Method and device for registration and immobilization

Abstract

Support devices and pods for the head and neck region of patients undergoing radiation therapy are provided herein. The pod generally includes a support shell shaped to generally conform to the shape of the head and neck region of the patient, a foam insert that conforms to the head and neck region of the patient, and an immobilization facemask attached directly to the shell, thereby facilitating close placement of the radiation beam delivery device to the patient and reducing any attenuation and perturbation of radiation doses directed at the patient. The components of the pod are made from materials having properties that reduce any attenuation and perturbation of prescribed radiation doses.

1 .- 20 . (canceled) 
     
     
         21 . A head-and-neck support device comprising:
 a support shell contoured to conform to the outline of a patient's head and neck region, the support shell extending longitudinally between a caudal end and a cephalad end, the shell extending laterally between a right shell lateral edge and left shell lateral edge, a lateral width of the support shell at the caudal end being greater than a lateral width of the shell at the cephalad end; and   a hook-and-fiber system configured to attach a facemask directly to the support shell to immobilize the patient during radiation treatment, the facemask extending laterally between a right facemask lateral edge and a left facemask lateral edge, the hook-and-fiber system located between the right facemask lateral edge and the right shell lateral edge and between the left facemask lateral edge and the left shell lateral edge.   
     
     
         22 . The device of claim  1 , wherein the hook-and-fiber system is made from materials having low atomic numbers. 
     
     
         23 . The device of claim  1 , wherein the hook-and-fiber system comprises materials that minimally perturb a radiation beam directed at the patient. 
     
     
         24 . The device of claim  1 , wherein the hook-and-fiber system is not apparent in images of the head-and-neck support device. 
     
     
         25 . The device of claim  1 , further comprising a foam insert that is molded to accommodate the patient's unique anatomy. 
     
     
         26 . The device of claim  1 , wherein the support shell has a radiographical thickness of less than about 7 mm of water at locations where a radiation beam passes through. 
     
     
         27 . The device of claim  1 , wherein the support shell has a radiographical thickness that is less than about 0.5 mm of water per 2 mm of distance at locations where a radiation beam passes through. 
     
     
         28 . The device of claim  1 , wherein the support shell is made from one of polyethylene fiber, aramid fiber, carbon fiber, and fiberglass. 
     
     
         29 . A device for supporting a patient during radiation treatment, the device comprising:
 a shell shaped and sized to approximate the shape of a patient's head, neck, and shoulder regions, the shell comprising a shell inner surface and a shell outer surface, the shell extending longitudinally between a caudal end and a cephalad end, the shell extending laterally between a right shell lateral edge and left shell lateral edge, the shell having a changing profile along the caudal to cephalad direction of the patient such that the width of the shell in a region shaped and size to accommodate the patient's head region is less than the width of the shell in a region shaped and sized to accommodate the patient's shoulder region, thereby allowing positioning of a radiation delivery device close to the patient's head region;   a facemask extending laterally between a right facemask lateral edge and a left facemask lateral edge; and   a hook-and-fiber system between the shell outer surface and the facemask near the right and left facemask lateral edges, the hook-and-fiber system configured to attach the facemask directly to the support shell to immobilize the patient during radiation treatment.   
     
     
         30 . The device of  claim 29 , wherein the shell has a radiographical thickness of less than about 7 mm of water at locations where a radiation beam passes through. 
     
     
         31 . The device of  claim 29 , wherein at least one of the right and left shell lateral edges has a radiographical thickness of less than about 1 mm. 
     
     
         32 . The device of  claim 29 , wherein the shell extends upwardly from the inner surface of the shell and around the sides of the patient's head forming a channel, the shell tapering to a smaller thickness as the shell extends upward to terminate at the right and left shell lateral edges. 
     
     
         33 . The device of  claim 32 , wherein at least one of the right shell lateral edge and the left shell lateral edge is tapered with a gradient from about 0.1 mm water equivalency/mm to about 5 mm water equivalency/mm. 
     
     
         34 . A pod for supporting a head and neck region of a patient during radiation treatment, the pod comprising:
 a shell generally conforming to the head and neck region of the patient, the shell comprising a shell inner surface and a shell outer surface, the shell extending longitudinally between a caudal end and a cephalad end, the shell extending laterally between a right shell lateral edge and left shell lateral edge, a width of the shell at the caudal end greater than a width of the shell at the cephalad end;   a facemask extending laterally between a right facemask lateral edge and a left facemask lateral edge; and   means for directly attaching the facemask to the outer surface of the support shell to immobilize the patient during radiation treatment, the direct attachment means located between the shell outer surface and the facemask near the right and left facemask lateral edges and allowing a beam delivery device to be positioned within about 5 mm to about 50 mm of a patient's skin in the head region.   
     
     
         35 . The pod of  claim 34 , wherein the direct attachment means comprises a hook-and-fiber system made of materials having an XCT number that lies on the standard XCT number to relative linear stopping power curve for proton and electrons and on the standard XCT number to relative linear attenuation curve for megavoltage x-rays. 
     
     
         36 . The pod of  claim 34 , further comprising a foam insert located between the right shell lateral edge and left shell lateral edge, the foam insert molded to accommodate the patient's unique head anatomy. 
     
     
         37 . The pod of  claim 36 , wherein the foam insert comprises polyurethane. 
     
     
         38 . The pod of  claim 34 , wherein the width of the shell in a region conforming to the patient's head region is approximately 22 cm. 
     
     
         39 . The pod of  claim 34 , wherein the width of the shell in a region conforming to the patient's shoulder region is approximately 56 cm. 
     
     
         40 . The pod of  claim 34 , wherein the shell has a radiographical thickness that is less than about 0.5 mm of water per 2 mm of distance at locations where a radiation beam passes through.