Patient Support Board

Abstract

The technology provided herein relates to radiation imaging and therapy, and in particular, but not exclusively, to patient support systems configured to support pediatric patients positioned in an upright position during medical imaging and / or medical procedures, and related methods, kits, and systems.

Description

[Technical Field]

[0001] This application claims the benefit of U.S. Provisional Patent Application No. 63 / 449,657, filed March 3, 2023, the entire contents of which are incorporated herein by reference for all purposes.

[0002] The technology provided herein relates to radiation imaging and therapy, and in particular, but not exclusively, to support boards configured to support a patient (e.g., a pediatric patient) positioned in a generally upright position during medical imaging and / or medical procedures, as well as related methods, kits, and systems. [Background technology]

[0003] Radiation sources have many applications in medicine, including medical imaging and radiation therapy. Radiation sources are typically configured to move relative to a stationary patient, for example, to expose specific parts or regions of the patient to radiation produced by the source. Furthermore, while radiation therapy and related diagnostic and planning imaging are traditionally performed with the patient in a prone or supine horizontal position, some patients benefit from therapy in non-traditional positions, such as an upright position. The clinical advantages of upright imaging and radiation therapy procedures are numerous and well documented. The first evidence of significant clinical benefit using a system for positioning an actual patient in an examination environment has recently been documented.

[0004] Patients under the age of 18 are generally considered pediatric patients, and pediatric patients can be classified as (1) pediatric patients tall enough to fit the adult patient contours according to the system design specifications, (2) small pediatric patients who do not require anesthesia, and (3) pediatric patients who require anesthesia. There is a need to develop a support assembly that allows pediatric patients to be treated in an upright position while meeting their anesthesia needs. Summary of the Invention [Problem to be solved by the invention]

[0005] The technology provided herein relates to radiation imaging and treatment, and particularly, but not exclusively, to support boards configured to support the front of a patient in an upright position during medical imaging and / or medical procedures, as well as related methods, kits, and systems. Some techniques for supporting a patient in an upright, stable position are described in U.S. Patent Application Publication No. 2020 / 0268327, which is incorporated herein by reference. [Means for solving the problem]

[0006] In some embodiments, a patient positioning system stabilizes and supports a pediatric patient in an upright (e.g., standing, sitting, kneeling, perched) position. Imaging and / or treating a patient in an upright position offers the advantage of increased patient comfort. Furthermore, diagnosing and / or treating a patient in an upright position offers advantages over diagnosing and / or treating a patient in a traditional horizontal position for many indications (e.g., lung cancer, breast cancer). While imaging and / or treating an upright patient offers diagnostic and therapeutic advantages, medical imaging and treatment require improved patient positioning systems to stabilize and support pediatric patients in a proper upright position for delivering therapeutic radiation to target areas and for planning treatment using medical imaging. The technology provided herein relates to an improved pediatric support for a patient positioning system that supports a pediatric patient in an upright position.

[0007] In one aspect, the present disclosure provides a patient support system including a base defining a central axis, a seat coupled to the base, and a board coupled to the base. The board includes a first side facing the central axis and a second side opposite the first side. The first side of the board is configured to engage with the front of a patient.

[0008] In some embodiments, the board includes an opening configured to receive at least a portion of the patient's head.

[0009] In some embodiments, the openings are located at the ends of the board.

[0010] In some embodiments, the board includes a first wing configured to at least partially support a first arm (e.g., left arm) of the patient, and the board includes a second wing configured to at least partially support a second arm (e.g., right arm) of the patient. In some embodiments, the wing supports both arms.

[0011] In some embodiments, an angle is formed between the board and the central axis, the angle being in the range of 5 degrees to 45 degrees.

[0012] In some embodiments, the angle is adjustable.

[0013] In some embodiments, the first side of the board has a first dimension at the end and a second dimension at the narrow portion, the second dimension being smaller than the first dimension.

[0014] In some embodiments, the end includes an opening.

[0015] In some embodiments, the first side of the board has a third dimension at the flared portion, the third dimension being greater than the first dimension.

[0016] In some embodiments, the narrow portion is disposed between the end and the flared portion.

[0017] In some embodiments, the base is rotatable about a central axis.

[0018] In some embodiments, the base is movable along the central axis.

[0019] In some embodiments, the central axis is vertical.

[0020] In some embodiments, the system further comprises a vacuum formed bag.

[0021] In some embodiments, the vacuum formed bag is placed on the sheet portion.

[0022] In some embodiments, the system further comprises a shell coupled to the board and configured to support the patient's lower back.

[0023] In some embodiments, the system further comprises a reminder member.

[0024] In some embodiments, the prompting member is a video display.

[0025] In some embodiments, the prompting member is a toy (eg, a fidget spinner).

[0026] In some embodiments, the patient is less than 60 inches tall.

[0027] In one aspect, the present disclosure provides a heel booster including a bottom surface including a notch configured to at least partially receive a heel support of an upright patient positioning system, the heel booster further including an elevated platform, a heel stop extending from the elevated platform, and a roller extending from the bottom surface.

[0028] In one aspect, the present disclosure provides a patient support system including a base defining a central axis, a pedestal coupled to the base, and a support pivotally coupled to the pedestal about a pivot axis, the support including a lower portion, an upper portion, and an arcuate connecting portion between the lower portion and the upper portion.

