitting, kneeling, perching, tilted position (e.g., leaning back), or leaning forward).

[0129] In some implementations, the patient is treated with a photon beam as the patient rotates around the patient's rotation axis.

[0130] Therefore, implementations of this technology relate to the disclosed photon radiation therapy system and methods of using it or its components for radiation therapy of a patient, for example, to kill unwanted tissue or cells. In some implementations, the patient has unwanted tissue or cells resulting from a transformation, such as a tumor, cancer, or growth. As used herein, the term "cancer" includes various malignant solid tumors that may be caused by viral infection, naturally occurring transformation, or exposure to environmental factors. The term "cancer" includes metastases from a primary tumor.

[0131] Coordinated movement of the beam delivery system and the scanner ring During treatment, the beam delivery system is positioned close to the patient (i.e., at the treatment location) to maximize radiation delivery to the treatment volume and minimize beam spread during delivery, as well as minimize radiation exposure to healthy tissue. When not used for treatment, the beam delivery system is positioned in a storage location within the walls of the treatment room.

[0132] Exemplary methods for treating patients Figures 8A to 8G It is shown schematically in the diagram. Figure 8A A scanner ring (500) of a medical imaging system and a beam delivery system (100) in a storage position (e.g., a system rotating away from the patient in the Y direction) are shown. Figure 8AIn the illustrated embodiment, the beam delivery system (100) is located in a storage position within the wall (620) of the treatment room, and the scanner ring (500) is positioned in an overhead position (e.g., away from the patient rotation system in the Z direction). When the beam delivery system (100) is in the storage position, the scanner ring (500) can be translated in the Z direction to position the scanner ring (500) for medical imaging of the patient (e.g., to acquire images of a patient portion (e.g., treatment volume) including the isocenter (900)). That is, positioning the beam delivery system (100) in the storage position provides spatial clearance for translating the scanner ring (500) along the Z-axis to a position for imaging the patient (e.g., for imaging a patient portion (e.g., treatment volume) including the isocenter (900)). Furthermore, when the beam delivery system (100) is in the storage position and the scanner ring (500) is positioned in the overhead position, the patient rotation system is accessible for positioning the patient in a posture for imaging and / or treating the patient. Therefore, implementations of the method for treating a patient include: positioning the beam delivery system in a storage location (e.g., away from the patient rotation system in the Y direction), positioning the scanner ring in a top position (e.g., away from the patient rotation system in the Z direction), and placing the patient on the patient rotation system in a posture for imaging and / or treatment.

[0133] Figure 8B The steps of translating a scanner ring (500) in the Z direction to position the scanner ring (500) for medical imaging of a patient (e.g., to acquire images of a patient portion (e.g., treatment volume) including an isocenter (900) are illustrated. Therefore, embodiments of the method provided herein include translating the scanner ring from a top position (e.g., away from the patient rotation system in the Z direction) to an imaging position (e.g., surrounding the patient, and thus positioned for acquiring medical images of a patient portion (e.g., treatment volume) including an isocenter (900)). Furthermore, embodiments of the method include acquiring medical images (e.g., CT scans) of the patient (e.g., the patient portion (e.g., treatment volume) including an isocenter) while the scanner ring is in the imaging position. In some embodiments, the patient's medical images are used to plan radiotherapy of the patient with a photon beam. In some embodiments, the patient's medical images are used to verify the position of the patient (e.g., treatment volume) relative to the patient rotation system, the axis of rotation of the patient rotation system, and / or the treatment beam before treating the patient with a photon beam. In some implementations, the patient's medical images are used to adjust the position of the patient (e.g., treatment volume) relative to the patient rotation system, the axis of rotation of the patient rotation system, and / or the treatment beam before treating the patient with a photon beam.

[0134] Figure 8CThe steps of translating the scanner ring (500) in the Z direction to position the scanner ring in a top position are illustrated. In some embodiments, the scanner ring is translated to the top position after imaging the patient to acquire medical images (e.g., a CT scan) of the patient (e.g., including isocentric patient portions (e.g., treatment volumes)). Therefore, embodiments of the method provided herein include translating the scanner ring from an imaging position (e.g., surrounding the patient's treatment volume) to a top position (e.g., away from the patient and patient rotation system in the Z direction).

[0135] Figure 8D The diagram illustrates translating a beam delivery system (100) in the Y direction from a storage location to position the beam delivery system near the patient rotation system, the patient, and / or isocenter for treating a patient (e.g., for delivering a photon (e.g., x-ray) beam to a treatment volume). Therefore, implementations of the method include translating the beam delivery system from a storage location (e.g., away from the patient rotation system, the patient, and / or isocenter in the Y direction) to a treatment location (e.g., near the patient rotation system, the patient, and / or isocenter).

