Installation of medical apparatus

Abstract

Provided herein is technology relating to installing a medical apparatus and particularly, but not exclusively, to methods for assembling, locating, and installing a radiological imaging or treatment apparatus and a patient support.

Description

[0001] ASTO-41840.601

[0002] INSTALLATION OF MEDICAL APPARATUS

[0003] CROSS-REFERENCE TO RELATED APPLICATION

[0004] This application claims priority to and the benefit of U.S. Provisional Patent Application No. 63 / 696,930, filed September 20, 2024, which is incorporated by reference herein in its entirety.

[0005] FIELD

[0006] Provided herein is technology relating to installing a medical apparatus and particularly, but not exclusively, to methods for assembling, locating, and installing a radiological imaging or treatment apparatus and a patient support.

[0007] BACKGROUND

[0008] Medical imaging and medical therapy systems are used to image and treat specified regions of interest within a body such as a human body. Providing accurate images and treatment of a region of interest relies at least in part on accurately and precisely installing the medical imaging or medical therapy system and an apparatus to support the body in a position appropriate for imaging or treatment. Accordingly, technologies are needed for installation of medical apparatuses and support apparatuses in clinical settings where they are used.

[0009] SUMMARY

[0010] Thus, provided herein are embodiments of technologies relating to installing a medical apparatus and particularly, but not exclusively, to methods for assembling, locating, and installing a radiological imaging (e.g., a computerized tomography scanner) or treatment apparatus and a patient support. In some embodiments, the technology relates to assembling, locating, and / or installing a medical imaging apparatus or system as described in U.S. Pat. App. Pub. No. 2022 / 0183641, which is incorporated herein by reference. In some embodiments, the technology relates to assembling, locating, and / or installing a patient positioning apparatus as described in U.S. Pat. No. 11,529,109, which is incorporated herein by reference. In some embodiments, the technology relates to assembling, locating, and / or installing a patient positioning system as described in U.S. Pat. App. Pub. No. 2023 / 0172566, which is incorporated herein by reference. In some embodiments, a patient positioning apparatus or patient positioning system comprises an apparatus or subsystem (a “patient rotation system”, abbreviated “PRS”) ASTO-41840.601 for rotating a patient in a vertical position (e.g., a substantially and / or essentially vertical position) as described in U.S. Pat. No. 11,529,109 or U.S. Pat. App. Pub. No. 2023 / 0172566.

[0011] For example, embodiments of the technology relate to methods for installing a patient rotation system (PRS). In some embodiments, the methods comprise identifying an isocenter in a treatment room comprising a room floor! providing a pit in the room floor, said pit having a pit floor (e.g., a machine finished pit floor); providing a PRS having a characteristic critical distance (C); identifying a beam height (B) as a distance from the room floor to the isocenter; identifying a pit depth (P) as a distance from the pit floor (e.g., a machine finished pit floor) to the room floor, wherein P + B = C. In some embodiments, the isocenter is at a point where a radiation beam intersects a vertical axis of rotation of the PRS.

[0012] The methods provided herein describe a pit floor that may be a rough pit floor (e.g., a customer provided pit floor) or a machine finished pit floor. The rough pit floor (e.g., the customer provided pit floor) describes the pit floor before mounting a pit plate to the pit floor, and the machine finished pit floor describes the pit floor after mounting the pit plate to the pit floor. The rough pit floor has a rough pit floor depth and the machine finished pit floor has a machine finished pit floor depth. The pit depth described herein refers to the machine finished pit floor depth unless the pit depth is explicitly indicated to be otherwise, e.g., a rough pit floor depth. Further, the pit depth (P) described herein is the distance between the top surface of the pit plate (as provided in a machine finished pit floor) to the room floor (e.g., the hospital finished room floor) unless explicitly described otherwise.

[0013] As described herein, the critical distance (C), pit depth (P), and beam height (B) are related by P + B = C.

[0014] In some embodiments, B = approximately 850 mm to 1500 mm (e.g., 850, 860, 870, 880, 890, 900, 910, 920, 930, 940, 950, 960, 970, 980, 990, 1000, 1010, 1020, 1030, 1040, 1050, 1060, 1070, 1080, 1090, 1100, 1110, 1120, 1130, 1140, 1150, 1160, 1170,

[0015] 1180, 1190, 1200, 1210, 1220, 1230, 1240, 1250, 1260, 1270, 1280, 1290, 1300, 1310,

[0016] 1320, 1330, 1340, 1350, 1360, 1370, 1380, 1390, 1400, 1410, 1420, 1430, 1440, 1450,

[0017] 1460, 1470, 1480, 1490, or 1500 mm).

[0018] In some embodiments, C - approximately 1870 mm (e.g., approximately 1820, 1821, 1822, 1823, 1824, 1825, 1826, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834,

[0019] 1835, 1836, 1837, 1838, 1839, 1840, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848,

[0020] 1849, 1850, 1851, 1852, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, ASTO-41840.601

[0021] 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876,

[0022] 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890,

[0023] 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904,

[0024] 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918,

[0025] 1919, or 1920 mm).

[0026] In some embodiments, P = approximately 320 mm to 1070 mm (e.g., approximately 320, 330, 340, 350, 360, 370, 380, 390, 400, 410, 420, 430, 440, 450, 460, 470, 480, 490, 500, 510, 520, 530, 540, 550, 560, 570, 580, 590, 600, 610, 620, 630, 640,

[0027] 650, 660, 670, 680, 690, 700, 710, 720, 730, 740, 750, 760, 770, 780, 790, 800, 810, 820,

[0028] 830, 840, 850, 860, 870, 880, 890, 900, 910, 920, 930, 940, 950, 960, 970, 980, 990, 1000,

[0029] 1010, 1020, 1030, 1040, 1050, 1060, or 1070 mm).

[0030] In some embodiments, the pit has a center (e.g., in an X-Y plane). In some embodiments, the center of the pit is substantially aligned on a vertical axis with the isocenter. In some embodiments, methods further comprise mounting a pit plate to the pit floor. In some embodiments, mounting a pit plate to the pit floor comprises suspending the pit plate above the pit floor. In some embodiments, suspending the pit plate above the pit floor comprises providing a support assembly to suspend the pit plate above the pit floor. In some embodiments, suspending the pit plate above the pit floor locates a bottom of the pit plate approximately 1 cm to 5 cm (e.g., approximately 1.0, 1.1,

[0031] 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,

[0032] 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, or 5.0 cm) above the pit floor. In some embodiments, methods further comprise adjusting a position of the pit plate to be normal to a vertical axis of rotation of the PRS and centered on the axis of rotation of the PRS. In some embodiments, methods further comprise providing a grout under the pit plate and allowing the grout to harden. In some embodiments, methods further comprise anchoring the pit plate to the pit floor.

[0033] In some embodiments, methods further comprise mounting the PRS to the pit plate. In some embodiments, mounting the PRS to the pit plate comprises mounting a pit ring to the pit plate, wherein said pit ring comprises a pit ring assembly and a slewing bearing; and mounting a number of pushing blocks to the pit plate, wherein said pushing blocks are operatively engaged with the slewing bearing. In some embodiments, methods further comprise adjusting a position of the slewing bearing using the pushing blocks. In some embodiments, methods further comprise mounting a PRS support to the slewing bearing, wherein the PRS support comprises a Z plate and a scissor lift. In some embodiments, methods comprise mounting the PRS to the PRS support. In some ASTO-41840.601 embodiments, methods further comprise aligning the PRS to the isocenter. In some embodiments, methods further comprise installing a floor assembly around the PRS.

[0034] While some embodiments of methods provided herein describe mounting the PRS to the pit plate by installing the pit ring, PRS support, and PRS in separate steps; or, alternatively, installing the pit ring assembly, slewing bearing, Z plate, scissor lift, and PRS in separate steps, some embodiments of methods comprise mounting the PRS to the pit plate by providing the pit ring assembly, PRS support, and PRS as a single PRS assembly (e.g., as a factory-assembled PRS assembly delivered to the installation site) and installing the PRS assembly to the pit plate.

[0035] The technology provided herein also provides methods for installing a medical imaging apparatus. For example, in some embodiments, methods comprise identifying an isocenter in a treatment room comprising a room floor! mounting a first pillar support plate to the room floor! mounting a second pillar support plate to the room floor! mounting a first scanner pillar to the first pillar support plate! mounting a second scanner pillar to the second pillar support plate! attaching a first scanner arm to the first scanner pillar and attaching a second scanner arm to the second scanner pillar, wherein the first scanner arm comprises a first yoke structured to translate along the first scanner arm and the second scanner arm comprises a second yoke structured to translate along the second scanner arm! attaching a scanner bridge to the first scanner arm and to the second scanner arm! and attaching a scanner ring to the first yoke and to the second yoke. In some embodiments, the first scanner arm is rotatably coupled to the first scanner pillar and the second scanner arm is rotatably coupled to the second scanner pillar. In some embodiments, methods comprise removably coupling a scanner arm alignment tool to the first scanner arm and removably coupling the scanner arm alignment tool to the second scanner arm to maintain the first scanner arm and the second scanner arm in the correct locations during installation and adjustment of the components of the CT scanner and, in particular, during installation and / or alignment of the first scanner arm and the second scanner arm. Accordingly, in some embodiments, methods comprise removing the scanner arm alignment tool from the CT scanner after the first scanner arm and the second scanner arm are installed and / or aligned.

[0036] In some embodiments, methods further comprise attaching a first counterweight to the first scanner arm and attaching a second counterweight to the second scanner arm. In some embodiments, mounting the first and second pillar support plates to the room floor comprises suspending the first and second pillar support plates above a first mounting pocket and a second mounting pocket provided in the room floor. In some ASTO-41840.601 embodiments, methods further comprise providing a grout under the first pillar support plate and the second pillar support plate and allowing the grout to harden. In some embodiments, methods further comprise anchoring the first pillar support plate to the room floor and anchoring the second pillar support plate to the room floor.

[0037] In some embodiments, mounting the first pillar support plate to the room floor and mounting the second pillar support plate to the room floor provides the first pillar support plate and the second pillar support plates to be level with a hospital finished floor of a treatment room.

[0038] Moreover, the technology provided herein also relates to methods for installing an integrated imaging and radiation treatment system. For example, in some embodiments, methods comprise installing a patient rotation system (PRS) aligned to a treatment isocenter, e.g., as described herein; and installing a CT scanner aligned to an imaging isocenter, e.g., as described herein. In some embodiments, the treatment isocenter and the imaging isocenter are substantially the same point. In some embodiments, the treatment isocenter and the imaging isocenter are different points separated by a known distance. In some embodiments, the known distance is used to plan a treatment using an image acquired using the CT scanner and the known distance from the imaging isocenter to the treatment isocenter.

[0039] In some embodiments, the treatment isocenter and the imaging isocenter are different points (e.g., within installation tolerances) when the PRS and CT scanner are installed due to small deviations in the installing processes and methods comprise adjusting the location of the PRS and / or adjusting the location of the CT scanner to align the treatment isocenter and the imaging isocenter to be at the same point. In some embodiments, the treatment isocenter and the imaging isocenter are different points after the PRS and the CT scanner are adjusted, e.g., to provide the treatment isocenter and the imaging isocenter at two locations that are separated by a known distance in the X, Y, and / or Z directions. An integrated imaging and radiation treatment system treatment comprising a treatment isocenter and an imaging isocenter separated by a known distance finds use in cases where imaging a patient and treating the patient occur at different locations in space, e.g., due to design constraints to avoid collisions of moving parts of the system or space constraints imposed by particular room geometries such that imaging and treatment are performed at different locations within the system.

