High-capacity adaptive therapy with extended treatment volume using mobile robots

Abstract

Mobile adjustable patient supports that facilitate gantry-based and non-gantry based radiation treatments are provided herein. Mobile adjustable patient supports can include a patient support that transitions between multiple configurations, including a supine, seated and standing positions and which can be moved within the treatment area as well as transport the patient to and from the treatment area and facilitate patient setup away from the treatment area. Mobile adjustable linac robots are also provided and facilitate non-gantry based radiation treatment in any suitable location. Mobile linac robots can include a linac that is adjustable by positioning mechanisms extending from a wheeled base. One or more such robots can be positioned, along with one or more imager robots, to facilitate radiotherapy in any suitable location without requiring any equipment fixed in place. Multiple linac robots can be used for multi-directional rapid treatment and / or rapid treatment of multiple sites for metastatic cancers.

Description

PATENTAtorney Docket No.: 107838-000510PC-1514061HIGH-CAPACITY ADAPTIVE THERAPY WITH EXTENDED TREATMENT VOLUME USING MOBILE ROBOTSCROSS-REFERENCES TO RELATED APPLICATIONS

[0001] This application claims the benefit of priority of U.S. Non-Provisional Patent Application No. 63 / 697,301 filed September 20, 2024, the entire contents of which are incorporated herein by reference for all purposes.FIELD OF ART

[0002] The present invention relates generally to the field of radiation therapy.BACKGROUND

[0003] Major technical advances in radiation therapy in the past two decades have provided marked improvements in delivering doses to targets with precision and accuracy. Linear accelerator (“linac”) based radiotherapy systems and methods have continued to improve and have become increasingly accurate and more rapid. This has led to more availability of treatments for difficult-to-access cancers and for treatment of multiple target sites associated with metastatic cancers wherein multiple treatment sites are treated in a single session.

[0003] While these advances have improved treatment outcomes for many patients, particularly those having metastatic cancers with multiple lesions, there remain considerable challenges with current treatment systems and methods. Such challenges include the substantial cost of equipment and installation, which typically requires extensive construction and securing of heavy equipment within a specially built gantry, and can entail building a pit where mounting equipment is incorporated into the structure of a concrete radiation vault. Other challenges of current treatments include inadequate treatment volumes to address all target sites, excessive setup time, and excessive treatment delivery times. These issues substantially limit the availability of current radiotherapy systems and limit patient throughput Further, these issues are compounded when treating patients with multiple target sites associated with metastatic cancers since the patient setup is often performed repeatedlybefore treatment of each additional target site. Thus, there remains a need for improved treatment systems, devices, and methods that address the above-noted issues.BRIEF SUMMARY

[0003] The present invention pertains to use of mobile robotic units that improve versatility of radiotherapy systems, and that further extend treatment volumes, and reduce patient setup and treatment delivery times.

[0004] In one aspect, the invention pertains to a radiation therapy system that includes: one or more positional sensors defining a reference frame of the system in a treatment area; a linear accelerator (linac) configured for radiation treatment of one or more targets; a mobile patient robot that includes a patient support that is adjustable by one or more positioning mechanisms extending from a mobile base; and a controller configured for determining a position of and controlling movement of the mobile patient robot relative the reference frame and adjustment of the patient support to facilitate radiotherapy. In some embodiments, the patient support is configured to assume differing configurations that includes: a supine position, a seated position and a standing position. In some embodiments, the system further includes a mobile linac robot that includes the linac that is adjustable by one or more positioning mechanisms extending from a mobile base of the mobile linac robot.

[0005] In another aspect, the invention pertains to a method of radiation treatment that includes steps of: positioning a patient in a patient support of a mobile patient robot in preparation for radiotherapy; transporting the patient to a treatment area of the radiotherapy system; determining a position of the mobile patient robot relative a frame of reference of the radiotherapy system by use of one or more positional sensors; and performing radiotherapy on the patient while positioned in the mobile patient robot and subsequently transporting the patient from the treatment area. In some embodiments, the radiotherapy system comprises a linac mounted on a gantry or a robotic arm secured at a fixed location in a treatment room. In some embodiments, the one or more positional sensors are mounted on the gantry or the robotic arm. In some embodiments, the radiotherapy system comprises the mobile patient robot and one or more mobile linac robots such that the radiotherapy system is without any gantry. In some embodiments, the method further entails: positioning the one or more mobile linac robots within the treatment area; determining a position of the one or more linac robots relative the frame of reference of the radiotherapy system by use of the one or more positional sensors; and performing radiotherapy on the patient while positioned in the mobilepatient robot via one or more linacs of the one or more mobile linac robots. In some embodiments, the one or more mobile linac robots comprise a plurality of mobile linac robots.BRIEF DESCRIPTION OF THE DRAWINGS

[0006] FIG. 1 shows a schematic of a radiotherapy system utilizing a mobile patient robot and mobile linac robot, in accordance with some embodiments.