[0029] In some embodiments, the pivot axis is perpendicular to the central axis.

[0030] In some embodiments, the support further includes a head portion extending from the upper portion and configured to support the patient's head.

[0031] In some embodiments, the system further includes a shin stop coupled to the lower portion and configured to support the patient's shin.

[0032] Some portions of this specification describe embodiments of the present technology in terms of algorithms and symbolic representations of operations on information. These algorithmic descriptions and representations are commonly used by those skilled in the data processing arts to effectively convey the substance of their work to others skilled in the art. These operations, while described functionally, computationally, or logically, are understood to be implemented by computer programs or equivalent electrical circuits, microcode, or the like. Further, it has proven convenient at times to refer to arrangements of these operations as modules, without loss of generality. The described operations and their associated modules may be embodied in software, firmware, hardware, or any combination thereof.

[0033] Certain steps, operations, or processes described herein may be performed or embodied in one or more hardware or software modules, alone or in combination with other devices. In some embodiments, software modules are implemented in 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 steps, operations, or processes described.

[0034] In some embodiments, the system comprises a computer and / or data storage that is virtually provided (e.g., as a cloud computing resource). In particular embodiments, the present technology comprises the use of cloud computing to provide a virtual computer system that comprises the components and / or performs the computer functions described herein. Thus, in some embodiments, cloud computing provides the infrastructure, applications, and software described herein over a network and / or the Internet. In some embodiments, computing resources (e.g., data analysis, calculations, data storage, application programs, file storage, etc.) are provided remotely over a network (e.g., the Internet and / or a cellular network).

[0035] Embodiments of the present technology may also relate to an apparatus for performing the operations herein. This apparatus may be specially constructed for the required purposes and / or may comprise a general-purpose computing device selectively activated or reconfigured by a computer program stored in the computer. Such a computer program may be stored on a non-transitory, tangible, computer-readable storage medium or any type of medium suitable for storing electronic instructions that can be coupled to a computer system bus. Furthermore, any computing system referred to herein may include a single processor or may be an architecture that utilizes a multiple processor design to increase computing power.

[0036] Further embodiments will be apparent to those skilled in the art based on the teachings contained herein.

[0037] This patent or application contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee.

[0038] These and other features, aspects, and advantages of the present technology will become better understood with regard to the following drawings. [Brief explanation of the drawings]

[0039] [Figure 1] Schematic of design considerations for an upright patient positioning device for treating lesions above the upper thigh. The small represents 5% of the size of Japanese women, and the large represents 95% of the size of American men. [Figure 2] 1 is a photograph of a booster seat used to fit a patient into an upright patient positioning system. [Figure 3] FIG. 10 is a schematic diagram of a heel booster used to adapt the upright patient positioning system to shorter patients. [Figure 4A-4B] Conceptual design of a lean-back patient immobilization device. Panel A shows the upright patient positioning system with a standard backrest inserted. Panel B shows the lean-back patient immobilization device inserted into the backrest slot and tilted to an upright position. [Figure 4C-4D] Panel C shows the patient tilted supine on a lean-back patient immobilization device, and Panel D shows the patient in the imaging position. [Figures 5A-5C] Conceptual design of the forward support patient board. Panel A shows the upright patient positioning system with a standard backrest inserted. Panel B shows the forward support patient board. Panel C shows the upright patient positioning system with the patient leaning against the forward support patient board. [Figure 6] FIG. 1 is a perspective view of an upright patient positioning system with an imaging system, a therapy system, and a forward support patient board. [Figure 7A] FIG. 7 is a perspective view of the system of FIG. 6, showing the imaging system in a tilted configuration. [Figure 7B] FIG. 7 is a perspective view of the system of FIG. 6 showing the therapy system in a treatment position. [Figure 7C]7 is a perspective view of the system of FIG. 6 showing the therapy system in a treatment position and the patient support system in a lowered position. [Figure 7D] 7 is a perspective view of the system of FIG. 6 showing the therapy system in a treatment position and the patient support system in a lowered and rotated position. [Figure 7E] 7 is a perspective view of the system of FIG. 6 showing the therapy system in a treatment position and the patient support system in another lowered and rotated position. [Figure 8] FIG. 1 is a front view of a forward support patient board. [Figure 9] FIG. 9 is a perspective view of the testing fixture including the front support patient board of FIG. 8. [Figure 10] 10 is a photograph of the test fixture of FIG. [Figure 11] FIG. 10 is a schematic diagram of the testing fixture of FIG. 9 showing the association of the face mask, body shell, and vacuum-formed bag. [Figure 12] 1 is a photograph of an exemplary patient. [Figure 13] 13 is a series of photographs of the exemplary patient of FIG. 12 supported in the testing fixture of FIG. 10. [Figure 14] 13 is another series of photographs of the exemplary patient of FIG. 12 supported in the testing fixture of FIG. 10. [Figure 15] FIG. 11 is a schematic diagram showing a body shell supporting a patient in the testing fixture of FIG. 10.

[0040] It should be understood that the drawings are not necessarily drawn to scale, and that objects within the drawings are not necessarily drawn to scale relative to each other. The drawings are representations intended to bring clarity and understanding to various embodiments of the devices, systems, and methods disclosed herein. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts. Furthermore, it should be understood that the drawings are not intended to limit the scope of the present teachings in any way. DETAILED DESCRIPTION OF THE INVENTION

[0041] The technology provided herein relates to radiation imaging and treatment, and in particular, but not exclusively, to support boards configured to support the front of a patient positioned in an upright position during medical imaging and / or medical procedures, as well as related methods, kits, and systems.

