A radiation therapy system comprising a therapeutic radiation system (e.g., an MV X-ray source, and/or a linac) and a co-planar imaging system (e.g., a kV X-ray system) on a fast rotating ring gantry frame. The therapeutic radiation system and the imaging system are separated by a gantry angle, and the gantry frame may rotate in a direction such that the imaging system leads the MV system. The radiation sources of both the therapeutic and imaging radiation systems are each collimated by a dynamic multi-leaf collimator (DMLC) disposed in the beam path of the MV X-ray source and the kV X-ray source, respectively. In one variation, the imaging system identifies patient tumor(s) positions in real-time. The DMLC for the imaging radiation source limits the kV X-ray beam spread to the tumor(s) and/or immediate tumor regions, and helps to reduce irradiation of healthy tissue (e.g., reduce the dose-area product).

An imaging apparatus comprises a rotatable gantry system positioned at least partially around a patient support; a first source of radiation coupled to the rotatable gantry system, the first source of radiation configured for imaging radiation; a second source of radiation coupled to the rotatable gantry system; and a first radiation detector coupled to the rotatable gantry system and laterally movable relative to a central beam of the first source of radiation to receive radiation from at least the first source of radiation over various fields of view. Alternative configurations of the imaging apparatus and methods of using the imaging apparatus are also provided.

The present invention provides a radiotherapeutical or radiosurgical system comprising at least two high-intensity radiation sources configured to rotate around a common rotation axis and a ring-shaped imaging device. A three-source configuration is considered as the most cost-effective and will be used as an example for illustration. The three radiation sources are specially configured with each radiation source emits a radiation beam having an angle (α1, α2 or α3 respectively) relative to the common rotation axis and targets at a common isocenter. During a radiation treatment, the angles α1, α2 and α3 are independently of each other constant or variable with a magnitude of less than ±15°, and it always remains that α1≠α2, α1≠α3, and α2≠α3. The special configuration of these high-intensity radiation sources and use of a unique compact MLC for each of the radiation sources make it possible for the system to rapidly deliver high-conformal non-coplanar stereotactic radiation treatment in one gantry rotation without any couch rotation. Consequently, a ring-shaped imaging device, which does not allow couch rotation, can be integrated into the system to provide high-precision image guidance. Therefore, the present invention can deliver high precision and high-conformal non-coplanar stereotactic radiation treatment to any part of the body in an extremely short time (0.1-20 seconds), which may exhibit numerous advantages over the prior art, such as reduction of radiation damage to the circulating immune cells in blood and mitigation of patient motion-induced problems, among others.

Disclosed herein is a method of positioning a patient for radiotherapy treatment using a radiotherapy system. The method comprises determining a first target position for the patient for radiotherapy treatment; implementing a spatial relationship between the patient and at least a part of the radiotherapy device, at a first time (t.sub.1), according to the first target position; providing radiotherapy treatment to the patient; determining a current position of the patient, at a second, subsequent time (t.sub.2); and determining whether a change of a spatial relationship between the patient and at least a part of the radiotherapy device should be made, according to the first target position.

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.

A radiation treatment session is initiated to deliver a therapeutic radiation beam from a therapeutic radiation source to a target. One or more X-ray radiation sources are caused to deliver an imaging radiation beam from the one or more X-ray radiation sources through the target to one or more X-ray detectors to acquire imaging data associated with the target during therapeutic radiation beam delivery. One or more volumetric images are constructed using the acquired imaging data.

System for treatment positioning is provided. The system may include a treatment component, an imaging component, and a couch. The treatment component may include a radiation source that has a radiation isocenter. The couch may be movable between the treatment component and the imaging component, and include a positioning line that has a positioning feature. The system may acquire at least one first image relating to a subject and the positioning line using the radiation source at a set-up position. The system may also acquire at least one second image relating to the subject and the positioning line using the imaging component at an imaging position. The system may further determine a treatment isocenter of a target of the subject based on the at least one second image, and determine a treatment position of the subject based on the first image(s), the second image(s), and the positioning line.

Disclosed herein is a medical instrument (100, 300). Execution of the machine executable instructions causes a processor (106) to: receive (206) a set of joint location coordinates (128) for a subject (118) reposing on a subject support (120), receive (207) a body orientation (132) in response to inputting the set of joint location coordinates into a predetermined logic module (130), calculate (208) a torso aspect ratio (134) from set of joint location coordinates. If (210) the torso aspect ratio is greater than a predetermined threshold (136) then (212) the body pose of the subject is a decubitus pose. Execution of the machine executable instructions further cause the processor to assign (220) the body pose as being a supine pose if the subject is face up on the subject support or assign (222) the body pose as being a prone pose if the subject is face down on the subject support if the torso aspect ratio is less than or equal to the predetermined threshold. Execution of the machine executable instructions further cause the processor to generate (216) a subject pose label (142).

A radio therapy system includes a first x-ray source. The first x-ray source is configured to produce first x-ray photons in a first energy range suitable for imaging and project the first x-ray photons onto an area designated for imaging. The system includes a second x-ray source configured to produce second x-ray photons in a second energy range higher energy than the first energy range, produce third x-ray photons in a third energy range higher energy than the first energy range, project the second x-ray photons onto the area designated for imaging, and project the third x-ray photons onto an area designated for treatment. The system includes an analytical portion configured to collect and combine data to create a composite output including at least one image, the combining based in part on a spectral analysis.

Systems and methods for tracking a target volume, e.g., tumor, in real-time during radiation treatment are provided. The system includes a memory to store a pre-acquired 3D image of the anatomy of interest in a first reference frame and a processor, operative coupled with the memory, to receive, from an ultrasound probe, a set-up ultrasound image of the anatomy of interest in a second reference frame. The processor further to establish a transformation between the first and second reference frames by registering the set-up ultrasound image with the pre-acquired 3D image and receive, from the ultrasound probe, an intrafraction ultrasound image of the anatomy of interest. The processor further to register the intrafraction ultrasound image with the set-up ultrasound image and track motion of the anatomy of interest based on the registered intrafraction ultrasound image.