[0007] FIG. 2A shows an exemplary system having a mobile adjustable patient support used with a gantry-based therapy system, in accordance with some embodiments.

[0008] FIG. 2B shows an exemplary system having a mobile adjustable patient support and mobile linac and imager robots, in accordance with some embodiments.

[0009] FIG. 2C shows an exemplary system having a mobile adjustable patient robot and multiple mobile adjustable linacs and imager robots

[0010] FIG. 2D and 2E show a mobile adjustable patient support used with a radiotherapy system with a C-arm mounted linac and a radiotherapy system with a robotic arm mounted linac, respectively, in accordance with some embodiments.

[0011] FIGS. 3A-3B shows a mobile patient robot, in accordance with some embodiments.

[0012] FIG. 4 shows a mobile linac robot, in accordance with some embodiments.

[0013] FIG. 5 shows an exemplary omnidirectional drive that can be used within the wheeled mobile base of the mobile patient robot, in accordance with some embodiments.

[0014] FIG. 6 shows an exemplary hexapod motion platform that can be used with a mobile adjustable linac robot, in accordance with some embodiments.

[0015] FIG. 7 shows mobile linac robot with a scissor lift, in accordance with some embodiments.

[0016] FIG. 8 shows an exemplary workflow for performing radiotherapy with a mobile patient robot, in accordance with some embodiments.

[0017] FIG. 9 shows an exemplary method of treating using a system having a mobile patient robot and a mobile linac robot, in accordance with some embodiments.

[0018] FIG. 10 shows an exemplary method of treating using a system having multiple linac robots, in accordance with some embodiments.DETAILED DESCRIPTION

[0019] The present invention relates generally to the field of radiation therapy, and in particular, pertains to use of mobile robotic units to improve versatility of radiotherapy systems, extend treatment volumes, and reduce patient setup and treatment delivery times.I. System Overview

[0020] While marked advancement have been made in recent decades, current radiotherapy systems still face certain challenges that limit efficiency and availability of treatment. These challenges include inadequate targetable volume and prolonged setup times and delivery times. Additional challenges induce the high costs of equipment, due partly to the considerable costs of building and installing heavy equipment within specialized radiation vaults.

[0021] In regard to inadequate targetable volumes, the need to treat multiple tumors in disparate parts of the body is increasing, especially with the emerging paradigm of comprehensive radioablation of metastases. The largest addressable volumes in current radiotherapy machines is approximately a cylinder of 50 cm diameter and 130 cm length. This is well below whole body access. Treatment of targets beyond the accessible volume of a given machine typically requires repositioning of the patient relative to the machine between treatments of individual targets. This is a highly time consuming and error prone process, and limits the number of targets that can be treated in a given patient and also decreases patient throughput / capacity of the treatment system. In specialized centers, total body or total skin irradiation can be performed by positioning the patient in a dedicated location at an extended distance from the radiation source. However, this approach is not suitable for treatment for many patients having internal target sites, such as solid tumors or lesions on specific organs.

[0022] In regard to prolonged setup times, in current radiotherapy environments, patients must be set up in the treatment room, often with customized positioning devices, which takes substantial time that takes away from available treatment time on the machine. In a typical US treatment time slot of 15 minutes for simple treatments, approximately 10 minutes is used for patient entrance / exit / transportation and setup, and 5 minutes for imaging / verification andtreatment delivery time. Complex treatments and setups can take much longer, such as 45-60 minutes, or even longer in the case of general anesthesia administration for certain patient populations like children. For example, when treating metastatic cancers having multiple target sites, there may be a need to reposition and patient multiple times between differing target sites, which substantially prolongs the session and accordingly limits patient throughput.