[0042] In this detailed description of various embodiments, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of the disclosed embodiments. However, those skilled in the art will understand that the various embodiments may be practiced without or with these specific details. In other instances, structures and devices are shown in block diagram form. Furthermore, those skilled in the art will readily understand that the specific order in which the methods are presented and performed is exemplary, and that it is contemplated that the order can be changed and still remain within the spirit and scope of the various embodiments disclosed herein.

[0043] All literature and similar materials cited in this application, including but not limited to patents, patent applications, papers, books, treatises, and Internet web pages, are expressly incorporated by reference in their entirety for any purpose. Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by those skilled in the art to which the various embodiments described herein belong. If the definition of a term in an incorporated reference appears to differ from the definition provided in the present teachings, the definition provided in the present teachings shall prevail. The section headings used herein are for organizational purposes only and should not be construed as limiting the subject matter described in any way.

[0044] definition To facilitate understanding of the present technology, several terms and phrases are defined below. Additional definitions are set forth throughout the detailed description.

[0045] Throughout the specification and claims, the following terms shall take the meanings expressly associated therewith unless the context clearly dictates otherwise. As used herein, the phrase "in one embodiment" may refer to the same embodiment, but does not necessarily refer to the same embodiment. Furthermore, as used herein, the phrase "in another embodiment" may refer to different embodiments, but does not necessarily refer to different embodiments. Thus, as described below, various embodiments of the invention can be readily combined without departing from the scope or spirit of the invention.

[0046] Additionally, as used herein, the term "or" is an inclusive "or" operator and is equivalent to the term "and / or" unless the context clearly dictates otherwise. The term "based on" is not exclusive and allows for additional unlisted elements to be based on unless the context clearly dictates otherwise. Additionally, throughout this specification, the meanings of "a," "an," and "the" include plural referents. The meaning of "in" includes "in" and "on."

[0047] As used herein, the terms "about," "approximately," "substantially," and "significantly" will be interpreted by those of ordinary skill in the art and will vary to some extent depending on the context in which they are used. If there are uses of these terms that are not clear to persons of ordinary skill in the art given the context in which they are used, "about" and "approximately" mean within ±10% of the particular term, and "substantially" and "significantly" mean more than ±10% of the particular term.

[0048] As used herein, the disclosure of a range includes the disclosure of all values ​​within the entire range and further divided ranges, including the endpoints and subranges given in the range. As used herein, the disclosure of a numerical range includes the endpoints and each number therebetween with the same precision. For example, in the range of 6 to 9, the numbers 7 and 8 are contemplated in addition to 6 and 9, and in the range of 6.0 to 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 expressly contemplated.

[0049] As used herein, the suffix "-free" refers to an embodiment of a technology that excludes a feature of the stem of the word to which "-free" is added. That is, the term "X-free" as used herein means "without X," where X is a feature of the technology that is excluded in the "X-free" technology. For example, a "calcium-free" composition does not contain calcium, a "mixing-free" method does not include a mixing step, etc.

[0050] Terms such as "first," "second," and "third" are used herein to describe various steps, elements, compositions, components, regions, layers, and / or portions; however, these steps, elements, compositions, components, regions, layers, and / or portions are not intended to be limited by these terms unless otherwise indicated. These terms are used to distinguish one step, element, composition, component, region, layer, and / or portion from another step, element, composition, component, region, layer, and / or portion. As used herein, terms such as "first," "second," and other numerical terms do not imply an order or sequence unless clearly indicated by context. Thus, a first step, element, composition, component, region, layer, or portion discussed herein could be referred to as a second step, element, composition, component, region, layer, or portion without departing from the art.

[0051] As used herein, the words "presence" or "absence" (or "present" or "absence") are used in a relative sense to describe the amount or level of a particular entity (e.g., a component, an action, an element). For example, when an entity is said to be "present," it means that the level or amount of this entity is above a predetermined threshold. Conversely, when an entity is said to be "absent," it means that the level or amount of this entity is below a predetermined threshold. The predetermined threshold may be the threshold of detection associated with a particular test used to detect the entity, or any other threshold. If an entity is "detected," it is "present." If an entity is "not detected," it is "absent."

[0052] As used herein, "increase" or "decrease" refers to a detectable (e.g., measured) positive or negative change in the value of a variable relative to a previously measured value, a pre-established value, and / or a standard control value, respectively. An increase is preferably at least a 10%, more preferably a 50%, even more preferably a 2-fold, even more preferably at least a 5-fold, and most preferably at least a 10-fold positive change relative to a previously measured, pre-established, and / or standard control value of the variable. Similarly, a decrease is preferably at least a 10%, more preferably a 50%, even more preferably at least a 80%, and most preferably at least a 90% negative change relative to a previously measured, pre-established, and / or standard control value of the variable. Other terms indicating quantitative changes or differences, such as "more" or "less," are used herein in the same manner as above.