[0040] In some embodiments, the treatment isocenter and the imaging isocenter are different points upon installation (e.g., within an installation tolerance) and prior to adjustment of the PRS and / or CT scanner that are separated by approximately 0.1 mm ASTO-41840.601 to 10 mm (e.g., approximately 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 1.1, 1.2, 1.3, 1.4,

[0041] 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,

[0042] 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,

[0043] 5.7, 5.8, 5.9, 6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6.9, 7.0, 7.1, 7.2, 7.3, 7.4, 7.5, 7.6, 7.7,

[0044] 7.8, 7.9, 8.0, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.8, 8.9, 9.0, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.8,

[0045] 9.9, or 10.0 mm). After adjusting the PRS and / or CT scanner, the imaging isocenter and the treatment isocenter may be aligned or may be non-aligned and separated by a known distance, depending on the requirements of the installation. In some embodiments, the treatment isocenter and the imaging isocenter are different points after adjustment of the PRS and / or CT scanner that are separated by approximately 0.1 mm to 400 mm (e.g., 0.1, 1, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, 150, 160, 170, 180, 190, 200, 210, 220, 230, 240, 250, 260, 270, 280, 290, 300, 310, 320, 330, 340, 350, 360, 370, 380, 390, or 400 mm).

[0046] In some embodiments, the PRS has an axis of rotation passing through the treatment isocenter. In some embodiments, a radiation beam passes through the treatment isocenter. In some embodiments, methods further comprise aligning the PRS to a radiation beam. In some embodiments, methods further comprise aligning the CT scanner to the PRS.

[0047] Further, embodiments of the methods described herein relate to quality assurance and validation of installation of the PRS and / or CT scanner. For example, in some embodiments, methods comprise validating the installation of the PRS and / or of the CT scanner. In some embodiments, methods comprise validating the installation of the PRS and / or of the CT scanner using a quality assurance device. In some embodiments, validating the installation of the PRS and / or of the CT scanner comprises rotating the PRS. In some embodiments, the quality assurance device is located on a seat of the PRS. In some embodiments, the quality assurance device comprises a first registration feature and the seat comprises a second registration feature, and the first registration feature and the second registration feature have complementary shapes.

[0048] Some portions of this description describe the embodiments of the 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 convey the substance of their work effectively 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. Furthermore, it has also proven convenient at times to refer to ASTO-41840.601 these arrangements of operations as modules, without loss of generality. The described operations and their associated modules may be embodied in software, firmware, hardware, or any combinations thereof.

[0049] Certain steps, operations, or processes described herein may be performed or implemented with one or more hardware or software modules, alone or in combination with other devices. In some embodiments, a software module is implemented with a computer program product comprising a computer-readable medium containing computer program code, which can be executed by a computer processor for performing any or all steps, operations, or processes described.

[0050] In some embodiments, systems comprise a computer and / or data storage provided virtually (e.g., as a cloud computing resource). In particular embodiments, the technology comprises use of cloud computing to provide a virtual computer system that comprises the components and / or performs the functions of a computer as described herein. Thus, in some embodiments, cloud computing provides infrastructure, applications, and software as described herein through a network and / or over the internet. In some embodiments, computing resources (e.g., data analysis, calculation, data storage, application programs, file storage, etc.) are remotely provided over a network (e.g., the internet and / or a cellular network).

[0051] Embodiments of the technology may also relate to an apparatus for performing the operations described herein. This apparatus may be specially constructed for the required purposes (e.g., an application-specific integrated circuit or a field- programmable gate array) and / or it may comprise a general-purpose computing device (e.g., a microcontroller, microprocessor, and the like) selectively activated or reconfigured by a computer program stored in the computer. The apparatus may be configured to perform one or more steps, actions, and / or functions described herein, e.g., provided as instructions of a computer program. Such a computer program may be stored in a non-transitory, tangible computer readable storage medium or any type of media suitable for storing electronic instructions, which may be coupled to a computer system bus. Furthermore, any computing systems referred to in the specification may include a single processor or may be architectures employing multiple processor designs for increased computing capability.

[0052] Additional embodiments will be apparent to persons skilled in the relevant art based on the teachings contained herein. ASTO-41840.601

[0053] BRIEF DESCRIPTION OF THE DRAWINGS

[0054] These and other features, aspects, and advantages of the present technology will become better understood with regard to the following drawings.

[0055] FIG. 1 is a flowchart showing an embodiment of a method for installing a medical imaging apparatus and patient rotation system (PRS).

[0056] FIG. 2A is a drawing showing a perspective view of a treatment room for housing the medical imaging apparatus and PRS. FIG. 2A shows an X-Y-Z coordinate system for reference.

[0057] FIG. 2B is a drawing showing an overhead view of a pit in the floor of the treatment room and exemplary dimensions of the treatment room, pit, and pit placement within the room.

[0058] FIG. 2C is a drawing showing a side view of the pit in the floor of the treatment room and exemplary dimensions of the treatment room, pit, and pit placement within the room. Dashed lines indicate that embodiments provide the floor of the pit at a range of depths from 320 mm below floor level to 1070 mm below floor level.

[0059] FIG. 2D is a drawing showing a side view of the floor of the room, the pit in the floor, the isocenter, and the relationship between the pit depth (P), critical distance (C), and beam height (B) as provided by Equation I or Equation II described herein.

[0060] FIG. 2E is a drawing showing a perspective view of a treatment room comprising a pit and mounting pockets in the floor of the treatment room.

[0061] FIG. 2F is a drawing showing an overhead view of a pit plate mounted in the pit of the floor and pillar support plates mounted in the mounting pockets.

[0062] FIG. 2G is a drawing showing a side view of the pit plate suspended within the pit so that the pit plate is free of contacting the floor of the pit; and the pillar support plates suspended within the mounting pockets so that each pillar support plate is free of contacting the bottom of the each of the respective mounting pockets.

[0063] FIG. 2H is a drawing of a grout-in tool coupled to a pit plate and coupled to pillar support plates to suspend the pit plate above the floor of the pit and to suspend the pillar support plates above the mounting pockets.

[0064] FIG. 21 is a drawing showing a support assembly suspending a grout-in tool.

[0065] FIG. 2J is a drawing showing a support assembly and grout-in tool comprising leveling feet.

[0066] FIG. 2K is a drawing showing a grout-in tool comprising short legs (top) and a grout-in tool comprising long legs (bottom). ASTO-41840.601

[0067] FIG. 2L is a drawing showing a side view of a grout composition poured under and around the pit plate in the floor of the pit and a grout composition poured under and around each pillar support plate within each of the respective mounting pockets.

[0068] FIG. 2M is a drawing showing an overhead view of a pit ring (comprising a pit ring assembly and a slewing bearing) mounted to the pit plate.

[0069] FIG. 2N is a drawing showing an alignment tool and a method for placing the pit ring assembly onto the pit plate using the alignment tool.

[0070] FIG. 20 is a drawing showing an overhead view of pushing blocks mounted on the pit plate and operatively engaged with the pit ring and thus with the slewing bearing.

[0071] FIG. 2P is a drawing showing a side view of a PRS support mounted to the slewing bearing.

[0072] FIG. 3A is a drawing showing a side view of a first scanner pillar mounted to the first pillar support plate and a second scanner pillar mounted to the second pillar support plate.

[0073] FIG. 3B is a drawing showing a side view of a first scanner arm rotatably coupled to the first scanner pillar and a second scanner arm rotatably coupled to the second scanner pillar.

[0074] FIG. 3C is a drawing showing a scanner arm alignment tool.

[0075] FIG. 3D is a drawing showing rotation of the scanner arms and translation of the yokes.

[0076] FIG. 3E is a drawing showing a side view of a scanner bridge attached to the first scanner arm and second scanner arm! and a first counterweight attached to the first scanner arm and a second counterweight attached to the second scanner arm.

[0077] FIG. 3F is a drawing showing a side view of a scanner ring mounted to a first yoke of the first scanner arm and to a second yoke of the second scanner arm.

[0078] FIG. 3G is a drawing showing a side view of a PRS mounted to the PRS support.

[0079] FIG. 3H is a drawing showing a scanner pillar pushing block comprising an adjustment bolt operatively engaged with a scanner pillar.

[0080] FIG. 4A is a drawing showing a perspective view of an assembled medical imaging apparatus comprising covers.

[0081] FIG. 4B is a drawing showing a perspective view of an assembled medical imaging apparatus and PRS in a treatment room.

[0082] FIG. 40 is a three-dimensional model showing an assembled medical imaging apparatus and PRS in a treatment room. ASTO-41840.601

[0083] FIG. 5A is a drawing of a QA device.

[0084] FIG. 5B is a drawing of the QA device located on the seat of the PRS.

[0085] It is to be understood that the figures are not necessarily drawn to scale, nor are the objects in the figures necessarily drawn to scale in relationship to one another. The figures are depictions that are intended to bring clarity and understanding to various embodiments of apparatuses, 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. Moreover, it should be appreciated that the drawings are not intended to limit the scope of the present teachings in any way.

[0086] DETAILED DESCRIPTION

[0087] Provided herein is technology relating to installing a medical apparatus and particularly, but not exclusively, to methods for locating, assembling, and installing a radiological imaging apparatus and a patient support.

[0088] In this detailed description of the various embodiments, for purposes of explanation, numerous specific details are set forth to provide a thorough understanding of the embodiments disclosed. One skilled in the art will appreciate, however, that these various embodiments may be practiced with or without these specific details. In other instances, structures and devices are shown in block diagram form. Furthermore, one skilled in the art can readily appreciate that the specific sequences in which methods are presented and performed are illustrative and it is contemplated that the sequences can be varied and still remain within the spirit and scope of the various embodiments disclosed herein.

[0089] All literature and similar materials cited in this application, including but not limited to, patents, patent applications, articles, books, treatises, and internet web pages are expressly incorporated by reference in their entirety for any purpose. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as is commonly understood by one of ordinary skill in the art to which the various embodiments described herein belongs. When definitions of terms in incorporated references appear to differ from the definitions provided in the present teachings, the definition provided in the present teachings shall control. The section headings used herein are for organizational purposes only and are not to be construed as limiting the described subject matter in any way. ASTO-41840.601

[0090] Definitions

[0091] To facilitate an understanding of the present technology, a number of terms and phrases are defined below. Additional definitions are set forth throughout the detailed description.

[0092] Throughout the specification and claims, the following terms take the meanings explicitly associated herein, unless the context clearly dictates otherwise. The phrase “in one embodiment” as used herein does not necessarily refer to the same embodiment, though it may. Furthermore, the phrase “in another embodiment” as used herein does not necessarily refer to a different embodiment, although it may. Thus, as described below, various embodiments of the invention may be readily combined, without departing from the scope or spirit of the invention.

[0093] In addition, 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 being based on additional factors not described, unless the context clearly dictates otherwise. In addition, throughout the specification, the meaning of “a”, “an”, and “the” include plural references. The meaning of “in” includes “in” and “on.”

[0094] As used herein, the terms “about”, “approximately”, “substantially”, and “significantly” are understood by persons of ordinary skill in the art and will vary to some extent 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 plus or minus less than or equal to 10% of the particular term and “substantially” and “significantly” mean plus or minus greater than 10% of the particular term.

[0095] As used herein, disclosure of ranges includes disclosure of all values and further divided ranges within the entire range, including endpoints and sub-ranges given for the ranges. As used herein, the disclosure of numeric ranges includes the endpoints and each intervening number therebetween with the same degree of precision. For example, for the range of 6-9. the numbers 7 and 8 are contemplated 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 contemplated.

[0096] As used herein, the suffix “ free” refers to an embodiment of the technology that omits the feature of the base root of the word to which “-free” is appended. That is. the term “X-free” as used herein means “without X”, where X is a feature of the technology ASTO-41840.601 omitted in the “X free” technology. For example, a “calcium-free” composition does not comprise calcium, a “mixing-free” method does not comprise a mixing step, etc.

[0097] Although the terms “first”, “second”, “third”, etc. may be used herein to describe various steps, elements, compositions, components, regions, layers, and / or sections, these steps, elements, compositions, components, regions, layers, and / or sections should not be limited by these terms, unless otherwise indicated. These terms are used to distinguish one step, element, composition, component, region, layer, and / or section from another step, element, composition, component, region, layer, and / or section. Terms such as “first”, “second", and other numerical terms when used herein do not imply a sequence or order unless clearly indicated by the context. Thus, a first step, element, composition, component, region, layer, or section discussed herein could be termed a second step, element, composition, component, region, layer, or section without departing from technology.

