CN116209499A - Dose and dose rate information correlation with volume for radiation treatment planning - Google Patents

Abstract

A method for planning a radiation treatment, accessing (802) information comprising a calculated dose and a calculated dose rate for a sub-volume in a treatment target, and also accessing (804) information comprising metric values of the sub-volume as a function of the calculated dose and the calculated dose rate. The graphical user interface includes a rendering based on the calculated dose, the calculated dose rate, and the metric value (806).

Description

Dose and dose rate information correlation with volume for radiation treatment planning

Cross Reference to Related Applications

The present application claims priority from U.S. provisional application Ser. No. 63/043,027, entitled "Correlation of Dose and dose rate information to Volume for radiation treatment planning," filed by Lansonneuror et al at 23, 6, 2020, which is incorporated herein by reference in its entirety.

Background

The use of radiation therapy to treat cancer is well known. Generally, radiation therapy involves directing a beam of energetic proton, photon, ion, or electron radiation ("therapeutic radiation") into a target or volume (e.g., a volume including a tumor or lesion) in a treatment target.

Before a patient is treated with radiation, a treatment plan specific to the patient is developed. The planned usage may define various aspects of the treatment based on simulations and optimizations of past experience. Generally, the purpose of a treatment plan is to deliver sufficient radiation to unhealthy tissue while minimizing radiation exposure to surrounding healthy tissue.

The objective of the planner is to find an optimal solution for a number of clinical purposes, which is contradictory in the sense that an improvement towards one purpose may have a detrimental effect on achieving another purpose. For example, treatment planning to protect the liver from a dose of radiation may result in the stomach being subjected to excessive radiation. These types of compromises result in an iterative process in which the planner creates different plans to find one that is best suited to achieve the desired result.

Relatively recent radiation biology studies have demonstrated the effectiveness of delivering an entire relatively high therapeutic radiation dose to a target in a single short period of time. This type of treatment is generally referred to herein as FLASH radiation therapy (FLASH RT). Evidence to date suggests that FLASH RT advantageously protects normal healthy tissue from damage when the tissue is exposed to high radiation doses for only a short period of time.

FLASH RT introduces significant interdependencies that are not captured by traditional radiation processing planning. Current tools such as dose-volume and dose rate volume histograms do not capture dose and dose rate interdependencies. For example, from a clinician's perspective, developing dose rate profiles for high quality plans is not trivial, as normal tissue may benefit from low dose rates in certain areas if the dose is minimized in those areas. Also, for example, irradiating a limited number of spots in the treatment volume may result in delivery of a high dose rate, but low dose uniformity at the tumor level, while on the other hand, the quality of the plan may be improved by increasing the number of spots at the expense of a reduced dose rate.

Disclosure of Invention

In one aspect the invention provides a computer system as defined in claim 1. In a further aspect, the invention provides a non-transitory computer readable storage medium having computer executable instructions for causing a computer system to perform a method for planning a radiation treatment as defined in claim 12. In a further aspect, the invention provides a non-transitory computer readable storage medium having computer executable instructions for causing a computer system to perform a method for planning a radiation treatment as defined in claim 17. Optional features are specified in the dependent claims.

Thus, according to some embodiments of the present invention, an improved method for generating and evaluating radiation treatment plans for FLASH radiation treatment (FLASH RT) and improving radiation treatment based on these plans is provided.

In some embodiments, a computer-implemented method for planning a radiation treatment includes accessing information including a calculated dose and a calculated dose rate for a subvolume in a treatment target (e.g., any number of voxels in any three-dimensional shape of a volume constituting the subvolume), and also accessing information including a metric value (e.g., number, percentage, or fraction) of the subvolume as a function of the calculated dose and the calculated dose rate. A Graphical User Interface (GUI) is then displayed that includes a rendering (e.g., a visual display) based on the calculated dose, the calculated dose rate, and the metric value.

In some embodiments, the rendering includes a visualization (e.g., a graphical element) of a dose-volume histogram as a first dimension of the GUI (e.g., an element or aspect of the visualization, or a spatial dimension in the virtual space), a visualization of a dose rate-volume histogram as a second dimension of the GUI, and a visualization of a metric value as a third dimension of the GUI. For example, the rendering may include a visualization of the calculated dose rate for each sub-volume, a visualization of the calculated dose for each sub-volume, and a visualization of the metric for each sub-volume. In some embodiments, the rendering further includes visualization of the prescribed dose and the prescribed dose rate. In some embodiments, the rendering further includes a visualization of normal tissue complication probabilities for each sub-volume. In some embodiments, the rendering further includes visualization of tumor control probabilities for each sub-volume. In some embodiments, different attribute values (e.g., color, pattern, gray level, alphanumeric text, or brightness) are associated with the visualized elements.

Displaying the GUI that visualizes the calculated dose and calculated dose rate for the subvolumes in the treatment target, and the metric values of the subvolumes as a function of the calculated dose and calculated dose rate in a single plot allows the clinician to better assess the balance between dose rate and dose uniformity. Basically in a single glance, the clinician can evaluate the quality of the proposed radiation treatment plan, make changes to the proposed plan, and evaluate the outcome of the changes.

In radiation therapy techniques, where the intensity of the particle beam is constant or modulated over the delivery field, such as in Intensity Modulated Radiation Therapy (IMRT) and Intensity Modulated Particle Therapy (IMPT), the beam intensity is varied over each treatment region of the patient (the volume in the treatment target). Depending on the processing mode, the degrees of freedom available for intensity modulation include beam shaping (collimation), beam weighting (spot scanning) and angle of incidence (which may be referred to as beam geometry). These degrees of freedom result in an almost unlimited number of potential treatment plans, thus continually effectively generating and evaluating high quality treatment plans beyond the capabilities of humans and relying on the use of computer systems, particularly in view of the time constraints associated with using radiation therapy to treat diseases such as cancer, and in cases where a large number of patients experience or need to experience radiation therapy during any given period of time.

Some embodiments according to the invention improve radiation treatment planning and treatment itself by extending FLASH RT to a wider variety of treatment platforms and target sites (e.g., tumors). By optimizing the balance between the dose rate of unhealthy tissue (e.g., tumor) delivered to the volume of the treatment target and the dose rate delivered to surrounding healthy tissue, the treatment plan generated as described herein is better for protecting healthy tissue from radiation, as compared to conventional techniques for FLASH dose rates. When used with FLASH dose rates, management of patient movement is simplified because the dose is administered in a short period of time (e.g., less than one second). Treatment planning, while still a complex task, is improved over conventional treatment planning. In addition to these benefits, the GUI facilitates treatment planning by allowing a planner to easily visualize key elements of a proposed treatment plan, easily visualize the effects of changes to the proposed plan on those elements, and compare different plans, and define and establish optimization goals.