[0053] As used herein, a "system" refers to multiple actual and / or abstract components that work together for a common purpose. In some embodiments, a "system" is an integrated collection of hardware and / or software components. In some embodiments, each component of a system interacts with and / or is related to one or more other components. In some embodiments, a system refers to a combination of components and software for controlling and directing a process. For example, a "system" or a "subsystem" may comprise one or more, or any combination of, mechanical devices, hardware, hardware components, circuits, electrical circuits, logic designs, logic components, software, software modules, components of software or software modules, software procedures, 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. Thus, the methods and apparatus of the embodiments, or certain aspects or portions thereof, may take the form of program code (e.g., instructions) embodied in a tangible medium, such as a floppy diskette, a CD-ROM, a hard drive, a flash memory, or any other machine-readable storage medium, which, when loaded into and executed by a machine, such as a computer, causes the machine to become an apparatus for practicing the embodiments. When executing the program code on a programmable computer, the computing device generally 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 connection with the embodiments, for example, through the use of application programming interfaces (APIs), reusable controllers, or the like.Such programs are preferably implemented in a high-level procedural or object-oriented programming language to communicate with a computer system. However, the programs can be implemented in assembly or machine language, if desired. In either case, the language may be a compiled or interpreted language, and combined with hardware implementations.

[0054] As used herein, the term "computed tomography" is abbreviated to "CT" and refers to both tomographic and non-tomographic radiography. For example, the term "CT" refers to numerous 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 the use of an X-ray source and detector that rotate around the patient, followed by the reconstruction of images into various planes. In the CT embodiments described herein (e.g., devices, apparatus, and methods provided for CT), the X-ray source is a stationary source, and the patient rotates relative to the stationary source. The current for X-rays used in CT represents the flow of current from the cathode to the anode and is typically measured in milliamperes (mA).

[0055] As used herein, the phrase "assembled to [verb]" means that the specified element or assembly has a structure that is shaped, sized, arranged, joined, and / or configured to perform the specified verb. For example, a member "assembled to move" is movably coupled to another element, includes an element that causes the member to move, or is otherwise configured to move in response to another element or assembly. Thus, as used herein, "assembled to [verb]" describes structure, not function. Additionally, as used herein, "assembled to [verb]" means that the specified element or assembly is intended and designed to perform the specified verb.

[0056] As used herein, the term "associated" means that elements are part of the same assembly and / or work together or act in some way relative to / with each other. For example, a car has four tires and four hubcaps. It is understood that all elements are combined as parts of the car, but each hubcap is "associated" with a particular tire.

[0057] As used herein, the term "coupled" refers to two or more components secured together by any suitable means. Thus, in some embodiments, a statement that two or more parts or components are "coupled" means that the parts are joined or move together directly or indirectly, for example, through one or more intermediate parts or components. As used herein, "directly coupled" means that the two elements are in direct contact with each other. As used herein, "fixedly coupled" or "fixed" means that the two components are coupled so that they move as one while maintaining a constant orientation relative to each other. Thus, when two elements are coupled, all portions of the elements are coupled. However, a reference to a particular portion of a first element being coupled to a second element, e.g., the first end of an axle being coupled to a first wheel, means that the particular portion of the first element is located closer to the second element than the other portions. Furthermore, an object resting on another object held in place solely by gravity is not "coupled" to the lower object unless the upper object is otherwise held substantially in place. That is, for example, a book on a table is not bound to it, and a book glued to the table is bound to it.

[0058] As used herein, the phrases "removably coupled" or "temporarily coupled" mean that one component is coupled to another component in an essentially temporary manner. That is, the two components are coupled in a manner that allows for easy joining or separation of the components without damaging the components. Thus, "removably coupled" components are easily separated and recoupled without damaging the components.

[0059] As used herein, the phrase "operably coupled" means that several elements or assemblies are coupled together that are each movable between a first position and a second position or between a first and a second configuration, such that movement of the first element from one position / configuration to another position / configuration similarly moves the second element between positions / configurations. Note that a first element is "operably coupled" to another element, and the opposite is not true.

[0060] As used herein, the phrase "rotatably coupled" refers to two or more components coupled such that at least one of the components is rotatable relative to the other.

[0061] As used herein, the phrase "translatably coupled" refers to two or more components coupled such that at least one of the components is translatable relative to the other.

[0062] As used herein, the phrase "temporarily disposed" means that a first element or assembly is placed on a second element or assembly such that the first element / assembly can be moved without separating or otherwise manipulating the first element. For example, a book that simply rests on a table, i.e., is not glued or fastened to the table, is "temporarily disposed" on the table.

[0063] As used herein, the term "corresponding" indicates that two structural components are similar in size and shape to one another and can be joined with a minimal amount of friction. Thus, an opening that "corresponds" to a member is sized slightly larger than the member so that the member can pass through the opening with a minimal amount of friction. This definition is modified when two components fit together "nicely." In that case, the difference in size between the components is even smaller, thereby increasing the amount of friction. If the elements forming the opening and / or the components inserted into the opening are made of a deformable or compressible material, the opening can even be slightly smaller than the components inserted into the opening. With respect to surfaces, shapes, and lines, two or more "corresponding" surfaces, shapes, or lines generally have the same size, shape, and contour.

[0064] As used herein, a "path of travel" or "path," when used in reference to a moving element, includes the space that the element travels through when in motion. Thus, any moving element inherently has a "path of travel" or "path."

