Prospective and retrospective on-line adaptive radiotherapy

1. A method, comprising:

performing, during a treatment delivery session, a delivery of a dose of radiation to an anatomical volume using a treatment beam;

detecting, during the treatment delivery session, a current state of the anatomical volume based on an imaging scan;

determining, based on a model of the anatomical volume, a future change in the current state of the anatomical volume during the treatment delivery session, wherein the model comprises at least one of anatomic structures, a motion model of the anatomical volume, or a deformation model of the anatomical volume; and

adjusting, while the anatomical volume is in the current state, a treatment delivery to anticipate the future change in the current state of the anatomical volume during the treatment delivery session.

2. The method of claim 1 , wherein performing, during the treatment delivery session, the delivery of the dose of radiation to the anatomical volume using the treatment beam is based on a treatment plan for a planned dose of radiation, and further comprising:

determining that the future change in the current state of the anatomical volume during the treatment delivery session will cause a dose difference between the dose of radiation that is delivered to the anatomical volume and the planned dose of radiation.

3. The method of claim 1 , further comprising:

determining that the future change in the current state of the anatomical volume during the treatment delivery session will cause one or more imaging times used for motion tracking of the anatomical volume to be aliased on a breathing phase; and

capturing, while the anatomical volume is in the current state, an image at a different breathing phase.

4. The method of claim 1 , wherein detecting the current state of the anatomical volume based on the imaging scan comprises:

detecting the current state of the anatomical volume based on one or more respiratory traces or one or more images.

5. The method of claim 4 , wherein the one or more images comprise a computed tomography (CT) image or an X-ray image.

6. The method of claim 4 , wherein the one or more images comprise a positron emission tomography (PET) image or a magnetic resonance imaging (MM) image.

7. The method of claim 1 , wherein adjusting, while the anatomical volume is in the current state, the treatment delivery comprises at least one of adjusting the treatment beam or adjusting imaging parameters.

8. The method of claim 1 , further comprising:

determining that the future change in the current state of the anatomical volume during the treatment delivery session is caused by a respiratory motion of the anatomical volume.

9. The method of claim 8 , further comprising:

in response to determining that the future change in the current state of the anatomical volume during the treatment delivery session is caused by the respiratory motion of the anatomical volume:

adjusting the treatment beam to increase the dose of radiation to the anatomical volume while the anatomical volume is in the current state; and

adjusting the treatment beam to decrease the dose of radiation to the anatomical volume while the anatomical volume is in a future configuration corresponding to the future change in the current state of the anatomical volume during the treatment delivery session.

10. The method of claim 1 , further comprising:

predicting, while the anatomical volume is in the current state, that a future state of the anatomical volume will cause a degradation of an ability to track a motion of the anatomical volume; and

adjusting, while the anatomical volume is in the current state, one or more imaging control parameters to mitigate the degradation of the ability to track the motion of the anatomic volume in the future state.

11. The method of claim 1 , further comprising:

determining that the future change in the current state of the anatomical volume during the treatment delivery session is caused by a deformation that affects at least one of a relative position of a region of interest, wherein the deformation of the at least one of the relative position of the region of interest is unrelated to a respiratory motion of the anatomical volume.

12. The method of claim 11 , further comprising:

in response to determining that the future change in the current state of the anatomical volume during the treatment delivery session is caused by the deformation:

adjusting the treatment beam to increase the dose of radiation to the anatomical volume when the treatment beam does not intersect critical structures; and

adjusting the treatment beam to decrease the dose of radiation to the anatomical volume when the treatment beam intersects the critical structures.

13. The method of claim 1 , wherein performing the delivery of the dose of radiation to the anatomical volume using the treatment beam comprises generating the treatment beam for a proton therapy.

14. The method of claim 1 , wherein performing, during the treatment delivery session, the delivery of the dose of radiation to the anatomical volume using the treatment beam comprises generating the treatment beam, and further comprising:

determining that the future change in the current state of the anatomical volume during the treatment delivery session causes an absence of the anatomical volume from a field of view of the treatment beam during a movement through a plurality of treatment beam directions around the anatomical volume.