[0098] As used herein, the word “presence” or “absence” (or, alternatively, “present” or “absent”) is used in a relative sense to describe the amount or level of a particular entity (e.g., component, action, element). For example, when an entity is said to be “present”, it means the level or amount of this entity is above a pre-determined threshold; conversely, when an entity is said to be “absent”, it means the level or amount of this entity is below a pre -determined threshold. The pre -determined threshold may be the threshold for detectability associated with the particular test used to detect the entity or any other threshold. When an entity is “detected” it is “present”; when an entity is “not detected” it is “absent”.

[0099] As used herein, an “increase” or a “decrease” refers to a detectable (e.g., measured) positive or negative change, respectively, in the value of a variable relative to a previously measured value of the variable, relative to a pre-established value, and / or relative to a value of a standard control. An increase is a positive change preferably at least 10%, more preferably 50%. still more preferably 2-fold. even more preferably at least 5 fold, and most preferably at least 10-fold relative to the previously measured value of the variable, the pre-established value, and / or the value of a standard control. Similarly, a decrease is a negative change preferably at least 10%, more preferably 50%, still more preferably at least 80%, and most preferably at least 90% of the previously measured value of the variable, the pre-established value, and / or the value of a standard control. Other terms indicating quantitative changes or differences, such as “more” or “less.” are used herein in the same fashion as described above. ASTO-41840.601

[0100] As used herein, a “system” refers to a plurality of real and / or abstract components operating together for a common purpose. In some embodiments, a “system” is an integrated assemblage of hardware and / or software components. In some embodiments, each component of the system interacts with one or more other components 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 methods. For example, a “system” or “subsystem” may comprise one or more of, or any combination of, the following: mechanical devices, hardware, components of hardware, circuits, circuitry, logic design, logical 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 a function 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 tangible media, such as floppy diskettes, CD-ROMs, hard drives, flash memory, or any other machine-readable storage medium wherein, when the program code is loaded into and executed by a machine, such as a computer, the machine becomes an apparatus for practicing the embodiments. In the case of program code execution on programmable computers, the computing device generally includes a processor, a storage medium readable by the processor (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, e.g., through the use of an application programming interface (API), reusable controls, 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 program(s) can be implemented in assembly or machine language, if desired. In any case, the language may be a compiled or interpreted language, and it may be combined with hardware implementations.

[0101] As used herein, the term “structured to [verb]” means that the identified element or assembly has a structure that is shaped, sized, disposed, coupled, and / or configured to perform the identified verb. For example, a member that is “structured to move” is movably coupled to another element and includes elements that cause the member to move or the member is otherwise configured to move in response to other elements or assemblies. As such, as used herein, “structured to [verb]” recites structure and not ASTO-41840.601 function. Further, as used herein, “structured to [verb]” means that the identified element or assembly is intended to, and is designed to, perform the identified verb.

[0102] As used herein, the term “associated” means that the elements are part of the same assembly and / or operate together or act upon / with each other in some manner. For example, an automobile has four tires and four hub caps. While all the elements are coupled as part of the automobile, it is understood that each hubcap is “associated” with a specific tire.

[0103] As used herein, the term “coupled” refers to two or more components that are secured, by any suitable means, together. Accordingly, in some embodiments, the statement that two or more parts or components are “coupled" shall mean that the parts are joined or operate together either directly or indirectly, e.g., through one or more intermediate parts or components.

[0104] As used herein, “directly coupled” means that two elements are directly in contact with each other. As used herein, “fixedly coupled” or “fixed” means that two components are coupled so as to move as one while maintaining a constant orientation relative to each other. Accordingly, when two elements are coupled, all portions of those elements are coupled. A description, however, of a specific portion of a first element being coupled to a second element, e.g., an axle first end being coupled to a first wheel, means that the specific portion of the first element is disposed closer to the second element than the other portions thereof. Further, an object resting on another object held in place only by gravity is not “coupled” to the lower object unless the upper object is otherwise maintained substantially in place. That is. for example, a book on a table is not coupled thereto, but a book glued to a table is coupled thereto.

[0105] As used herein, the term “removably coupled” or “temporarily coupled” means that one component is coupled with another component in an essentially temporary manner. That is, the two components are coupled in such a way that the joining or separation of the components is easy and does not damage the components. Accordingly, “removably coupled” components may be readily uncoupled and recoupled without damage to the components.

[0106] As used herein, the term “operatively coupled” means that a number of elements or assemblies, each of which is movable between a first position and a second position, or a first configuration and a second configuration, are coupled so that as the first element moves from one position / configuration to the other, the second element moves between positions / configurations as well. It is noted that a first element may be “operatively coupled” to another without the opposite being true. ASTO-41840.601

[0107] As used herein, the term “rotatably coupled'’ refers to two or more components that are coupled in a manner such that at least one of the components is rotatable with respect to the other.

[0108] As used herein, the term “translatably coupled” refers to two or more components that are coupled in a manner such that at least one of the components is translatable with respect to the other.

[0109] As used herein, the term “temporarily disposed” means that a first element or assembly is resting on a second element or assembly in a manner that allows the first element / assembly to be moved without having to decouple or otherwise manipulate the first element. For example, a book simply resting on a table, e.g., the book is not glued or fastened to the table, is “temporarily disposed” on the table.

[0110] As used herein, the term “correspond” indicates that two structural components are sized and shaped to be similar to each other and may be coupled with a minimum amount of friction. Thus, an opening which “corresponds” to a member is sized slightly larger than the member so that the member may pass through the opening with a minimum amount of friction. This definition is modified if the two components are to fit “snugly” together. In that situation, the difference between the size of the components is even smaller whereby the amount of friction increases. If the element defining the opening and / or the component inserted into the opening are made from a deformable or compressible material, the opening may even be slightly smaller than the component being inserted into the opening. With regard to surfaces, shapes, and lines, two or more “corresponding” surfaces, shapes, or lines have generally the same size, shape, and contours.

[0111] As used herein, a “path of travel" or “path,” when used in association with an element that moves, includes the space an element moves through when in motion. As such, any element that moves inherently has a “path of travel" or “path.”

[0112] As used herein, the statement that two or more parts or components “engage” one another shall mean that the elements exert a force or bias against one another either directly or through one or more intermediate elements or components. Further, as used herein with regard to moving parts, a moving part may “engage” another element during the motion from one position to another and / or may “engage” another element once in the described position. Thus, it is understood that the statements, “when element A moves to element A first position, element A engages element B,” and “when element A is in element A first position, element A engages element B” are equivalent statements and mean that element A either engages element B while moving to element ASTO-41840.601

[0113] A first position and / or element A either engages element B while in element A first position.

[0114] As used herein, the term “operatively engage” means “engage and move.” That is, “operatively engage" when used in relation to a first component that is structured to move a movable or rotatable second component means that the first component applies a force sufficient to cause the second component to move. For example, a screwdriver may be placed into contact with a screw. When no force is applied to the screwdriver, the screwdriver is merely “coupled” to the screw. If an axial force is applied to the screwdriver, the screwdriver is pressed against the screw and “engages” the screw. However, when a rotational force is applied to the screwdriver, the screwdriver “operatively engages” the screw and causes the screw to rotate. Further, with electronic components, “operatively engage” means that one component controls another component by a control signal or current.

[0115] As used herein, the term “number” shall mean one or an integer greater than one (e.g., a plurality).

[0116] As used herein, in the phrase “ [x] moves between its first position and second position,” or, “ [y] is structured to move [x] between its first position and second position,” “[x]” is the name of an element or assembly. Further, when [x] is an element or assembly that moves between a number of positions, the pronoun “its” means “ [x],” i.e., the named element or assembly that precedes the pronoun “its.”

[0117] As used herein, a “radial side / surface” for a circular or cylindrical body is a side / surface that extends about, or encircles, the center thereof or a height line passing through the center thereof. As used herein, an “axial side / surface” for a circular or cylindrical body is a side that extends in a plane extending generally perpendicular to a height line passing through the center. That is, generally, for a cylindrical soup can. the “radial side / surface” is the generally circular sidewall, and the “axial side(s) / surface(s)” are the top and bottom of the soup can.

[0118] As used herein, the word “unitary” means a component is created as a single piece or unit. That is, a component that includes pieces that are created separately and then coupled together as a unit is not a “unitary” component or body.

[0119] As used herein, a “coupling assembly” includes two or more couplings or coupling components. The components of a coupling or coupling assembly are generally not part of the same element or other component. As such, the components of a “coupling assembly” may not be described at the same time in the following description. ASTO-41840.601

[0120] As used herein, a “coupling’’ or “coupling component(s)’’ is one or more component(s) of a coupling assembly. That is, a coupling assembly includes at least two components that are structured to be coupled together. It is understood that the components of a coupling assembly are compatible with each other. For example, in a coupling assembly, if one coupling component is a snap socket, the other coupling component is a snap plug, or, if one coupling component is a bolt, then the other coupling component is a nut.

[0121] As used herein, a “planar body’’ or “planar member’’ is a generally thin element including opposed, wide, generally flat surfaces as well as a thinner edge surface extending between the wide flat surfaces. The edge surface may include generally flat portions, e.g., as on a rectangular planar member, or be curved, as on a disk, or have any other shape.

[0122] As used herein, and when used in reference to communicating data or a signal, “in electronic communication” includes both hardline and wireless forms of communication.

[0123] As used herein, “in electric communication” or “in electrical communication” means that a current passes, or can pass, between the identified elements. Being “in electric communication” is further dependent upon an element’s position or configuration. For example, in a circuit breaker, a movable contact is “in electric communication” with the fixed contact when the contacts are in a closed position. The same movable contact is not “in electric communication” with the fixed contact when the contacts are in the open position.

[0124] As used herein, the term “radiation source” or “source” refers to an apparatus that produces radiation (e.g., ionizing radiation) in the form of photons (e.g., described as particles or waves). In some embodiments, a radiation source is a linear accelerator (“linac”) that produces x-rays or electrons to treat a cancer patient by contacting a tumor with the x ray or electron beam. In some embodiments, the source produces particles (e.g., photons, electrons, neutrons, hadrons, ions (e.g.. protons, carbon ions, other heavy ions)). In some embodiments, the source produces electromagnetic waves (e.g., x rays and gamma rays having a wavelength in the range of approximately 1 pm to approximately 1 nm). While it is understood that radiation can be described as having both wave like and particle-like aspects, it is sometimes convenient to refer to radiation in terms of waves and sometimes convenient to refer to radiation in terms of particles. Accordingly, both descriptions are used throughout without limiting the technology and ASTO-41840.601 with an understanding that the laws of quantum mechanics provide that every particle or quantum entity is described as either a particle or a wave.

[0125] As used herein, the term “static source’’ refers to a source that does not revolve around a patient during use of the source for imaging or therapy. In particular, a “static source” remains fixed with respect to an axis passing through the patient while the patient is being imaged or treated. While the patient may rotate around said axis to produce relative motion between the static source and rotating patient that is equivalent to the relative motion of a source revolving around a static patient, a static source does not move with reference to a third object, frame of reference (e.g., a treatment room in which a patient is positioned), or patient axis of rotation during imaging or treatment while the patient is rotated with respect to said third object, said frame of reference (e.g.. said treatment room in which said patient is positioned), or said patient axis of rotation through the patient during imaging or treatment. A static source may be installed on a mobile platform and thus the static source may move with respect to the Earth and fixtures on the Earth as the mobile platform moves to transport the static source. Thus, the term “static source” may refer to a mobile “static source” provided that the mobile “static source” does not revolve around an axis of rotation through the patient during imaging or treatment of the patient. Further, the static source may translate and / or revolve around the patient to position the static source prior to imaging or treatment of the patient or after imaging or treatment of the patient, Thus, the term “static source” may refer to a source that translates or revolves around the patient in non-imaging and non treatment use. e.g., to position the source relative to the patient when the patient is not being imaged and / or treated. In some embodiments, the “static source" is a photon source and thus is referred to as a “static photon source”.

