Rapid imaging systems and methods for facilitating rapid radiation therapies

Abstract

Methods and system for facilitating rapid radiation treatments are provided herein and relate in particular to radiation generation and delivery, beam control, treatment planning, imaging and dose verification. The methods and systems described herein are particularly advantageous when used with a compact high-gradient, very high energy electron (VHEE) accelerator and delivery system (and related processes) capable of treating patients from multiple beam directions with great speed, using all-electromagnetic or radiofrequency deflection steering is provided, that can deliver an entire dose or fraction of high-dose radiation therapy sufficiently fast to freeze physiologic motion, yet with a better degree of dose conformity or sculpting than conventional photon therapy.

What is claimed is: 
     
         1 . An imaging system for image verification in a high-energy rapid radiation delivery treatment system configured to deliver an entire conformal 3D dose for a given radiation treatment session in less than 10 seconds, wherein high-energy comprises 1-250 MeV and the entire dose is at least 1 Gy, the system comprising:
 an imaging device configured for obtaining a 3D treatment image of an anatomical structure that includes the a targeted tissue to which the treatment is to be delivered; and   a processing unit having a recordable memory with a plurality of predetermined 3D treatment plans recorded thereon, the plurality of predetermined treatment plans determined from a plurality of pre-treatment images, the processing unit being configured to:   determine a shape and/or location of the anatomical structure at treatment based on the treatment image and the plurality of pre-treatment images; and   determine a single actual conformal 3D treatment pattern suitable for delivery from which the entire conformal 3D dose is delivered to the targeted tissue, wherein the single conformal 3D treatment pattern is determined based on the determined shape and/or location of the anatomical structure and one or more of the plurality of predetermined treatment plans,   wherein the imaging device is operably coupled to the rapid radiation delivery treatment system.   
     
     
         2 . The system of  claim 1  wherein the actual treatment pattern is a plurality of actual treatment patterns each associated with a different direction of the plurality of differing directions from where a plurality particle beams from a treatment system are delivered to the targeted tissue. 
     
     
         3 . The system of  claim 1  wherein
 the imaging system is configured to perform a re-planning process, wherein the re-planning process comprises: 
 obtaining a plurality of images in rapid succession immediately before treatment, and 
 configured to alter the plurality of predetermined treatment plans based on the plurality of images obtained immediately before treatment, wherein the re-planning process is performed in less than 20 seconds. 
 
     
     
         4 . The imaging system of  claim 1  wherein the processing unit is further configured to:
 determine the actual treatment plan by: 
 selecting one of the predetermined treatment plans, and 
 adapting the selected predetermined treatment plans based on the treatment image. 
 
     
     
         5 . The imaging system of  claim 1  wherein the imaging device includes any of CT, MR, PET, SPECT and ultrasound imaging or any combination thereof. 
     
     
         6 . The imaging system of  claim 1  wherein the imaging system comprises a full ring integrated CT imaging system. 
     
     
         7 . The imaging system of  claim 1  wherein the processing unit is further configured to:
 perform an initial simulation prior to treatment to determine the plurality of predetermined treatment plans based on a plurality of anticipated anatomical variations. 
 
     
     
         8 . The imaging system of  claim 7  wherein the processing unit is further configured to:
 perform rapid image acquisition to obtain the treatment image in about 1 second or less for verification and perform rapid comparison of the treatment image with one of the plurality of pre-treatment images by subtraction or registration to determine the actual treatment plan. 
 
     
     
         9 . The imaging system of  claim 7  wherein the one or more pretreatment plans comprise a 3D reconstruction of the anatomical structure and the processing unit is further configured to determine the actual treatment pattern by dynamically updating the 3D reconstruction during data acquisition so as to optimize the treatment pattern. 
     
     
         10 . The imaging system of  claim 1  wherein the treatment image is a high-quality 3D image covering an entire treatment volume of the targeted tissue to be traversed by a plurality of treatment beams directed to the targeted tissue from multiple directions. 
     
     
         11 . The imaging system of  claim 1  wherein the predetermined treatment plan includes a segmentation of anatomic structures and the processing unit is further configured to:
 perform an automatic or semi-automatic re-segmentation of anatomic structures and recalculation of or selection of a plurality of pre-calculated validated plans. 
 
     
     
         12 . The system of  claim 1 , wherein the treatment system is configured for electron therapy or photon therapy. 
     
     
         13 . The system of  claim 1 , wherein the treatment image is a “real-time” image such that the single treatment plan is based on the “real-time” image at treatment delivery. 
     