[0023] In regard to prolonged delivery times, current x-ray radiotherapy systems are limited by the output of a single conventional linac, with typical delivery times in the range of 2-5 minutes. Delivery time can be reduced by orders of magnitude with a new class of much more efficient, high-output linac, optimizing source-to-subject distance within each treatment plan, and delivering with multiple linacs from different beam directions simultaneously.

[0024] In order to address the above-noted challenges and inefficiencies, the system describes herein take advantage of advances in mobile robotics as well as recent developments in compact, power-efficient linacs in order to extend treatment volumes, reduce patient setup time and reduce treatment delivery time. Additionally, these advances allow for improved versatility of the system, which can utilized mobile robots without requiring extensive construction and installation of capital equipment or inegration within costly radiation vaults.

[0025] In one aspect, the invention pertains to a mobile patient support robot that can move the patient to various differing positions far beyond the capabilities of conventional patient support tables and chairs, thereby extending the available treatment volumes without requiring repeat setup and repositioning of the patient. Such mobile patient robots can also be used to transport the patient to and from the treatment area and to allow patient setup away from the treatment area. Such patient support robots can be used to faciltiate gantry -based radiation therapies as well as non-gantry based systems, for example, those using one or more mobile adjustable linac robots.

[0026] In regard to the reference frame, a stable rigid structure within the treatment room can serve as the spatial point of reference for spatial positioning and movements of all other components. This structure need not be any costly or specialized equipment and can include an existing part of the room or a simple, inexpensive fixture readily mounted within the room. In some embodiments, the frame of reference is the treatment room itself, whichserves as the reference point from which the mobile components of the system can be determined. For example, in some embodiments, the reference frame can be any part of the treatment room, or a frame or gantry extending along the treatment area and from which the positions of the patient support and / or linac is determined. In other embodiments, the reference frame or point may be the patient support itself, or any mobile components of the system (e.g. a movable robot). Thus, in some embodiments, the system component positions can be determined / coordinated by relative positions of the components within the system.

[0027] As shown in FIG 1, the reference frame 101 can be defined as the treatment room or associated fixture. The positions of all components will be determined relative to the reference frame using one or more positioning sensors 102, which can be active or passive, including technologies such as optical cameras / imagers, LIDAR, millimeter wave scanners, RFID, X-ray imagers, or others. In some embodiments, the positioning sensor 102 detects a corresponding marker or sensor 115, 125 of each of the robots and can further obtain additional positioning information from each component (e.g. by wireless communication or any suitable means). Markers can include a visual pattern, AR tag, QR code or any suitable marker, and sensors can include range (e.g. LiDAR, ultrasonic, radar), vision (e.g. cameras), beacon (e.g. wireless, infrared, GPS) or any suitable localization sensor. It is appreciated that marker or sensor can be used on any of the mobile robots in FIGS. 1-7. Conversely, rather than sensors in the room detecting the position of the robot, sensors on the robot (cameras or other sensors) can determine the robot’s position relative to the environment, with or without using reference markers in the room. Positional and movement accuracy can be maintained through a feedback and correction system relative to the reference frame 101. This approach replaces a conventional spatial reference point such as the mechanical rotational isocenter within a treatment machine or conventional stereotactic frames.

[0028] The components of the system can include any of a mobile patient robot 110 and a mobile linac robot 120. The system can further include an imager 124 that is integrated with the linac robot or included within a separate mobile robot. As shown, the mobile patient robot 110 can include a patient support 111 that can support the patient P in various differing orientations, including an upright orientation that extends the available treatment volume. In some embodiments, the support can transition between multiple configurations, such as a supine position, a seated position, and a standing position. The mobile patient robot 110 further includes a positioning mechanism 112, which can reconfigure the support in the various different configuration or orientations and a wheeled mobile base 113, which canmove the patient robot 110 with high precision for patient positioning in the treatment area for treatment, and which can further be used to transport the patient P to and from the treatment room. While a wheeled base is described in various embodiments, it is appreciated that other mobile mechanisms can be used, such as tank tracks, air cushion, magnetic levitation, or any other suitable mobile means could be used with certain potential advantages. Besides robot mounted patient positioning systems, robot mounted linacs, robot mounted imagers / scanners, the system can also include robot mounted shields that can be repositioned to shield the radiation beam from a corresponding radiation source (e.g., linac) that is transmitted through the patient, which would reduce the required shielding in the walls of the treatment room and reduce room construction costs. Additionally, the robots can include a mechanism to temporarily anchor their position within the room if it is desired to fix their location in the room during treatment delivery for greater positional stability. In some embodiments, there can be fixed anchoring points within the room for the robots, or a mechanism to anchor to arbitrary locations within the room. For example, a retractable magnet on the robot that can anchor to a metallic floor or portions of the floor. There are multiple other mechanisms that could be used for repositionable anchoring.