[0126] Embodiments of the technology described herein are described in relation to a coordinate system that comprises an X axis, a Y axis, and a Z axis defined with respect to a radiation beam and axis of rotation of a PRS. See FIG. 2A-2C, showing a drawing of a treatment room 200 comprising a floor 210, a back wall 220, a radiation beam 800. and an axis of rotation 700 of the PRS. The isocenter 900 is shown at the intersection of the radiation beam 800 and the axis of rotation 700 of the PRS. As shown in FIG. 2A-2C, embodiments use a coordinate system in which the X axis and Y axis together are in and / or define a horizontal plane and the Z axis is and / or defines a vertical axis. With respect to a patient positioned on the PRS, the X axis is a left-right, horizontal, or frontal axis; the Y axis is an anteroposterior, dorsoventral, or sagittal axis; and the Z axis is a sagittal or longitudinal axis. The X axis and the Y axis together are in and / or ASTO-41840.601 define a horizontal, transverse, and / or axial plane. The Y axis and the Z axis together are in and / or define a sagittal or longitudinal plane. The X axis and the Z axis together are in and / or define a frontal or coronal plane.

[0127] Accordingly, in some embodiments, descriptions of movements as “forward”' or “backward’’ are movements along the Y axis! descriptions of movements as “left” or “right” are movements along the X axis; and descriptions of movements as “up” and “down” are movements along the Z axis. Furthermore, a rotation described as “roll” is rotation around the Y axis; a rotation described as “pitch” is rotation around the X axis; and a rotation described as “yaw” is rotation around the Z axis. Thus, in some embodiments, technologies are described as having six degrees of freedom, e.g., translations along one or more of the X, Y, and / or Z axes and rotations around one or more of the X. Y, and / or Z axes.

[0128] As used herein, the term “high / ” refers to a chemical element that comprises a large number of protons in the nucleus, e.g.. a chemical element having an atomic number that is 12 or more (e.g., 12 to 83). Exemplary “high-Z” chemical elements include, but are not limited to, copper (Cu), aluminum (Al), iron (Fe), titanium (Ti), tungsten (W), tantalum (Ta), lead (Pb), tin (Sn), antimony (Sb), and bismuth (Bi).

[0129] As used herein, the term “lowZ” refers to a chemical element that comprises a small number of protons in the nucleus, e.g., a chemical element having an atomic number that is from 1 to 11. Exemplary “lowZ” chemical elements include, but are not limited to, beryllium (Be), boron (B), carbon (C). hydrogen (H). oxygen (O), and nitrogen (N).

[0130] As used herein, the term “high Z material” refers to a material comprising a “high Z” chemical element, e.g., a material that is a pure, substantially pure, and / or effectively pure high-Z chemical element; and / or a material comprising at least 50% by weight (e.g., at least 50, 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61, 62, 63, 64, 65, 66, 67, 68, 69. 70. 71. 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92. 93, 94, 95, 96, 97, 98, 99, 99.1, 99.2, 99.3, 99.4. 99.5. 99.6. 99.7. 99.8. or 99.9%) of a high- Z chemical element. In some embodiments, a high-Z material is a mixture, composite, alloy, ceramic, oxide, and / or a polymer comprising at least 50% by weight (e.g., at least 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72. 73,

[0131] 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97.

[0132] 98, 99, 99.1, 99.2, 99.3, 99.4, 99.5, 99.6, 99.7, 99.8, or 99.9%) of a high-Z chemical element. In some embodiments, a high-Z material comprises embedded particles of a high-Z chemical element or a combination of high-Z chemical elements. In some ASTO-41840.601 embodiments, a high Z material comprises a combination of two or more high Z chemical elements, e.g.. a material comprising two or more pure, substantially pure, and / or effectively pure high-Z chemical elements; or a material comprising at least 50% by weight (e.g., at least 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 99.1, 99.2, 99.3, 99.4, 99.5, 99.6, 99.7, 99.8, or 99.9%) of a combination of two or more high Z chemical elements (e.g., in a mixture, composite, alloy, ceramic, oxide, and / or a polymer).

[0133] As used herein, the term “lowZ material” refers to a material comprising a “low Z” chemical element, e.g.. a material that is a pure, substantially pure, and / or effectively pure lowZ chemical element; a molecule comprising lowZ chemical elements connected by chemical bonds; and / or a material comprising at least 50% by weight (e.g., at least 50, 51 , 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71 , 72, 73, 74,

[0134] 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98,

[0135] 99, 99.1, 99.2, 99.3, 99.4, 99.5, 99.6, 99.7, 99.8, or 99.9%) of a lowZ chemical element or a molecule comprising lowZ chemical elements connected by chemical bonds. In some embodiments, a lowZ material is a mixture, composite, ceramic, oxide, and / or a polymer comprising at least 50% by weight (e.g., at least 50, 51, 52, 53. 54. 55. 56. 57. 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84. 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 99.1, 99.2, 99.3, 99.4, 99.5, 99.6, 99.7, 99.8, or 99.9%) of a lowZ chemical element or a molecule comprising lowZ chemical elements connected by chemical bonds. In some embodiments, a lowZ material comprises embedded particles of a lowZ chemical element or a molecule comprising low Z chemical elements connected by chemical bonds; or comprises embedded particles comprising a combination of lowZ chemical elements or molecules comprising lowZ chemical elements connected by chemical bonds. In some embodiments, a lowZ material comprises a combination of two or more lowZ chemical elements or molecules comprising lowZ chemical elements connected by chemical bonds, e.g., a material comprising two or more pure, substantially pure, and / or effectively pure lowZ chemical elements or molecules comprising lowZ chemical elements connected by chemical bonds; or a material comprising at least 50% by weight (e.g., at least 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 99.1, 99.2, 99.3, 99.4, 99.5, 99.6, 99.7, 99.8, or 99.9%) of a combination of two or more lowZ chemical ASTO-41840.601 elements or molecules comprising lowZ chemical elements connected by chemical bonds (e.g., in a mixture, composite, alloy, ceramic, oxide, and / or a polymer).

[0136] Description

[0137] In some embodiments, e.g.. as shown in FIG. 1. the technology provides a method 1000 for installing a medical imaging apparatus and patient rotation system (PRS), e.g.. for use in a radiotherapy system (e.g., comprising a beam). For example, in some embodiments, methods comprise providing a treatment room. Further, as shown in FIG. 1. methods 1000 comprise identifying 1100 the coordinates of an isocenter, determining 1200 the dimensions of a pit, providing 1300 the pit having the determined dimensions, mounting 1400 a pit plate to the floor of the pit and mounting pillar support plates to the floor laterally to the pit, mounting 1500 a pit ring and pit ring bearing to the pit plate, assembling and mounting 1600 a PRS support to the pit ring bearing, assembling and mounting 1700 a computerized tomography (CT) scanner, installing 1800 the PRS on the PRS support, aligning 1910 the PRS to the isocenter, and aligning 1920 the CT scanner to the PRS. In some embodiments, methods further comprise installing a floor assembly. In some embodiments, methods further comprise validating the installation (e.g., the position) of the PRS, e.g., using a quality assurance device (e.g., a phantom) or using imaging (e.g., a camera provided as a component of an optical guidance tracking system as described in lnt’1 Pat. App. No. PCT / US2024 / 026297, incorporated herein by reference). Each of these steps of the methods 1000 is further described below.

[0138] In some embodiments, e.g., as shown in FIG. 1, methods 1000 comprise providing a treatment room (see, e.g., FIG. 2A). The treatment room 200 is the room that will house (comprise) the medical imaging apparatus and the PRS and in which a patient is imaged and / or treated. In some embodiments, the treatment room 200 further comprises a radiation source 600 (not shown), e.g., a photon (e.g., x-ray beam, a hadron (e.g., a proton) beam). In some embodiments, the treatment room is provided with a radiation beam 800 from a radiation source 600 located in a neighboring room. In some embodiments, providing a treatment room 200 comprises identifying a treatment room in which the medical imaging apparatus and PRS are to be installed. In some embodiments, providing a treatment room 200 comprises identifying a room comprising a radiation source or identifying a room provided with a radiation beam 800 from a radiation source located in a neighboring room. In some embodiments, providing a treatment room 200 comprises constructing a treatment room 200 in which the medical imaging apparatus and PRS are to be installed. In some embodiments, the treatment ASTO-41840.601 room 200 has minimal dimensions of approximately 4700 mm x 4500 mm x 3050 mm in the X, Y, and Z dimensions, respectively. In some embodiments, the treatment room 200 has minimal dimensions of at least 4700 mm x 4500 mm x 3050 mm in the X, Y. and Z dimensions, respectively. The technology is not limited in the size of the treatment room provided that the treatment room accommodates the medical imaging apparatus and patient rotation system (PRS) as described herein, e.g.. so that the medical imaging apparatus and PRS may be installed in the treatment room, so that the treatment room allows sufficient space for clearance of moving components, and so that the treatment room provides sufficient space around the medical imaging apparatus and PRS after installation of the medical imaging apparatus and PRS for persons to maneuver around the medical imaging apparatus and PRS (i.e.. between the walls of the treatment room and the medical imaging apparatus and PRS.

[0139] FIG. 2A-FIG. 2C show a coordinate system provided for a treatment room 200 in relation to a radiation beam 800, axis of rotation 700 of a PRS. and isocenter 900. The Z axis is aligned with (e.g., parallel to) or substantially aligned with (e.g., substantially parallel to) a gravity vector. In some embodiments, methods 1000 comprise identifying 1100 the location of an isocenter in the treatment room 200. In some embodiments, identifying the location of the isocenter in the treatment room 200 comprises identifying the X, Y. and Z coordinates of the location of the isocenter in the treatment room. As shown in FIG. 2A, the X, Y, and Z coordinates of the isocenter 900 are defined as the point where the radiation beam 800 and axis of rotation 700 of a PRS intersect. Accordingly, the Z coordinate of the isocenter (e.g., the height of the isocenter above the floor 210) is provided by the height of the radiation beam 800 above the floor 210 where the radiation beam 800 intersects the axis of rotation 700 of the PRS; the X coordinate is determined by the location of the radiation beam 800 and / or by the desired position of the axis of rotation 700 of the PRS; and the Y coordinate is determined by the desired position of the of the axis of rotation 700 of the PRS. In some embodiments, the Y coordinate is determined by a source to isocenter distance that optimizes the spot size at the isocenter and / or optimizes beam quality. In some embodiments, the X and Y coordinates of the isocenter 900 are near the center of the treatment room 200 to provide sufficient space around the medical imaging apparatus and PRS after installation of the medical imaging apparatus and PRS for persons to maneuver around the medical imaging apparatus and PRS (i.e., between the walls of the treatment room and the medical imaging apparatus and PRS). For example, embodiments provide X and Y coordinates near the center of a treatment room 200 that is 4700 mm x 4500 mm in the ASTO-41840.601

[0140] X and Y dimension, e.g., near 2350 mm ± 500 mm from a lateral wall in the X dimension and near 2250 mm ± 500 mm from a back wall 220 (e.g., the back wall 220 comprising or adjacent to the source 600 of the radiation beam 800) in the Y dimension. In some embodiments, methods 1000 comprise affixing targets on the walls, ceiling, and / or floor of the treatment room 200 marking the X, Y, and / or Z coordinates of the isocenter. In some embodiments, a laser level is used with the markers on the walls, ceiling, and / or floor to locate the isocenter (e.g., to identify the position of the isocenter) in space. Exemplary laser levels that may be used by one of ordinary skill in the art to practice the technology described herein include, e.g., a Leica Tri plane laser (Leica LINO 6R) and / or a Leica Dual plane laser (Leica LINO L2). Other laser levels may be known in the art,

