The invention comprises a method and apparatus for using a single robotic positioning arm to simultaneously move, relative to a proton beam path entering a treatment room containing the patient, both: (1) a patient support and (2) an imaging system. The robotic arm moving the imaging system and patient independently from movement of a nozzle system directing protons into the treatment rooms allows: simultaneously translating past the patient and rotating around the patient an X-ray source of the imaging system; translating a rotatable unit, of the imaging system, longitudinally past the patient on a translation guide rail; moving the patient support and the imaging system through at least four degrees of freedom relative to a movable proton beam; and/or simultaneous or alternating movement of the proton treatment beam and the imaging system relative to the patient.

Described is a process for performing radiotherapy treatment according to the invention comprising the following operations: S.1) providing a radiotherapy system (1) comprising a radiation head (3), a movement system (7), a diagnostics subsystem for images, in turn comprising a probe (13) and a position detection subsystem (11); S.2) by means of the at least one probe (13) acquiring a plurality of images (IM_1, IM_2, IMJ, IM_N) of internal sections of a body to be treated (P); S.3) by means of the position detection subsystem (11) detecting the position in space of the probe (13) whilst it acquires each of said images (IMJ, IMJ, IMJ, IM_N); S.4) on the basis of said images (IMJ, IMJ, IMJ, IM_N) and by means of the movement system (7) moving the radiation head (3) and performing a predetermined treatment on the body to be treated (P).

Disclosed is a computer-implemented method which encompasses comparing the requirements for radiation therapy imposed by a patient's individual condition to the capabilities and requirements of different types of treatment machines to determine a suitable radiation treatment strategy including an identification of the treatment machine which shall be used and a treatment plan. Furthermore, a treatment plan is generated by simulating the envisaged radiation treatment. The type of treatment machine associated with a predetermined value for the sum of weights for all fields assigned to that treatment machine is determined as the treatment machine for treating the patient, and corresponding information is output detailing the treatment specifics such as radiation treatment parameters specifically suited for the patient target region tumor thereby reducing radiation exposure, efficient use of the machine and appropriate gating and tracking modes.

Exemplary inventive practice implements Europium Tetrakis Dibenzoylmethide Triethylammonium (EuD.sub.4TEA) so as to administer ion beam therapy with extreme precision. An EUD.sub.4TEA-inclusive marker (e.g., a solid or gel) is exactingly placed on the skin of a patient in accordance with a predetermined location of cancerous tissue beneath the skin. An ion beam aimed at the EUD.sub.4TEA-inclusive marker results in luminescence of at least a portion of the EUD.sub.4TEA-inclusive marker, thereby indicating that at least a portion of the ion beam is traveling through the EUD.sub.4TEA-inclusive marker and striking the cancer therebelow. According to other modes of exemplary inventive practice, a medical phantom contains a tumor replica that is visibly contrastive inside the medical phantom in terms of luminescence versus non-luminescence. The tumor replica is targeted in ion beam testing to discern optimal geometric and radiative conditions for treating a correspondingly situated patient on the same treatment couch.

The invention relies on a medical device for an intracorporeal location, wherein: it comprises a deformable armature, at least partially made of a shape memory material and having an Ea end and an Eb end, said Ea end being larger than said Eb end, it has an essentially triangular, trapezoidal, ovally or diamond-shaped, the sides of which extending between said Eb end and the corners of said Ea end, said deformable armature optionally includes a middle rip extending from said Ea end to said Eb end and multiple cross elements extending between the middle rip and said sides, wherein said sides are formed by sides braces, it comprises at least one x-ray visible marker fixed at the deformable armature selected from the group consisting of gold, silver, platinum, tantalum, tungsten, niobium, palladium, iridium, it comprises a guide suited for the intracorporeal introduction of said medical device, and an extraction holder of the medical device.

The invention also relies on a device for the introduction, by an endoscopic or percutaneous way, of the medical device, and on a method for accurately targeting a target area during radiation treatment through image guidance comprising determining the location of the medical device in real time using at least one method of targeting selected from the group consisting of lasers, visual, infrared, MRI/MRS, RF and radiation; and modifying the radiation treatment beam path to adaptively compensate for a change in position of the target area.

A motion compensation system includes a plurality of RF transmitters, a plurality of direction of arrival sensors, and a positioning table which together are usable to compensate for intrafraction motion of a patient during a medical procedure. The positioning table may be a secondary table arranged next to or above a primary table such as a radiotherapy couch, allowing for repositioning of part of patient such as the head and neck relative to a remainder of the body. The motion compensation system employs a direction of arrival sensor that includes rotating antenna elements in a configuration that improves the ease and accuracy of signal processing and analysis to identify the position of an RF transmitter affixed to a patient. The repositioning table has six degrees of freedom and is safe for use in imaging and radiation intensive environments.

A system includes a first radiation source configured to provide therapeutic radiation in a treatment area and an automated patient transport configured to transport a patient from a preparation area to the treatment area, to position a treatment volume in the patient relative to the therapeutic radiation from the first radiation source, and to support the patient in receiving the therapeutic radiation. The automated patient transport comprises a first detector configured to detect a first patient positioning indicator located in and/or on the patient indicative of a position of the treatment volume.

The invention comprises a method and apparatus for reducing a kinetic energy of positively charged particles, comprising the steps of: (1) transporting the positively charged particles from an accelerator into an exit nozzle system along a beam line; (2) providing a first chamber of the exit nozzle system, the first chamber comprising: an incident side comprising an incident aperture, an exit side comprising an exit aperture, and a beam path of the positively charged particles from the incident aperture to the exit aperture; (3) filling the beam path in the chamber with a liquid; and (4) using the liquid to reduce the kinetic energy of the positively charged particles. The kinetic energy dissipater is optionally used in combination with a proton therapy cancer treatment system and/or a proton tomography imaging system.

The invention comprises a method and apparatus for imaging a tumor with X-rays while, simultaneously or alternatingly, treating or imaging the tumor with positively charged particles. An X-ray imaging system, such as one or two sets of a cone beam X-ray source coupled to an X-ray detector, is rotatable about a first axis and a patient. The X-ray imaging system is positioned off axis a path of charged particles delivered through an exit port of a nozzle system from a synchrotron and does not block a path of the positively charged particles from the exit nozzle to the patient or an imaging path from the patient to a scintillation detector. Fiducial indicators are used to confirm an unobstructed path of the positively charged particles in a treatment room comprising many movable elements, such as the X-ray imaging system and a patient positioning system/couch.

Apparatus for improving image guidance in radiation therapy applications are described. In one aspect, a patient support with integrated radiopaque markers is described. In another aspect, a bite block with integrated sensors, radiopaque markers, or both, is described. The integrated sensors may include a radiation detector, a pH sensor, or both. Radiation detectors that may be used include a dosimeter. As an example, the dosimeter may include a film dosimeter, an ion chamber dosimeter, a diode dosimeter, or other suitable dosimeters and combinations thereof.