In summary, some embodiments according to the present disclosure relate to generating and implementing a treatment plan that is most efficient (relative to other plans) and has minimal (or most acceptable) side effects (e.g., lower dose rates outside of the area being treated). Thus, the field of radiation treatment planning is specifically improved according to some embodiments of the invention, and the field of radiation therapy is generally improved. Some embodiments according to the invention allow for faster generation of more efficient treatment plans. Furthermore, some embodiments according to the present invention help improve the functionality of a computer because, for example, by reducing the complexity of generating a processing plan, less computing resources are needed and consumed, meaning that computer resources are freed up to perform other tasks.

In addition to radiation therapy techniques such as IMRT and IMPT, embodiments in accordance with the invention may be used for spatially segmented radiation therapies, including high dose spatially segmented grid radiation therapies, mini-beam radiation therapies and microbeam radiation therapies.

These and other objects and advantages according to embodiments of the present invention will be recognized by those skilled in the art upon review of the following detailed description, which is set forth in the various drawings.

This summary is provided to introduce a selection of concepts that are further described below in the detailed description. This summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used to limit the scope of the claimed subject matter.

Drawings

The accompanying drawings, which are incorporated in and form a part of this specification, wherein like numerals depict like elements, illustrate embodiments of the present disclosure and, together with the detailed description, serve to explain the principles of the disclosure.

FIG. 1 is a block diagram of one example of a computer system upon which embodiments described herein may be implemented.

Fig. 2 is a block diagram illustrating one example of an automatic radiation therapy treatment planning system in an embodiment in accordance with the invention.

FIG. 3 illustrates a knowledge-based planning system in an embodiment in accordance with the invention.

Fig. 4 is a block diagram illustrating selected components of a radiation therapy system upon which an embodiment according to the present invention may be implemented.

Fig. 5A and 5B illustrate examples of dose rate-volume histograms in one embodiment according to the invention.

Fig. 5C illustrates sub-volumes in a volume of a treatment target in accordance with one embodiment of the invention.

Fig. 5D illustrates one example of an illumination time-volume histogram in one embodiment in accordance with the invention.

FIG. 6 is a flowchart of one example of computer-implemented operations for radiation treatment planning in an embodiment in accordance with the invention.

Fig. 7 illustrates one example of a dose rate contour in an embodiment in accordance with the invention.

Fig. 8, 9 and 10 are flowcharts of one example of computer-implemented operations for planning radiation processing in an embodiment in accordance with the invention.

Fig. 11, 12, 13A, 13B, 14-28, 29A, 29B, 30A, 30B, and 31-35 are examples of graphical user interfaces on a display device and are used for planning radiation treatment according to embodiments of the invention.

Detailed Description

Reference will now be made in detail to the various embodiments of the present disclosure, examples of which are illustrated in the accompanying drawings. While described in conjunction with these embodiments, it will be understood that these embodiments are not intended to limit the present disclosure to these embodiments. On the contrary, the present disclosure is intended to cover alternatives, modifications and equivalents, which may be included within the spirit and scope of the disclosure as defined by the appended claims. Furthermore, in the following detailed description of the present disclosure, numerous specific details are set forth in order to provide a thorough understanding of the present disclosure. However, it is understood that the present disclosure may be practiced without these specific details. In other instances, well-known methods, procedures, components, and circuits have not been described in detail so as not to unnecessarily obscure aspects of the present disclosure.

Some portions of the detailed descriptions which follow are presented in terms of procedures, logic blocks, processing, and other symbolic representations of operations on data bits within a computer memory. These descriptions and representations are the means used by those skilled in the data processing arts to most effectively convey the substance of their work to others skilled in the art. In this application, a process, logic block, procedure, etc., is conceived to be a self-consistent sequence of steps or instructions leading to a desired result. The steps are those utilizing physical manipulations of physical quantities. Usually, though not necessarily, these quantities take the form of electrical or magnetic signals capable of being stored, transferred, combined, compared, and otherwise manipulated in a computer system. It has proven convenient at times, principally for reasons of common usage, to refer to these signals as transactions, bits, values, elements, symbols, characters, samples, pixels, or the like.

It should be borne in mind, however, that all of these and similar terms are to be associated with the appropriate physical quantities and are merely convenient labels applied to these quantities. Unless specifically stated otherwise as apparent from the following discussions, it is appreciated that throughout the present disclosure, discussions utilizing terms such as "accessing," "generating," "representing," "applying," "indicating," "storing," "using," "adjusting," "including," "calculating," "computing," "determining," "visualizing," "displaying," "drawing," "associating," "inter-partition" or "rounding" or the like, refer to the actions and processes (e.g., the flowcharts of fig. 6 and 8-10) of a computer system, or similar electronic computing device or processor (e.g., computer system 100 of fig. 1). A computer system or similar electronic computing device manipulates and transforms data represented as physical (electronic) quantities within the computer system memories, registers or other such information storage, transmission or display devices.

The following discussion includes terms such as "dose," "dose rate," "energy," and the like. Values are associated with each such term unless otherwise stated. For example, the dose has a value and may have a different value. For simplicity, the term "dose" may refer to a value such as a dose unless otherwise specified or apparent from the discussion.

Portions of the detailed description that follows are presented and discussed in terms of methods. Although steps describing the operations of these methods and their ordering are disclosed in the figures herein (e.g., fig. 6 and 8-10), these steps and ordering are merely examples. Embodiments are well suited to performing various other steps or variations of the steps recited in the flowcharts of the figures herein, in a sequence other than that depicted and described herein.

The embodiments described herein may be discussed in the general context of computer-executable instructions, such as program modules, residing on some form of computer-readable storage medium, executed by one or more computers or other devices. By way of example, and not limitation, computer readable storage media may comprise non-transitory computer storage media and communication media. Generally, program modules include routines, programs, objects, components, data structures, etc. that perform particular tasks or implement particular abstract data types. The functionality of the program modules may be combined or distributed as desired in various embodiments.

Computer storage media includes volatile and nonvolatile, removable and non-removable media implemented in any method or technology for storage of information such as computer readable instructions, data structures, program modules or other data. Computer storage media includes, but is not limited to, random Access Memory (RAM), read Only Memory (ROM), electrically Erasable Programmable ROM (EEPROM), flash memory or other memory technology, compact disk ROM (CD-ROM), digital Versatile Disks (DVD) or other optical storage, magnetic disk storage, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other medium that can be used to store the desired information and that can be accessed to retrieve the information.

