Portal and real time imaging for treatment verification

1. A system for radiotherapy comprising;

a first imaging system that generates projection images of an area of interest of an object;

a second imaging system that generates portal images of the area of interest of the object synchronously with the generation of the projection images; and

a processing system that receives data associated with the projection images and data associated with the portal images and reconstructs 3D and 4D portal images from the projection images and the portal images.

2. The system of claim 1 , wherein the first imaging system includes an x-ray source that emits x-rays towards the object, and a detector that receives x-rays penetrating through the area of interest of the object and generates signals for the generation of the projection images of the area of interest of the object.

3. The system of claim 2 , wherein the first imaging system includes a cone-beam computed tomography system, wherein the detector receives fan-shaped x-rays after they pass through the area of interest of the object, the detector generating an imaging signal for each of the received fan-shaped x-rays.

4. The system of claim 3 , wherein the x-ray source includes a kV x-ray source.

5. The system of claim 1 , wherein the second imaging system includes a radiation therapy source.

6. The system of claim 5 , wherein the radiation therapy source generates a beam with an energy ranging from about 4 MeV to about 25 MeV.

7. The system of claim 5 , wherein the second imaging system includes an imager that receives a beam emitted by the radiation therapy source and transmitted through the area of interest of the object to generate the portal images.

8. The system of claim 7 , wherein the processing system provides feedback to the second imaging system to control the beam to provide a dynamic delivery control process for the treatment of the area of interest of the object.

9. The system of claim 8 , wherein the output from the radiation therapy source is varied.

10. The system of claim 8 , wherein the shape of the beam is varied.

11. The system of claim 1 further comprising a table upon which the object is positioned.

12. The system of claim 11 , wherein the table has multiple degrees of freedom.

13. The system of claim 12 , wherein one degree of freedom is along an x-axis.

14. The system of claim 13 , wherein a second degree freedom is a roll degree of freedom about the x-axis.

15. The system of claim 11 , wherein one degree of freedom is along a z-axis.

16. The system of claim 15 , wherein a second degree of freedom is a yaw degree of freedom about the z-axis.

17. The system of claim 12 , wherein a first degree of freedom is along an x-axis, a second degree of freedom is a roll degree of freedom about the x-axis, a third degree of freedom is along a z-axis, and a fourth degree of freedom is a yaw degree of freedom about the z-axis.

18. A method for radiotherapy comprising;

generating projection images of an area of interest of an object with a first imaging system;

generating portal images of the area of interest of the object with a second imaging system synchronously with the generation of the projection images; and

receiving data associated with the projection images and data associated with the portal images and reconstructing 3D and 4D portal images from the projection images and the portal images with a processing system.

19. The method of claim 18 , wherein the first imaging system includes a radiation source that emits kV radiation, and the second imaging system includes a therapy radiation source that emits a beam with MeV energy.

20. The method of claim 18 wherein the processing system provides feedback to the second imaging system to control the beam to provide a dynamic delivery control process for the treatment of the area of interest of the object.