[0029] The mobile linac robot 120 includes a compact linac 121, which can be moved to various differing orientations and positions (e.g. up / down, pitch / yaw) in order to direct the treatment beam to a target in the patient P from differing treatment angles as needed. The mobile linac robot 120 further includes positioning mechanism 122 which can reconfigure the linac in the differing orientations and positions (e.g., left / right, forward / rearward, yaw), and a wheeled mobile base 123, which can move the linac in the treatment area with high precision for positioning before or during treatment, and which can further be used to transport the linac to and from the treatment area. In some embodiments, the linac robot can include an integrated imager 124 as shown, or the imager can be provided within a separate mobile robot.A. Gantry Based System

[0030] As shown in FIG. 2A, concepts described herein can be utilized in a gantry -based system 200 that supports and moves the linac 221 during treatment. Such systems typically include an integrated imager 224 (e.g. MRI, cone-beam CT, etc.) for image guidance during radiotherapy. Such system could use conventional x-ray, proton beam, ion beam, neutron beam, electron beam, etc. In such embodiments, the gantry serves as the reference frame 201and the mobile patient support 110 can transport the patient P to the system, support the patient in differing positions and move the patient support with precision relative the system. Advantageously, this mobile patient robot 110 avoids the need for an integrated patient table / support integrated with the system or installed in the treatment room floor, as is common in conventional systems. Thus, the mobile patient robot 110 allows for more versatility in orienting, positioning for patient setup and further improves workflow by transporting the patient to and from the treatment system 200. For example, the patient support could assume a typical supine position for some patient treatments, and assume a standing position extended treatment volume for other patient treatments. FIG. 2D shows a mobile adjustable patient support 110 used with a radiotherapy system with a C-arm mounted linac 140. FIG. 2E show a mobile adjustable patient support 110 used with a radiotherapy system having a linac 151 mounted on a robotic arm 150. It is appreciated that these setups can utilize any of the localization and tracking approaches and features described herein.B. Mobile Systems

[0031] As shown in FIG. 2B, concepts described herein can be applied to a non-gantry based system 300 having mobile components that can include the mobile patient robot 110, the mobile linac robot 120. Non-gantry based could also be any fixed beamline treatment system that is not mobile. Such systems could use conventional x-ray, proton beam, ion beam, neutron beam, electron beam, etc. In this embodiment, the reference frame 101 can be part of the treatment room itself, and can utilize a positioning sensor 102 disposed in the room or fixture mounted in the room. The system can further include an image integrated with the linac robot or disposed in a separate mobile imager robot 130. Such systems have the advantages of not requiring the size and expense of a gantry, or any permanent mounting of large heavy components. This allows versatility in that the system can be deployed in any suitably sized vault or room with sufficient radiation shielding.C. Multiple Linac Systems

[0032] As shown in FIG. 2C, the concepts described herein can further utilize a fleet of mobile linac robots 130 for a given treatment as well as the mobile patient robot 110 described above. By utilizing the treatment room as the reference frame, the positioning sensor 102 can determine the relative positions of the multiple robots relative each other so as to position the multiple linac robots 120 relative the patient according to a given treatment plan. The positioning sensors can be room based or robot based, as long as the sensorsprovide accurate positioning information for all robots relative to a reference frame and / or each other. The system can further include imagers integrated within the linac robots or separate imager robots 130 that can be controlled in a same or similar manner as the linac robots. Such systems have the advantage of being able to provide more efficient treatment in directing multiple treatment beams to a given target concurrently or in rapid succession. In some embodiments, this may entail delivering radiation from multiple directions concurrently or in rapid succession so as to deliver an entire fraction or entire dose of radiation without requiring repositioning of the patient or linacs. This approach allows for FLASH therapy or delivery of an entire treatment dose in a short period of time (e.g. less than 10 seconds). In other embodiments, this may entail utilizing different linacs to direct radiation at different targets in the patient, such as in treating metastatic cancer. Such an approach greatly reduces the overall treatment time as multiple sites can be treated concurrently or in rapid succession without requiring repositioning of the patient between treating of different targets.II. Mobile Adjustable Patient Support Robot