[0065] As used herein, a statement that two or more parts or components "engage" one another shall mean that the elements exert a force or bias on one another, either directly or through one or more intermediate elements or components. Additionally, as used herein with respect to a movable part, the movable part may "engage" another element during movement from one position to another and / or may "engage" another element once at the described position. Thus, the statements "element A engages element B when element A moves to element A's first position" and "element A engages element B when element A is in element A's first position" are understood to be equivalent statements and mean that element A engages element B while moving to element A's first position and / or that element A engages element B while element A is in element A's first position.

[0066] As used herein, the phrase "operably engage" means "engage and move." That is, when used in reference to a first component assembled to move a second, movable or rotatable component, "operably engage" means that the first component applies a force sufficient to move the second component. For example, a screwdriver is placed in contact with a screw. When no force is applied to the screwdriver, the screwdriver is simply "coupled" to the screw. When 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 rotates it. Furthermore, in electronic components, "operably engage" means that one component controls another component via a control signal or current.

[0067] As used herein, the term "number" is intended to mean an integer greater than or equal to one (eg, plural).

[0068] As used herein, in the phrases "[x] moves between its first and second positions" or "[y] is assembled to move [x] between its first and second positions," "[x]" is the name of an element or assembly. Furthermore, when [x] is an element or assembly that moves between positions, the pronoun "the" refers to "[x]," i.e., the named element or assembly that precedes the pronoun "the."

[0069] As used herein, the "radial sides / surfaces" of a circular or cylindrical body are those sides / surfaces that extend around or surround its center or a height line passing through its center. As used herein, the "axial sides / surfaces" of a circular or cylindrical body are those sides that extend in a plane that extends approximately perpendicular to the height line passing through the center. That is, generally, in the case of a cylindrical soup can, the "radial sides / surfaces" are the generally circular sidewalls and the "axial sides / surfaces" are the top and bottom of the soup can.

[0070] As used herein, a "diagnostic" test includes detecting or identifying a disease state or condition in a subject, determining the likelihood that a subject will suffer from a given disease or condition, determining the likelihood that a subject with a disease or condition will respond to a therapy, determining the prognosis (or likely progression or regression) of a subject with a disease or condition, and determining the effectiveness of a treatment for a subject with a disease or condition. For example, a diagnostic can be used to detect whether a subject has or is likely to have cancer, or whether such a subject will respond favorably to a compound (e.g., a pharmaceutical agent, e.g., a drug) or other treatment.

[0071] As used herein, the term "condition" generally refers to a disease, illness, injury, abnormality, or change in health status.

[0072] As used herein, the term "treating" or "treatment," with respect to a disease, refers to preventing the disease, slowing the onset or rate of progression of the disease, reducing the risk of developing the disease, preventing or delaying the onset of symptoms associated with the disease, alleviating or terminating symptoms associated with the disease, causing complete or partial regression of the disease, or any combination thereof. In some embodiments, "treatment" includes exposing a patient or a portion thereof (e.g., a tissue, organ, body part, or other localized region of a patient's body) to radiation (e.g., electromagnetic radiation, ionizing radiation).

[0073] 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 line source and is 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 diverging.

[0074] As used herein, the term "patient" or "subject" refers to a mammal identified and / or selected for imaging and / or treatment with radiation. Thus, in some embodiments, the patient or subject comes into contact with a radiation beam, e.g., 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 animal or livestock, a farm animal or pet, or an animal used in clinical research. In some embodiments, the subject or patient has cancer and / or is recognized to have or be at risk of having cancer.

[0075] As used herein, the term "treatment region" or "imaging region" refers to a region of a patient (e.g., tissue) selected for imaging and / or treatment with radiation. For example, in some embodiments, the "treatment region" or "imaging region" includes a tumor in a cancer patient. As used herein, the term "healthy tissue" refers to a region of a patient (e.g., tissue) that is not a treatment region and / or does not include a treatment region. In some embodiments, the imaging region is larger than the treatment region and includes the treatment region.

[0076] As used herein, the term "radiation source" or "ray source" refers to a device that generates radiation (e.g., ionizing radiation) in the form of photons (e.g., described as particles or waves). In some embodiments, the radiation source is a linear accelerator ("linac") that generates X-rays or electrons to treat cancer patients by contacting tumors with the X-ray or electron beam. In some embodiments, the radiation source generates particles (e.g., photons, electrons, neutrons, hadrons, ions (e.g., protons, carbon ions, other heavy ions)). In some embodiments, the radiation source generates electromagnetic waves (e.g., X-rays and gamma rays having wavelengths ranging from about 1 pm to about 1 nm). It is understood that radiation can be described as having both wave-like and particle-like aspects, although it is sometimes convenient to describe radiation in terms of waves and sometimes in terms of particles. Thus, both descriptions are used throughout, without limiting the present technology, with the understanding that the laws of quantum mechanics describe all particles or quantum entities as either particles or waves.