[0141] Further, embodiments of methods 1000 comprise determining 1200 the dimensions of a pit 250 provided in the floor 210 of the treatment room 200. See FIG. 2B and 2C. Determining 1200 the dimensions of the pit 250 comprises determining a critical distance (C). The relationship between the pit depth (P), critical distance (C), and beam height (B) is provided by the following Equation (l): pit depth (P) = critical distance (C) - beam height (B) (I) or, alternatively, by Equation (II): pit depth (P) + beam height (B) = critical distance (C) (II)

[0142] See FIG. 2D. In some embodiments, the beam height has been previously established in a treatment room 200. In some embodiments, the critical distance equals 1870 mm (e.g.. 1870 mm ± 50 mm) above the floor 210 of the treatment room 200 (e.g., in the Z direction above floor level). In some embodiments, the pit depth in the floor 210 of the treatment room 200 (e.g., in the Z direction below floor level) is 320 mm to 1070 mm. See FIG. 2C. In some embodiments, the pit width and length in the X and Y dimensions are 2500 mm ± 10 mm x 2500 mm ± 10 mm. See FIG. 2B. Accordingly, in some embodiments, the X Y coordinates of the isocenter 900 and the axis of rotation 700 of the PRS are at or near 1250 mm x 1250 mm in relation to the side boundaries of the pit 250. See, e.g., FIG. 2B and FIG. 2C. These measurements are exemplary, e.g.. as shown in the drawings, and do not limit the technology. ASTO-41840.601

[0143] In some embodiments, methods 1000 comprise providing 1300 a pit 250 in a floor 210 of a treatment room 200. See, e.g.. FIG. 2E. In some embodiments, providing 1300 a pit 250 in the floor 210 of the treatment room 200 comprises providing 1300 the pit 250 so that the pit 250 is positioned with the center of the pit 250 aligned with the isocenter 900 and axis of rotation 700 of the PRS. In some embodiments, providing 1300 a pit 250 in the floor 210 of the treatment room 200 comprises digging the pit 250 in the floor 210 of a pre-existing treatment room 200. In some embodiments, providing 1300 a pit 250 in the floor 210 of the treatment room 200 comprises constructing the pit 250 while the room 200 is constructed. In some embodiments, providing 1300 a pit 250 in the floor 210 of the treatment room 200 comprises providing forms in the pit 250 and pouring concrete into the pit 250.

[0144] Further, embodiments of methods comprise providing mounting pockets 231. 232 in the floor 210 on either side of the pit 250 into which pillar support plates are mounted in the next step. See, e.g.. FIG. 2E. The mounting pockets 231. 232 are shallow depressions provided in the floor 210 in positions that are adjacent to and lateral to the pit 250 and into which pillar support plates are placed and mounted such that the pillar support plates are flush with the floor 210. In some embodiments, the floor 210 of the treatment room is a “hospital finished floor’ comprising a concrete floor base and a floor finish provided over the concrete floor base.

[0145] In some embodiments, the mounting pockets 231, 232, comprise openings that are coupled to conduits and / or ducts through which cables may be routed from the first scanner pillar 311 and / or from the second scanner pillar 312 to other components (e.g., through or under the floor), e.g., to connect components of the CT scanner and / or components mounted to or incorporated into the CT scanner to other components. In some embodiments, cables are provided to provide power to components mounted in the pit 250, the PRS, components supporting the PRS, and components thereof. For example, in some embodiments, cables provide power to the CT scanner (e.g., the imaging x-ray source and / or the CT detector), to motors that rotate the first and second scanner arms with respect to the scanner pillars, or to motors that translate the scanner ring. In some embodiments, cables provide control signals for activating and deactivating the CT scanner to obtain an image, to rotate the first and second scanner arms with respect to the scanner pillars, or to translate the scanner ring. In some embodiments, cables are provided to carry data from the CT scanner to a computer that processes CT image data. In some embodiments, cables provide power to the PRS. e.g., to rotate the PRS. In some embodiments, cables provide control signals to the PRS. In ASTO-41840.601 some embodiments, cables provide power to a PRS support, e.g., to move the PRS in the Z dimension. In some embodiments, cables are provided to carry data or control signals between the CT scanner components and a computer that collects data or comprises a control software for controlling the CT scanner. In some embodiments, cables are routed among a system cabinet, the CT scanner, PRS, and / or a user interface.

[0146] Next, in some embodiments, methods 1000 comprise mounting 1400 a pit plate 260 to the floor of the pit 250 and mounting pillar support plates 271, 272 in the mounting pockets 231, 232 provided in the floor 210 of the treatment room. See, e.g., FIG. 2F. In some embodiments, the pit plate 260 comprises an opening. While the pit plate 260 is shown comprising a circular opening, the technology is not limited to a pit plate 260 comprising a circular opening and a circular opening should be understood to be exemplary. Accordingly, the opening in the pit plate may be polygonal (e.g.. rectangular (e.g., square), triangular, hexagonal, etc.), oval, rounded rectangular, etc.

[0147] Mounting 1400 the pit plate 260 to the floor of the pit 250 and mounting pillar support plates 271, 272 in the mounting pockets 231, 232 provided in the floor 210 of the treatment room comprise suspending the pit plate 260 above the floor of the pit 250 and suspending the pillar support plates 271, 272 above the mounting pockets 271. 272. See, e.g., FIG. 2G.

[0148] In some embodiments, a “grout-in tool" 275 is used to support and suspend the pit plate 260 above the floor of the pit 250 and support and suspend the pillar support plates 271, 272 above the mounting pockets 271, 272. The grout-in tool 275 comprises a rigid beam that is removably coupled to the pit plate 260 and to the mounting pillar support plates 271, 272 to maintain their relative locations to each other in space while they are suspended and placed into position. In some embodiments, the grout in tool 275 comprises a beam having sufficient rigidity such that it does not substantially flex or deflect when supporting the pit plate 260 and mounting pillar support plates 271, 272. See, e.g.. FIG. 2H.

[0149] In some embodiments, a support assembly 276 is used to suspend the pit plate 260 above the floor of the pit 250 and to suspend the pillar support plates 271, 272 above the mounting pockets 271, 272. In some embodiments, the support assembly 276 suspends the grout-in tool 275, which is removably coupled to the pit plate 260 and to the mounting pillar support plates 271, 272. In some embodiments, the support assembly comprises two braced support legs, a cross beam, and an adjustable overhead support 277 suspended from the cross beam. In some embodiments, the overhead support 277 comprises a winch. In some embodiments, the overhead support 277 (e.g., ASTO-41840.601 the winch) is operably coupled to a number of chains, straps, or cables that support the grout-in tool 275 and thus indirectly support and suspend the pit plate 260 above the floor of the pit 250 and support and suspend the pillar support plates 271, 272 above the mounting pockets 271, 272. See, e.g., FIG. 21. Further, in some embodiments, the support assembly comprises lockable wheels and / or fine adjustment mechanisms to adjust the positions of the support assembly 276, pit plate 260, and / or pillar support plates 271, 272 in the X, Y, and Z dimensions for precisely locating the pit plate 260 and / or pillar support plates 271, 272 in space.

[0150] Further, in some embodiments, the grout in tool 275 comprises a number of leveling feet 278 that contact the floor 210 and that support both ends of the grout-in tool 275. At least one leveling foot 278 is provided on each end of the grout in tool 275, though more than one leveling foot may be provided on each end of the grout -in tool 275 (e.g., at least one first leveling foot 278 supports a first end of the grout-in tool 275 and at least one second leveling foot 278 supports a second end of the grout in tool 275). The leveling feet 278 are adjustable in the X, Y, and Z directions for precisely positioning the grout-in tool 275 in the X, Y, and Z directions and thus the leveling feet 278 are used to precisely position the pit plate 260 in the X, Y, and Z directions above the floor of the pit 250 and to precisely position the pillar support plates 271, 272 in the X, Y, and Z directions above the mounting pockets 271, 272. See. e.g., FIG. 2J. In some embodiments, a level is placed on the grout in tool to assist positioning and locating the grout-in tool and, thus, to assist positioning and locating the pit plate 260 in the X. Y, and Z directions above the floor of the pit 250 and to precisely position the pillar support plates 271, 272 in the X, Y, and Z directions above the mounting pockets 271, 272. In some embodiments, a number of laser level(s) (e.g., a Leica Tri plane laser (Leica LINO 6R) and / or a Leica Dual plane laser (Leica LINO L2)) is / are used to provide reference locations in the X. Y, and / or Z directions and / or to identify the isocenter 900 for assisting in positioning and locating the pit plate 260 in the X. Y, and Z directions above the floor of the pit 250 and to precisely position the pillar support plates 271. 272 in the X. Y, and Z directions above the mounting pockets 271, 272. For instance, embodiments provide that the pit plate 260 is normal or substantially normal to the Z axis (e.g., normal to a gravity vector) and / or that the pillar support plates 271, 272 are normal or substantially normal to the Z axis (e.g.. normal to a gravity vector).

[0151] Thus, in some embodiments, the position of the pit plate 260 is adjusted to be level in the X Y plane and normal to the axis of rotation of the PRS: and the position of the pit plate 260 is adjusted to be centered on the axis of rotation of the PRS, e.g., so ASTO-41840.601 that the isocenter and the center of the pit plate 260 are co axially aligned on the axis of rotation of the PRS.

[0152] As shown in FIG. 2K, in some embodiments, the grout-in tool 275 comprises a number of legs 279. In some embodiments, the legs 279 are adjustable in length to provide a range of lengths for the legs 279. In some embodiments, the grout-in tool 275 comprises a number of legs 279 that are removable and replaceable by legs 279 having a different length. As shown in FIG. 2K, in some embodiments, the grout-in tool 275 is used with shorter legs 279 (top) and, in some embodiments, the grout-in tool 275 is used with longer legs 279 (bottom). The grout in tool 275 is used with legs 279 having an appropriate length for the pit depth of the pit provided in the methods described herein. As described herein, various embodiments of the methods provide a pit 250 having a pit depth in the floor 210 ranging from 320 mm to 1070 mm (e.g.. 320 mm to 1070 mm below the level of the floor (e.g.. hospital finished floor)). Tn particular, embodiments of the grout-in tool 275 comprise legs 279 that are used to accommodate holding the pit plate at different positions for different pit depths, e.g., in some embodiments ranging from approximately 970 mm (e.g., for a 900 mm beam height) to 620 mm (e.g., for a 1250 mm beam height). In some embodiments, the grout-in tool 275 comprises legs 279 that are used to accommodate holding the pit plate at a height appropriate for a 1400- mm beam height. In some embodiments, the grout-in tool 275 comprises legs 279 that have a length of approximately 559 mm for a 1250-mm beam height. In some embodiments, the grout-in tool 275 comprises legs 279 that have a length of approximately 909 mm for a 900- mm beam height.

[0153] As shown in FIG. 2G, in some embodiments, the pillar support plates 271, 272 are suspended so that the top surfaces of the pillar support plates 271, 272 are at the same height as (e.g., flush with) the floor 210 and so that empty space is provided between the bottom surfaces of the pillar support plates 271, 272 and the floors of the mounting pockets 231, 232. In some embodiments, the floor 210 of the treatment room is a “hospital finished floor” comprising a concrete floor base and a floor finish provided over the concrete floor base. Accordingly, in some embodiments, the pillar support plates 271, 272 are suspended so that the top surfaces of the pillar support plates 271, 272 are at the same height as (e.g., flush with) the hospital finished floor and so that empty space is provided between the bottom surfaces of the pillar support plates 271, 272 and the floors of the mounting pockets 231, 232. Similarly, in some embodiments, the pit plate 260 is supported above the floor of the pit 250 so that approximately 1-5 cm (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, ASTO-41840.601

[0154] 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, or 5.0 cm) of empty space is provided between the bottom surface of the pit plate 260 and the floor of the pit 250. See. e.g., FIG. 2G.