     
         14 . A high-energy treatment system for delivering a rapid radiation treatment to a patient, wherein high-energy comprises 1-250 MeV, the system comprising:
 a plurality of accelerating structures configured to rapidly deliver a plurality of particle treatment beams to the targeted tissue of a patient from a plurality of differing directions such that an entire dose of the radiation treatment for the treatment session is delivered to the targeted tissue in less than 10 seconds;   an imaging system in accordance with  claim 1 ; and   a control unit operatively coupling the plurality of accelerating structures to the imaging system, wherein the control unit is configured to deliver the plurality of beams to the targeted tissue according to the actual treatment pattern determined by the imaging system.   
     
     
         15 . A method for treating a tissue of a patient, said method comprising:
 obtaining a 3D treatment image of an anatomical structure of the patient with an imaging system, the anatomical structure including a tissue targeted for treatment;   determining a shape and/or location of the anatomical structure at treatment based on the treatment image and a plurality of pre-treatment images obtained prior to obtaining the treatment image;   determining a single actual 3D conformal treatment plan for the targeted tissue based on the treatment image and a treatment plans one or more treatment plans determined from the plurality of pre-treatment images; and   delivering an entire 3D conformal dose of a radiation treatment to the targeted tissue for a given treatment session with a high-energy rapid radiation treatment system, wherein the entire 3D conformal dose is delivered according to the single actual treatment plan in less than 10 seconds, wherein high-energy comprises 1-250 MeV and the entire dose is at least 1 Gy.   
     
     
         16 . The method of  15  wherein the determined shape and/or location of the anatomical structure at treatment corresponds to a particular pre-treatment image when the treatment image corresponds to another image of the plurality of pre-treatment images immediately preceding the particular pre-treatment image. 
     
     
         17 . The method of  claim 15  wherein determining the shape and/or location comprises performing a segmentation of the plurality of pre-treatment images and wherein determining the actual treatment plan includes performing a rapid re-segmentation of the treatment image and dose calculation according to the determined shape and/or location of the anatomical structure immediately before treatment. 
     
     
         18 . The method of  claim 15  wherein obtaining the treatment image comprises obtaining a full CT scan. 
     
     
         19 . The method of  claim 18  further comprising:
 performing registration with the full CT scan, wherein the full CT scan and registration is performed within about one second or less. 
 
     
     
         20 . The method of  claim 15  wherein obtaining the treatment image comprises:
 detuning a linear accelerator of a treatment system through which one or more electron beams are accelerated for delivering a radiation treatment; 
 detuning the linear accelerator to generate an electron beam of lower energy than those of the one or more electron beams for treatment; and 
 directing the lower-energy electrons to a high-Z target so as to produce a diagnostic energy spectrum suitable for imaging of the targeted tissue with the same linear accelerator as is used for acceleration of the one or more treatment beams. 
 
     
     
         21 . The method of  claim 20  further comprising any of:
 determining a treatment plan based on a diagnostic image obtained using the lower-energy electron beam; 
 tuning the linear accelerator so as to provide a higher energy electron beam suitable for treatment after obtaining the diagnostic image; and 
 performing detuning and tuning of the linear accelerator sufficiently rapidly so as to obtain the diagnostic image, determine the treatment plan and deliver an entire treatment dose based on the determined treatment plan in less than one minute. 
 
     
     
         22 . The method of  claim 15 , wherein the treatment comprises electron therapy or photon therapy. 
     
     
         23 . The method of  claim 15 , wherein the treatment image is a “real-time” image such that the single treatment plan is based on the “real-time” image at treatment delivery. 
     
     
         24 . A method of performing a high-energy, rapid radiation treatment with a delivery treatment system configured to deliver an entire 3D conformal dose for a given radiation treatment session to a targeted tissue in less than 10 seconds, wherein high energy comprises 1-250 MeV and the entire dose is at least 1 Gy, the method comprising:
 performing an initial simulation prior to treatment so as to produce a plurality of treatment plans before treatment optimized for differing anticipated anatomical variations, wherein the treatment plans comprise a segmentation of anatomical structures that include the targeted tissue;   at the time of treatment, acquire a diagnostic image covering the entire treatment volume of the targeted tissue and surrounding tissue that may be traversed by one or more radiation treatment beams;   performing re-segmentation of anatomical structures of the diagnostic image and recalculation or selection of treatment plan options from one or more of the treatment plans produced before treatment;   verifying segmentation and selection of treatment plan options;   rapidly obtaining a treatment image and verifying selection of a single treatment plan from the plurality of treatment plan options within about one second or less; and   rapidly delivering a high-energy radiation treatment beam according to the determined and verified selected treatment plan, wherein an entire dose of the treatment is delivered within 10 seconds or less in accordance with the single treatment plan.   
     
