Portal dosimetry system

1. A computer-implemented method of evaluating treatment parameters for a patient undergoing radiotherapy, wherein a portal imaging device is located under the patient such that a radiation beam passes through the patient to the portal imaging device, the method comprising:

obtaining, from an initial medical imaging device, a planning image of the patient prior to radiotherapy, the planning image including an expected portal image of a target region of the patient;

obtaining a portal image during radiotherapy from the portal imaging device, the portal image corresponding to an actual dose distribution delivered to the target region of the patient when a radiation beam is turned on;

generating, by a processor of a portal dosimetry system, during radiotherapy, a first portal dosimetry image identifying one or more differences between the planning image and the portal image;

accessing, over an electronic communications network, a database configured to store a plurality of prior portal dosimetry images identifying:

differences between prior planning images and prior portal images;

assessment information for the prior portal dosimetry images, the assessment information including at least one of true positive difference information and false positive difference information; and

one or more corresponding decisions made regarding the prior portal dosimetry images;

performing a similarity measurement, by the processor, between the first portal dosimetry image and the prior portal dosimetry images from the database;

determining, by the processor, whether to interrupt radiotherapy, wherein the determination is based on an analysis of the similarity measurement, the assessment information, and the corresponding decisions made regarding the prior portal dosimetry images; and

providing, by the processor, an indication of whether to interrupt radiotherapy, the indication being displayed on a graphical user interface of the portal dosimetry system.

2. The method of claim 1 , wherein the processor further generates a ranked list of likely explanations for any differences seen in the difference portal dosimetry image based on the assessment information.

3. The method of claim 1 , wherein the one or more corresponding decisions are related to at least one of: whether the patient is a different patient, whether the patient is outside of a predefined position, whether the radiation beam is being delivered to a location outside of a predefined region, whether a change in the patient's position is greater than a predefined threshold, or combinations thereof.

4. The method of claim 1 , wherein the portal image comprises a 3D image reconstructed from a plurality of 2D images of the target region obtained during radiotherapy.

5. The method of claim 1 , wherein the planning image comprises a 3D image that includes a plurality of predicted 2D images of the target region.

6. The method of claim 1 , wherein the similarity measurement is performed between the first portal dosimetry image and the prior portal dosimetry images for the same patient from previous treatment sessions.

7. The method of claim 1 , wherein the processor further determines a gamma index based on differences between the planning image and the portal image, wherein a gamma test is failed if the gamma index exceeds a threshold value.

8. The method of claim 1 , wherein the interruption of radiotherapy includes making one or more changes to a treatment plan.

9. A portal dosimetry system for evaluating treatment parameters for a patient undergoing radiotherapy, the system comprising:

a database storing a plurality of prior portal dosimetry images, wherein each prior portal dosimetry image includes:

differences between a prior planning image and a prior portal image;

assessment information for the prior portal dosimetry image, the assessment information including at least one of true positive difference information and false positive difference information; and

one or more corresponding decisions made regarding the prior portal dosimetry image;

an initial medical imaging device configured for obtaining a planning image including an expected portal image of a target region of the patient;

a portal imaging device located under the patient such that a radiation beam passes through the patient to the portal imaging device, wherein the portal imaging device is configured to take a portal image corresponding to an actual dose distribution delivered to the target region of the patient when a radiation beam is turned on during radiotherapy;

a display configured to display a graphical user interface; and

a processor configured to:

generate, during radiotherapy, a first portal dosimetry image identifying one or more differences between the planning image and the portal image;

access, over an electronic communications network, the database;

perform a similarity measurement between the portal dosimetry image and the prior portal dosimetry images from the database;

determine whether to interrupt radiotherapy, wherein the determination is based on an analysis of the similarity measurement, the assessment information, and the corresponding decisions made regarding the one or more prior portal dosimetry images; and

provide an indication of whether to interrupt radiotherapy to the display.

10. The system of claim 9 , wherein the processor is further configured to generate a ranked list of likely explanations for any differences seen in the first portal dosimetry image based on the assessment information.

11. The system of claim 9 , wherein the one or more corresponding decisions are related to at least one of: whether the patient is a different patient, whether the patient is outside of a predefined position, whether the radiation beam is being delivered to a location outside of a predefined region, whether a change in the patient's position is greater than a predefined threshold, or combinations thereof.

12. The system of claim 9 , wherein the portal image comprises a 3D image reconstructed from a plurality of 2D images of the target region obtained during radiotherapy.

13. The system of claim 9 , wherein the planning image comprises a 3D image that includes a plurality of predicted 2D images of the target region.

14. The system of claim 9 , wherein the similarity measurement is performed between the portal dosimetry image and the prior portal dosimetry images for the same patient from previous treatment sessions.

15. The system of claim 9 , wherein the processor is further configured to determine a gamma index based on differences between the planning image and the portal image, wherein a gamma test is failed if the gamma index exceeds a threshold value.

16. The system of claim 9 , wherein the interruption of radiotherapy includes making one or more changes to a treatment plan.

17. A system for evaluating treatment parameters for a patient undergoing radiotherapy using a portal imaging device located under the patient such that a radiation beam passes through the patient to the portal imaging device when a radiation beam is turned on during radiotherapy, wherein the portal imaging device is configured to take a portal image corresponding to an actual dose distribution delivered to a target region of the patient when a radiation beam is turned on during radiotherapy, the system comprising:

a database storing a plurality of prior portal dosimetry images, wherein each prior portal dosimetry image includes:

differences between a prior planning image and a prior portal image;

assessment information for the prior portal dosimetry image, the assessment information including at least one of true positive difference information and false positive difference information; and

one or more corresponding decisions made regarding the prior portal dosimetry image;

an initial medical imaging device configured for obtaining a planning image including an expected portal image of the target region of the patient; and

a graphical display configured to provide an indication of whether to interrupt radiotherapy based on a difference between the planning image and the portal image.

18. The system of claim 17 , further comprising:

a processor configured to:

generate, during radiotherapy, a portal dosimetry image identifying one or more differences between the planning image and the portal image;

access, over an electronic communications network, the database;

perform a similarity measurement between the portal dosimetry image and the prior portal dosimetry images from the database; and

determine whether to interrupt radiotherapy, wherein the determination is based on an analysis of the similarity measurement, the assessment information, and the corresponding decisions made regarding the one or more prior portal dosimetry images.

19. The system of claim 18 , wherein the processor further generates a ranked list of likely explanations for any differences seen in the first portal dosimetry image based on the assessment information.

20. The system of claim 18 , wherein the one or more corresponding decisions are related to at least one of: whether the patient is a different patient, whether the patient is outside of a predefined position, whether the radiation beam is being delivered to a location outside of a predefined region, whether a change in the patient's position is greater than a predefined threshold, or combinations thereof.

21. The system of claim 18 , wherein the portal image comprises a 3D image reconstructed from a plurality of 2D images of the target region obtained during radiotherapy.

22. The system of claim 18 , wherein the planning image comprises a 3D image that includes a plurality of predicted 2D images of the target region.

23. The system of claim 18 , wherein the similarity measurement is performed between the first portal dosimetry image and the prior portal dosimetry images for the same patient from previous treatment sessions.

24. The system of claim 18 , further comprising the processor determining a gamma index based on differences between the planning image and the portal image, wherein a gamma test is failed if the gamma index exceeds a threshold value.

25. The system of claim 18 , wherein the interruption of radiotherapy includes making one or more changes to a treatment plan.