Communication media may embody computer-executable instructions, data structures, and program modules and includes any information delivery media. By way of example, and not limitation, communication media includes wired media such as a wired network or direct-wired connection, and wireless media such as acoustic, radio Frequency (RF), infrared and other wireless media. Combinations of any of the above should also be included within the scope of computer readable media.

Radiation treatment plan using different types of histograms

FIG. 1 illustrates a block diagram of one example of a computer system 100 upon which embodiments described herein may be implemented. In its most basic configuration, system 100 includes at least one processing unit 102 and memory 104. This most basic configuration is illustrated in fig. 1 by dashed line 106. The system 100 may also have additional features and/or functionality. For example, system 100 may also include additional storage (removable and/or non-removable) including, but not limited to, magnetic or optical disks or tape. Such additional storage is illustrated in fig. 1 by removable storage 108 and non-removable storage 120. The system 100 may also contain communication connection(s) 122 that allow the device to communicate with other devices, for example, in a networked environment using logical connections to one or more remote computers.

The system 100 also includes input device(s) 124 such as keyboard, mouse, pen, voice input device, touch input device, etc. Also included are output device(s) 126 such as a display device, speakers, printer, etc. The display device may be, for example, a cathode ray tube display, a light emitting diode display or a liquid crystal display.

In the example of fig. 1, memory 104 includes computer-readable instructions, data structures, program modules, etc. associated with an "optimizer" model 150. However, the optimizer model 150 may alternatively reside in any one of the computer storage media used by the system 100, or may be distributed over some combination of computer storage media, or may be distributed over some combination of networked computers. The function of the optimizer model 150 is described below.

Fig. 2 is a block diagram illustrating one example of an automated radiation therapy treatment planning system 200 in an embodiment in accordance with the invention. The system 200 includes an input interface 210 that receives patient-specific information (data) 201, a data processing component 220 that implements the optimizer model 150, and an output interface 230. The system 200 may be implemented in whole or in part on the computer system 100 (FIG. 1) or using the computer system 100 (FIG. 1) as a software program, hardware logic, or a combination thereof.

In the example of fig. 2, patient-specific information is provided to and processed by the optimizer model 150. In an embodiment, the optimizer model 150 generates a prediction result and then a treatment plan based on the prediction result may be generated.

Fig. 3 illustrates a knowledge-based planning system 300 in an embodiment in accordance with the invention. In the example of fig. 3, system 300 includes a knowledge base 302 and a process planning tool set 310. The knowledge base 302 includes patient records 304 (e.g., radiation treatment plans), treatment types 306, and statistical models 308. The treatment planning tool set 310 in the example of fig. 3 includes a current patient record 312, a treatment type 314, a medical image processing module 316, an optimizer model (module) 150, a dose distribution module 320, and a final radiation treatment plan 322.

The process planning tool set 310 searches the knowledge base 302 (via patient records 304) for previous patient records similar to the current patient record 312. The statistical model 308 may be used to compare the predicted outcome for the current patient record 312 to the statistical patient. A radiation treatment plan 322 is generated using the current patient record 312, the selected treatment type 306, and the selected statistical model 308, the tool set 310.

More specifically, based on past clinical experience, there may be the most frequently used type of treatment when a patient exhibits a particular diagnosis, stage, age, weight, sex, complications, etc. The first step treatment type 314 may be selected by selecting a treatment type that the planner has used in the past for similar patients. Patient results may be included in the treatment planning process, which may include normal tissue complication probabilities (e.g., local recurrence failure, and overall survival as a function of dose and/or dose rate) as a function of dose rate and patient-specific treatment type results. The medical image processing module 316 provides automatic contouring and automatic segmentation of two-dimensional cross-sectional slices (e.g., from any imaging modality such as, but not limited to, computed Tomography (CT), positron emission tomography-CT, magnetic resonance imaging, and ultrasound) to form a three-dimensional (3D) image using medical images in the current patient record 312. The dose and dose rate profiles are calculated by the dose and dose rate distribution module 320. The dose and dose rate distribution module 320 may utilize the optimizer model 150.

In an embodiment according to the invention, the optimizer model 150 uses a dose prediction model to provide, for example, a 3D dose distribution, fluence and dose rate, and associated dose-volume histogram (DVH) and dose rate-volume histogram (DRVH).

The following discussion relates to beams, volumes, doses, dose rates, and other elements or values. The following discussion is in the context of modeling elements and calculated values in the process planning tool set 310 and the optimizer model 150 (FIG. 3), unless otherwise stated or explicitly stated in the discussion.

Fig. 4 is a block diagram illustrating selected components of a radiation therapy system 400 upon which an embodiment according to the present invention may be implemented. In the example of fig. 4, system 400 includes a beam system 404 and a nozzle 406.

The beam system 404 generates and transmits the beam 401. The beam 401 may be a proton beam, an electron beam, a photon beam, an ion beam, or a nuclear beam (e.g., carbon, helium, and lithium). In an embodiment, the beam system 404 includes components that direct (e.g., bend, steer or direct) the beam system in a direction toward the nozzle 406 and into the nozzle 406, depending on the type of beam. In an embodiment, a radiation therapy system can include one or more multi-leaf collimators (MLCs); each MLC leaf can be independently moved back and forth by control system 410 to dynamically shape the aperture through which the beam passes, to block or unblock portions of the beam, thereby controlling the beam shape and exposure time. The beam system 404 may also include components for adjusting (e.g., reducing) the beam energy entering the nozzle 406.

The nozzles 406 are used to direct the beam at various locations (volumes in the treatment target) (e.g., volumes in the patient) in the treatment chamber that are supported on a patient support 408 (e.g., chair or table). The volume in the treatment target may be an organ, a portion of an organ (e.g., a volume or region within an organ), a tumor, diseased tissue, or a patient contour. The volume in the treatment target can include unhealthy tissue (e.g., a tumor) and healthy tissue. The volume in the treatment target may be (virtually) divided into a plurality of voxels. The sub-volume may comprise a single voxel or a plurality of voxels.

The nozzle 406 may be mounted on or part of a gantry, which may be movable relative to the patient support 408, which patient support 408 may also be movable. In an embodiment, the beam system 404 is also mounted on or part of the gantry. In another embodiment, the beam system is separate from (but in communication with) the gantry.

The control system 410 of fig. 4 receives and implements a prescribed radiation treatment plan. In an embodiment, the control system 410 comprises a computer system having a processor, memory, an input device (e.g., a keyboard), and a display, possibly in a well-known manner. The control system 410 may receive data regarding the operation of the system 400. The control system 410 may control parameters of the beam system 404, the nozzle 406, and the patient support 408, including parameters such as the energy, intensity, direction, size, and/or shape of the beam, based on the data it receives and based on prescribed radiation treatment plans.

