Abstract: A radiation treatment delivery system, includes a linear accelerator (LINAC) and a multileaf collimator (MLC), coupled with the distal end of the LINAC, wherein the MLC has two banks of leaves, organized into a plurality of opposing leaf pairs. The system further includes a processing device, operatively coupled to the LINAC and the MLC, to control the plurality of leaf pairs of the MLC such that for each of a plurality of radiation beam delivery positional sections corresponds to a range of radiation beam positions over a discrete time interval, wherein each leaf pair of the plurality of opposing leaf pairs is open to a fixed opening for a fraction of time in the discrete time interval and closed for the remaining fraction of time in the discrete time interval, while a radiation beam of the radiation treatment system is active.

Abstract: A method includes determining a first estimate of leaf positions for a plurality of leaves of a multi-leaf collimator (MLC) in a reference coordinate space based on an image generated by an image-based aperture verification system, wherein the leaf positions for the plurality of leaves define an aperture for the MLC. The method further includes determining a second estimate of the leaf positions for the plurality of leaves in the reference coordinate space based on data from an additional source. The method further includes verifying the leaf positions for the plurality of leaves based on comparing the first estimate to the second estimate, wherein the leaf positions are verified if the first estimate deviates from the second estimate by less than a threshold value.

Abstract: A method includes receiving, from a volumetric imager, a first image including a target of a patient. The method further includes receiving a second image including the target of the patient. The method further includes tracking, by a processing device, a position of the target using the first image and the second image.

Abstract: A system for delivering radiation dose, includes a gantry to move about a target to be irradiated and a radiation source mounted to the gantry and directed inward toward the target, The system further includes a collimator mounted to the gantry and in front of the radiation source, the collimator to shape a radiation beam directed at the target, wherein the collimator is to modulate a sub-beam intensity of the radiation beam across a plurality of sub-beams that subdivide a fluence field into a two-dimensional (2D) grid, and wherein a plurality of independent two-dimensional (2D) sub-beam intensity patterns are delivered from a plurality of gantry angles while the gantry moves continuously.

Abstract: A robotic patient positioning assembly including a patient treatment couch, and a robotic arm coupled to the patient treatment couch. The robotic arm is configured to move the patient treatment couch along five rotational degrees of freedom and one substantially vertical, linear degree of freedom.

Abstract: A method of the present disclosure includes performing, by a processing device, a first image registration between a reference image of a patient and a motion image of the patient to perform alignment between the reference image and the motion image, wherein the reference image and the motion image include a target position of the patient. The method further includes performing, by the processing device, a second image registration between the reference image and a motion x-ray image of the patient, via a first digitally reconstructed radiograph (DRR) for the reference image of the patient. The method further includes tracking at least a translational change in the target position based on the first registration and the second registration.

Abstract: Systems and methods for tracking a target volume, e.g., tumor, in real-time during radiation treatment are provided. Under one aspect, a system includes an ultrasound probe, an x-ray imager, a processor, and a computer-readable medium that stores a 3D image of the tumor in a first reference frame and instructions for causing the processor to: instruct the x-ray imager and ultrasound probe to substantially simultaneously obtain inherently registered x-ray and set-up ultrasound images of the tumor in a second reference frame; establish a transformation between the first and second reference frames by registering the 3D image and the x-ray image; instruct the ultrasound probe to obtain an intrafraction ultrasound image of the tumor; registering the intrafraction ultrasound image with the set-up ultrasound image; and track target volume motion based on the registered intrafraction ultrasound image.

Abstract: Described herein is a medical accelerator target including a target constructed of a material having an atomic number that is greater than or equal to 40 or having a thickness of less than 0.2 radiation lengths.

Abstract: Systems, methods, and related computer program products for image-guided radiation treatment (IGRT) are described. For one preferred embodiment, an IGRT apparatus is provided comprising a ring gantry having a central opening and a radiation treatment head coupled to the ring gantry that is rotatable around the central opening in at least a 180 degree arc. For one preferred embodiment, the apparatus further comprises a gantry translation mechanism configured to translate the ring gantry in a direction of a longitudinal axis extending through the central opening. Noncoplanar radiation treatment delivery can thereby be achieved without requiring movement of the patient. For another preferred embodiment, an independently translatable 3D imaging device distinct from the ring gantry is provided for further achieving at least one of pre-treatment imaging and setup imaging of the target tissue volume without requiring movement of the patient.

Abstract: Systems and methods for tracking a target volume, e.g., tumor, during radiation treatment are provided. Under one aspect, a system includes an ultrasound probe, an x-ray imager, a processor, and a computer-readable medium that stores a 3D image of the tumor in a first reference frame and instructions to cause the processor to: instruct the x-ray imager and ultrasound probe to substantially simultaneously obtain inherently registered x-ray and set-up ultrasound images of the tumor in a second reference frame; establish a transformation between the first and second reference frames by registering the 3D image and the x-ray image; instruct the ultrasound probe to obtain an intrafraction ultrasound image of the tumor; registering the intrafraction ultrasound image with the set-up ultrasound image; and track target volume motion based on the registered intrafraction ultrasound image.