[0033] As described previously, in one aspect, the invention pertains to a mobile patient support robot for maneuvering the patient. The mobile patient robot can also be used for transporting the patient to and from the treatment area. This is further advantageous and efficient as compared to conventional approaches as a patient can be positioned and prepared for a procedure in one mobile patient support, while a prior patient is being treated while in another mobile patient support. Thus, the use of the mobile patient support for transporting the patient to and from the treatment area further streamlines workflow, thereby increasing patient throughput.

[0034] FIGS. 3A-3B shows an exemplary mobile patient robot 110 that includes a patient support 111, positioning mechanism 112, and wheeled mobile base 113. The positioning mechanism 112 can adjust the patient support 111 to various differing configurations, including a supine position, a seated position and a vertical standing position that extends available treatment volume and can further include additional patient restraints / support features (not shown). The mobile patient robot can further include positional sensors or markers 115 and a control unit 116 that wirelessly communicates with a central control unit of the system that commands and controls movements of the robot for transport of the patient and positioning of the patient for the radiotherapy procedure. As described herein, a controlunit can include a processor and a memory having executable instructions recorded thereon for performing one or more of the functions described herein.

[0035] In some embodiments, the mobile patient robot can be configured to provide any of the following features or any combination thereof: a) tracking / localization; b) posture modulation and stabilization; c) dynamic positioning; and d) patient transport.

[0036] a. Tracking / localization entails precision monitoring of in room position relative to the reference frame through sensors (e.g. cameras, RFID in room "GPS," etc.) in order to provide feedback to the mobile patient robot and dynamic beam control for precision delivery.

[0037] b. Posture modulation and stabilization includes modulating between various positions, including any of: lying, sitting, standing, perched posture with stabilization aids (cushions, shin brace, harness, etc.) including components such as seat, backrest, headrest, footrest. Preferably, components that may be in the radiation (treatment or imaging) beam path(s) should be constructed from minimally attenuating materials such as carbon fiber composites. Transitions between the positions (such as sitting to standing) can be accomplished by appropriate movements of the positioning components.

[0038] c. Dynamic positioning can include any of various mechanisms to provide dynamic and precision movement. In some embodiments, this includes use of a motion base with holonomic drive (e.g. Mecanum [a.k.a., Swedish or lion] wheel drive, omniwheel, Kiwi drive, etc.), which provides 2-D translation with zero turning radius and rotation about an arbitrary vertical axis, and combinations of translation and rotation for 3 degrees of freedom, and unlimited range within the treatment room. Among other options, this approach enables seamless variation of source-to-subject distance, unlimited within the room. In some embodiments, the posture modulation mechanism provides a limited amount of vertical translation and pitch, for 5 total degrees of freedom. Position can be modulated between beams or during beams for dynamic trajectory delivery unlimited within the room.

[0039] d. Patient transport can include manual or automated transport of the patient in / near the treatment position in / out of the treatment room to optimize in-room time, minimize patient transfers, and maximize patient throughput and comfort. Ideally, this includes untethered (e.g. battery powered), with recharging at a docking station. Preferably, localization of the mobile patient robot outside of the treatment room within the clinic / department will be tracked by sensors and active or passive position reporting / detectionby / of the mobile patient robot relayed to a command center to facilitate optimal patient flow / traffic monitoring and control. Another variation would be for the mobile patient robot to follow marked routes such as colored lines or reflectors on the ground or RF beacons placed along the route, or similar concepts.

