MRI guided radiotherapy
Systems, methods, and computer software relating to gating using non-parallel imaging planes, determining accumulated dose to tissues during radiotherapy with actual beam delivery information, stopping/adjusting/reoptimizing therapy based on such accumulated doses and the generation and use of prognostic motion models and prognostic-motion adapted radiation treatment plans are disclosed.
1. A non-transitory, machine-readable medium storing instructions which, when executed by at least one programmable processor, cause the at least one programmable processor to perform operations comprising:
acquiring real-time images of a patient from a magnetic resonance imaging system in at least two non-parallel planes;
contouring an anatomical structure of the patient in the at least two non-parallel planes;
setting spatial limits for movement of the anatomical structure in the at least two non-parallel planes;
controlling a radiotherapy device to deliver a radiotherapy beam to the patient;
gating off the radiotherapy beam when the anatomical structure exceeds a spatial limit for movement of the anatomical structure in either of the at least two non-parallel planes;
acquiring actual beam delivery information during delivery of the radiotherapy beam, the actual beam delivery information comprising actual beam measurements including one or more of: measured monitor units, measured multileaf collimator leaf positions, measured gantry positions, measured couch positions and measured fluence profiles;
calculating dose to tissues during the delivery of the radiotherapy beam based on the acquired real-time images and the acquired actual beam delivery information;
accumulating dose to tissues during the delivery of the radiotherapy beam; and
displaying the accumulated dose to tissues, during delivery of the radiotherapy beam, in three orthogonal planes.
2. The machine-readable medium of claim 1 , wherein the at least two non-parallel planes are three orthogonal planes.
3. The machine-readable medium of claim 1 , wherein the at least two non-parallel planes are orthogonal.
4. The machine-readable medium of claim 1 , wherein the at least two non-parallel planes are oblique.
5. The machine-readable medium of claim 1 , wherein the acquiring of the real-time images from the magnetic resonance imaging system in at least two non-parallel planes is performed by energizing and controlling one or more subsystems of a gradient coil system of the magnetic resonance imaging system.
6. The machine-readable medium of claim 1 , wherein the acquiring of the real-time images from the magnetic resonance imaging system in at the least two non-parallel planes includes T1 and T2 weighted volumetric scans at a stereotactic radiosurgery (SRS) isocenter.
7. The machine-readable medium of claim 1 , wherein the contouring of the anatomical structure of the patient is performed via machine autocontouring.
8. The machine-readable medium of claim 1 , wherein the contouring of the anatomical structure of the patient is performed via a machine receiving manual user input.
9. The machine-readable medium of claim 1 , wherein the radiotherapy device is further controlled to deliver stereotactic radiosurgery (SRS) to the patient.
10. The machine-readable medium of claim 1 , wherein the magnetic resonance imaging system operates at a field strength of less than 1.0 Tesla.
11. The machine-readable medium of claim 1 , wherein the spatial limits are set within 0.5 mm of the boundaries of the anatomical structure in the at least two non-parallel planes.
12. The machine-readable medium of claim 1 , the operations further comprising:
determining accumulated dose to a contoured anatomical structure;
providing a notification or alarm if the accumulated dose to the contoured anatomical structure exceeds a specified limit;
stopping the delivery of the radiotherapy beam if the accumulated dose to the contoured anatomical structure exceeds the specified limit; and
determining a reoptimized treatment plan if the accumulated dose to the contoured anatomical structure exceeds the specified limit.
13. The machine-readable medium of claim 12 , wherein determining the reoptimized treatment plan takes into account the accumulated dose and accounts for any under dosage or over dosage.
14. A non-transitory, machine-readable medium storing instructions which, when executed by at least one programmable processor, cause the at least one programmable processor to perform operations comprising:
acquiring real-time images of a patient from a magnetic resonance imaging system in at least two non-parallel planes;
contouring an anatomical structure of the patient in the at least two non-parallel planes;
setting spatial limits for movement of the anatomical structure in the at least two non-parallel planes;
controlling a radiotherapy device to deliver a radiotherapy beam to the patient;
gating off the radiotherapy beam when the anatomical structure exceeds a spatial limit for movement of the anatomical structure in either of the at least two non-parallel planes;
acquiring actual beam delivery information during delivery of the radiotherapy beam, the actual beam delivery information comprising actual beam measurements including one or more of: measured monitor units, measured multileaf collimator leaf positions, measured gantry positions, measured couch positions and measured fluence profiles;
calculating dose to tissues during the delivery of the radiotherapy beam based on the acquired real-time images and the acquired actual beam delivery information; wherein calculating the dose to tissues further utilizes deformable image registration and the real-time images including assigned relative electron densities; and
accumulating dose to tissues during the delivery of the radiotherapy beam.
15. A non-transitory, machine-readable medium storing instructions which, when executed by at least one programmable processor, cause the at least one programmable processor to perform operations comprising:
acquiring real-time images of a patient from a magnetic resonance imaging system in at least two non-parallel planes;
contouring an anatomical structure of the patient in the at least two non-parallel planes;
setting spatial limits for movement of the anatomical structure in the at least two non-parallel planes;
controlling a radiotherapy device to deliver a radiotherapy beam to the patient;
gating off the radiotherapy beam when the anatomical structure exceeds a spatial limit for movement of the anatomical structure in either of the at least two non-parallel planes;
acquiring actual beam delivery information during delivery of the radiotherapy beam, the actual beam delivery information comprising actual beam measurements including one or more of: measured monitor units, measured multileaf collimator leaf positions, measured gantry positions, measured couch positions and measured fluence profiles;
calculating dose to tissues during the delivery of the radiotherapy beam based on the acquired real-time images and the acquired actual beam delivery information; and
accumulating dose to tissues during the delivery of the radiotherapy beam; wherein accumulating dose to tissues further utilizes deformable image registration and the the real-time images including assigned relative electron densities.
16. The machine-readable medium of claim 15 , wherein the dose is accumulated in the real-time images.
17. The machine-readable medium of claim 16 , the operations further comprising displaying the accumulated dose in the real-time images acquired during delivery of the radiotherapy beam using deformable image registration between the the real-time images and the real-time images acquired during delivery of the radiotherapy beam.
18. The machine-readable medium of claim 17 , wherein calculating the dose to tissues further utilizes independent measurements of the magnetic resonance imaging system and the radiotherapy device in order to synchronize the acquired real-time images and acquired actual beam information.
19. The machine-readable medium of claim 15 , the operations further comprising: displaying the accumulated dose to tissues during delivery of the radiotherapy beam.
20. The machine-readable medium of claim 19 , the operations further comprising displaying the accumulated dose on the real-time images acquired during delivery of the radiotherapy beam.
21. The machine-readable medium of claim 19 , the operations further comprising displaying the accumulated dose on the real-time images.
22. The machine-readable medium of claim 19 , the operations further comprising displaying the accumulated dose in a plurality of imaging planes.
23. The machine-readable medium of claim 22 , the operations further comprising displaying the accumulated dose in three orthogonal planes.