[0077] As used herein, the term "stationary source" refers to a source that does not rotate around a patient during use for imaging or therapy. In particular, a "stationary source" remains fixed relative to an axis that passes through the patient while the patient is being imaged or treated. The patient can rotate about the axis to cause relative motion between the stationary source and the rotating patient equivalent to the relative motion of the source rotating around the stationary patient, but the stationary source does not move relative to a third object, frame of reference (e.g., the treatment room in which the patient is located), or patient axis of rotation during imaging or treatment, while the patient rotates relative to the third object, frame of reference (e.g., the treatment room in which the patient is located), or patient axis of rotation that passes through the patient during imaging or treatment. Thus, the stationary source is mounted on a moving stage, whereby the stationary source can move relative to the Earth and a fixture on the Earth as the moving stage moves to carry the stationary source. Thus, the term "stationary source" can refer to a movable "stationary source" as long as the movable "stationary source" does not rotate about an axis of rotation through the patient during patient imaging or treatment. Additionally, a stationary source can be translated and / or rotated around the patient to position the stationary source before imaging or treating the patient or after imaging or treating the patient. Thus, the term "stationary source" can refer to a source that translates or rotates around the patient during non-imaging and non-treatment use, for example, to position the source relative to the patient when the patient is not being imaged and / or treated. In some embodiments, the "stationary source" is a photon source and is therefore referred to as a "stationary photon source."

[0078] Some of the embodiments herein relate to patient support assemblies configured for patients of the 95th percentile American male and 5th percentile Japanese female height. It should be understood that this is a preferred embodiment suitable for use with a wide range of patient populations, and that patient support assemblies configured to accommodate patients of different height ranges may be equally suitable. The 5th percentile Japanese female patient is approximately 1490 mm tall. The 95th percentile American male patient is approximately 1900 mm tall.

[0079] In some embodiments, the patient support assembly provides the patient in a "seated position." As used herein, the term "seated position" refers to a patient in a generally stationary position with the torso tilted backward relative to a vertical axis, and optionally with the knees bent.

[0080] explanation Upright patient positioning systems (UPPS) are designed to position patients within a range of heights, including those at the 95th percentile for American men and the 5th percentile for Japanese women. Such upright patient positioning systems are described in detail in U.S. Patent Application Publication No. 2020 / 0268327 (U.S. Patent Application No. 16 / 649,337), which is incorporated herein by reference in its entirety. Referring to FIG. 1, patients within these height ranges can be positioned for imaging and treatment in a seated or upright position without the need for additional or specialized immobilization and support devices.

[0081] The first category of pediatric patients includes young patients who are the same height or taller than the 5th percentile Japanese female and who can be positioned in a standard or designed manner. In some embodiments, there may be conditions related to the patient's maturity and / or medical condition that require additional measures or special procedures to enable treatment of pediatric patients in this first category. Also, it is generally accepted or assumed that patients in this first category are old enough to comply with treatment requirements without being sedated or anesthetized.

[0082] The second category of pediatric patients is those who are shorter than 5% of Japanese women and can undergo the course of treatment without the need for sedation or anesthesia. These pediatric patients may not fit comfortably into standard upright patient positioning systems and may require additional immobilization or booster devices to accommodate them. As detailed herein, patients in this second category are positioned in two ways: (1) a posterior tilt in a seated or perched position or orientation for pelvic, thoracic, head, neck, and intracranial targets; and (2) a forward tilt for posterior lesions, particularly craniospinal irradiation (CSI) treatment. The support devices for each method are detailed below.

[0083] Tilt Backwards: In some embodiments, a booster seat or specially designed support system is coupled to the standard backrest of the upright patient positioning system. An example of a commercially available booster seat is shown in Figure 2. See, for example, Special Tomato® Soft-Touch® Floor Sitter with Wedge (https: / / www.adaptivemall.com / special-tomato-soft-touch-floor-sitter.html).

[0084] Referring to Figure 3, in some embodiments, the positioning system includes a heel booster 10 that can be used to raise the floor height higher to compensate for shorter legs and provide more standard knee support and movement. In the illustrated embodiment, the heel booster 10 has a bottom surface 14 that includes a notch 18 that at least partially receives an existing heel support 22 of an upright patient positioning system. The heel booster 10 further includes an elevated foothold 26 positioned above the existing heel stop 22 and an elevated heel stop 30 extending from the elevated foothold 26. The heel booster 10 further includes rollers 34 (e.g., roller bars) extending from the bottom surface 14 and configured to assist in moving the heel booster 10 relative to the existing heel support 22.

[0085] Referring to FIG. 4, a conceptual design of a tilt-back patient support device is shown. Panel A shows an upright patient support system with a standard backrest inserted. Panel B shows a pediatric-specific device inserted into the backrest slot and tilted to an upright position. Patient support system 38 includes a base 42 forming a central axis 46, a pedestal 50 (e.g., inserted into the backrest slot) coupled to base 42, and a support 54 (e.g., a support board) pivotally coupled to pedestal 50 about pivot axis 58. Panel C shows a patient loaded onto system 38 and tilted into a supine position. Panel D shows a patient loaded onto system 38 and positioned in an imaging position.

[0086] In some embodiments, the support 54 is shaped like a car seat familiar to children. The support 54 includes a lower portion 62, an upper portion 66, and an arcuate connecting portion 70 between the lower portion 62 and the upper portion 66. In the illustrated embodiment, the support 54 further includes a head portion 74 extending from the upper portion 66. The head portion 74 is configured to support the occipital region of the patient's head. In the illustrated embodiment, shin stops 78 are coupled to the lower portion 62 and configured to support the patient's shins.