     
         25 . The method of  claim 24  wherein the one or more treatment plans comprise a 3D reconstruction of anatomical structure, the method further comprising:
 dynamically updating the 3D reconstruction from the diagnostic image acquired at the time of treatment to obtain an optimal plan choice and the selected treatment plan. 
 
     
     
         26 . The method of  claim 24  wherein any of:
 re-segmentation is performed through deformable image registration; 
 re-segmentation is automatic or semi-automatic so as to be performed in less than 10 seconds; 
 obtaining the diagnostic image comprises obtaining a full CT scan; 
 verification segmentation and treatment plan selectionthe method further comprises verifying segmentation and selection of treatment plan options, which comprises automated or semi-automated rapid image comparison utilizing subtraction and/or registration; and 
 the entire process is performed in about 20 seconds or less and treatment is delivered in about one second or less. 
 
     
     
         27 . The method of  claim 24 , wherein the treatment comprises electron therapy or photon therapy. 
     
     
         28 . The method of  claim 24 , wherein the treatment image is a “real-time” image such that the single treatment plan is based on the “real-time” image at treatment delivery. 
     
     
       29. The system of  claim 14 , wherein the plurality of treatment beams comprise charged particle beams or photon beams.  
     
     
       30. The system of  claim 14 , wherein the targeted tissue comprises a tumor or a non-tumor target.  
     
     
       31. The system of  claim 14 , wherein the system is configured to synchronize dose delivery with a time of optimal uptake of a therapeutic agent in the targeted tissue or a normal tissue to be protected.  
     
     
       32. The system of  claim 31 , wherein the imaging device is further configured to provide information to the control unit of the treatment system to trigger dose delivery based on the time of optimal uptake of the therapeutic agent.  
     
     
       33. The imaging system of  claim 1 , wherein the imaging device is further configured to detect uptake of a therapeutic agent in the targeted tissue or normal tissue after administering of the therapeutic agent to the patient and configured to trigger delivery of the dose, by the treatment system, to the targeted tissue.  
     
     
       34. The imaging system of  claim 33 , wherein the therapeutic agent comprises any of a drug, radiosensitizer, a radioprotector, and a dose-enhancing agent.  
     
     
       35. The method of  claim 15  further comprising:
 administering a therapeutic agent to the patient, wherein the therapeutic agent comprises any of a drug, a radiosensitizer, a radioprotector, and a dose-enhancing agent.  
 
     
     
       36. The method of  claim 35  further comprising:
 synchronizing radiation dose delivery with a time of optimal uptake of the therapeutic agent in the targeted tissue or a normal tissue to be protected.  
 
     
     
       37. The method of  claim 36  further comprising:
 imaging to detect an optimal uptake of the therapeutic agent for triggering dose delivery.  
 
     
     
       38. The method of  claim 15 , wherein the targeted tissue comprises a tumor or a non-tumor target.  
     
     
       39. The method of  claim 38 , wherein the non-tumor target comprises any of nerves, facet joints, foci in the brain, portions of the lung, and pathways in the heart.  
     
     
       40. A method for treating a targeted tissue in a patient, said method comprising:
 administering a therapeutic agent comprising any of a drug, a radiosensitizer, a radioprotector, and a dose enhancing agent; and   administering an entire effective dose of high-dose radiation to the targeted tissue in less than 10 seconds, wherein there is a single dose delivery for a given treatment session,   wherein administering the entire effective dose comprises delivering the entire effective dose synchronized with an optimal uptake of the therapeutic agent based on real-time imaging of the targeted tissue or tissue to be protected.    
     
     
       41. The system of  claim 40 , wherein the targeted tissue comprises a tumor or a non-tumor target.  
     
     
       42. The system of  claim 41 , wherein the non-tumor target comprises any of: nerves, facet joints, foci in the brain, portions of the lung, and pathways in the heart.  
     
     
       43. The method of  claim 40 , wherein the effective dose is at least 1 Gray.  
     
     
       44. The method of  claim 40 , wherein the effective dose is delivered within one or more pulses.  
     
     
       45. The method of  claim 40 , wherein the effective dose is delivered within one second or less.  
     
     
       46. The method of  claim 40 , wherein administering the effective dose of radiation comprises generating a high energy radiation treatment beam, wherein high energy comprises between 1-250 MeV.  
     
     
       47. The method of  claim 40 , wherein administering the effective dose of radiation comprises generating one or more charged particle beams and directing the one or more charged particle beams toward the targeted tissue.  
     
     
       48. The method of  claim 40 , wherein administering the effective dose of radiation comprises generating an electron therapy beam or a photon therapy beam for delivery to the targeted tissue.  
     
