Radiation treatment planning and delivery for moving targets in the heart

Abstract

A radiation treatment planning system includes a computing device; and an interface for a user to communicate with the computing device and plan delivery of at least one radiation beam, wherein the computing device is configured to: acquire a calculated position of each of the at least one radiation beam required to treat a target tissue in a patient, wherein each of the positions is a function of a phase of a physiological cycle of the patient; determine dosages in the target tissue to be irradiated, wherein timing of some or all of the at least one radiation beam is based on the phase of the physiological cycle of the patient.

What is claimed is: 
     
         1 . A radiation treatment planning system comprising:
 a computing device; and   an interface for a user to communicate with the computing device and plan delivery of at least one radiation beam, wherein the computing device is configured to:
 acquire a calculated position of each of the at least one radiation beam required to treat a target tissue in a patient, wherein each of the positions is a function of a phase of a physiological cycle of the patient; 
 determine dosages in the target tissue to be irradiated, wherein timing of some or all of the at least one radiation beam is based on the phase of the physiological cycle of the patient. 
   
     
     
         2 . The radiation treatment planning system of  claim 1 , wherein the calculated position of each of the at least one radiation beam is acquired based on a received image volume encompassing the target tissue. 
     
     
         3 . The radiation treatment planning system of  claim 2 , wherein the image volume is generated by at least one of computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), X-ray, and ultrasound. 
     
     
         4 . The radiation treatment planning system of  claim 2 , wherein the computing device is further configured to receive definition by the user of a target representing the target tissue and any radiation sensitive structures by the user outlining a series of contours in slices through the image volume. 
     
     
         5 . The radiation treatment planning system of  claim 4 , wherein the computing device is further configured to adjust an irradiation dose delivered to the radiation sensitive structures. 
     
     
         6 . The radiation treatment planning system of  claim 1 , wherein the computing device is further configured to register a three dimensional electrogram with the received image volume. 
     
     
         7 . The radiation treatment planning system of  claim 2 , wherein
 the image volume is a time series of image volumes distributed throughout a movement cycle of a moving target within a target region including the target tissue, and   the computing device is further configured to calculate a dose distribution for each of the image volumes.   
     
     
         8 . The radiation treatment planning system of  claim 1 , wherein the computing device is further configured to:
 acquire a baseline set of a plurality of images of the target tissue with each image taken at a different phase of the physiological cycle and registered to a phase at which the image was taken;   acquire a current image of the target tissue, wherein the current image of the target tissue is taken at a current phase of the physiological cycle;   register the current image of the target tissue to an image in the baseline set of a plurality of images of the target tissue that occurred at a same phase of the physiological cycle as the current phase of the physiological cycle; and   update the calculated position of the each of the at least one radiation beam based on the registration.   
     
     
         9 . The radiation treatment planning system of  claim 1 , wherein the computing device is further configured to generate a three dimensional surface rendering of dose distribution of each of the at least one radiation beam. 
     
     
         10 . The radiation treatment planning system of  claim 1 , wherein the computing device is further configured to display multi-planar reconstruction-views of axial, sagittal, and coronal slices through a single volume in a volumetric movie. 
     
     
         11 . The radiation treatment planning system of  claim 1 , wherein the computing device is further configured to provide the user provides 3-dimensional tools to orient and place a geometric-shape at an image to define the target tissue. 
     
     
         12 . The radiation treatment planning system of  claim 1 , wherein the computing device is further configured to provide the user an ability to view a target area using a virtual-fly though technique. 
     
     
         13 . The radiation treatment planning system of  claim 1 , wherein the computing device is further configured to expand identification of the target tissue with a margin that is based on motion estimates to account for motion of the target tissue that cannot be tracked. 
     
     
         14 . The radiation treatment planning system of  claim 13 , wherein an estimate of the motion of the target tissue is determined by position measurements for one point on the target tissue at multiple times during the physiological cycle. 
     
     
         15 . The radiation treatment planning system of  claim 1 , further comprising a haptic feedback device to provide force feedback to the user when the user is defining the target tissue within an image volume encompassing the target tissue. 
     
     
         16 . The radiation treatment planning system of  claim 1 , wherein the physiological cycle is a heartbeat cycle or a respiratory cycle.