[0040] Advantageously, the mobile patient robot overcomes the issue of prolonged setup time in the room, since a stable treatment position can be established within the mobile patient robot prior to entry to the treatment room to maximize the utilization of the treatment room for delivery time. Multiple mobile patient robots can be used to set up different patients simultaneously for transport in and out of the treatment room in rapid succession. Delivery time and treatment room size can be minimized because the large size and slow movement of rotating treatment gantries can be replaced by patient rotation using the mobile patient robot. This solves part of the problem of limited treatment target volume by enabling easy variation of the source-to-subject distance anywhere within the treatment room, and also any amount of translation parallel to the plane of the floor within the treatment room. In combination with movement of the radiation source, arbitrary height (perpendicular to the floor) can be reached within the treatment room. Preferably, the mobile patient robot would be compatible with practically all available radiation delivery platforms, including gantry based and fixed beam. When used with gantry based (or mobile treatment head) systems, near 4-pi beam access can be possible.III. Mobile Adjustable Linac and Imager Robots

[0041] In another aspect, the invention pertains to a mobile adjustable linac robot, which can adjust a position and / or orientation of the linac and move the linac to differing positions within the treatment area of the treatment room by use of a wheeled mobile base. An example of such a mobile adjustable linac and associated components are shown in FIG. 1, 4 and 7. As shown in FIGS. 1 and 4, the mobile linac robot 120 includes a linac 121 supported on and adjustable by positioning mechanisms 122 that is mounted on a wheeled mobile base 123. FIG. 6 shows an exemplary motion platform with a hexapod positioning mechanism 122’ on which the linac can be mounted. While a hexapod motion platform is shown, it is appreciated that various other motion platforms and mechanisms could be used. The positioning mechanism can further include a scissor-lift for up / down movement of the linac. It is appreciated that the mobile linac robot can include any combination of the above elements.

[0042] In some embodiments, the mobile adjustable linac robot can include any of the following features: a) linac mounted on motion stage / platform; b) mobile base unit; c) adjustable / positionable mechanism and controller; and d) compact highly efficient linac.

[0043] a. Linac, including power source and associated component (e.g., magnetron) can be mounted on a motion stage (e.g. at least 1 degree of swivel, or plus vertical travel, or full 6D), such as a hexapod platform (a.k.a., Stewart), such as shown in FIG. 6, and which can be potentially combined with vertical translation lift (e.g. scissor lift), as shown in FIG. 7. In some embodiments, the positioning mechanisms can include a multi-articulated robotic arm. Preferably, the swivel action, especially if 2D, in combination with translation, can provide whole body beam access (e.g., up to 2.5 m range), or even more if combined with extended source-to-subject distance. If the unit is a fixed location in the treatment room, there is a coni cal / py rami dal solid angle of beam access. In some embodiments, combined with patient rotation or rotation around the patient, there is a toroidal solid angle of beam access, potentially close to 4-pi. It is appreciated that swivel action allows always directing the most intense central portion of the bremsstrahlung x-ray beam to cover target volume of a large range of size and location without resorting to using the less intense off-axis portion of the beam. This increases delivery efficiency and decreases treatment time. Swivel action can also be used for dynamic target motion tracking if needed.

[0030] b. Mobile Base Unit. The unit is mobile by mounting on a transportation base (e.g., holonomic drive platform) to add additional degrees of freedom, including dynamic trajectory delivery and variable source-to-subject distance even with a static patient positioning system. In some embodiments, the linac robot is hardwired to a power source. In some embodiments, the linac robot is untethered (e.g. battery powered) and can be recharging at a docking station.

[0030] c. Positioning Mechanism. Position / orientation of the linac on the robot is monitored and can be further adjusted relative to the reference frame. The robot can include a control unit that is communicatively coupled to a central controller and that adjusted the location and / or orientation of the mobile base as well as the position and / or orientation of the linac relative the mobile base in order to achieve a treatment angle and beam trajectory to the target in accordance with a treatment plan. In some embodiments, the linac can be adjusted along 4D or even 6D of freedom to allow for improved access to the target.

[0030] d. Compact, Hi h-Efficient Linac Design. The linac robot unit described above is made practical by use of a compact, power-efficient linac design. Various conventionallinacs may be used. In some embodiments, the linac design is in accordance with that described in U.S. Patent Publication No. 2023 / 0380047, incorporated by reference herein.

[0030] In yet another aspect, the system includes an imager, which images the patient for imaging of the patient for target verification and image guidance during radiotherapy. In some embodiments, the imager is included within a separate mobile imaging robot. The imager robot can include any of the following features: X-ray, optical, mm-wave, or other imaging sources and detectors on similar mobile platforms to above provide volumetric imaging with patients in arbitrary posture or orientation, potentially combined with data from other sensors either fixed in the room or also mobile.