[0155] In some embodiments, prior to the next step of pouring grout to anchor the pit plate 260 and mounting pillar support plates 271, 272, the positions of the pit plate 260 and mounting pillar support plates 271, 272 are checked using the targets provided on the walls, ceiling, and / or floor of the treatment room 200 marking the X, Y, and / or Z coordinates of the isocenter and a number of laser levels (e.g., a Leica Tri plane laser (Leica LINO 6R) and / or a Leica Dual plane laser (Leica LINO L2)) to locate the isocenter (e.g., to identify the position of the isocenter) in space.

[0156] Next, mounting 1400 the pit plate 260 to the floor of the pit 250 and mounting pillar support plates 271. 272 in the mounting pockets 231, 232 provided in the floor 210 of the treatment room comprise pouring a grout composition into the pit 250 and into the mounting pockets 231, 232 to flow under the suspended pit plate 260 and under pillar support plates 271, 272. In some embodiments, the grout is a selfdeveling grout. Methods 1000 comprise allowing the grout to harden, thereby anchoring the pit plate 260 to the floor of the pit 250 and anchoring the pillar support plates 271, 272 in the mounting pockets 231, 232. FIG. 2L shows grout composition 273 in mounting pocket 231, grout composition 274 in mounting pocket 232, and grout composition 261 in pit 250. Grout composition 273, grout composition 274, and grout composition 261 each harden to provide hardened grout composition 273, hardened grout composition 274. and hardened grout composition 261.

[0157] After the grout has hardened and thereby fixedly coupled the pit plate 260 to the floor of the pit 250, embodiments further comprise mechanically anchoring the pit plate 260 to the floor of the pit 250 and thus securely coupling the pit plate 260 to the physical building structure. In some embodiments, mechanically anchoring the pit plate 260 to the floor of the pit 250 comprises bolting the pit plate 260 to the floor of the pit 250. The type of mechanical anchor may vary depending on the building materials, location, and local seismic conditions. After the grout has hardened and thereby fixedly coupled the mounting pillar support plates 271, 272 in the mounting pockets 231, 232 provided in the floor 210, embodiments further comprise mechanically anchoring the mounting pillar support plates 271, 272 to the floor 210 and thus securely coupling the mounting pillar support plates 271, 272 to the physical building structure. In some embodiments, mechanically anchoring the mounting pillar support plates 271. 272 to the floor 210 comprises bolting each of the mounting pillar support plates 271, 272 to the floor 210. ASTO-41840.601

[0158] The type of mechanical anchor may vary depending on the building materials, location, and local seismic conditions.

[0159] In some embodiments, methods comprise mounting the PRS to the pit plate. Some embodiments of methods 1000 comprise mounting 1500 (e.g., translatably coupling) a pit ring 240 to the pit plate 260. In some embodiments, the pit ring 240 comprises a pit ring assembly 241 and a slewing bearing 242. First, in some embodiments, the pit ring assembly 241 is assembled (e.g.. from a number of pieces) and translatably coupled to the pit plate 260. Next, in some embodiments, the slewing bearing 242 is fixedly coupled to the pit ring assembly 241. FIG. 2M. In some embodiments, the PRS comprises levelling feet for adjusting the position of the PRS in the Z dimension.

[0160] In some embodiments, the pit plate 260 comprises a plurality of (e.g.. 2. 3, 4, 5. or more) threaded bolts 265: and the pit ring assembly 241 comprises a plurality of (e.g., 2. 3, 4, or 5) bolt holes 245 configured to mate with the threaded bolts 265 of the pit plate 260. FIG. 2N. After placing the pit ring assembly 241 onto the pit plate 260, nuts 269 are tightened onto the bolts 265 to secure the pit ring assembly 241 to the pit plate 260. In some embodiments, the bolt holes 245 mate with the bolts 265 with a tolerance of approximately 2 mm to allow for adjusting the location of the pit ring assembly 241 prior to securing the pit ring assembly 241 to the pit plate 260 by tightening the threaded nuts 269 onto the threaded bolts 265 (i.e., to fixedly couple the pit ring assembly 241 to the pit plate 260).

[0161] In some embodiments, placing the pit ring assembly 241 onto the pit plate 260 comprises using an alignment tool 268. FIG. 2N. The alignment tool 268 has a top and a base, and the diameter of the top is smaller than the diameter of the base. The alignment tool 268 comprises threads to mate with the threads of the bolts 265, and the alignment tool 268 is configured to be removably coupled to a bolt 265 by turning the alignment tool 268 such that the threads of the alignment tool 268 and the threads of the bolt 265 engage and secure the alignment tool 268 to the bolt 265.

[0162] As shown in FIG. 2N, embodiments of the technology provide methods 2000 comprising providing an alignment tool 268 to assist in placing the pit ring assembly 241 onto the pit plate 260. For example, in some embodiments, methods comprise removably coupling 2100 at least two alignment tools to each of at least two bolts of the pit plate. Next, embodiments of methods comprise mating 2200 the bolt holes of the pit ring assembly with the bolts and alignment tools of the pit plate and placing 2300 the pit ring assembly onto the pit plate. After removing 2400 the alignment tools from the ASTO-41840.601 bolts, methods comprise fixedly coupling 2500 the pit ring assembly to the pit plate by tightening nuts to the bolts. In some embodiments, methods comprise adjusting the location of the pit ring assembly prior to tightening the nuts to the bolts.

[0163] As described herein, some embodiments of mounting the PRS to the pit plate comprise installing the pit ring assembly individually and some embodiments of mounting the PRS to the pit plate comprise installing the pit ring assembly as a component of a PRS assembly (e.g., as a factory-assembled PRS assembly delivered to the installation site) comprising the pit ring assembly. Accordingly, it is to be understood that the methods 2000 provide for using the alignment tools to assist mounting the PRS to the pit plate in both types of installations.

[0164] Next, in some embodiments, methods comprise mounting a number of pushing blocks (e.g., pushing blocks 281, 282, 283) on the pit plate 260. In particular, in some embodiments, the pushing blocks 281 , 282, 283 are mounted (e.g., fixedly coupled) on the pit plate 260 around the pit ring 240 at intervals of 120° (e.g., essentially and / or substantially 120°) to be operatively engaged with the pit ring 240. See, e.g., FIG. 20. The pushing blocks (e.g., pushing blocks 281, 282, 283) are used to adjust the position of the slewing bearing 242 in the X, Y, and / or Z dimensions to be level and centered on the isocenter. In some embodiments, the pushing block translates the slewing bearing 242 a distance of 1 mm per 1 full rotation of the screw head in the pushing block. While the technology is described herein comprising three pushing blocks (e.g., pushing blocks 281, 282, 283), the technology is not limited to three pushing blocks and is not limited to three pushing blocks mounted on the pit plate 260 around the pit ring 240 at intervals of 120°. In some embodiments, four pushing blocks are mounted (e.g., fixedly coupled) on the pit plate 260 around the pit ring 240 at intervals of 90° (e.g., essentially and / or substantially 90°) to be operatively engaged with the pit ring 240. Embodiments comprising 2, 3, 4, 5, 6, 7. 8, or more pushing blocks are contemplated herein with the pushing blocks arranged at appropriate intervals around the pit ring 240 to adjust the position of the slewing bearing 242 in the X. Y, and / or Z dimensions as needed.

[0165] Next, embodiments of methods comprise assembling and mounting 1600 the PRS support 290 to the slewing bearing 242. In some embodiments, the PRS support comprises a Z plate 291, a first scissor lift 292, a second scissor lift 293 (not shown) opposite the first scissor lift 292, and an XY frame 294. FIG. 2P.

[0166] While some embodiments of methods provided herein describe mounting the PRS to the pit plate by installing the pit ring, PRS support, and PRS in separate steps; or, alternatively, installing the pit ring assembly, slewing bearing, Z plate, scissor lifts, XY ASTO-41840.601 frame, and PRS in one or more separate steps, some embodiments of methods comprise mounting the PRS to the pit plate by providing the pit ring assembly. PRS support (e.g., comprising the Z plate, the first scissor lift 292. the second scissor lift, and the XY frame), and PRS as a single PRS assembly (e.g., as a factory assembled PRS assembly delivered to the installation site) and installing the PRS assembly to the pit plate.

[0167] In some embodiments, embodiments of methods comprise assembling and mounting 1700 the CT scanner 300. First, methods comprise mounting a first scanner pillar 311 to a first pillar support plate of the pillar support plates 271, 272 and mounting a second scanner pillar 312 to a second pillar support plate of the pillar support plates 271, 272. FIG. 3A. In some embodiments, the first scanner pillar 311 and second scanner pillar 312 are placed on the pillar support plates 271, 272 but are not fully connected or bolted to the pillar support plates 271. 272 and are later fully connected or bolted to the pillar support plates 271. 272 after adjusting the positions of the first scanner pillar 311 and / or second scanner pillar 312.

[0168] Next, assembling and mounting 1700 the CT scanner 300 comprises attaching a first scanner arm 321 to the first scanner pillar 311 and attaching a second scanner arm 322 to the second scanner pillar 312. FIG. 3B.

[0169] In some embodiments, assembling and mounting 1700 the CT scanner 300 comprises using a scanner arm alignment tool 323. FIG. 3C. In particular, embodiments comprise removably coupling the scanner arm alignment tool 323 to the first scanner arm 321 and removably coupling the scanner arm alignment tool 323 to the second scanner arm 322 to maintain the first scanner arm 321 and the second scanner arm 322 in the correct locations during installation and adjustment of the components of the CT scanner 300 and, in particular, during installation and / or alignment of the first scanner arm 321 and the second scanner arm 322. In some embodiments, the scanner arm alignment tool 323 is removed from the CT scanner 300 after the first scanner arm 321 and the second scanner arm 322 are installed and / or aligned.

[0170] The first scanner arm 321 is rotatably coupled to the first scanner pillar 311 and the second scanner arm 322 is rotatably coupled to the second scanner pillar 312, e.g., the first scanner arm 321 is structured to rotate around an axis of rotation (e.g., axis p) relative to the first scanner pillar 311 and the second scanner arm 322 is structured to rotate around an axis of rotation (e.g., axis p) relative to the second scanner pillar 312. FIG. 3D. In some embodiments, the axis of rotation (e.g.. axis p) is parallel (e.g., substantially and / or effectively parallel) to the X axis of the coordinate system. ASTO-41840.601

[0171] The first scanner arm 321 comprises a first yoke 323 and the second scanner arm 322 comprises a second yoke 324. The first yoke 323 is translatably coupled to the first scanner arm 321 and the second yoke 324 is translatably coupled to the second scanner arm 322. Thus, the first yoke 323 is structured to translate along the first scanner arm 321 (e.g., along translation axis al) and the second yoke 324 is structured to translate along the second scanner arm 322 (e.g., along translation axis a2). Translation axis al and translation axis a2 rotate around axis of rotation p in coordination with the rotation of the first scanner arm 321 and the second scanner arm 322 around axis of rotation p. FIG. 3D.

[0172] Next, assembling and mounting 1700 the CT scanner 300 comprises attaching a scanner bridge 330 to the first scanner arm 321 and to the second scanner arm 322. FIG. 3E. In some embodiments, the scanner bridge 330 comprises markings on the surface of the scanner bridge 330 and the markings indicate the center of the scanner bridge 330 in the X and / or Y directions. The markings on the scanner bridge 330 find use in aligning the scanner bridge 330 to the remainder of the CT scanner and / or for aligning the CT scanner 300 to the PRS and / or to the isocenter.

[0173] Further, in some embodiments, assembling and mounting 1700 the CT scanner 300 comprises attaching a first counterweight 341 to the first scanner arm 321 and attaching a second counterweight 342 to the second scanner arm 322. FIG. 3E. Counterweights and counterweighting are described in, e.g., U.S. Pat. App. Pub. No. 2022 / 0183641, entitled “MULTI-AXIS MEDICAL IMAGING” and which is incorporated herein by reference.

