A positioning apparatus and a positioning method has a control element and function 40 includes a radiograph acquisition element 41 that acquires radiograph data detected by two radiography systems selected from a group consisting of a flat panel detector, a DRR (Digital Reconstructed Radiograph) generation element 42 that generates DRR in two different directions by virtually performing fluoroscopic projection relative to the 3-dimensional CT data obtained through the network 17, a positioning element 43 that positions a CT to the X-ray fluoroscopic radiograph obtained from two radiography systems, and a displacement distance calculation element 44 that calculates a displacement distance of the tabletop 31 based on the gap between radiographs for improved positioning. The positioning element 43 has a multidimensional optimization element 45 and a 1-dimensional optimization element 46 that optimize parameters relative to rotation and translation of the fluoroscopic projection to maximize an evaluation function that evaluates a matching degree between the DRR and the X-ray fluoroscopic radiograph.

A radiation therapy system is equipped with a combined imaging system, such as an imaging system combining computed tomography (CT), spectral CT, and single photon emission tomography imaging (SPECT), for guidance of radiation beams providing radiotherapy. The system can include at least one x-ray source that emits an x-ray beam at a low energy level for imaging and/or an x-ray beam at a high energy level for radiation therapy. The system can also include at least one imager, such as a cadmium zinc telluride (CZT) or cadmium telluride (CdTe) flat-panel imager that receives x-ray beams traversing a subject from the x-ray source and gamma rays emitted by radioisotope tracers injected into the subject. Based on the guidance of the triple images (CT, spectral CT, and SPECT), a computer system can control the radiation therapeutic beam delivery to target areas, such as lesions and/or tumors.

A radiation treatment apparatus, comprising a gantry structure comprising a beam member extending between first and second ends of the gantry structure. The radiation treatment apparatus also includes a radiation treatment head movably mounted to the beam member in a manner that allows (i) translation of the radiation treatment head along the beam member between the first and second ends, and (ii) gimballing of the radiation treatment head relative to the beam member, the gimballing comprising pivotable movement in at least one independent pivot direction defined with respect to the beam member. The radiation treatment apparatus also includes a patient couch operative coupled with the radiation treatment head in manner to provide movement of the patient couch relative to the radiation treatment head.

A method of the present disclosure includes performing, by a processing device, a first image registration between a reference image of a patient and a motion image of the patient to perform alignment between the reference image and the motion image, wherein the reference image and the motion image include a target position of the patient. The method further includes performing, by the processing device, a second image registration between the reference image and a motion x-ray image of the patient, via a first digitally reconstructed radiograph (DRR) for the reference image of the patient. The method further includes tracking at least a translational change in the target position based on the first registration and the second registration.

Systems and methods for tracking a target volume, e.g., tumor, in real-time during radiation treatment are provided. Under one aspect, a system includes an ultrasound probe, an x-ray imager, a processor, and a computer-readable medium that stores a 3D image of the tumor in a first reference frame and instructions for causing the processor to: instruct the x-ray imager and ultrasound probe to substantially simultaneously obtain inherently registered x-ray and set-up ultrasound images of the tumor in a second reference frame; establish a transformation between the first and second reference frames by registering the 3D image and the x-ray image; instruct the ultrasound probe to obtain an intrafraction ultrasound image of the tumor; registering the intrafraction ultrasound image with the set-up ultrasound image; and track target volume motion based on the registered intrafraction ultrasound image.

An X-ray fluoroscopic apparatus is capable of irradiating exactly a therapeutic beam considering a specific-regional area, and in addition is able to perform an easy confirmation of the specific region even when the specific region is difficult to visually recognize by a user. A control element 30 has a DRR image generation element 31, an X-ray fluoroscopic radiograph generation element 32, a template area selection element 33, a template generation element 34, a position detection element 35, a radiation area projection element 36, a specific region projection element 37, a superimposition element 38, an image display element 39, a gating element 40 and a memory storing element 41 that stores a variety of data including image data.

A radiation-treatment plan to treat a treatment target in a given patient takes into account imaging-based dosing of that patient by, for example, automatically accounting for radiation dosing of the given patient that results from imaging to determine at least one physical position of the given patient when forming the radiation-treatment plan. These teachings are particularly beneficial when applied in application settings where the aforementioned imaging comprises obtaining images using megavoltage-sourced radiation. By one approach these teachings provide for automatically accounting for radiation dosing of the given patient that results from imaging by, at least in part, automatically adjusting therapeutic dosing of the given patient as a function of the radiation dosing of the given patient that results from such imaging.

Subject positioning systems and methods are provided. A method may include obtaining first information of at least part of a subject when the subject is located at a preset position, and determining, based on the first information, a first position of each of one or more feature points located on the at least part of the subject. The method may include obtaining, using an imaging device, second information of the at least part of the subject when the subject is located at a candidate position. The method may further include determining, based on the second information, a second position of each of the one or more feature points, a first distance between the first position and the second position for each feature point of the one or more feature points, and a target position of the subject based at least in part on the one or more first distances.

Systems and methods for real-time target validation during radiation treatment therapy based on real-time target displacement and radiation dosimetry measurements.

A processing device determines a plurality of angles from which tracking images can be generated by an imaging device. The processing device generates a plurality of projections of a treatment planning image of a patient, the treatment planning image comprising a delineated target, wherein each projection of the plurality of projections has an angle that corresponds to one of the plurality of angles from which the tracking images can be taken. The processing device determines, for each angle of the plurality of angles, a value of a tracking quality metric for tracking the target based on an analysis of a projection generated at that angle. The processing device selects a subset of the plurality of angles that have a tracking quality metric value that satisfies a tracking quality metric criterion.