     
       49. The method of  claim 40 , wherein the therapeutic agent comprises a drug.  
     
     
       50. The method of  claim 49 , wherein the drug comprises a chemo drug.  
     
     
       51. The method of  claim 40 , wherein the therapeutic agent is a radiosensitizer.  
     
     
       52. The method of  claim 40 , wherein the therapeutic agent is a radioprotector.  
     
     
       53. The method of  claim 40 , wherein the therapeutic agent is a dose-enhancing agent.  
     
     
       54. The method of  claim 53 , wherein the dose-enhancing agent is transient or slow-uptake.  
     
     
       55. The method of  claim 40 , wherein the therapeutic agent further comprises a contrast agent.  
     
     
       56. The method of  claim 40 , further comprising:
 timing the administering of the therapeutic agent relative the administering of the effective dose of radiation so as to synchronize an optimal uptake of the therapeutic agent with delivery of the effective dose of radiation.    
     
     
       57. The method of  claim 40 , wherein administering of the effective dose of radiation is triggered by a time of optimal uptake of the therapeutic agent in the target tissue or normal tissue to be protected.  
     
     
       58. The method of  claim 56 , wherein the time of optimal uptake of the therapeutic agent is image-based, wherein image based comprises imaging with ay of: MRI, PET/CT, SPECT, PET, and ultrasound images.  
     
     
       59. A computer-implemented method of radiation treatment planning for treating a targeted tissue with a treatment system in combination with a therapeutic agent, the method comprising:
 real-time imaging of the targeted tissue or tissue to be protected and determining, with the treatment system, an optimal uptake of the therapeutic agent;   determining, with the treatment system, a prescribed effective dose of radiation to be delivered into the targeted tissue from a high-energy rapid radiation treatment system, wherein the prescribed effective dose is based, at least partly, on a response of the targeted tissue to the therapeutic agent; and   determining, with the treatment system, a plurality of radiation beams to deliver the prescribed effective dose to the targeted tissue in less than 10 seconds and determining, with the treatment system, minimum beam energies for the plurality of radiation beams to achieve the prescribed effective dose at the targeted tissue; and   delivering the entire effective dose synchronized with the optimal uptake of the therapeutic agent, wherein there is a single dose delivery during a given treatment session.    
     
     
       60. The computer-implemented method of  claim 59 , the method further comprising:
 delivering the plurality of radiation beams to the targeted tissue, with the treatment system, wherein a timing of the delivery of the plurality of radiation beams is based on the response of an uptake of the therapeutic agent by the targeted tissue.    
     
     
       61. The computer-implemented method of  claim 59 , wherein the therapeutic agent comprises any of a drug, a radiosensitizer, a radioprotector, and a dose-enhancing agent.  
     
     
       62. The computer-implemented method of  claim 59 , wherein the method further comprises:
 triggering, with the treatment system, a delivery of radiation based on an image-based assessment of an optimal uptake of the agent within the targeted tissue or a normal tissue to be protected.    
     
     
       63. A non-transitory computer-readable storage medium having computer-executable instructions for causing a computing system to perform a method of high-energy rapid radiation treatment planning for treating a targeted tissue in combination with a therapeutic agent, the method comprising:
 real-time imaging of the targeted tissue or tissue to be protected and determining, with the treatment system, an optimal uptake of the therapeutic agent;   accessing, with the treatment system, treatment plan delivery parameters from a memory of the computing system, wherein the treatment plan parameters comprise a prescribed effective dose to be delivered to the targeted tissue, directions of a plurality of radiation beams to deliver the prescribed effective dose to the targeted tissue in less than 10 seconds, and beam energies of the plurality of radiation beams;   accessing, with the treatment system, information comprising a response of the targeted tissue or a normal tissue with the therapeutic agent; and   adjusting, with the treatment system, the treatment based on the information regarding the therapeutic agent response; and   delivering the entire prescribed effective dose synchronized with the optimal uptake of the therapeutic agent, wherein there is a single dose delivery during a given treatment session.    
     
     
       64. The non-transitory computer-readable storage medium of  claim 63 , wherein accessing information of the response comprises an image-based assessment of uptake of the therapeutic agent in the targeted tissue or the normal tissue, and adjusting, with the treatment system, the treatment comprises triggering delivery of the plurality of radiation beams based on the image-based assessment.  
     
     
       65. The non-transitory computer-readable storage medium of  claim 63 , wherein the therapeutic agent comprises any of a drug, a radiosensitizer, a radioprotector, and a dose-enhancing agent.  
     
     
       66. The non-transitory computer-readable storage medium of  claim 65 , wherein the therapeutic agent comprises a chemo drug.