Disclosed is a computer-implemented method of determining a treatment plan, encompassing acquiring patient image data, acquiring target data describing targets, acquiring position data describing control points which define one or more arcs, and determining target projection data which describes outlines of the target in a beam's-eye view. Margin data is acquired. For the outlines, margins are applied to determine auxiliary outlines. Beam shaping device data is determined describing configurations of the collimator leaves so that irradiation of the auxiliary outlines is enabled. Based on these configurations, the irradiation amount is simulated for voxels of the patient image data. Constraints to be fulfilled by the treatment plan may be set. Configurations of blockings, arc-weights and margins are proposed. Only different combinations of these parameters are proposed while additional possible parameters are neglected. An optimization algorithm is used to minimize an objective function. The best configuration is selected as the treatment plan.

A tandem applicator assembly for brachytherapy that includes a tandem and a camera system. The tandem has a tubular main body with a trail end and a lead end. A transparent cap is affixed to the lead end. The camera system is removably received by the tandem through the trail end of the tubular main body. The camera system is disposed inside of the transparent cap. The camera system includes at least one digital camera configured to acquire color images from a patient through the transparent cap. The tandem applicator assembly may be used with a treatment planning system and method for customizing a treatment plan for a patient undergoing brachytherapy.

Disclosed herein is a medical system (400) comprising a magnetic resonance imaging system (402) configured for acquiring magnetic resonance imaging data (444, 444′) from a subject (418) within an imaging zone (408). The medical system further comprises a subject support (100) configured for supporting at least a portion of the subject within the imaging zone, wherein the subject support comprises a radiotherapy couch top (102) 5 configured for receiving the subject. The radiotherapy couch top comprises a flat surface (104) configured for supporting the subject. The radiotherapy couch top further comprises a head support region (110) configured for receiving a head of the subject, wherein the head region comprises a depression (108). The head region is configured for receiving a flat head support plate (112). The medical system further comprises a flat head support plate. The flat head support plate is configured to form part of the flat surface (104′) when installed in the head region.

In one aspect, the present disclosure relates to a method of adaptive treatment of a subject with a tumor. The method may include administering a first pulse dose of radiation to a tumor within a subject; administering a second pulse dose of radiation to the tumor, wherein the second pulse dose is administered after an observation period, the observation period having a duration of at least 7 days; and concurrently treating the subject with an immunotherapy.

A system for assisting in performing an interventional procedure includes a first subsystem (1) and a second subsystem at different places, especially in different rooms. At a first place the first subsystem a) generates a first image of a subject (22) while an interventional device (12) is introduced into the subject and b) determines the position of the interventional device within the subject. At a second place the second subsystem a) generates a second image of the subject with the introduced interventional device and b) plans and/or monitors a treatment based on the second image and the already determined position of the interventional device, i.e. the second subsystem does not need to start a completely new position determination procedure, thereby reducing technical efforts. Moreover, the first and second images are generated by different imaging modalities which allows for, for instance, improved image guidance, planning and/or monitoring.

A computer-implemented method of segmenting a reconstructed volume of a region of patient anatomy includes: determining an anatomical region associated with the reconstructed volume; detecting one or more metal objects disposed in an initial 3D metal object mask associated with the reconstructed volume; for each of the one or more metal objects disposed in the initial 3D metal object mask, determining a volume associated with the metal object; determining a value for at least one segmentation parameter based on the anatomical region and on the volume associated with the one or more metal objects; and generating a final 3D metal object mask associated with the reconstructed digital volume using the value for the segmentation parameter.

A radiation treatment plan three-dimensional dose prediction machine learning model is trained using a training corpus that includes a plurality of radiation treatment plans that are not specific to a particular patient and wherein the training corpus includes some, but not all, possible patient volumes of interest. Information regarding the patient (including information regarding at least one volume of interest for the patient that was not represented in the training corpus) is input to the radiation treatment plan three-dimensional dose prediction machine model. The latter generates predicted three-dimensional dose distributions that include a predicted three-dimensional dose distribution for the at least one volume of interest that was not represented in the training corpus.

In a method to determine a patient (radiation) dose distribution (13), it is provided to calculate, from a measured signal (7) of a detector (6) placed behind a region of interest, a dose distribution (11) for a patient-shaped water equivalent phantom (12) and to compute from this a patient dose distribution (13) that takes into account inhomogeneities of a matter distribution of the patient (4).

Systems and methods are described for the monitoring of patient motion via the detection of changes in capacitance, as measured using a capacitance position sensing electrode array. The changes in capacitance may be processed to determine a corresponding positional offset, for example, using a calibration data set relating capacitance to offset for each electrode of the array. The detected positional offset may be employed to provide feedback to a surgeon or operator of a medical device, or directly to the medical device for the control thereof. A medical procedure may be interrupted when the positional offset is detected to exceed a threshold. Alternatively, the detected positional offset may be employed to manually or automatically reconfigure a medical device to compensate for the detected change in position. Various configurations of capacitive position sensing devices are disclosed, including embodiment in incorporating capacitive sensing electrodes with a mask or other support structure.

A linear particle accelerator (LINAC) radiotherapy system of a subject is provided. The system includes a gantry and an adaptive radiotherapy computing device. The gantry includes a radiation delivery assembly including LINACs and an x-ray imaging assembly, wherein the gantry defines a c-arm. The at least one processor of the adaptive radiotherapy computing device is programmed to receive first images of the subject acquired by an imaging system, and receive second images of the subject acquired by the x-ray imaging assembly, wherein the first images have higher resolutions than the second images. The at least one processor is further programmed to adapt a treatment plan using the second images, wherein the treatment plan was designed based on the first images, and a level of optimization in adapting the treatment plan is adjustable. The at least one processor is also programmed to output the adapted treatment plan.