[0174] As used herein, the first scanner arm, the second scanner arm, and the scanner bridge collectively provide a component of the CT scanner termed a “gantry”. In some embodiments, the gantry optionally comprises the first counterweight and the second counterweight,

[0175] Finally, assembling and mounting 1700 the CT scanner 300 comprises attaching a scanner ring 350 to the first yoke 323 and second yoke 324 of the first scanner arm 321 and second scanner arm 322, respectively. FIG. 3F. Embodiments of the assembled scanner are provided in, e.g., U.S. Pat. App. Pub. No. 2022 / 0183641, entitled “MULTIAXIS MEDICAL IMAGING” and which is incorporated herein by reference.

[0176] In some embodiments, assembling and mounting 1700 the CT scanner 300 comprises attaching covers on the CT scanner 300 (e.g., on the first scanner pillar 311, second scanner pillar 312, first scanner arm 321, second scanner arm 322, scanner ASTO-41840.601 bridge 330, and / or scanner ring 350. Drawings of the fully assembled CT scanner 300 are shown in FIG. 4A, FIG. 4B, and FIG. 4C.

[0177] Methods provided herein comprise installing 1800 the PRS 400 on the PRS support 290. FIG. 3G. in some embodiments, the PRS is a patient positioning apparatus as described in U.S. Pat. No. 11,529, 109, which is incorporated herein by reference. In some embodiments, the PRS is a patient support that is a component of a patient positioning system as described in U.S. Pat. App. Pub. No. 2023 / 0172566. which is incorporated herein by reference.

[0178] Drawings of the fully assembled CT scanner 300 and PRS 400 are shown in FIG. 4A, FIG. 4B. and FIG. 4C.

[0179] In some embodiments, the PRS comprises a back rest. In some embodiments, the back rest is removable. In some embodiments, the PRS comprises a seat. See, e.g.. FIG. 5B. Tn some embodiments, the seat comprises a ridge that functions to assist in positioning a seated patient on the seat. For example, in some embodiments, the ridge is located between the patient’s legs when the patient is seated. In some embodiments, the ridge finds use as a registration feature as described herein. See, e.g., FIG. 5B.

[0180] In some embodiments, methods comprise mounting a scanner pillar pushing block 284 to the scanner pillar support plate 272. FIG. 3H. As shown in FIG. 3H, the scanner pillar pushing block 284 comprises a threaded adjustment bolt 285 that contacts the scanner pillar 312 and is operatively engaged with the scanner pillar 312. Turning the adjustment bolt 285 pushes the scanner pillar 312 contacted by the adjustment bolt 285 with respect to the pillar support plate 272 in the X dimension. The scanner pillar pushing block 284 is used to locate and / or adjust the position of the scanner pillar 312 in the X dimension and thus finds use in locating and / or adjusting the location of the scanner ring in the X dimension (e.g., with respect to the beamline). While not shown in FIG. 3H. embodiments also comprise mounting a second scanner pillar pushing block 284 comprising a threaded adjustment bolt 285 to the scanner pillar support plate 271 where the adjustment bolt 285 is operatively engaged with the scanner pillar 311. Accordingly, turning the adjustment bolt 285 pushes the scanner pillar 311 contacted by the adjustment bolt 285 with respect to the pillar support plate 271. Thus, the positions of the scanner pillars 311, 312 can be adjusted across the beamline using the adjustment bolts 285 of the scanner pillar pushing blocks 284 mounted to the pillar support plates 271, 272. Further, embodiments provide that the scanner pillar pushing block(s) is / are removed after installing and adjusting the CT scanner as described herein. ASTO-41840.601

[0181] In some embodiments, embodiments of methods comprise installing a floor over gaps or holes in the floor 210. In some embodiments, embodiments of methods comprise installing a floor assembly around the PRS. For example, in some embodiments, methods comprise installing a floor assembly as described in Infl Pat. App. No. PCT / US2024 / 028106 (“FLOOR ASSEMBLY FOR PATIENT POSITIONING SYSTEM’), which is incorporated herein by reference. For example, embodiments provide a PRS including an opening formed in a floor, a carriage movable with respect to the opening, and a stack of plates coupled to the carriage. The stack of plates includes a first plate, a second plate, a spacer positioned between the first plate and the second plate, and a key coupled between the first plate and the second plate. The first plate is slidable with respect to the second plate. See, e.g.. Infl Pat, App. No. PCT / US2024 / 028106 (“FLOOR ASSEMBLY FOR PATIENT POSITIONING SYSTEM "), which is incorporated herein by reference.

[0182] In some embodiments, methods comprise aligning 1910 the PRS 400 to the isocenter 900. In some embodiments, methods comprise aligning a radiation source 600 with the PRS and / or aligning the PRS to the radiation source 600. In some embodiments, aligning the radiation source and the PRS is as described in Inti Pat. App. No. PCT / US2023 / 072346, which is incorporated herein by reference. For example, in some embodiments, methods comprise aligning a rotation axis of the PRS with the radiation beam. Some embodiments of methods comprise providing a reference target on the PRS, rotating the PRS about a rotation axis, detecting a radiation beam from the radiation source to produce images of the reference target located on the PRS, analyzing the images to determine a displacement of the PRS relative to the rotation axis, and adjusting the PRS to align the PRS relative to the rotation axis. In some embodiments, methods comprise adjusting the radiation source and / or RPS such that the central axis of the radiation beam intersects the rotation axis.

[0183] In some embodiments, methods comprise aligning 1920 the CT scanner to the PRS. In some embodiments, methods comprise providing a control system that monitors the positions of the PRS, the CT scanner, and / or the radiation beam to provide measured parameter values describing the positions of the PRS. CT scanner, and radiation beam relative to each other, relative to a frame of reference, and / or relative to a point (e.g., the origin of a coordinate system as described herein, the intersection of the radiation beam with the axis of rotation, etc.) in the space wherein the PRS, the CT scanner, and / or the radiation beam are located. In some embodiments, methods comprise providing target values for the positions of the PRS, the CT scanner, and / or the ASTO-41840.601 radiation beam relative to each other, relative to a frame of reference, and / or relative to a point (e.g., the origin of a coordinate system as described herein, the intersection of the radiation beam with the axis of rotation, etc.) in the space wherein the PRS, the CT scanner, and / or the radiation beam are located. In some embodiments, the control system determines a difference between one or more target values for the positions of the PRS, the CT scanner, and / or the radiation beam and one or more measured parameter values of the PRS. the CT scanner, and / or the radiation beam.

[0184] Accordingly, methods comprise measuring parameter values describing the positions of the PRS, CT scanner, and radiation beam relative to each other, relative to a frame of reference, and / or relative to a point (e.g., the origin of a coordinate system as described herein, the intersection of the radiation beam with the axis of rotation, etc.) in the space wherein the PRS, the CT scanner, and / or the radiation beam are located; and determining a difference between one or more target values for the positions of the PRS. the CT scanner, and / or the radiation beam and one or more measured parameter values of the PRS, the CT scanner, and / or the radiation beam.

[0185] In some embodiments, measuring the parameter values comprises providing a reference target (a “phantom ”) on the PRS and determining the position of the reference target. Further, in some embodiments, methods comprise providing a quality assurance (QA) device 500 (e.g., a phantom) for verifying alignment of the PRS to the isocenter and / or for verifying alignment of the CT scanner to the PRS. See, e.g., FIG. 5A. As shown in FIG. 5A, embodiments, a QA device 500 comprises a base 510. a body 520, and a marker 530. The base 510 comprises a registration feature 511 (e.g., an indent) on the bottom surface of the base 510. The body 520 is coupled to the top surface of the base 510. In some embodiments, the body 520 comprises a number of handles 521. In some embodiments, a user uses the handles 521 to move and position the QA device for use in a method to verify alignment of the PRS to the isocenter and / or for verifying alignment of the CT scanner to the PRS. The base 520 comprises a number of lines 522. 523 on a number of vertical surfaces. In particular, in some embodiments, the base 520 comprises a number of (e.g., 1, 2. 3, 4, 5. etc.) vertical lines 522 and / or a number of (e.g.. 1, 2, 3. 4, 5, etc.) horizontal lines 523 on one or more vertical surfaces. FIG. 5A shows vertical lines 522 and horizontal lines 523 on one surface of the QA device 500. However, embodiments provide a QA device 500 in which the four vertical surfaces comprise vertical lines 522 and horizontal lines 523 that continue around all four surfaces of the QA device 500. ASTO-41840.601

[0186] In some embodiments, the base 510 is made of a polymer such as a polyoxymethylene. In some embodiments, the body 520 is made of aluminum (e.g.. machined, assembled, and skimmed) or plastic. In some embodiments, the marker comprises a clear polymer (e.g., poly(methyl methacrylate), polycarbonate) and a marker 530. The marker 530 comprises a feature 531 that is discernible by a user when irradiated by the beam, when imaged with a camera, and / or when imaged by the CT scanner 300. In some embodiments, the feature 531 comprises a metal (e.g., a steel ball bearing having a diameter of approximately 1 cm (e.g., 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 1.1, 1.2, 1.3. 1.4, or 1.5 cm)).

[0187] FIG. 5B shows the QA device in an exemplary use. The PRS 400 is shown after removing the seat back from the PRS 400. The PRS 400 comprises a seat, and. in some embodiments, the seat comprises a registration feature 410. The QA device 500 is placed on the seat of the PRS 400, and the registration feature 511 of the QA device 500 mates with the registration feature 410 of the seat of the PRS 400. Mating of the registration feature 511 of the QA device 500 with the registration feature 410 of the seat of the PRS 400 positions the QA device 500 in a correct position for performing QA validation of the PRS 400 and / or CT scanner 300. FIG. 5B shows the axis of rotation 700 of the PRS and the isocenter 900.

[0188] In some embodiments, methods for performing QA validation of the PRS comprise placing the QA device on the PRS (e.g., on the seat of the PRS), irradiating the QA device with a horizontal laser (e.g.. as produced by a laser level), and rotating the QA device around the axis of rotation of the PRS. Validating the PRS comprises observing the laser on the surface of the QA device during rotation of the QA device and confirming that the laser remains positioned on a horizontal line that continues around all four faces of the QA device as the QA device is rotated around the axis of rotation of the PRS. In some embodiments, the horizontal laser is positioned to be coincident with the position of the beam when the beam is produced; accordingly, the laser finds use in providing a surrogate for the beam during QA validation of the PRS and / or CT scanner. In some embodiments, methods comprise correctly mating the registration feature of the seat with the registration feature of the QA device and / or confirming correct mating of the registration feature of the seat with the registration feature of the QA device. In some embodiments, a horizontal line of the QA device is used to level the QA device with respect to a horizontal laser. In some embodiments, a horizontal line of the QA device is placed to coincide with the isocenter. See, e.g., FIG. 5B. ASTO-41840.601

[0189] In some embodiments, methods for performing QA validation of the PRS comprise placing the QA device on the PRS (e.g., on the seat of the PRS) and imaging the QA device with an overhead camera (e.g., as provided by an optical guidance tracking system described in Int’l Pat. App. No. PCT / US2024 / 026297. incorporated herein by reference). In some embodiments, methods for performing QA validation of the PRS comprise placing the QA device on the PRS (e.g.. on the seat of the PRS), imaging the QA device with an overhead camera (e.g., as provided by an optical guidance tracking system described in Infl Pat. App. No. PCT / US2024 / 026297, incorporated herein by reference), and rotating the QA device around the axis of rotation of the PRS while imaging the QA device. Validating the PRS comprises observing the marker 530 and / or feature 531 of the QA device during rotation of the QA device and confirming that the marker 530 and / or feature 531 of the QA device remains centered within the field of view of the overhead camera and does not translate during rotation of the QA device.

