In certain embodiments novel sparse orthogonal collimators (SOCs) for use in radiotherapy are provided. In certain embodiments the SOCs comprise 2 layer 4 bank orthogonal collimators with 2-8 leaves in each of the 4 banks. Instead of using the limited heuristic approach to create jaw-only IMRT, a novel fluence map optimization method is provided based on wavelet decomposition and this method is used for IMRT. An algorithm to simplify the fluence maps with minimal and predictable dose quality compromise is also provided.

Systems and methods for shuttle mode radiation delivery are described herein. One method for radiation delivery comprises moving the patient platform through the patient treatment region multiple times during a treatment session. This may be referred to as patient platform or couch shuttling (i.e., couch shuttle mode). Another method for radiation delivery comprises moving the therapeutic radiation source jaw across a range of positions during a treatment session. The jaw may move across the same range of positions multiple times during a treatment session. This may be referred to as jaw shuttling (i.e., jaw shuttle mode). Some methods combine couch shuttle mode and jaw shuttle mode. Methods of dynamic or pipelined normalization are also described.

A method for delivering radiation treatment may include defining a preliminary trajectory including a plurality of control points. Each control point may be associated with position parameters of a gantry and a couch. The method may also include generating a treatment plan based on the preliminary trajectory by optimizing an intensity and position parameters of a collimator and MLC leaves for each control point. The method may also include decomposing the treatment plan into a delivery trajectory including the plurality of control points. Each of the plurality of control points may be further associated with the optimized intensity, the optimized position parameters of the collimator and the MLC leaves, an output rate, and a motion parameter of each of the gantry, the couch, the collimator, and the MLC leaves. The method may further include instructing a radiation delivery device to deliver the treatment plan according to the delivery trajectory.

An example particle therapy system includes a particle accelerator to output a particle beam having a spot size; a scanning system for the particle accelerator to scan the particle beam in two dimensions across at least part of a treatment area of an irradiation target; and an adaptive aperture between the scanning system and the irradiation target. The adaptive aperture includes structures that are movable relative to the irradiation target to approximate a shape to trim part of the treatment area. The part of the treatment area has a size that is based on an area of the spot size.

Systems and methods for shuttle mode radiation delivery are described herein. One method for radiation delivery comprises moving the patient platform through the patient treatment region multiple times during a treatment session. This may be referred to as patient platform or couch shuttling (i.e., couch shuttle mode). Another method for radiation delivery comprises moving the therapeutic radiation source jaw across a range of positions during a treatment session. The jaw may move across the same range of positions multiple times during a treatment session. This may be referred to as jaw shuttling (i.e., jaw shuttle mode). Some methods combine couch shuttle mode and jaw shuttle mode. Methods of dynamic or pipelined normalization are also described.

Methods of treatment trajectory optimization for radiotherapy treatment of multiple targets include determining beam's eye view (BEV) regions and a BEV region connectivity manifold for each target group of a plurality of target groups separately. The information contained in the BEV regions and the BEV region connectivity manifolds for all target groups is used to guide an optimizer to find optimal treatment trajectories. To improve the visibility of insufficiently exposed voxels of planning target volumes (PTVs), a post-processing step may be performed to enlarge certain BEV regions, which are considered for exposing during treatment trajectory optimization.

Methods of beam angle optimization for intensity modulated radiotherapy (IMRT) treatment include determining beam's eye view (BEV) regions and a BEV region connectivity manifold by evaluating dose response of each region of interest for each vertex in a delivery coordinate space (DCS). The information contained in the BEV regions and the BEV region connectivity manifold is used to guide an optimizer to find optimal field geometries in the IMRT treatment. To improve the visibility of insufficiently exposed voxels of planning target volumes (PTVs), a post-processing step may be performed to enlarge certain BEV regions, which are considered for exposing during treatment trajectory optimization.

An example method includes: receiving, from a treatment planning process, information that is based on a dose distribution for an irradiation target; and performing at least one of the following operations: moving structures to trim spots of a particle beam so that the spots of the particle beam approximate pre-trimmed spots for which characteristics are obtained based on the information received; moving structures to produce a trimming curve for a layer of an irradiation target based on a specification of a trimming curve for the layer included in the information received; moving structures to produce a single trimming curve for all radiation fields of an irradiation target based on specifications of the single trimming curve included in the information received; or moving structures based on configuration information for the structures in the information received.

Systems and methods for volumetric modulated arc therapy (VMAT) treatment planning include a processor determining, using a current solution of a non-convex VMAT optimization problem, a search region defining a corresponding spatial movement range for each leaf of a plurality of leaves of a MLC. The current solution can include first positions of the plurality of leaves of the MLC. The processor can merge, for each spatial movement range of a corresponding leaf, beamlets associated with the spatial movement range, and transform the nonconvex VMAT optimization problem into a convex VMAT optimization based on the merging of b camlets associated with each spatial movement range. The processor can solve the convex VMAT optimization problem to determine at least second positions of the plurality of leaves of the MLC.

Improved radiation therapy with field-in-field multi-leaf collimator, utilizing leaf sequencing Field-in-Field's (FIF) to accurately reproduce the input fluence map or original optimized dose distribution. The number of apertures used is constrained to a user-specified value all the way down to as few as 2 apertures which significantly magnifies the effect of poorly formed apertures. The disclosed invention further includes producing fluence maps with a homogenous dose throughout the treated volume utilizing leaf-sequencing Field-in-Field that reproduces more precise input fluence maps to yield optimized dose distribution.