[0136] Figure 8E The steps for generating a photon beam (800) by a beam delivery system (100) are illustrated. Figure 8E As shown, when the beam delivery system is in the treatment position, the patient (e.g., the patient portion (e.g., the treatment volume) including the isocenter (900)) is brought into contact with a photon (e.g., X-ray) beam. Furthermore, as... Figure 8E As shown, when the medical imaging system is in the overhead position, the patient (e.g., a patient portion including the isocenter (900) (e.g., a treatment volume)) is brought into contact with a photon (e.g., an X-ray) beam. Therefore, embodiments of the method include generating the photon beam by a beam delivery system, and in some embodiments, the method includes bringing the patient (e.g., a patient portion including the isocenter (900) (e.g., a treatment volume)) into contact with the photon beam. In some embodiments, the photon beam is an X-ray beam. Figure 8F The beam delivery system is shown in the treatment position after the patient has been treated (e.g., when the beam delivery system stops generating a beam).

[0137] Figure 8GThe steps are illustrated in which the beam delivery system (100) is translated in the Y direction from the treatment position to position the beam delivery system in a storage location away from the patient rotation system, the patient, and / or isocenter. As described above, some embodiments provide the storage location within the wall (620) of the treatment room. Therefore, embodiments of the method include translating the beam delivery system from the treatment position (e.g., close to the patient rotation system, the patient, and / or isocenter in the Y direction) to the storage location (e.g., away from the patient rotation system, the patient, and / or isocenter in the Y direction). When the beam delivery system (100) is in the storage location and the scanner ring (500) is positioned in the top position, the patient can be released from the fixation, and the patient can exit the patient rotation system (e.g., through the patient entry / exit area (e.g., as...)). Figure 2C As shown in the diagram). Therefore, an implementation of the method for treating a patient includes: positioning the beam delivery system at a storage location (e.g., away from the patient rotation system, the patient, and / or isocenter in the Y direction) and allowing the patient to leave the patient rotation system.

[0138] baffle assembly In some embodiments, when not used for beam delivery, the beam delivery system is located in a storage position within the wall. For example, in some embodiments, the beam delivery system (e.g., the treatment head housing (190) of the beam delivery system) is retracted to a position flush with the wall fascia, for example, to provide sufficient clearance for the scanner ring to be deployed to the imaging position as described herein. In some embodiments, a linear motion unit is operatively engaged with the beam delivery system and is configured to translate the beam delivery system in the Y direction, thereby providing the beam delivery system in both the treatment position and the storage position. For example, Figure 8H An embodiment of the beam delivery system (100) is shown when the beam delivery system (100) is in a treatment position (e.g., the beam delivery system (100) is close to the patient and the patient rotation system). Figure 8H As shown, in some embodiments, the beam delivery system (100) includes a treatment head housing (190) and a shield assembly (192). The shield assembly (192) further includes a shield (194) and a pulley mechanism (196).

[0139] In addition, such as Figure 8HAs shown, in some embodiments, the treatment head housing (190) includes a recess or "cutout" (191) in its lower portion. The recess (191) in the treatment head housing (190) is provided so that during patient treatment, when the treatment head beam delivery system (100) is in the treatment position (e.g., close to the patient) and the patient and patient rotation system are rotating, the patient and / or patient rotation system does not collide with the beam delivery system (100). In other words, the recess (191) in the treatment head housing (190) provides space for the rotating patient and / or patient rotation system.

[0140] When the beam delivery system (100) is translated to the storage position, for example, so that the front surface of the treatment head housing (190) is flush with the wall (620), the presence of the recess (191) leaves an open gap in the wall, visible to the patient from the patient rotation system. Therefore, as Figure 8I As shown, in some embodiments, the beam delivery system (100) includes a shield (194) of a shield assembly (192) that translates into a position with an open gap in the covering wall when the beam delivery system (100) is in the storage position. The shield assembly (192) is positioned behind the wall (620) of the treatment chamber, i.e., between the shield assembly (192) and the patient rotation system and the patient when the patient is positioned on the patient rotation system. Thus, the shield (194) closes the gap created when the beam delivery system (100) retracts into the wall (620). In some embodiments, the shield assembly (192) includes a pulley mechanism (196) operatively engaged with the shield (194). The pulley mechanism (196) is configured to automatically lower the shield (194) when the beam delivery system (100) (e.g., the treatment head housing (190)) is extended in the treatment position, and to automatically raise the shield (194) when the beam delivery system (100) (e.g., the treatment head housing (190)) is retracted to the storage position.

