Disclosed herein are systems and methods for guiding the delivery of therapeutic radiation using incomplete or partial images acquired during a treatment session. A partial image does not have enough information to determine the location of a target region due to, for example, poor or low contrast and/or low SNR. The radiation fluence calculation methods described herein do not require knowledge or calculation of the target location, and yet may help to provide real-time image guided radiation therapy using arbitrarily low SNR images.

A method of operating a radiotherapy system mounted on a gantry surrounding a magnetic resonance imaging system is provided, the radiotherapy system comprising a radiotherapy beam generator, and a radiotherapy imaging system, wherein the gantry is arranged to rotate the radiotherapy beam generator around the magnetic resonance imaging system. The method comprises obtaining a reference image, the reference image including a predetermined feature of the magnetic resonance imaging system located near the radiotherapy imaging system; rotating the gantry relative the magnetic resonance imaging system; obtaining a second image, the second image including the predetermined feature of the magnetic resonance imaging system located near the radiotherapy imaging system; and determining changes in the relative positions of the radiotherapy beam generator, the radiotherapy imaging system, and the magnetic resonance imaging system based on differences in the position of the predetermined feature in the reference image and in the further image.

A system and method include acquisition of a set of tomographic images of a patient volume associated with each of a plurality of timepoints of a first radiopharmaceutical therapy cycle, determination, for each of the plurality of timepoints, of a systematic uncertainty for each of a plurality of regions within the patient volume based on the set of tomographic images associated with the timepoint, determination, for each of the plurality of timepoints, of a quantitative statistical uncertainty based on the set of tomographic images associated with the timepoint, determination of a dose and a dose uncertainty for each of the plurality of regions based on the set of tomographic images, the systematic uncertainty and the quantitative statistical uncertainty for each of the plurality of timepoints, and display of a cumulative dose and cumulative dose uncertainty for each of the plurality of regions based on the dose and the dose uncertainty determined for each of the plurality of regions.

Systems and techniques may be used to estimate a patient state during a radiotherapy treatment. For example, a method may include generating a dictionary of expanded potential patient measurements and corresponding potential patient states using a preliminary motion model. The method may include training, using a machine learning technique, a correspondence motion model relating an input patient measurement to an output patient state using the dictionary. The method may include estimating, using a processor, the patient state corresponding to an input image using the correspondence motion model.

Disclosed herein are methods for radiotherapy treatment plan optimization for irradiating one or more target regions using both an internal therapeutic radiation source (ITRS) and an external therapeutic radiation source (ETRS). One variation of a method comprises iterating through ITRS radiation dose values and ETRS radiation dose values to attain a cumulative dose that meets prescribed dose requirements. In some variations, an ITRS is an injectable compound that has a targeting backbone and a radionuclide, and images acquired using an imaging compound that has the same targeting backbone as the injectable compound can be used to calculate the radiation dose deliverable using the injectable ITRS, and also to calculate firing filters for delivering radiation using a biologically-guided radiation therapy (BGRT) system. Image data acquired from a previous treatment session may be used to adapt the dose provided by an ITRS and/or ETRS for a future treatment session.

Some embodiments relate to imageable radioisotopic microspheres. In some embodiments, the imageable microspheres are radiolabeled with imageable radioisotopes. In some embodiments, the imageable radioisotope is directly coupled to a surface of a substrate of the microsphere. In some embodiments, the imageable microspheres can be used as surrogate particles to predict the distribution of therapeutic microspheres comprising radiotherapeutic isotopes.

An apparatus comprising a radiation source, coincident positron emission detectors configured to detect coincident positron annihilation emissions originating within a coordinate system, and a controller coupled to the radiation source and the coincident positron emission detectors, the controller configured to identify coincident positron annihilation emission paths intersecting one or more volumes in the coordinate system and align the radiation source along an identified coincident positron annihilation emission path.

A radiotherapy device and a control driving method thereof are provided. The radiotherapy device includes a radiation source apparatus, the radiation source apparatus includes a plurality of radiation sources and a collimator, and source points of the plurality of radiation sources are within a preset included angle range in a longitude direction. The preset included angle range is 5 to 60 degrees. The collimator is provided with a plurality of collimating hole groups, and an included angle of each of the collimating hole groups in the longitude direction is within the preset included angle range; and each of the collimating hole groups includes a plurality of collimating holes, and radiation beams emitted from the plurality of radiation sources intersect at a common focus after passing through the collimating holes of the collimating hole groups.

Techniques are described herein for delivering a particle beam composed of a plurality of beamlets from a continuously rotating gantry towards a target, by determining a plurality of predefined spots on the target and configuring them into a set of smaller spots on the outside of the target and a set of larger spots on the inside of the target, optimizing the delivery of the rotating particle beam such that the inside edge and the outside edge of the arc of the rotating beam are delivered to the spots located at the center of the target, and the central component of the arc of the beam is delivered to the spots located at the outside of the target.

A radiation beam delivery apparatus is provided that utilizes a plurality of treatment heat actuators to provide accurate positioning of a treatment head relative to the patient. The apparatus fallows for six degrees of freedom for the treatment heat and further provides for a patient support that can be Independently adjusted along a patient-s x axis, a y-axis, and roll and pitch movements.