As described above, the beam 401 entering the nozzle 406 has a specific energy. Thus, in an embodiment according to the present disclosure, the nozzle 406 includes one or more components that affect (e.g., reduce, modulate) the beam energy. The term "beam energy adjuster" is used herein as a general term for one or more components that affect the beam energy in order to control the extent of the beam (e.g., how far the beam penetrates into the target), to control the dose delivered by the beam, and/or to control the depth-dose profile of the beam, depending on the type of beam. For example, for a proton beam or ion beam having a bragg peak, the beam energy adjuster may control the position of the bragg peak in the volume of the treatment target. In various embodiments, the beam energy adjuster 407 comprises a range modulator, a range shifter, or both a range modulator and a range shifter.

In radiation therapy techniques, where the intensity of the particle beam is constant or modulated over the delivery field, such as Intensity Modulated Radiation Therapy (IMRT) and Intensity Modulated Particle Therapy (IMPT), the beam intensity is varied over each treatment region in the patient (treating the volume in the target). Depending on the processing mode, the degrees of freedom available for intensity modulation include beam shaping (collimation), beam weighting (spot scanning) and angle of incidence (which may be referred to as beam geometry). These degrees of freedom result in an almost unlimited number of potential treatment plans, and thus continue to effectively generate and evaluate high quality treatment plans beyond the capabilities of humans and rely on the use of computer systems, particularly in view of the time constraints associated with using radiation therapy to treat diseases such as cancer, and in cases where a large number of patients experience or need to experience radiation therapy during any given period of time.

The beam 401 may have virtually any regular or irregular cross-sectional (e.g., eye view of the beam) shape. For example, the shape of the beam 401 may be defined using an MLC that obscures a portion or portions of the beam. Different beams may have different shapes.

In an embodiment, beam 401 includes a number of beam segments or sub-beams (which may also be referred to as spots). The beam 401 is assigned a maximum energy (e.g., 80 MeV) and the energy level of each beam segment is defined as a percentage or fraction of the maximum energy. Essentially, each beam segment is weighted according to its energy level; some beam segments are weighted to have a higher energy level than others. By weighting the energy of each beam segment, in effect, the intensity of each beam segment is also weighted. A defined energy level or intensity may be achieved for each beam segment using the beam energy adjuster 407.

Each beam segment may deliver a relatively high dose rate (a relatively high dose in a relatively short period of time). For example, each beam segment may deliver at least 40 gray (Gy) in less than one second, and may deliver as much as 120Gy or more per second.

In operation, in an embodiment, beam segments are delivered sequentially. For example, a first beam segment is delivered to a volume in the treatment target (on), and then off, then a second beam segment is on, then off, and so on. Each beam segment may be turned on for only a fraction of a second (e.g., on the order of milliseconds).

A single beam may be used and applied from different directions and in the same plane or in different planes. Alternatively, multiple beams may be used in the same plane or in different planes. The direction and/or number of beams may be varied over multiple treatment sessions (i.e., segmented in time) so that a uniform dose is delivered over the volume of the treatment target. The number of beams delivered at any one time depends on the number of gantry or nozzles in the radiation treatment system (e.g., radiation treatment system 400 of fig. 4) and the treatment plan.

In an embodiment according to the invention, DRVH (which is different from DVH) is generated for volumes in the treatment target. DRVH may be generated based on the proposed radiation treatment plan. The DRVH may be stored in a computer system memory and used to generate a final radiation treatment plan to be used to treat the patient. The parameter values that have an effect on the dose rate can be adjusted until the DRVH meets or is associated with the goal of patient treatment.

Fig. 5A illustrates one example of a DRVH 500 in an embodiment in accordance with the invention. DRVH plots the cumulative dose rate-volume in the treatment target frequency distribution, which summarizes the simulated dose rate distribution within the treatment target volume of interest, which is generated by the proposed radiation treatment plan. The optimizer model 150 of fig. 1 may be used to determine a simulated dose rate distribution. DRVH indicates the dose rate and the percentage of the volume of treatment target that received that dose rate. For example, as shown in fig. 5A, a dose rate of X or greater (at least X) is received by 100% of the volume in the treatment target, a dose rate of Y or greater (at least Y) is received by 50% of the volume in the treatment target, and so on. DRVH 500 may be displayed as a Graphical User Interface (GUI) or as part thereof (see discussion below).

For example, the volume in the treatment target may comprise different organs, or it may comprise healthy tissue and unhealthy tissue (e.g., a tumor). Accordingly, referring to fig. 5B and 5c, drvh 510 includes a plurality of curves 512 and 514, respectively, showing a simulated dose rate distribution for a first subvolume 522 (e.g., for one organ, or for healthy tissue) and a simulated dose rate distribution for a second subvolume 524 (e.g., for a second organ, or for unhealthy tissue) of volume 504 in the treatment target. More than two simulated dose rate profiles may be included in the DRVH. The DRVH 510 may be displayed as or as part of a GUI.

In an embodiment according to the invention, an illumination time-volume histogram (which is different from, but may be used with, DVH and/or DRVH) is generated for a volume in a treatment target. The illumination time-volume histogram may be stored in a computer system memory and used in combination with or in place of DVH and/or DRVH to generate the radiation treatment plan.

Fig. 5D illustrates one example of an illumination time-volume histogram 550 in one embodiment in accordance with the invention. The shot time-volume histogram plots the cumulative shot time-volume plot in the treatment target frequency distribution, which summarizes the simulated shot time distribution within the volume of the treatment target that would result from the proposed radiation treatment plan. The simulated illumination time distribution may be determined using the optimizer model 150 of fig. 1. The illumination time-volume histogram indicates the illumination time (length of time) and the percentage of the volume illuminated for these lengths of time. The DRVH 550 may be displayed as or as part of a GUI.

Fig. 6 is a flowchart 600 of one example of computer-implemented operations for a radiation treatment plan including generating a DVH, DRVH, or illumination time-volume histogram in accordance with some embodiments of the invention. Flowchart 600 may be implemented as computer-executable instructions (e.g., optimizer model 150 of fig. 1) residing on some form of computer-readable storage medium (e.g., in memory of computer system 100 of fig. 1).

In block 602 of FIG. 6, the proposed radiation treatment plan is defined (e.g., using the optimizer model 150 of FIGS. 1 and 2), stored in and accessed from computer system memory. The proposed radiation treatment plan includes parameter values and other parameters that may affect the dose and dose rate. Parameters that may affect the dose and dose rate include, but are not limited to, the number of shots that process the volume in the target, the duration of each shot (shot time), and the dose deposited in each shot. The parameters may also include the direction of the beams to be directed into the volume of the treatment target, and the beam energy of each beam. The parameters may also include a time period during which the irradiation is applied (e.g., multiple irradiations are applied over a time period such as an hour, where each irradiation in the time period is separated from the next irradiation by another time period) and a time interval between each irradiation time period (e.g., the time period of each hour duration is separated from the next time period by one day). If the volume in the processing target is divided into sub-volumes or voxels, the parameter values may be based on each sub-volume or each voxel (e.g., the value of each sub-volume or voxel).