[0141] Oscillating Multi-Leaf Collimator In some embodiments, the technology provides a method for generating a photon beam using a beam generation system including a multi-leaf collimator. In some embodiments, the technology provides a method for treating a patient with photons (e.g., X-rays) generated by a beam delivery system including a multi-leaf collimator. Rotating collimators have been used in radiotherapy to maximize the conformity of the radiation field to the target volume (e.g., a tumor), to provide an increased field size, to reduce interleaf leakage, to reduce treatment time, and to minimize the exposure of normal tissue to radiation dose. See, for example, Otto (2002) “Enhancement of IMRT delivery through MLC rotation” Phys Med Biol. 47: 3997–4017; Kim (2018) “Optimal collimator rotation based on the outline of multiple brain targets in VMAT” Radiation Oncology 13: 88; and Sandrini (2018) “Evaluation of collimator rotation for volumetric modulated arc therapy lung stereotacticbody radiation therapy using flattening filter free” Applied Radiation and Isotopes 141:257–260, each of which is incorporated herein by reference. See also Lyu (2018) “VMAT optimization with dynamic collimator rotation” Med. Phys. 45: 2399–2410, which is incorporated herein by reference. Typically, conventional techniques involve rotating the collimator by at least 90 degrees, for example, by a full 360 degrees or by 180 degrees in one direction and 180 degrees in the opposite direction.

[0142] However, when the beam delivery system is in the treatment position (e.g., close to the patient and patient rotation system), rotating the collimator provided herein by more than 45 to 90 degrees can result in a collision between the beam delivery system and the patient or patient rotation system, as the patient or patient rotation system rotates during treatment. Surprisingly, the benefits of rotating the collimator can be provided by rotating it by relatively small angles (e.g., approximately 15 degrees from the 0 position, or approximately 30 degrees between two alternating positions), which is useful in the techniques described herein.

[0143] Therefore, compared to conventional techniques, the technique provided herein oscillates the multi-leaf collimator back and forth between a first position and a second position at an angle 30 degrees apart. This angle is smaller than the rotation angle typically used in previous methods, which involved rotating the multi-leaf collimator by more than 30 degrees, for example, up to 90, 180, or 360 degrees. In other words, the method involves alternatingly rotating the multi-leaf collimator about the beam axis between the first and second positions through an angle of approximately 30 degrees in two rotational directions. The first position is a rotation of approximately 15 degrees relative to the horizontal axis in a first direction, and the second position is a rotation of approximately 15 degrees relative to the horizontal axis in a second direction, wherein the rotation in the second direction is a rotation in the opposite direction to the rotation in the first direction. Thus, when the first rotation direction is clockwise, the second rotation direction is counterclockwise; when the first rotation direction is counterclockwise, the second rotation direction is clockwise. In other words, when the first rotation direction is positive, the second rotation direction is negative; when the first rotation direction is negative, the second rotation direction is positive. Therefore, this implementation of the oscillating multi-leaf collimator technology can maximize the conformity of the radiation field to the target volume (e.g., tumor), provide an increased field size, reduce inter-leaf leakage, reduce treatment time, and minimize the exposure of normal tissue to radiation dose in the disclosed system, which includes rotating the patient and a patient rotation system, without introducing collision risk.

