A radiation therapy apparatus determines a set of angles that have a tracking quality metric value that satisfies a tracking quality metric criterion. During an alignment phase or a treatment phase for a treatment stage of a target by the radiation therapy apparatus, the radiation therapy apparatus performs selects at least a first angle and a second angle from the set of angles for a first rotation of the gantry. The radiation therapy apparatus generates, using an imaging device mounted to the gantry, a first tracking image of the target from the first angle during the first rotation of the gantry. The radiation therapy apparatus generates, using the imaging device, a second tracking image of the target from the second angle during the first rotation of the gantry. The radiation therapy apparatus performs the target tracking based on the first tracking image and the second tracking image.

A system for limited view imaging is provided. The system may obtain a reference image of an object. The system may identify, from the reference image, one or more critical boundaries between a target organ of the object and one or more adjacent organs of the target organ. The system may determine an imaging angle range of the object based on the one or more critical boundaries. The system may further cause an imaging device to scan the object based on the imaging angle range, the object being in a breath-hold state during the scan.

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. 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.

A system proton treatment system including a proton accelerator structured to generate a proton beam, a plurality of beamline pathways configured to direct the proton beam from the proton accelerator to a corresponding plurality of treatment rooms, a rotatable bending magnet located between the proton accelerator and the plurality of treatment rooms, the rotatable bending magnet being structured to selectively rotate between multiple treatment rooms, and an upright patient positioning mechanism disposed in each of the treatment rooms, the upright patient positioning mechanism being structured to support a patient within a particular treatment room and to rotate the patient between a fixed imaging source and imaging panel.

A computer implemented method for determining a two dimensional DRR referred to as dynamic DRR based on a 4D-CT, the 4D-CT describing a sequence of three dimensional medical computer tomographic images of an anatomical body part of a patient, the images being referred to as sequence CTs, the 4D-CT representing the anatomical body part at different points in time, the anatomical body part comprising at least one primary anatomical element and secondary anatomical elements, the computer implemented method comprising the following steps: acquiring the 4D-CT; acquiring a planning CT, the planning CT being a three dimensional image used for planning of a treatment of the patient, the planning CT being acquired based on at least one of the sequence CTs or independently from the 4D-CT, acquiring a three dimensional image, referred to as undynamic CT, from the 4D-CT, the undynamic CT comprising at least one first image element representing the at least one primary anatomical element and second image elements representing the secondary anatomical elements; acquiring at least one trajectory, referred to as primary trajectory, based on the 4D-CT, the at least one primary trajectory describing a path of the at least one first image element as a function of time; acquiring trajectories of the second image elements, referred to as secondary trajectories, based on the 4D-CT; for the image elements of the undynamic CT, determining trajectory similarity values based on the at least one primary trajectory and the secondary trajectories, the trajectory similarity values respectively describing a measure of similarity between a respective one of the secondary trajectories and the at least one primary trajectory; determining the dynamic DRR by using the determined trajectory similarity values, and, in case the planning CT is acquired independently from the 4D-CT, further using a transformation referred to as planning transformation from the undynamic CT to the planning CT, at least a part of image values of image elements of the dynamic DRR being determined by using the trajectory similarity values.

A method and apparatus for marking a target with a radiopaque marker is disclosed. The method may include providing a radiopaque filament and inserting at least portion of the radiopaque filament into tissue. The filament may extend continuously and at last partially around a perimeter of the target so that the filament is disposed in a plurality of surgical planes to demarcate the target with the radiopaque maker.

Systems and methods for automatic, customized radiation treatment plan generation for cancer are disclosed. According to an aspect, a method includes receiving data indicating anatomy information of a patient and radiation beam characteristics of a radiation therapy system. Further, the method includes determining energy levels for application of radiation beams to the patient.

A medical apparatus according to an embodiment includes an acquirer, an identifier, an output controller, a display controller, and an input operation acquirer. The acquirer acquires a fluoroscopic image of a object from an imager which performs imaging by irradiating the object with an electromagnetic wave to generate the fluoroscopic image. The identifier identifies a target position of the object in the fluoroscopic image. The output controller outputs an irradiation permission signal to a therapeutic device which irradiates the object with a therapeutic beam when the target position identified by the identifier is settled within an irradiation permission range. The display controller causes a display to display an interface image for receiving an instruction to start each of a preparation stage of a therapy and an irradiation stage of the therapeutic beam. The input operation acquirer acquires details of an input operation performed by a user in the interface image.

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