[0030] In still another aspect, the system can include multiple linac robots and / or imager robots in order to further improve efficiency in dose delivery and / or to treat multiple targets concurrently or in rapid succession. In some implementations, multiple mobile linac robots provide multiple simultaneous beam angles and multiplication of the delivery speed, which can be realized at rapid speeds, including up to FLASH speed. In some embodiments, in a multi -room configuration, the number of linac robots can be dynamically reapportioned between rooms according to the needs of treatment plans being delivered. Similar principles apply to tracking, control and coordination of the imaging robots described above.IV. Methods of Treatment

[0044] FIGS. 8-10 depict exemplary methods of treating a patient that utilize one or more mobile robotic unit, as described above. It is appreciated that these methods could include one or more additional robotic units, such as the imager units described above, or could include various other steps or combination of steps.

[0045] As shown in FIG. 8, the treatment method includes steps of: positioning a patient in a patient support of a mobile patient robot in preparation for radiotherapy; transporting the patient to the radiotherapy system to perform radiotherapy; determining a position of the mobile patient robot relative a frame of reference of the radiotherapy system by use of one or more positional sensors; and performing radiotherapy on the patient positioned in the mobile patient robot and transporting the patient from the system via the mobile patient robot. This is advantageous as it allows patient positioning to be performed outside the treatment area, including while the prior patient is being treated. Additionally, the patient can quickly be transported out from the treatment area and assisted outside the treatment area while the next patient in another mobile unit is transported into the treatment area for treatment. Thisapproach greatly streamlines the workflow, thereby improving patient throughput and improving availability of treatment.

[0046] As shown in FIG. 9, the treatment method includes steps of: positioning a patient in a patient support of a mobile patient robot in a treatment area for radiotherapy; positioning a linac in a mobile linac robot in the treatment area for radiotherapy; determining a position of the mobile patient robot and mobile linac robot relative a frame of reference of the radiotherapy system with positional sensor(s); and coordinating movement / positioning of the mobile patient robot and mobile linac robot (and optional imager robot) and performing radiotherapy. Such method can further include positioning one or more imager robots in the treatment area for image verification and image guidance during radiotherapy.

[0047] As shown in FIG. 10, the method includes steps of: positioning a patient in a patient support of a mobile patient robot in a treatment area for radiotherapy; positioning a plurality of linacs of a plurality of mobile linac robots in the treatment area; determining a position of the mobile patient robot and plurality of mobile linac robots relative a frame of reference of the radiotherapy system with positional sensor(s); and coordinating movement / positioning of mobile patient robot and mobile linac robot, and optional imager robot(s), and performing radiotherapy entailing directing multiple treatment beams at a target and / or directing treatment beams to differing targets. By directing multiple treatment beams to the target concurrently, ultra-rapid therapies, such as FLASH, can be realized without any gantry. Additionally, treatment of multiple target sites (e.g. 5 or more, 10 or more, up to 20 or more) can be treated in rapid succession within a single treatment session.

[0048] In the foregoing specification, the invention is described with reference to specific embodiments thereof, but those skilled in the art will recognize that the invention is not limited thereto. Various features, embodiments and aspects of the above-described invention can be used individually or jointly. Further, the invention can be utilized in any number of applications beyond those described herein without departing from the broader spirit and scope of the specification. The specification and drawings are, accordingly, to be regarded as illustrative rather than restrictive. It will be recognized that the terms “comprising,” “including,” and “having,” as used herein, are specifically intended to be read as open-ended terms of art. Unless stated otherwise, the term “about” is considered to mean within + / - 10%. It is further appreciated that the various listings and groups of species can be incorporated into an open group (e.g. “comprising”) of species or within a closed group (e.g. “consisting”)of species in the recited combination or any combination thereof. Any references to publication, patents, or patent applications are incorporated herein by reference in their entirety for all purposes.

Claims

WHAT IS CLAIMED IS:

1. A radiation therapy system comprising: one or more positional sensors defining a reference frame of the system in a treatment area; a linear accelerator (linac) configured for radiation treatment of one or more targets; a mobile patient robot that includes a patient support that is adjustable by one or more positioning mechanisms extending from a mobile base; and a controller configured for determining a position of and controlling movement of the mobile patient robot relative the reference frame and adjustment of the patient support to facilitate radiotherapy.

2. The radiation therapy system of claim 1 wherein the patient support is configured to assume differing configurations that includes: a supine position, a seated position and a standing position.