[0144] Specifically, implementations of the method provided herein include dynamically oscillating a multi-leaf collimator back and forth about the beam axis while generating a photon beam—that is, by alternately rotating the multi-leaf collimator about the beam axis to a first position relative to the horizontal axis during the generation of the photon (e.g., X-ray) beam, the first position being approximately 15 degrees (e.g., 10.0, 10.1, 10.2, 10.3, 10.4, 10.5, 10.6, 10.7, 10.8, 10.9, 11.0, 11.1, 11.2, 11.3, 11.4, 11.5, 11.6, 11.7, 11.8, 11.9, 12.0, 12.1, 12.2, 12.3, 12.4, 1) in a first direction. 2.5, 12.6, 12.7, 12.8, 12.9, 13.0, 13.1, 13.2, 13.3, 13.4, 13.5, 13.6, 13.7, 13.8, 13.9, 14.0, 14.1, 14.2, 14.3, 14.4, 14.5, 14.6, 14.7, 14.8, 14.9, 1 5.0, 15.1, 15.2, 15.3, 15.4, 15.5, 15.6, 15.7, 15.8, 15.9, 16.0, 16.1, 16.2, 16.3, 16.4, 16.5, 16.6, 16.7, 16.8, 16.9, 17.0, 17.1, 17.2, 17.3, 17.4, 1 7.5, 17.6, 17.7, 17.8, 17.9, 18.0, 18.1, 18.2, 18.3, 18.4, 18.5, 18.6, 18.7, 18.8, 18.9, 19.0, 19.1, 19.2, 19.3, 19.4, 19.5, 19.6, 19.7, 19.8, 19.9, or 20.0 degrees), and during the generation of a photon (e.g., X-ray) beam, the multi-leaf collimator is rotated about the beam axis to a second position, which is a rotation of approximately 15 degrees (e.g., 10.0, 10.1, 10.2, 10.3, 10.4, 10.5, 10.6, 10.7, 10.8, 10.0 degrees) relative to the horizontal axis in a second direction. 9, 11.0, 11.1, 11.2, 11.3, 11.4, 11.5, 11.6, 11.7, 11.8, 11.9, 12.0, 12.1, 12.2, 12.3, 12.4, 12.5, 12.6, 12.7, 12.8, 12.9, 13.0, 13.1, 13.2, 13.3, 13. 4, 13.5, 13.6, 13.7, 13.8, 13.9, 14.0, 14.1, 14.2, 14.3, 14.4, 14.5, 14.6, 14.7, 14.8, 14.9, 15.0, 15.1, 15.2, 15.3, 15.4, 15.5, 15.6, 15.7, 15.8, 15.9, 16.0, 16.1, 16.2, 16.3, 16.4, 16.5, 16.6, 16.7, 16.8, 16.9, 17.0, 17.1, 17.2, 17.3, 17.4, 17.5, 17.6, 17.7, 17.8, 17.9, 18.0, 18.1, 18.2, 18.3, 18.4, 18.5, 18.6, 18.7, 18.8, 18.9, 19.0, 19.1, 19.2, 19.3, 19.4, 19.5, 19.6, 19.7, 19.8, 19.9 or 20.0 degrees). In some implementations, the rotational angular velocity of the swing motion is less than about 6 degrees per second (e.g., 1 to 6 degrees per second (e.g., 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4.0, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, 5.0, 5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7, 5.8, 5.9, or 6.0 degrees per second)). In some embodiments, the beam delivery system includes a rotary drive bearing operably engaged with a multi-leaf collimator, which causes the multi-leaf collimator to alternately rotate to a first position and a second position, for example, to provide a rocking motion. Figure 9A The multi-leaf collimator (150) is shown in a 0-degree position within the treatment head housing (190), i.e., aligned with the horizontal axis. Figure 9B A multi-leaf collimator (150) rotated 15 degrees in one direction is shown within the treatment head housing (190). Figure 9C A method for using a rocking multi-leaf collimator is shown, comprising: alternately rotating the multi-leaf collimator (150) from a first position (I) to a second position (II). Figure 9C As shown, the oscillating multi-leaf collimator (150) between the first position (I) and the second position (II) includes alternating rotations of 30 degrees between the first position (I) and the second position (II). In some embodiments, the oscillating multi-leaf collimator (150) includes an initial rotation of 15 degrees from the 0-degree position to the first position (I). Figure 9C (top). In some embodiments, the oscillating multi-leaf collimator (150) includes: a final rotation of 15 degrees from the second position (II) to the 0-degree position (top). Figure 9C ,bottom).

[0145] Although Figure 9CThe first position (I) is shown as a counterclockwise rotation from the 0-degree position, and the second position (II) is shown as a clockwise rotation from the 0-degree position, but the first position (I) and the second position (II) are interchangeable, such that the first position (I) can be a clockwise rotation from the 0-degree position, and the second position (II) can be a counterclockwise rotation from the 0-degree position.