The appropriate dose threshold curve(s) (e.g., normal tissue reserve dose versus dose rate or exposure time) may be utilized in the optimization model 150 (fig. 3) to formulate a dose limit for the radiation treatment plan. For example, the beam direction (gantry angle) and beam segment weights may be determined using an appropriate (e.g., tissue dependent) dose threshold curve. That is, parameters affecting the dose may be adjusted during radiation treatment planning such that the limitations in the dose threshold curve are met. The dose threshold curve may be tissue dependent. For example, the dose threshold curve for the lung may be different from the dose threshold curve for the brain.

Dose limiting may include, but is not limited to: maximum limit on the irradiation time of each sub-volume (voxel) in the target (e.g., treatment time less than x1 seconds for each voxel of the target tissue); maximum limit on irradiation time for each sub-volume (voxel) outside the target (e.g., treatment time is less than x2 seconds for each voxel of normal tissue; x1 and x2 may be the same or different); a minimum limit on the dose rate for each sub-volume (voxel) in the target (e.g., a dose rate greater than y1 Gy/sec for each voxel of the target tissue); and/or a minimum limit on the dose rate for each sub-volume (voxel) outside the target (e.g., the dose rate is greater than y2 Gy/sec for each voxel of normal tissue; y1 and y2 may be the same or different). In general, the amount of time that normal tissue is intended to be irradiated is limited.

In block 604, in one embodiment, DVH and DRVH are generated based on parameter values in the proposed radiation treatment plan. The dose and dose rate for each sub-volume or voxel may be determined. The dose rate is the sum of the doses deposited in each shot divided by the sum of the shot duration. The dose rate may be determined and recorded using a fine time index (e.g., time increments on the order of milliseconds); that is, for example, the dose per sub-volume or voxel may be recorded in time increments on the order of per millisecond per beam and per fraction. The dose and dose rate are cumulative. For example, depending on the beam direction and energy, the cumulative dose and dose rate of some portions (e.g., sub-volumes or voxels) of the volume in the treatment target may be higher than other portions. The dose and dose rate for each sub-volume or voxel may be calculated to include ray-tracing (and monte carlo simulations) in which each beam particle is traced to determine the primary scatter, secondary scatter, etc. of each particle to obtain a true voxel-based or sub-volume-based dose rate during each shot.

In one embodiment, an illumination time-volume histogram is generated. The illumination time-volume histogram may be generated in substantially the same manner as just described for generating DRVH.

In block 606, the DVH, DRVH, and/or irradiation time-volume histogram may be evaluated by determining whether the proposed radiation treatment plan meets a target (e.g., clinical purpose) specified for treatment of the patient. Clinical objectives or targets may be represented according to a set of quality metrics (such as target uniformity, vital organ preservation, etc.) with corresponding target values. Another way to evaluate histograms is a knowledge-based method that incorporates and reflects current best practices collected from multiple previous similar treatments of other patients. Yet another way to assist the planner is to use a multi-standard optimization (MCO) method for processing planning. Pareto surface navigation is an MCO technique that facilitates exploring a trade-off between clinical goals. For a given set of clinical purposes, a treatment plan is considered pareto optimal if it meets these purposes and if no metrics can be improved without deteriorating at least one other metric.

As described above, for FLASH RT, a dose rate of at least 40Gy in less than 1 second, and a dose rate of up to 120Gy per second or more, may be used. Thus, another way to evaluate DVH and DRVH is to define dose and dose rate thresholds based on FLASH RT dose rates, and also specify thresholds for dose and dose rate in the treatment target. DVH and DRVH can be evaluated by determining whether a measure of volume in the treatment target (e.g., fraction, number, or percentage of subvolumes or voxels) meets the dose and dose rate thresholds. For example, a dose rate volume histogram may be considered satisfactory if 60% of the volume in the treatment target (specifically, the volume portion in the treatment target includes unhealthy tissue) receives a dose rate of at least 50Gy per second.

In block 608 of fig. 6, some or all of the parameter values of the proposed radiation treatment plan may be iteratively adjusted to generate different DVH, DRVH, and/or irradiation time-volume histograms to determine a final set of parameter values that produce a histogram (or histograms) that yields a prescribed (final) radiation treatment plan that best meets the objectives of the patient treatment (clinical objectives) or meets the above-described thresholds.

In block 610, the final set of parameter values is then included in a prescribed radiation treatment plan for treating the patient.

Generally, embodiments according to the present invention optimize radiation treatment plans based on dose, dose rate, and/or irradiation time. This is not to say that treatment plan optimization is based solely on dose, dose rate and/or irradiation time.

Correlation of dose, dose rate and volume of treatment plan

Fig. 8, 9 and 10 are flowcharts 800, 900 and 1000 (800-1000) of examples of computer-implemented methods for planning radiation treatment in an embodiment in accordance with the invention. The flowcharts 800-1000 may be implemented as computer-executable instructions (e.g., the optimizer model 150 of fig. 1) residing on some form of computer-readable storage medium (e.g., in memory of the computer system 100 of fig. 1). In these embodiments, the GUI is generated and displayed as a result of the disclosed methods. For example, the GUI visualizes the calculated dose (e.g., total calculated dose) and calculated dose rate for a subvolume in the treatment target in a single rendering, as well as a metric value for the subvolume as a function of the calculated dose and calculated dose rate. Examples of GUIs in accordance with the present invention are provided in FIGS. 11, 12, 13A, 13B and 14-28, 29A, 29B, 30A, 30B and 31-35.

In block 802 of fig. 8, information including a calculated dose (e.g., a total calculated dose) and a calculated dose rate for a subvolume in a treatment target (e.g., any number of voxels of any three-dimensional shape of the volume that comprises the subvolume), and information including a metric value (e.g., number, percentage, or fraction) of the subvolume as a function of the calculated dose and the calculated dose rate, is accessed from computer system memory.

In block 804, information including metric values (numbers, percentages, or fractions) of sub-volumes as a function of calculated dose (e.g., total calculated dose) and calculated dose rate is also accessed from computer system memory.

In block 806, a GUI including a rendering (e.g., visual display) based on the calculated dose, the calculated dose rate, and the metric value is displayed on the display device 126 (fig. 1) of the computer system.

In block 808 of FIG. 8, different attribute values (e.g., color, pattern, gray level, alphanumeric text, or brightness) are associated with the visualized elements in the GUI.