15. The method of claim 14 , further comprising:

in response to determining that the future change in the current state of the anatomical volume during the treatment delivery session causes the absence of the anatomical volume from the field of view of the treatment beam during the movement through the plurality of treatment beam directions around the anatomical volume:

adjusting the treatment beam to prevent the dose of radiation to the anatomical volume during a successive motion through the plurality of treatment beam directions around the anatomical volume; and

adjusting the treatment beam to increase the dose of radiation to the anatomical volume during different motions of the treatment beam around the anatomical volume, wherein the anatomical volume is continuously within the field of view of the treatment beam during the successive motion through the plurality of treatment beam directions.

16. The method of claim 14 , further comprising:

determining a position of the anatomical volume during a successive movement through the plurality of treatment beam directions around the anatomical volume to generate a determined target position;

determining a confidence score associated with the determined target position; and

determining the absence of the anatomical volume from the field of view of the treatment beam based on the confidence score.

17. The method of claim 14 , wherein adjusting, while the anatomical volume is in the current state, the treatment delivery to anticipate the future change in the current state of the anatomical volume during the treatment delivery session comprises: adjusting one or more control parameters of a collimator.

18. A radiation delivery system, comprising:

a radiation source to generate a treatment beam for a delivery of a dose of radiation; and

a processing device, operatively coupled to the radiation source, to:

perform, during a treatment delivery session, the delivery of the dose of radiation to an anatomical volume;

detect, during the treatment delivery session, a current state of the anatomical volume;

determine, based on a model of the anatomical volume, a future change in the current state of the anatomical volume during the treatment delivery session, wherein the model comprises at least one of anatomic structures, a motion model of the anatomical volume, or a deformation model of the anatomical volume; and

adjust, while the anatomical volume is in the current state, a treatment delivery to anticipate the future change in the current state of the anatomical volume during the treatment delivery session.

19. The radiation delivery system of claim 18 , wherein the processing device performs, during the treatment delivery session, the delivery of the dose of radiation to the anatomical volume based on a treatment plan for a planned dose of radiation, and wherein the processing device further to:

determine that the future change in the current state of the anatomical volume during the treatment delivery session will cause a dose difference between the dose of radiation that is delivered to the anatomical volume and the planned dose of radiation.

20. The radiation delivery system of claim 18 , wherein the processing device further to:

determine that the future change in the current state of the anatomical volume during the treatment delivery session will cause one or more imaging times used for motion tracking of the anatomical volume to be aliased on a breathing phase; and

capture, while the anatomical volume is in the current state, an image at a different breathing phase.

21. The radiation delivery system of claim 18 , wherein the processing device further to:

detect the current state of the anatomical volume based on one or more respiratory traces or one or more images.

22. The radiation delivery system of claim 21 , wherein the one or more images comprise a computed tomography (CT) image or an X-ray image.

23. The radiation delivery system of claim 21 , wherein the one or more images comprise a positron emission tomography (PET) image or a magnetic resonance imaging (MRI) image.

24. The radiation delivery system of claim 18 , wherein the processing device further to:

adjust the treatment beam, or

adjust imaging parameters.

25. The radiation delivery system of claim 18 , wherein the processing device further to:

determine that the future change in the current state of the anatomical volume during the treatment delivery session is caused by a respiratory motion of the anatomical volume.

26. The radiation delivery system of claim 18 , wherein the processing device further to:

adjust the treatment beam to increase the dose of radiation to the anatomical volume while the anatomical volume is in the current state; and

adjust the treatment beam to decrease the dose of radiation to the anatomical volume while the anatomical volume is in a future configuration corresponding to the future change in the current state of the anatomical volume during the treatment delivery session.

27. The radiation delivery system of claim 18 , wherein the processing device further to:

predict, while the anatomical volume is in the current state, that a future state of the anatomical volume will cause a degradation of an ability to track a motion of the anatomical volume; and

adjust, while the anatomical volume is in the current state, one or more imaging control parameters to mitigate the degradation of the ability to track the motion of the anatomical volume in the future state.

28. A non-transitory computer-readable storage medium including instructions which, when executed by a processing device of a radiation delivery system, cause the radiation delivery system to:

perform, during a treatment delivery session, a delivery of a dose of radiation to an anatomical volume;

detect, during the treatment delivery session, a current state of the anatomical volume;

determine, based on a model of the anatomical volume, a future change in the current state of the anatomical volume during the treatment delivery session, wherein the model comprises at least one of anatomic structures, a motion model of the anatomical volume, or a deformation model of the anatomical volume; and

adjust, while the anatomical volume is in the current state, a treatment delivery to anticipate the future change in the current state of the anatomical volume during the treatment delivery session.