[0146] Furthermore, although the oscillating multi-leaf collimator is described in terms of a 15-degree rotation relative to the 0-degree position and a 30-degree rotation between the first and second positions, the technique is not limited to a 15-degree rotation relative to the 0-degree position and a 30-degree rotation between the first and second positions. Therefore, the technology includes 10.0 to 20.0 degrees from the 0-degree position to the first position or from the 0-degree position to the second position (e.g., 10.0, 10.1, 10.2, 10.3, 10.4, 10.5, 10.6, 10.7, 10.8, 10.9, 11.0, 11.1, 11.2, 11.3, 11.4, 11.5, 11.6, 11.7, 11.8, 11.9, 12.0, 12.1, 12.2, 12.3, 12.4, 12.5, 12.6, 12.7, 12.8, 12.9, 13.0, 13.1, 13.2, 13.3, 13.4, 13.5, 13...). 6, 13.7, 13.8, 13.9, 14.0, 14.1, 14.2, 14.3, 14.4, 14.5, 14.6, 14.7, 14.8, 14.9, 15.0, 15.1, 15.2, 15.3, 15.4, 15.5, 15.6, 15.7, 15.8, 15.9, 16.0, 16.1, 16.2, 16.3, 16.4, 16.5, 16.6, 16.7, 16.8, 16.9, 17.0, 17.1, 17.2, 17.3, 17.4, 17.5, 17.6, 17.7, 17.8, 17.9, 18.0, 18.1 18.2, 18.3, 18.4, 18.5, 18.6, 18.7, 18.8, 18.9, 19.0, 19.1, 19.2, 19.3, 19.4, 19.5, 19.6, 19.7, 19.8, 19.9, or 20.0 degrees, and includes rotation of 20.0 to 40.0 degrees (e.g., 20.0, 20.1, 20.2, 20.3, 20.4, 20.5, 20.6, 20.7, 20.8, 20.9, 21.0, 21.1, 21.2, 21.3, 21.4, 21.5, 21.6, 21.7, 20.0 degrees) between the first and second positions during the oscillation. 1.8, 21.9, 22.0, 22.1, 22.2, 22.3, 22.4, 22.5, 22.6, 22.7, 22.8, 22.9, 23.0, 23.1, 23.2, 23.3, 23.4, 23.5, 23.6, 23.7, 23.8, 23.9, 24.0, 24.1, 24.2, 24.3, 24.4, 24.5, 24.6, 24.7, 24.8, 24.9, 25.0, 25.1, 25.2, 25.3, 25.4, 25.5, 25.6, 25.7, 25.8, 25.9, 26.0, 26.1, 26.2, 26.3, 26.4, 26.5, 26.6, 26.7, 26.8, 26.9, 27.0, 27.1, 27.2, 27.3, 27.4, 27.5, 27.6, 27.7, 27.8, 27.9, 28.0, 28.1, 28.2, 28.3, 28.4, 28.5, 28.6, 28.7, 28.8, 28.9, 29.0, 29.1, 29.2, 29.3, 29.4, 29.5, 29.6, 29.7, 2 9.8, 29.9, 30.0, 30.1, 30.2, 30.3, 30.4, 30.5, 30.6, 30.7, 30.8, 30.9, 31.0, 31.1, 31.2, 31.3, 31.4, 31.5, 31.6, 31.7, 31.8, 31.9, 32.0, 32.1, 32.2, 32.3, 32.4, 32.5, 32.6, 32.7, 32.8, 32.9, 33.0, 33.1, 33.2 33.3, 33.4, 33.5, 33.6, 33.7, 33.8, 33.9, 34.0, 34.1, 34.2, 34.3, 34.4, 34.5, 34.6, 34.7, 34.8, 34.9, 35.0, 35.1, 35.2, 35.3, 35.4, 35.5, 35.6, 35.7, 35.8, 35.9, 36.0, 36.1, 36.2, 36.3, 36.4, 36.5, 36.6, 36. Alternating rotations of 7, 36.8, 36.9, 37.0, 37.1, 37.2, 37.3, 37.4, 37.5, 37.6, 37.7, 37.8, 37.9, 38.0, 38.1, 38.2, 38.3, 38.4, 38.5, 38.6, 38.7, 38.8, 38.9, 39.0, 39.1, 39.2, 39.3, 39.4, 39.5, 39.6, 39.7, 39.8, 39.9, or 40.0 degrees.

[0147] tilt position In some embodiments, the technology provides a method for treating a patient in an inclined position. As used herein, the term "inclined position" refers to a patient standing in a reclining position, wherein the longitudinal axis of the standing patient is tilted at an angle of approximately 15 degrees relative to the vertical Z-axis of the photon radiation therapy system, for example, 10 to 20 degrees (e.g., 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 degrees), such that the patient's head is positioned more posteriorly and the patient's feet are positioned more anteriorly. The "inclined position" can be provided by rotating the patient (e.g., a patient supported on a patient rotation system (300)) about an axis orthogonal to the Z-axis (e.g., a horizontal axis, such as the X-axis) by an angle ψ, such that the patient's head moves posteriorly and the patient's feet move anteriorly. See also Figure 10A In some implementations, the angle ψ is approximately 15 degrees relative to the vertical Z-axis of the photon radiation therapy system, for example, 10 to 20 degrees (e.g., 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 degrees). Patients in an inclined position are more stable than patients standing and not in an inclined position; therefore, patient movement is eliminated and / or minimized during treatment and imaging (e.g., for treatment planning or to verify or adjust patient position for treatment).