Referring now to FIG. 9, in block 902, a radiation treatment plan is accessed from a computer system memory. The radiation treatment plan includes, for example, the number of beams to be directed to the volume into the treatment target, the direction of the beams, and the dose rate range for each beam.

In block 904, the dose (e.g., total dose) for each sub-volume is calculated using the number and direction of beams and the range of dose rates.

In block 906, the dose rate for each sub-volume is calculated using the number and direction of beams and the range of dose rates.

In block 908, metric values (e.g., numbers, fractions, or percentages) calculated to receive at least the respective dose level (e.g., total dose) and at least the sub-volume of the respective dose rate level are determined for different levels or ranges (e.g., intervals) of dose (e.g., total dose) and different levels or ranges (e.g., intervals) of dose rate.

In block 910, a GUI including a rendering (e.g., visual display) based on the calculated dose, the calculated dose rate, and the metric value is displayed on the display device 126 (fig. 1).

Referring now to fig. 10, in block 1002, a DVH is generated that processes a volume in a target.

In block 1004, a volumetric DRVH is generated.

In block 1006, a GUI including a combined rendering of the DVH and DRVH is displayed on the display device 126 (fig. 1) of the computer system. The combined plot visualizes the measure of the volume calculated to receive the given dose as a function of the dose rate, and also visualizes the measure of the volume calculated to receive the given dose rate as a function of the dose.

In an embodiment, the drawing in the GUI generated and displayed as described above includes a visualization (e.g., a graphical element) of a DVH that is a first dimension of the GUI (e.g., an element or aspect of the visualization, or a spatial dimension in the virtual space), a visualization of a DRVH that is a second dimension of the GUI, and a visualization of a metric value that is a third dimension of the GUI. For example, the rendering may include a visualization of the calculated dose rate for each sub-volume, a visualization of the calculated dose (e.g., the calculated total dose) for each sub-volume, and a visualization of the metrics for each sub-volume. In an embodiment, the rendering further comprises visualization of the prescribed dose and the prescribed dose rate. In an embodiment, the rendering further comprises a visualization of Normal Tissue Complication Probability (NTCP) for each sub-volume. In an embodiment, the rendering further includes a visualization of Tumor Control Probability (TCP) for each subvolume.

Although the operations in fig. 6 and 8-10 are presented in series and in a particular order, the invention is not so limited. These operations may be performed in a different order and/or in parallel, and the operations may also be performed in an iterative manner. As described above, the use of an optimizer model 150 executing consistently on the computer system 100 (FIG. 1) for radiation treatment planning as disclosed herein is important due to the different parameters that need to be considered, the range of values of these parameters, the interrelationship of these parameters, the need for an efficient and least risky treatment plan for the patient, and the need for fast generation of high quality treatment plans.

11, 12, 13A, 13B and 14-28, 29A, 29B, 30A, 30B and 31-35 illustrate examples of GUIs that may be used to display information associated with planning radiation treatment in accordance with embodiments of the invention. The GUI may be generated using the methods described above and implemented using computer executable instructions (e.g., the optimizer model 150 of FIG. 1) residing on some form of computer readable storage medium (e.g., the memory of the computer system 100 of FIG. 1) and may be displayed on the output device 126 of the computer system.

Embodiments in accordance with the present invention are not limited to the GUIs illustrated in FIGS. 11, 12, 13A, 13B and 14-28, 29A, 29B, 30A, 30B and 31-35. Generally, the GUI in an embodiment according to the invention allows dose, dose rate, dose and dose rate per volume, and interdependencies between the measure of volume as a function of dose and as a function of dose rate to be easily visualized for radiation treatment planning. In the discussion that follows, the dose, dose rate, etc. are calculated values.

Further, the disclosed GUI may include information other than that included in the examples. For example, the GUI may also be used to present information such as the direction of the beams to be directed into each sub-volume and the beam energy of each beam.

In an embodiment, a drop down menu or other type of GUI element (not shown in the figures) may be used to select and establish settings (e.g., attributes, thresholds, etc.) of the GUI as well as the type(s) of information to be displayed at any one time.

Furthermore, the GUI need not be a static display. For example, the information presented in the GUI may be programmed to change over time or in response to user input to illustrate the cumulative dose or dose rate versus time. Further, for example, the GUI may be programmed to sequentially present different cross-sectional slices of the volume in the processing target to provide a depth dimension to the two-dimensional representation, or to manipulate (e.g., rotate) the virtual three-dimensional representation so that it can be viewed from different perspectives.

In the example of fig. 11, GUI 1100 includes a two-dimensional plot of dose rate versus dose. The dose and dose rate for each sub-volume (e.g., voxel) are plotted in two dimensions. The distribution (measure) of the sub-volumes is projected onto the dose axis to generate DVH and also onto the dose rate axis to generate DRVH.

In the example of fig. 12, GUI 1200 includes a two-dimensional plot of dose rate versus dose for normal tissue and for tumors. The dose and dose rate of each sub-volume (e.g., voxel) are visualized (plotted) in two dimensions. A tissue specific filter is defined in the graph for normal tissue and a tumor specific filter is defined in the graph for tumor tissue. Different filters may be defined to account for the response of different tissues to dose and dose rate. The voxels may be color coded to indicate the relative values of NTCP and TCP. In the example of fig. 12, a color key is included in GUI 1200 and is associated with each graph as shown. The color of the voxels in the graph may be compared to the keys to indicate the relative value of NTCP or TCP.

In the example of fig. 13A and 13B, GUI 1300 includes a visualization of dose and dose rate. GUI 1300 includes a rendering of a plane at an isocenter of a volume of a treatment target. The total area of the plane is divided into different smaller areas, wherein the size of each smaller area indicates (e.g., is proportional to) the volume of the target that receives a dose level (fig. 13A) or dose rate (fig. 13B). Smaller areas may be color coded to indicate the dose level. In the example of fig. 13A and 13B, color keys are included in GUI 1300 to associate colors in the drawing with different dose levels and different dose rate levels, respectively. The color of each smaller region may be compared to the color in the key to determine the dose/dose rate level of each smaller region.

In the example of fig. 14, GUI 1400 includes a plot of the dose along one axis and a measure (percentage) of the volume receiving a given dose along a corresponding axis, and a plot of the dose rate along another axis and a percentage of the volume receiving a given dose rate along a corresponding axis. GUI 1400 is useful for visualizing and identifying qualitative trends. In this figure, each "X" represents one voxel with a dose and a dose rate. Each "X" has a certain transparency so that the density of points in the graph can be visualized.