Abstract: A method is described, including acquiring, using a camera, an image of a radiation beam incident on a phantom, the radiation beam being emitted by a radiation source. The method further includes determining a beam pointing offset based on the image and calibrating a position of the radiation source based on the beam pointing offset. A calibration system is described including the phantom, the camera, and a processing device. A phantom having an X-ray luminescent material is also described.

Abstract: A processing device determines a plurality of angles from which tracking images can be generated by an imaging device. The processing device generates a plurality of projections of a treatment planning image of a patient, the treatment planning image comprising a delineated target, wherein each projection of the plurality of projections has an angle that corresponds to one of the plurality of angles from which the tracking images can be taken. The processing device determines, for each angle of the plurality of angles, a value of a tracking quality metric for tracking the target based on an analysis of a projection generated at that angle. The processing device selects a subset of the plurality of angles that have a tracking quality metric value that satisfies a tracking quality metric criterion.

Abstract: A radiation treatment apparatus, comprising a gantry structure comprising a beam member extending between first and second ends of the gantry structure. The radiation treatment apparatus also includes a radiation treatment head movably mounted to the beam member in a manner that allows (i) translation of the radiation treatment head along the beam member between the first and second ends, and (ii) gimballing of the radiation treatment head relative to the beam member, the gimballing comprising pivotable movement in at least one independent pivot direction defined with respect to the beam member. The radiation treatment apparatus also includes a patient couch operative coupled with the radiation treatment head in manner to provide movement of the patient couch relative to the radiation treatment head.

Abstract: A method of image-guided radiation treatment is described. The method may include acquiring digitally reconstructed radiographs (DRRs) of a patient and generating a first set of image data of part or all of the patient using imaging radiation at a first energy level and a second set of image data of part or all of the patient using imaging radiation at a second energy level, wherein the first energy level is an energy level selected within the range of 50-100 kV and the second energy level is an energy level selected within the range of 100-150 kV. The method ma also include processing the first and second sets of image data to generate an enhanced image, wherein the enhanced image comprises a combination of the first and second sets of image data, and wherein part or all of the image data comprises the target.

Abstract: A radiation therapy apparatus determines a set of angles that have a tracking quality metric value that satisfies a tracking quality metric criterion. During an alignment phase or a treatment phase for a treatment stage of a target by the radiation therapy apparatus, the radiation therapy apparatus performs selects at least a first angle and a second angle from the set of angles for a first rotation of the gantry. The radiation therapy apparatus generates, using an imaging device mounted to the gantry, a first tracking image of the target from the first angle during the first rotation of the gantry. The radiation therapy apparatus generates, using the imaging device, a second tracking image of the target from the second angle during the first rotation of the gantry. The radiation therapy apparatus performs the target tracking based on the first tracking image and the second tracking image.

Abstract: A radiation therapy apparatus determines a set of angles that have a tracking quality metric value that satisfies a tracking quality metric criterion. During an alignment phase or a treatment phase for a treatment stage of a target by the radiation therapy apparatus, the radiation therapy apparatus performs selects at least a first angle and a second angle from the set of angles for a first rotation of the gantry. The radiation therapy apparatus generates, using an imaging device mounted to the gantry, a first tracking image of the target from the first angle during the first rotation of the gantry. The radiation therapy apparatus generates, using the imaging device, a second tracking image of the target from the second angle during the first rotation of the gantry. The radiation therapy apparatus performs the target tracking based on the first tracking image and the second tracking image.

Abstract: Imaging guided radiation treatment apparatus and methods are described. A method includes processing a first population of x-ray cone beam projection images to compute therefrom a time sequence of sliding-window tomographic image volumes characterized in that each subsequent member of the time sequence is computed using at least one same x-ray cone beam projection image as used in computing at least one previous member of the time sequence. The method also includes operating an IGRT apparatus to deliver treatment radiation to the target based at least in part on a comparison between at least one of the time sequence of sliding-window tomographic image volumes and a pre-acquired image data set.

Abstract: A method of image guided radiation treatment (IGRT) is described. The method may include receiving a pre-acquired image data set of the body part acquired in a reference frame generally independent of a reference frame of an IGRT apparatus, processing a first population of x-ray cone beam projection images to compute therefrom a first tomosynthesis image volume; and operating a radiation treatment head of the IGRT apparatus to deliver treatment radiation to the body part based at least in part on a comparison between the first tomosynthesis image volume a pre-acquired image data set of the body part.

Abstract: A method of selecting a radiation therapy treatment plan for a patient. The treatment plan is implemented through a radiation delivery system including a gantry capable of rotating around a couch, in which the couch is movable in a linear direction relative to the gantry. The movement of the couch and the gantry creates a helical delivery path having a pitch. A radiation module delivers a radiation beam, where the beam has a beam weight corresponding to a radiation fluence. The method includes receiving, by a controller, an objective including a desired dose, a desired dose distribution, or a dose constraint, optimizing the pitch to obtain an optimized pitch, optimizing, the beam weight to obtain optimized beam weight, determining, based on the optimized pitch and the optimized beam weight a treatment plan or a treatment dose, and outputting the treatment plan or the treatment dose.

Abstract: A method and apparatus for treatment planning using four dimensional imaging data.