[0148] Therefore, in some embodiments, the technology provides a method including: providing a patient in an inclined position and bringing the patient's treatment volume into contact with a photon beam.

[0149] In some embodiments, a method for treating a patient in an inclined position includes: imaging the patient in the inclined position, for example, using a medical imaging system as described herein, comprising a gantry (220) and a scanner ring (250), wherein the gantry is tilted at an angle such that the scanner ring can be translated to surround the patient (e.g., positioning a treatment volume within an aperture in the scanner ring), and acquiring medical images of the treatment volume while the patient is in the inclined position. See also Figure 10B .

[0150] Therefore, in some embodiments, the method includes: rotating a gantry including a scanner ring, providing a patient in an inclined position (e.g., by rotating a patient rotation system about an axis orthogonal to the Z-axis), translating the scanner ring to an imaging position where the patient's treatment volume is located within an aperture of the scanner ring, imaging the patient, translating the scanner ring to an overmount position, and treating the patient with a photon beam.

[0151] Rotational therapy In some embodiments, the technology provides a method of rotational therapy. The method of rotational therapy includes: contacting the patient with a photon (e.g., X-ray) beam while rotating the patient about an axis of rotation. In some embodiments, the method of rotational therapy includes: contacting the patient with a photon (e.g., X-ray) beam while: 1) rotating the patient about an axis of rotation; 2) oscillating a multi-leaf collimator about the beam axis; and 3) moving the blades of the multi-leaf collimator to modulate the beam shape. In some embodiments, the method of rotational therapy includes: contacting the patient with a photon (e.g., X-ray) beam while: 1) rotating the patient about an axis of rotation; 2) oscillating a multi-leaf collimator about the beam axis; 3) moving the blades of the multi-leaf collimator to modulate the beam shape; and 4) translating the patient in a vertical direction, for example, to provide helical beam delivery.

[0152] In some embodiments, rotational therapy is used to treat a patient in an inclined position. Therefore, in some embodiments, the method of rotational therapy includes: providing a patient in an inclined position (e.g., by rotating the patient and / or a patient rotation system about an axis orthogonal to the Z-axis (e.g., the X-axis), and contacting the patient in the inclined position with a photon (e.g., X-ray) beam while rotating the patient about the patient's rotation axis. In some embodiments, the method of rotational therapy includes: providing a patient in an inclined position (e.g., by rotating the patient and / or a patient rotation system about an axis orthogonal to the Z-axis (e.g., the X-axis), and contacting the patient in the inclined position with a photon (e.g., X-ray) beam while: 1) rotating the patient about the patient's rotation axis; 2) oscillating a multi-leaf collimator about the beam axis; and 3) moving the blades of the multi-leaf collimator to modulate the beam shape. In some embodiments, the method of rotational therapy includes: providing a patient in an inclined position (e.g., by rotating the patient and / or a patient rotation system about an axis orthogonal to the Z-axis (e.g., the X-axis), and bringing the patient in the inclined position into contact with a photon (e.g., X-ray) beam while: 1) rotating the patient about the patient's rotation axis; 2) oscillating a multi-leaf collimator about the beam axis; 3) moving the blades of the multi-leaf collimator to modulate the beam shape; and 4) translating the patient in a vertical direction, for example, to provide helical beam delivery.

[0153] In some implementations of rotational therapy, the rotational speed is constant. In some implementations of rotational therapy, the rotational speed is variable. In some implementations of rotational therapy, the speed at which the patient is translated vertically is constant. In some implementations of rotational therapy, the speed at which the patient is translated vertically is variable.

[0154] While the disclosure herein relates to certain exemplary embodiments, it will be understood that these embodiments are presented by way of example and not by way of limitation. For all purposes, all publications and patents mentioned in the foregoing specification are incorporated herein by reference in their entirety. Various modifications and variations to the use of the described compositions, methods, and techniques will be apparent to those skilled in the art without departing from the scope and spirit of the described techniques. Although the technique has been described in conjunction with specific exemplary embodiments, it should be understood that the claimed invention should not be unduly limited to these specific embodiments. Indeed, various modifications to the described modes of implementation that are apparent to those skilled in the art are intended to fall within the scope of the appended claims.

Claims

1. A photon beam delivery system for use in a photon radiation therapy system, the photon beam delivery system comprising: A photon generator configured to generate a high-energy photon beam; A collimator, positioned between the photon generator and the patient; A collimator housing, the collimator housing being positioned around the collimator, wherein the collimator is connected to the collimator housing using an interference fit; A multi-leaf collimator, wherein the multi-leaf collimator is positioned between the collimator and the patient; The photon beam passes through the collimator and the multi-leaf collimator before reaching the patient.