[0190] In some embodiments, methods for QA validation comprise placing the QA device on the PRS (e.g.. on the seat of the PRS) and irradiating the QA device with the beam (e.g., a photon (e.g., an x-ray) or a hadron (e.g., a proton) beam). In some embodiments, methods for QA validation comprise placing the QA device on the PRS (e.g., on the seat of the PRS), locating the marker 530 and / or feature 531 of the QA device at the isocenter 900, irradiating the QA device with the beam (e.g., a photon (e.g., an x-ray) or a hadron (e.g., a proton) beam), and detecting scatter of the beam by the marker 530 and / or feature 531. In some embodiments, the marker comprises a radiolucent material (e.g., a plastic such as acrylic or polystyrene) in which is embedded a feature comprising a high- Z material (e.g., lead, stainless steel) that scatters the beam. Accordingly, when the marker is placed at the isocenter, the beam is scattered more by the feature when the beam is correctly aligned with the isocenter than when the beam is misaligned with the isocenter. Validation of the beam alignment with the PRS comprises confirming that the feature scatters the beam when the feature is placed at the isocenter. Furthermore, embodiments comprise rotating the QA device and irradiating the QA device while the QA device is rotating. Validation of the beam alignment with the PRS and / or validation of a correct location and orientation of the PRS with respect to the beam comprises observing that the marker continuously scatters the beam while the QA device is rotating (e.g., through one -half rotation, through one full rotation, or through more than one rotation). Furthermore, validation of the beam alignment with the PRS and / or validation of a correct location and orientation of the PRS with respect to the beam comprises observing that the marker scatters the beam without substantial variation in ASTO-41840.601 detectable scatter while the QA device is rotating (e.g., through one half rotation, through one full rotation, or through more than one rotation).

[0191] In some embodiments, methods for performing QA validation of the PRS comprise placing the QA device on the PRS (e.g., on the seat of the PRS) and imaging the QA device with the CT scanner 300. In some embodiments, methods for performing QA validation of the PRS comprise placing the QA device on the PRS (e.g., on the seat of the PRS), performing a first imaging the QA device with the CT scanner 300. rotating the QA device around the axis of rotation of the PRS to a new angle, and performing a second imaging the QA device with the CT scanner 300. Validating the PRS comprises observing the marker 530 and / or feature 531 of the QA device in a CT image and confirming that the marker 530 and / or feature 531 of the QA device is positioned correctly within the image produced by the CT scanner.

[0192] Some embodiments of methods comprise obtaining, providing, and / or determining an “imaging isocenter”, which is a point where the CT scanner and PRS are aligned. Some embodiments of methods comprise obtaining, providing, and / or determining a “treatment isocenter”, which is a point where the PRS is aligned to the treatment isocentre. In some embodiments, the imaging isocenter and the treatment isocenter are the same point. In some embodiments, the imaging isocenter and the treatment isocenter are different points. In some embodiments, the difference between the imaging isocenter and the treatment isocenter is approximately 0.1 to 10 mm (e.g., 0.1, 0.2, 0.3, 0.4, 0.5. 0.6, 0.7, 0.8. 0.9, 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8. 1.9, 2.0, 2.1,

[0193] 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,

[0194] 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, 6.0, 6.1, 6.2, 6.3,

[0195] 6.4. 6.5, 6.6, 6.7, 6.8, 6.9, 7.0, 7.1, 7.2, 7.3, 7.4. 7.5, 7.6, 7.7, 7.8, 7.9, 8.0, 8.1, 8.2, 8.3, 8.4.

[0196] 8.5. 8.6, 8.7, 8.8. 8.9, 9.0, 9.1, 9.2, 9.3, 9.4, 9.5. 9.6, 9.7, 9.8, 9.9, or 10.0 mm).

[0197] The alignment of the PRS and the radiation source is of high importance and should have a low tolerance and low error, e.g.. so that the radiation source is able to target the patient tissue accurately. The alignment of the CT scanner and the PRS is also of high importance and should have a low tolerance and low error, e.g.. so that imaging of the patient to plan treatment can be performed with a high accuracy. The CT scanner and the radiation source are mechanically linked to each other because they are both fixedly coupled to the floor.

[0198] In some embodiments, methods comprise locating and / or adjusting the position of the PRS. In some embodiments, methods comprise levelling the PRS by levelling the pit ring (e.g., by levelling the pit ring assembly and / or by levelling the slewing bearing). ASTO-41840.601

[0199] Further, in some embodiments, methods comprise locating and / or adjusting the position of the PRS in the Z dimension, e.g., by adjusting the levelling feet of the PRS (e.g., after the pit plate has been correctly set using the grout in tool). Is some embodiments, methods comprise locating and / or adjusting the position of the PRS in the X and / or Y dimensions using the pushing blocks to move the PRS. In some embodiments, methods comprise using the pushing blocks to adjust the position of the in the X. Y, and / or Z dimensions. Accordingly, methods comprise adjusting the location and / or position of the PRS to be level and centered on the isocenter.

[0200] In some embodiments, methods comprise locating and / or adjusting the location of the CT scanner. In some embodiments, methods comprise levelling the CT scanner by adjusting a number of adjustment bolts provided in the scanner pillars to raise and / or lower each scanner pillar with respect to each pillar support plate. In particular, in some embodiments, each adjustment bolt is threaded through a component at the base of a scanner pillar and contacts a pillar support plate so that turning the adjustment bolt in a first direction pushes against a pillar support plate to raise the appropriate scanner pillar and turning the adjustment bolt in a second direction lowers the appropriate scanner pillar. The grout in tool holds the pillar support plates level with respect to each other during installation and thus minimal adjustment of the adjustment bolt is typically performed. In some embodiments, methods comprise adjusting the position of the scanner ring in the Z dimension by locating and / or adjusting the position of the scanner ring on the first scanner arm and / or on the second scanner arm (e.g.. on the first yoke and / or on the second yoke). Further, in some embodiments, methods comprise adjusting the position of the scanner ring in the Z dimension by locating and / or adjusting the position of the scanner pillars and thus the scanner arms using the adjustment bolts, e.g., similarly as described above. In some embodiments, methods comprise locating and / or adjusting the scanner ring in the X dimension using a number of scanner pillar pushing blocks to move the CT scanner across the beamline, e.g.. using a number of scanner pillar pushing blocks bolted to the pillar support plates during installation and that contact and operatively engage with the scanner pillars. Turning a bolt in a scanner pillar pushing block pushes a scanner pillar contacted by the scanner pillar pushing block with respect to the pillar support plate. The scanner pillar pushing block(s) is / are removed after installing and adjusting the CT scanner. In some embodiments, methods comprise locating and / or adjusting the location of the scanner ring in the Y dimension by adjusting the scanner ring on the yokes with respect to the scanner arms. For example, in some embodiments, the scanner ring and / or yokes ASTO-41840.601 comprise an adjustable mounting component that may be adjusted to move the scanner ring into position.

[0201] Although the disclosure herein refers to certain illustrated embodiments, it is to be understood that these embodiments are presented by way of example and not by way of limitation. All publications and patents mentioned in the above specification are herein incorporated 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 technology as described. 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 obvious to those skilled in the art are intended to be within the scope of the following claims.

Claims

ASTO-41840.601CLAIMSWE CLAIM:

1. A method for installing a patient rotation system (PRS), said method comprising: identifying an isocenter in a treatment room comprising a room floor; providing a pit in the room floor, said pit having a pit floor; providing a PRS having a characteristic critical distance (C); identifying a beam height (B) as a distance from the room floor to the isocenter; identifying a pit depth (P) as a distance from the pit floor to the room floor, wherein P + B = C.

2. The method of claim 1, wherein the isocenter is at a point where a radiation beam intersects a vertical axis of rotation of the PRS.

3. The method of claim 1, wherein the isocenter is a treatment isocenter.

4. The method of claim 1, wherein B = approximately 850 mm to approximately1500 mm.

5. The method of claim 1, wherein C = approximately 1870 mm.

6. The method of claim 1, wherein P = approximately 320 mm to approximately1070 mm.

7. The method of claim 1, wherein the pit has a center substantially aligned on a vertical axis with the isocenter.

8. The method of claim 1, further comprising mounting a pit plate to the pit floor.

9. The method of claim 8, wherein mounting a pit plate to the pit floor comprises suspending the pit plate above the pit floor.

10. The method of claim 9, wherein suspending the pit plate above the pit floor comprises providing a support assembly to suspend the pit plate above the pit floor.ASTO-41840.60111. The method of claim 9, suspending the pit plate above the pit floor locates a bottom of the pit plate approximately 1 cm to 5 cm above the pit floor.

12. The method of claim 9, further comprising adjusting a position of the pit plate to be normal to a vertical axis of rotation of the PRS and centered on the axis of rotation of the PRS.

13. The method of claim 9, further comprising providing a grout under the pit plate and allowing the grout to harden.

14. The method of claim 8, further comprising mounting the PRS to the pit plate.

15. The method of claim 14. wherein mounting the PRS to the pit plate comprises- mounting a pit ring to the pit plate, wherein said pit ring comprises a pit ring assembly and a slewing bearing; and mounting a number of pushing blocks to the pit plate, wherein said pushing blocks are operatively engaged with the slewing bearing.

16. The method of claim 15, further comprising adjusting a position of the slewing bearing using the pushing blocks.

17. The method of claim 15, further comprising mounting a PRS support to the slewing bearing, wherein the PRS support comprises a Z plate and a scissor lift.

18. The method of claim 14, further comprising aligning the PRS to the isocenter.

19. The method of claim 14, further comprising installing a floor assembly around the PRS.

20. A method for installing a medical imaging apparatus, the method comprising: identifying an isocenter in a treatment room comprising a room floor; mounting a first pillar support plate to the room floor; mounting a second pillar support plate to the room floor; mounting a first scanner pillar to the first pillar support plate!ASTO-41840.601 mounting a second scanner pillar to the second pillar support plate; attaching a first scanner arm to the first scanner pillar and attaching a second scanner arm to the second scanner pillar, wherein the first scanner arm comprises a first yoke structured to translate along the first scanner arm and the second scanner arm comprises a second yoke structured to translate along the second scanner arm; attaching a scanner bridge to the first scanner arm and to the second scanner arm; and attaching a scanner ring to the first yoke and to the second yoke.

21. The method of claim 20. wherein the first scanner arm is rotatably coupled to the first scanner pillar and the second scanner arm is rotatably coupled to the second scanner pillar.

22. The method of claim 20, further comprising attaching a first counterweight to the first scanner arm and attaching a second counterweight to the second scanner arm.

23. The method of claim 20. wherein mounting the first and second pillar support plates to the room floor comprises suspending the first and second pillar support plates above a first mounting pocket and a second mounting pocket provided in the room floor.

24. The method of claim 23. further comprising providing a grout under the first and second pillar support plates and allowing the grout to harden.

25. The method of claim 20. wherein mounting the first and second pillar support plates to the room floor provides the first and second pillar support plates to be level with a hospital finished floor of a treatment room.

26. A method of installing an integrated imaging and radiation treatment system, said method comprising: installing a patient rotation system (PRS) aligned to a treatment isocenter; and installing a CT scanner aligned to an imaging isocenter.ASTO-41840.60127. The method of claim 26. wherein the treatment isocenter and the imaging isocenter are substantially the same point.

28. The method of claim 26. wherein the treatment isocenter and the imaging isocenter differ by approximately 0. 1 mm to 10 mm.

29. The method of claim 26. wherein the PRS has an axis of rotation passing through the treatment isocenter.

30. The method of claim 26. wherein a radiation beam passes through the treatment isocenter.

31. The method of claim 26. further comprising aligning the PRS to a radiation beam.

32. The method of claim 26. further comprising aligning the CT scanner to the PRS.

33. The method of claim 26. further comprising validating the installation of the PRS and / or of the CT scanner.

34. The method of claim 33. wherein validating the installation of the PRS and / or of the CT scanner comprises using a quality assurance device.

35. The method of claim 33. wherein validating the installation of the PRS and / or of the CT scanner comprises rotating the PRS.

36. The method of claim 33. wherein the quality assurance device is located on a seat of the PRS.

37. The method of claim 36. wherein the quality assurance device comprises a first registration feature and the seat comprises a second registration feature, and the first registration feature and the second registration feature have complementary shapes.

Images