In the example of fig. 15, GUI 1500 includes a two-dimensional rendering of dose rate levels (ranges or intervals) on one axis and dose levels (ranges or intervals) on another axis. A measure (percentage) of the volume of a given combination of received dose and dose rate is projected into the plot. In the example of fig. 15, approximately 9% of the volume receives a dose of at least approximately 17.5Gy at a dose rate of approximately 250Gy per second. The projection of the volume may be color coded to indicate a measure of the volume receiving a given dose and dose rate. In the example of fig. 15, color keys are included in GUI 1500 to associate colors in the rendering with different metrics of the volume. One or more colors of the projection of the volume may be compared to the colors in the key to determine the dose/dose rate level for each smaller region.

GUI 1500 allows for easy visualization and identification of the overall quantitative characteristics. For example, as shown by the circled areas in fig. 16, 17, and 18, the intra-field dose rate gradients and field edges with peaks of 18Gy and 260Gy per second, respectively, are easily visualized.

In the example of fig. 19, GUI 1900 includes a two-dimensional plot of dose rate levels (ranges or intervals) on one axis and dose levels (ranges or intervals) on another axis. In this example, for each point in the plot, a measure (e.g., percentage) of the volume at or above the dose level and dose rate is represented as a color. In the example of fig. 19, color keys are included in GUI 1900 to associate colors in the rendering with different metrics of the volume. Further, in this example, the horizontal slice (indicated by the dashed line in fig. 19) represents the DVH of the volumetric region above the given dose rate.

In the example of fig. 20, GUI 2000 includes a two-dimensional plot of dose rate levels (ranges or intervals) on one axis and dose levels (ranges or intervals) on the other axis. In this example, each line in the plot represents a measure (e.g., a percentage) of the volume at or above a given dose level and dose rate. In the example of fig. 20, each line is a different color, and a color key is included in GUI 2000 to associate the color of the line under drawing with different metrics of volume. For example, in the example of fig. 21, approximately 60% of the volume receives at least 17.5Gy at a dose rate of at least 250Gy per second.

In the example of fig. 22, GUI 2000 also includes an area 2010 representing the prescribed dose and dose rate. In this example, the prescription is at least 150Gy to 90% of the volume per second, with the 90% of the volume receiving more than 10Gy. In this example, the prescription is satisfied because region 2010 is surrounded by a line corresponding to 90% of the volume.

In the example of fig. 23, for a given dose rate (e.g., at least 40Gy per second), GUI 2300 includes a two-dimensional plot of the dose rate level (range or interval) on one axis and a measure (fraction) of the volume of the received given dose on the other axis. In this example, each line in the drawing represents a different subvolume (e.g., planning Target Volume (PTV), right lung, and spinal cord). In the example of fig. 23, each line is a different color, and color keys are included in GUI 2300 to associate the color of the line under drawing with the associated sub-volume. In this example, 80% of the PTVs receive a dose of greater than 60Gy and a dose rate of 40Gy per second.

In the example of fig. 24, GUI 2400 includes a two-dimensional plot of dose rate levels (ranges or intervals) on one axis and a measure (percentage) of the volume receiving a given dose on the other axis. GUI 2400 represents a DVH graph for a region at or above a dose rate. In this example, each line in the plot represents a different dose rate. In the example of fig. 24, each line is a different color, and color keys are included in GUI 2400 to associate the colors of the lines being drawn with different dose rates.

In the example of fig. 25, for a given dose rate (e.g., 150Gy per second), GUI 2500 includes a two-dimensional plot of dose rate level (range or interval) on one axis and a measure (percentage) of the volume receiving the given dose on the other axis. GUI 2500 represents a visualization (graph) of DVH at or above a given dose rate. In the example of fig. 25, GUI 2500 also includes an area 2502 representing the prescribed dose and dose rate. In this example, the prescription is at least 150Gy to 90% of the volume per second, with the 90% of the volume receiving more than 10Gy.

In the example of fig. 26, GUI 2600 includes a plot of a scatter plot of dose rate levels (ranges or intervals) on one axis and dose levels (ranges or intervals) on another axis, showing dose and dose rate distributions for different subvolumes (e.g., spinal cord, right lung, and PTV). In this example, each subvolume is represented as a different color, and color keys are included in GUI 2600 to associate colors in the drawing with the different subvolumes.

In the example of fig. 27 and 28, GUIs 2700 and 2800 include rendering of volumes (e.g., CT images). In these examples, differently colored contours are used to delineate portions (e.g., voxels) of the volume that have doses and dose rates above a particular threshold, below a particular threshold, or within a particular range. Color keys are included in GUIs 2700 and 2800 to associate colors in the drawing with, for example, dose levels. In the example of fig. 27, the dose distribution is shown in the depicted rectangular region for only sub-volumes (voxels) with a dose rate between 40Gy and 120Gy per second. In the example of fig. 28, the depicted rectangular region contains voxels with a dose above 10Gy and a dose rate above 10Gy per second.

In the example of fig. 29A, GUI 2900 includes a plot of cumulative dose versus time. The GUI 2900 is useful for determining the time interval (dt) required to deliver a given dose level (e.g., 90%).

Fig. 29B illustrates an example of GUI 2910 in which more than one dose rate is specified per voxel. When a particular dose or range of dose rates is specified, the corresponding dose is displayed. In the example of fig. 29B, the lower line in the graph (which may be shown using a first color) represents the dose rate as a function of time, and the upper line in the graph (which may be shown using a second, different color) represents the cumulative dose as a function of time. The slope of the upper line is the dose rate as a function of time. For the illustrated voxels, GUI 2910 provides a visualization of the dose, average dose rate, and the dose to be delivered for a dose rate or range of dose rates. In this example, GUI 2910 shows a dose of 60Gy, an average dose rate of about 40Gy per second, and a dose of about 40Gy delivered at a dose rate in the range of 150Gy to 200Gy per second.

In the example of fig. 30A, GUI 3000 includes a plot of the superposition of isodose contours on the dose rate distribution in a volume (e.g., CT image). In the example of fig. 30A, different colors are used to indicate different dose levels and different dose rates. Color keys are included in GUI 3000 to correlate colors in the drawing with dose levels and dose rates. By using the pointer shown in the figure to select different dose levels and different dose rates to be drawn in the GUI 3000, the drawing can be manipulated using keys. For example, one color may be used to represent a dose in the range of 5-11Gy, and different shades of that color may be used to represent different ranges of dose rates corresponding to that range of doses (e.g., 151-201Gy, 201-252Gy, and 252-303Gy per second). The user may interactively change the position of the pointer on one or both of the vertical and horizontal axes. By changing the position of these pointers, the corresponding ranges of doses and dose rates associated with a particular color or shade are also changed, and the isodose contours in GUI 3000 are correspondingly changed.