2. The beam delivery system according to claim 1, wherein, The photon generator includes a waveguide and a waveguide shield positioned around the waveguide.

3. The beam delivery system according to claim 2, wherein, The waveguide shield is coupled to a guide rail, which is configured to allow the waveguide shield to move between a first position and a second position. The waveguide shield is positioned around the waveguide in the first position, and the waveguide shield is positioned at a certain distance from the waveguide in the second position.

4. The beam delivery system according to claim 1, further comprising: An adjustment ring, which is connected to the photon generator; as well as Mounting plate, the mounting plate abutting against the adjusting ring. The adjustment ring and mounting plate are configured to adjust the orientation of the photon generator relative to the collimator.

5. The beam delivery system according to claim 4, wherein, The adjusting ring and the mounting plate are in contact along a substantially spherical surface.

6. The beam delivery system according to claim 1, wherein, The beam delivery system includes a treatment head housing that includes a recess, wherein the recess is sized and configured to prevent collisions between the beam delivery system, the patient, and the photon radiation therapy system during operation.

7. The beam delivery system according to claim 6, wherein, The beam delivery system includes a treatment head configured to move between a treatment location and a storage location.

8. The beam delivery system of claim 7, further comprising a shield, wherein, When the treatment head is in the treatment position, the shield is configured to be in a lowered position, and when the treatment head is in the storage position, the shield is configured to be in a raised position.

9. The beam delivery system according to claim 1, wherein, The multi-leaf collimator is configured to rotate alternately clockwise and counterclockwise around the beam axis between a first position and a second position while the beam delivery system provides the high-energy photon beam.

10. The beam delivery system according to claim 9, wherein, The multi-leaf collimator rotates approximately 5 to 45 degrees between the first position and the second position.

11. The beam delivery system according to claim 9, wherein, The multi-leaf collimator rotates approximately 5 to 25 degrees to reach the first position or the second position.

12. The beam delivery system according to claim 9, wherein, The multi-leaf collimator rotates approximately 30 degrees between the first position and the second position.

13. The beam delivery system according to claim 9, wherein, The multi-leaf collimator is rotated approximately 15 degrees from position 0 to reach either the first or the second position.

14. The beam delivery system according to claim 9, wherein, The multi-leaf collimator rotates between the first position and the second position while the patient rotates around the patient's rotation axis.

15. The beam delivery system according to claim 9, wherein, The multi-leaf collimator rotates between the first position and the second position while multiple blades of the multi-leaf collimator translate.

16. A photon radiation therapy system, comprising: Beam delivery system, medical imaging system, and patient rotation system.

17. The photon radiation therapy system according to claim 16, wherein, The beam delivery system is the beam delivery system according to claim 1.

18. The photon radiation therapy system according to claim 16, wherein, The medical imaging system includes a scanner ring configured to move between a top position and an imaging position, and wherein the beam delivery system is configured to move between a treatment position and a storage position.

19. The photon radiation therapy system according to claim 18, wherein, When the beam delivery system is in the treatment position, the scanner ring is in the top position, and when the beam delivery system is in the storage position, the scanner ring is in the imaging position.

20. The photon radiation therapy system according to claim 18, wherein, The movement of the scanner ring between the top position and the imaging position is coordinated with the movement of the beam delivery system between the treatment position and the storage position.

21. The photon radiation therapy system according to claim 16, wherein, The patient rotation system is configured to support a patient in an upright position for imaging and treatment.

22. The photon radiation therapy system according to claim 16, wherein, The medical imaging system includes: First scanner support and second scanner support; A rack, rotatably connected to the first scanner support and the second scanner support; and A scanner ring, slidably coupled to the frame, wherein the scanner ring includes a photon source and a photon detector on opposite sides of an aperture surrounded by the scanner ring.

23. The photon radiation therapy system according to claim 22, wherein, The patient rotation system is configured to support a patient in an inclined position.

24. The photon radiation therapy system of claim 23, further comprising a patient supported in an inclined position.

25. The photon radiation therapy system according to claim 24, wherein, The gantry rotates about a horizontal axis to image the patient in an inclined position.

26. The photon radiation therapy system according to claim 24, wherein, The patient, supported in an inclined position, comes into contact with photon radiation generated by the beam generation system.

27. The photon radiation therapy system according to claim 16, wherein, The medical imaging system is configured with rotational orientation, such that an angle of approximately 110 to 135 degrees is formed between the beam axis and the long axis of the scanner bridge.