3. The radiation therapy system of claim 1 or 2 wherein the mobile base includes wheels and an omnidirectional drive for precision adjustment of the mobile patient robot to any location and / or orientation within the treatment area.

4. The radiation therapy system of any of claims 1-3 wherein the controller is further configured to transport the patient to and from the treatment area such that patient setup can be performed away from the treatment area.

5. The radiation therapy system of any of claims 1-4 further comprising: a mobile linac robot that includes the linac that is adjustable by one or more positioning mechanisms extending from a mobile base of the mobile linac robot.

6. The radiation therapy system of claim 5 wherein the one or more positioning mechanisms include a motion platform.

7. The radiation therapy system of claim 5 wherein the one or more positioning mechanisms further include a vertical translation lift for up / down movement of the linac.

8. The radiation therapy system of any of claims 1-7 wherein the controller is further configured for determining and controlling movement of the mobile linac robot relative the reference frame and adjustment of the linac position and / or orientation to facilitate radiotherapy.

9. The radiation therapy system of any of claims 1-8 wherein the system is without any gantry supporting the linac.

10. The radiation therapy system of any of claims 1-9 wherein the system further includes: a plurality of mobile linac robots, each supporting a linac that is adjustable by one or more positioning mechanisms extending from a wheeled mobile base of the respective linac robot.

11. The radiation therapy system of claim 10 wherein the controller is further configured to coordinate a location of the plurality of mobile linac robots within the reference frame so as to facilitate one or more treatment plans.

12. The radiation therapy system of claim 11 wherein the controller is configured to coordinate positioning of the plurality of mobile linac robots so as direct a radiation treatment to a target from multiple directions concurrently or in rapid succession so as to deliver an entire treatment dose in less than 10 seconds.

13. The radiation therapy system of claim 11 wherein the controller is configured to coordinate positioning of the plurality of mobile linac robots so direct treatment to different targets with different mobile linac robots of the plurality in order to treat multiple targets associate with metastatic cancer.

14. The radiation therapy system of claim 1 further comprising: a gantry that supports and controls movement of the linac.

15. The radiation therapy system of claim 14 further comprising: wherein the one or more positional sensors for determining the frame of reference are mounted on the gantry.

16. The radiation therapy system of any of claims 1-15 further comprising: one or more imager robots, each having a diagnostic imager that is adjustable by one or more positioning mechanisms extending from a wheeled mobile base of the respective imager robot.

17. A method of radiation treatment comprising: positioning a patient in a patient support of a mobile patient robot in preparation for radiotherapy; transporting the patient to a treatment area of the radiotherapy system; determining a position of the mobile patient robot relative a frame of reference of the radiotherapy system by use of one or more positional sensors; and performing radiotherapy on the patient while positioned in the mobile patient robot and subsequently transporting the patient from the treatment area.

18. The method of claim 17 wherein the radiotherapy system comprises a linac mounted on a gantry or a robotic arm secured at a fixed location in a treatment room.

19. The method of claim 18 wherein the one or more positional sensors are mounted on the gantry or the robotic arm.

20. The method of claim 17 wherein the radiotherapy system comprises the mobile patient robot and one or more mobile linac robots such that the radiotherapy system is without any gantry.

21. The method of claim 20 further comprising: positioning the one or more mobile linac robots within the treatment area; determining a position of the one or more linac robots relative the frame of reference of the radiotherapy system by use of the one or more positional sensors; and performing radiotherapy on the patient while positioned in the mobile patient robot via one or more linacs of the one or more mobile linac robots.

22. The method of claim 20 or 21 wherein the one or more mobile linac robots comprise a plurality of mobile linac robots.

23. The method of claim 22 further comprising: coordinating positioning of the plurality of mobile linac robots and controlling radiation delivery so as direct a radiation treatment to a target from multiple directions concurrently or in rapid succession so as to deliver an entire treatment dose in less than 10 seconds.

24. The method of claim 22 further comprising: coordinating positioning of the plurality of mobile linac robots and controlling radiation delivery so direct treatment to different targets with different mobile linac robots of the plurality in order to treat multiple targets associate with metastatic cancer.

25. The method of any of claims 20-24 further comprising: imaging the patient before and / or during the treatment session with one or more imager robots, each having a diagnostic imager that is adjustable by one or more positioning mechanisms extending from a mobile base of the respective imager robot.

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