In a radiation therapy system, treatment X-rays are delivered to a target volume at the same time that imaging X-rays are also delivered to the target volume for generating image data of the target volume. That is, during an imaging interval in which imaging X-rays are delivered to the target volume, one or more pulses of treatment X-rays are also delivered to the target volume. In each pixel of an X-ray imaging device of the radiation therapy system, image signal is accumulated during portions of the imaging interval in which only imaging X-rays are delivered to the target volume and is prevented from accumulating in each pixel during the pulses of treatment X-rays.

The invention comprises a method and apparatus for tracking and/or imaging impact of a particle beam treating a tumor using one or more imaging systems positionable about the tumor, such as a positron emission tracking and/or imaging system, where resulting tracking/imaging data: dynamically determines a treatment beam position, tracks a history of treatment beam positions, guides the treatment beam, and/or images a tumor before, during, and/or after treatment with the charged particle beam.

An image calibration method includes capturing and correcting a flood field image for background signal and effects of known image-panel features (dead/bad pixels). The corrected image is processed to separate frequencies characteristic of relative pixel sensitivities from frequencies characteristic of radiation energy fluence. The incident energy fluence has a known maximum in-field energy fluence gradient. A model that describes the incident energy fluence on a detector is generated or received. The corrected image may be modeled at frequencies at or below the maximum in-field energy fluence gradient. A pixel sensitivity matrix (PSM) is generated by adjusting the corrected image with the model of the incident energy fluence on the detector. For example, the corrected image signal may be divided by the model or the model may be subtracted from the corrected image. The PSM may be used to correct additional raw images captured by the detector.

Disclosed herein is a method of characterising physical properties of an attenuating element in a radiotherapy device having a radiotherapy radiation source and a radiotherapy radiation detector on respective sides of the attenuating element. The method comprises obtaining an average detected radiotherapy radiation intensity at two or more locations around the attenuating element, comparing the detected intensity at one location with the average intensity, and characterising a corresponding physical property based on the comparison.

Disclosed herein is a method of positioning a patient for radio-therapy treatment using a radiotherapy device. The method comprises determining an identity of a treatment beam that is to be used to treat the patient, determining an offset between a reference location and an isocentre location for the identified treatment beam that is to be used to treat the patient, and changing a spatial relationship between the patient and at least a part of the radiotherapy device, according to the determined offset.

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.

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.