28. The photon radiation therapy system according to claim 27, wherein, The rotational orientation of the medical imaging system provides an increased entry / exit area compared to the non-rotational orientation of the medical imaging system.

29. A method of treating a patient, the method comprising: A photon radiation therapy system is provided, the photon radiation therapy system comprising a beam delivery system, a medical imaging system, and a patient rotation system; Position the patient in an upright position on the patient rotation system; Imaging the patient in the upright position on the patient rotation system; Photon beams are generated through the beam delivery system; as well as The patient, who is in the upright position, is brought into contact with the photon beam.

30. The method of claim 29, further comprising: The patient rotation system and the patient are rotated while the patient is brought into contact with the photon beam.

31. The method of claim 29, further comprising: While bringing the patient into contact with the photon beam, the multi-leaf collimator is rotated alternately between a first position and a second position around the beam axis.

32. The method according to claim 31, wherein, The first position and the second position are approximately 5 to 45 degrees apart.

33. The method according to claim 31, wherein, The first position and the second position are approximately 30 degrees apart.

34. The method of claim 29, further comprising: The patient is translated vertically while being brought into contact with the photon beam.

35. The method of claim 29, further comprising translating a plurality of blades of the multi-leaf collimator while bringing the patient into contact with the photon beam.

36. The method according to claim 29, wherein, The upright position is an inclined position, in which the patient's head is positioned at the rear and the patient's feet are positioned at the front.

37. A method of treating a patient, the method comprising: A photon radiation therapy system is provided, the photon radiation therapy system comprising a beam delivery system, a medical imaging system, and a patient rotation system; Position the patient in an upright position on the patient rotation system; Imaging the patient in an upright position on the patient rotation system; Photon beams are generated through the beam delivery system; as well as The patient, in the upright position, is brought into contact with the photon beam, and simultaneously: a) Rotate the patient rotation system and the patient; b) Rotate the multi-leaf collimator alternately between the first and second positions around the beam axis; c) Move the patient vertically; as well as d) Translate multiple blades of the multi-leaf collimator.

38. The method according to claim 37, wherein, The first position and the second position are approximately 5 to 45 degrees apart.

39. The method according to claim 37, wherein, The first position and the second position are approximately 30 degrees apart.

40. The method of claim 37, wherein, Imaging the patient provides medical images of the patient for planning treatment, verifying patient location, or adjusting patient location.

41. The method according to claim 37, wherein, The patient had cancer.

42. A method of treating a patient, the method comprising: A medical imaging system is provided, the medical imaging system including a scanner ring in a top position; Provides a beam delivery system located in a storage location; Position the patient in an upright position on the patient rotation system; The scanner ring is translated to the imaging position, in which the patient is located within the aperture of the scanner ring; Imaging the patient; The scanner ring is moved to the top position; The beam delivery system is moved to the treatment position; To bring the patient into contact with a photon beam generated by the beam delivery system; and The beam delivery system is moved to the storage location.

43. The method of claim 42, further comprising: The patient rotation system and the patient are rotated while the patient is brought into contact with the photon beam.

44. The method according to claim 42, wherein, Imaging the patient provides medical images of the patient for planning treatment, verifying patient location, or adjusting patient location.

45. The method according to claim 42, wherein, The patient had cancer.

46. ​​The method according to claim 42, wherein, The beam delivery system includes a treatment head housing, and the treatment head housing includes a recess to provide clearance for rotation of the patient rotation system and / or the patient when the beam delivery system is in the treatment position.

47. The method according to claim 46, wherein, The beam delivery system, located in the storage position, provides the treatment head housing in a position where the surface of the treatment head housing is flush with the wall.

48. The method according to claim 47, wherein, The beam delivery system further includes a shield that covers the gaps in the wall when the beam delivery system is in the storage position.

49. A method of treating a patient, the method comprising: A photon radiation therapy system is provided, the photon radiation therapy system comprising a beam delivery system and a patient rotation system; The patient is positioned at an angle on the patient rotation system, wherein the patient includes the head and feet; as well as When the patient is in the tilted position, the patient is brought into contact with photon radiation generated by the beam delivery system.

50. The method according to claim 49, wherein, Positioning the patient in an inclined position on the patient rotation system includes: positioning the patient in an upright position on the patient rotation system and rotating the patient rotation system and the patient about a horizontal axis such that the patient's head moves backward and the patient's feet move forward.

51. The method according to claim 49, wherein, The patient, in the tilted position, is tilted approximately 15 degrees relative to the Z-axis.

Images