[0087] In the illustrated embodiment, pivot axis 58 is orthogonal to central axis 46. In the illustrated embodiment, pivot axis 58 is positioned behind the patient to allow the patient to lean backward into a supine position (FIG. 4C). For example, a supine position may be required to make certain medical procedures (e.g., application of immobilization devices, administration of anesthesia, insertion of intravenous tubing) easier and safer.

[0088] In some embodiments, the pedestal 50 and the support 54 are radiolucent. In some embodiments, the support 54 and / or the pedestal 50 are portable and removable from the base 42. In the illustrated embodiment, the pedestal 50 is attached to and removed from a backrest slot 82 formed in the base 42. Advantageously, a portable patient support allows for easy patient access to and from the treatment room. For example, the patient may be carried in and out of the room while in or on the support 54.

[0089] Forward Tilt: Referring to FIG. 5, a patient support system 110 is shown for supporting a patient in a forward-leaning position. This position is useful, for example, for craniospinal irradiation (CSI) treatments. The system 110 includes a base 114 forming a central axis 118 and a seat portion 122 coupled to the base 114. The system 110 further includes a board 126 (also referred to herein as a front support or support board) coupled to the base 114. Panel A of FIG. 5 shows the upright patient positioning system with a standard backrest inserted. Panel B of FIG. 5 shows the board 126 (e.g., the front support). Panel C of FIG. 5 shows a patient leaning forward onto the board 126. The board 126 includes a first side 130 facing the central axis 118 and a second side 134 opposite the first side 130. As described in further detail herein, the first side 130 of the board 126 is configured to engage and support the front of the patient.

[0090] In some embodiments, the board 126 is inserted into a backrest slot 138 in the base 114 of the upright patient positioning system. In the illustrated embodiment, an angle 142 (FIG. 5B) is formed between the board 126 and the central axis 118. In some embodiments, the angle 142 is within a range of about 5 degrees to about 45 degrees. In some embodiments, the angle 142 is adjustable.

[0091] 6, system 110 is shown with an imaging system. Board 126 includes a first wing 146 configured to at least partially support one arm of a patient and a second wing 150 configured to at least partially support the other arm of the patient.

[0092] In the illustrated embodiment, the board 126 includes an opening 154 configured to receive at least a portion of the patient's head. In some embodiments, the opening 154 is located at an end 158 of the board 126.

[0093] 7A-7E, a patient and patient support system 110 are shown in various imaging and treatment configurations. As shown, the base 114 is rotatable about a central axis 118, and the base 114 is movable along the central axis 118. In the illustrated embodiment, the central axis 118 is vertical.

[0094] 8, 9, and 10, one embodiment of a front support board 162 with an examination stand 166 is shown. Board 162 is similar to and interchangeable with board 126. Front support board 162 is sized for children aged 1.5 to 7 years. In some embodiments, the overall length of a body suitable for front support board 162 is within the range of 30 inches to 52 inches. In some embodiments, the overall length of a patient's body is less than about 60 inches tall.

[0095] 8 , board 162 includes end 170 with opening 174, narrow portion 178, and flared portion 182 with wings 186. In the illustrated embodiment, narrow portion 178 is disposed between end 170 and flared portion 182. First side 190 of board 162 has first dimension 194 at end 170 and second dimension 198 at narrow portion 178. Second dimension 198 is smaller than first dimension 194. First side 190 of board 162 has third dimension 202 at flared portion 182. Third dimension 202 is larger than first dimension 194.

[0096] Referring to FIG. 11 , the system further includes a vacuum-formed bag 206 (e.g., a backlock bag or cushion). In some embodiments, the vacuum-formed bag 206 is placed over the seat portion 122 and molded to provide a customized seating contour for the patient. The vacuum-formed bag 206 is used to secure the patient's buttocks (e.g., pelvic area) to the seat portion. The patient's vertical position along the board is adjusted by the total thickness of the vacuum-formed bag 206 under the patient.

[0097] 11 , the system further includes a shell 210 coupled to the board 162 and configured to support the patient's lower back. See, for example, FIG. 15 . In some embodiments, the shell 210 is a thermoplastic body shell. In some embodiments, both ends of the shell 210 are removably coupled to the wings 186 of the board 162. The board 162 provides a flat surface in the abdominal area that allows the thermoplastic body shell 210 to be attached around the patient's back to hold the patient in a reproducible and comfortable position.

[0098] Continuing with reference to FIG. 11 , the system further includes a face mask 214 for supporting and / or immobilizing the patient's head. In some embodiments, an opening 174 in the end 170 of the board 162 selectively receives a portion of the face mask 214. In some embodiments, the face mask 214 is a thermoplastic face mask. The opening 174 can accommodate a prone face mask system. In some embodiments, the face mask 214 is removably secured to the board 162 at the opening 174. The face mask 214 allows the patient to view animations during CT simulation and treatment, making treatment (e.g., CSI Therapy) technology compatible with the Stanford Avatar project (see Susie Hineker Communication / Papers). The face mask system also allows for a thermoplastic shell to be attached to the back of the patient's head to hold the entire head in place.

[0099] In some embodiments, the system includes an attention member 218 configured to attract or distract the patient's attention while the patient is positioned on the board 162. In other words, the patient's face protrudes through the opening 170 so that the patient can see or interact with the attention member 218. In some embodiments, the attention member 218 is visible to the patient when the patient's face is inserted into the opening 170 of the board 162. In other words, the patient can see the attention member 218 through the opening 170 and can interact with or manipulate the attention member 218 with their hands. In some embodiments, the attention member is a video display or a tablet computer ( FIGS. 13 and 14 ). In other embodiments, the attention member is a toy, such as a fidget spinner, or other suitable manipulable toy ( FIGS. 13 and 14 ). In some embodiments, a mounting bracket for the attention member is coupled to the board.

[0100] In some embodiments, the system further includes an arm and leg support system for immobilizing the patient's arms and legs.

[0101] 12-14, exemplary patients of various sizes are shown supported by the board 162 and testing stand 166 of FIG. 10. For reference, a meter stick is shown positioned relative to the exemplary patient of FIG. 12.

[0102] Finally, there is a third category of pediatric patients, who, although smaller than 5% of Japanese women, cannot undergo the course of treatment without being sedated or anesthetized. In some embodiments, anesthesia is administered to patients immobilized in an upright position using the systems detailed herein.

[0103] Although the disclosure herein refers to certain illustrated embodiments, it should be understood that these embodiments are presented by way of example and not limitation.

[0104] All publications and patents mentioned in the above specification are incorporated herein by reference in their entirety for all purposes. Various modifications and variations of the described compositions, methods, and uses of the technology will be apparent to those skilled in the art without departing from the scope and spirit of the described technology. Although the technology has been described in connection with specific exemplary embodiments, it should be understood that the invention as claimed should not be unduly limited to such specific embodiments. Indeed, various modifications of the described modes for carrying out the invention that are apparent to those skilled in the art are intended to be within the scope of the following claims.

[0105] References 1.Yang J,et al.Advantages of simulating thoracic cancer patients in an upright position.Pract Radiat Oncol.2014;4:e53-e58.2. 2.McCarroll,R.E.,et al(2017),Reproducibility of patient setup in the seated treatment position:A novel treatment chair design.J Appl Clin Med Phys,18:223-229.doi:10.1002 / acm2.12024 3.Thomas Rockwell Mackie,et al “Is upright radiotherapy medically and financially better?”,AIP Conference Proceedings 2348,020002(2021)https: / / doi.org / 10.1063 / 5.0051770 4.S.Boisbouvier,et al Upright patient positioning for pelvic radiotherapy treatments,Technical Innovations&Patient Support in Radiation Oncology,Volume 24,2022,Pages 124-130,ISSN 2405-6324,https: / / doi.org / 10.1016 / j.tipsro.2022.11.003.

Claims

1. 1. A patient support system comprising: a base portion forming a central axis; a seat portion coupled to a base; a board coupled to the base, the board including a first surface facing the central axis and a second surface opposite the first surface; Equipped with The system, wherein the first surface of the board is configured to engage with the front of the patient.

2. The system of claim 1 , wherein the board includes an opening configured to receive at least a portion of the patient's head.

3. The system of claim 2 , wherein the opening is located at an end of the board.

4. 10. The system of claim 1, wherein the board includes a first wing configured to at least partially support a first arm of the patient, and the board includes a second wing configured to at least partially support a second arm of the patient.

5. 10. The system of claim 1, wherein an angle is formed between the board and the central axis, the angle being in the range of 5 degrees to 45 degrees.

6. The system of claim 5 , wherein the angle is adjustable.

7. 10. The system of claim 1, wherein the first side of the board has a first dimension at an end and a second dimension at a narrow portion, the second dimension being smaller than the first dimension.

8. The system of claim 7 , wherein the end includes an opening.

9. The system of claim 8 , wherein the first side of the board has a third dimension at the flared portion, the third dimension being greater than the first dimension.

10. The system of claim 9 , wherein the narrow portion is disposed between the end and the flared portion.

11. The system of claim 1 , wherein the base is rotatable about a central axis.

12. The system of claim 1 , wherein the base is movable along a central axis.

13. The system of claim 1 , wherein the central axis is vertical.

14. The system of claim 1 further comprising a vacuum formed bag.

15. The system of claim 14 , wherein the vacuum-formed bag is disposed in the seat portion.

16. The system of claim 1 , further comprising a shell coupled to the board and configured to support the patient's lower back.

17. The system of claim 1 further comprising a prompting member.

18. 20. The system of claim 17, wherein the prompting member is a video display.

19. 20. The system of claim 18, wherein the attention member is a toy.

20. 10. The system of claim 1, wherein the patient is less than 60 inches tall.

21. 1. A heel booster comprising: a bottom surface including a notch configured to at least partially receive a heel support of an upright patient positioning system, the heel booster further comprising an elevated platform, a heel stop extending from the elevated platform, and a roller extending from the bottom surface.

22. 1. A patient support system comprising: a base portion forming a central axis; a pedestal coupled to the base; a support coupled to the base so as to be pivotable about a pivot axis; A patient support system, wherein the support includes a lower portion, an upper portion, and an arcuate connecting portion between the lower portion and the upper portion.

23. 23. The patient support system of claim 22, wherein the pivot axis is perpendicular to the central axis.

24. 23. The patient support system of claim 22, wherein the support further includes a head portion extending from the upper portion and configured to support the patient's head.

25. 23. The patient support system of claim 22, further comprising a shin stop coupled to the lower portion and configured to support the patient's shin.

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