Fig. 30B illustrates one example of a GUI3010 in which doses corresponding to a particular dose rate range are plotted on top of a CT image (e.g., a CT image also shown in fig. 30A). In this example, the dose rate range limits are applied separately for each voxel and the corresponding portion of the dose is visualized. Alternatively, a dose rate distribution limited by the accumulated dose in each voxel may be visualized; for example, the GUI may display a dose rate in each voxel at which X percent of the dose has been accumulated at each voxel. The user may select a dose percentage for selecting a dose rate for each voxel display. Similar to the above, the user may also interactively select and adjust the position of the pointer to associate colors with dose ranges. In this example, the user may also adjust the position of the pointer to select a dose rate range. Only the dose to be delivered at the selected dose rate is drawn in GUI 3010. The example of fig. 30B shows an isodose profile for a dose to be delivered at a dose rate range of 201-252Gy per second.

In the example of fig. 31, for a given volume or sub-volume (e.g., structure "S1"), GUI 3100 includes a two-dimensional plot of dose rate level (range or interval) on one axis of the graph and a measure (percentage) of the volume receiving the given dose on the other axis of the graph. The lines in the graph depict the different areas of visualization. These lines define regions representing different DVHs corresponding to different dose rates. In this example, each region is represented by a different coloring level, and keys are included in GUI 3100 to associate coloring levels in the visualization with dose levels and dose rates. Further, in this example, different pointers are included in the drawing to indicate different purposes (e.g., prescription dose and dose rate).

In the example of fig. 32, the GUI 3200 includes a drawing of a region of beam superposition in three dimensions. The number of times a voxel is traversed by the beam is color coded. The GUI 3200 includes x and y coordinates in a plane of the volume shown in the visualization, and also includes z coordinates indicating a depth of the plane in the volume. The specific targets in the volume are outlined in the example of fig. 32. In this example, five beams are shown and a key is included in the GUI 3200 to correlate the color of a voxel with the number of beams reaching that voxel.

In the example of fig. 33, GUI 3300 includes a plot of the cumulative dose delivered above a certain dose rate threshold (e.g., above 40Gy per second). In the example of fig. 33, different colors are used to indicate different cumulative doses. Color keys are included in GUI 3300 to correlate colors in the drawing with dose levels and dose rates. The specific targets in the volume are outlined in the example of fig. 33.

In the example of fig. 34, GUI 3400 includes a plot of the cumulative dose delivered below a certain dose rate threshold (e.g., below 40Gy per second). In the example of fig. 34, different colors are used to indicate different cumulative doses. Color keys are included in GUI 3400 to correlate colors in the drawing with dose levels and dose rates. The specific targets in the volume are outlined in the example of fig. 34.

In the example of fig. 35, GUI 3500 includes a plot of DVH delivered at doses above a certain dose rate threshold (e.g., above 40Gy per second). In this example, the dashed line represents total DVH, and the solid line represents DVH above a certain dose rate threshold (e.g., above 40Gy per second). The difference between each pair of solid and dashed lines indicates that the organ portions at the hazardous volume are not delivered at a high enough dose rate. In the example of fig. 35, different colors are used to indicate different organs or structures. Color keys are included in GUI 3500 to associate colors in the drawing with different organs or structures.

In summary, some embodiments according to the present invention improve radiation treatment planning and treatment itself by extending FLASH RT to a broader variety of treatment platforms and target sites. In contrast to conventional techniques, even for non-FLASH dose rates, the treatment plan generated as described herein is better for protecting normal tissue from radiation by reducing (if not minimizing) the magnitude of the dose to normal tissue (off target) by design (and in some cases, integrating). When used with FLASH dose rates, management of patient movement is simplified because the dose is administered in a short period of time (e.g., less than one second). Process planning, while still a complex task of finding a balance between competing and relevant parameters, is simplified relative to conventional planning. The techniques described herein may be used for stereotactic radiosurgery and stereotactic body radiation therapy with single or multiple metastases.

In addition to these benefits, the GUI facilitates treatment planning by allowing a planner to easily visualize key elements of a proposed treatment plan (e.g., dose rate per sub-volume), easily visualize the impact of changes to the proposed plan on those elements, and easily visualize comparisons between different plans.

In addition to radiation treatment techniques in which the intensity of the particle beam is constant or modulated over the delivery field (such as IMRT and IMPT), embodiments according to the invention may be used for spatially segmented radiation treatments, including high dose spatially segmented grid radiation treatments, mini-beam radiation therapy and microbeam radiation treatments.

Although the subject matter has been described in language specific to structural features and/or methodological acts, it is to be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or acts described above. Rather, the specific features and acts described above are disclosed as example forms of implementing the claims.

Claims (20)

1. A computer system, comprising:

a processor;

a display device coupled to the processor; and

a memory coupled to the processor and comprising instructions that, when executed, cause the processor to perform a method for planning radiation processing, the method comprising:

accessing information comprising a calculated dose and a calculated dose rate for a plurality of sub-volumes in a volume in a treatment target;

accessing information comprising metric values for the plurality of subvolumes as a function of the calculated dose and the calculated dose rate; and

A Graphical User Interface (GUI) is displayed on the display device, the GUI including a rendering based on the calculated dose, the calculated dose rate, and the metric value.

2. The computer system of claim 1, wherein the rendering includes a visualization of a dose-volume histogram as a first dimension of the GUI, a visualization of a dose-volume histogram as a second dimension of the GUI, and a visualization of the metric as a third dimension of the GUI.

3. The computer system of claim 1 or 2, wherein the rendering comprises a visualization of the calculated dose for each of the plurality of subvolumes.

4. A computer system according to claim 1, 2 or 3, wherein the rendering comprises a visualization of calculated dose rates for each of the plurality of sub-volumes.

5. The computer system of claim 1, 2, 3, or 4, wherein the rendering includes a visualization of the metric value for each of the plurality of subvolumes.

6. The computer system of any one of claims 1 to 5, wherein the rendering further comprises visualization of a prescribed dose and a prescribed dose rate.

7. The computer system of any of claims 1 to 6, wherein the GUI further comprises a visualization of normal tissue complication probabilities for each of the plurality of subvolumes.

8. The computer system of any one of claims 1 to 7, wherein the GUI further comprises a visualization of tumor control probability for each of the plurality of subvolumes.

9. The computer system of any one of claims 1 to 8, wherein the method further comprises:

associating attribute values to the plotted elements corresponding to the calculated dose, the calculated dose rate, and the metric value; and

and displaying the element according to the attribute value.

10. The computer system of claim 9, wherein the attribute value is a value of an attribute selected from the group consisting of: color, pattern, gray scale, alphanumeric text, and brightness.

11. The computer system of any of claims 1 to 10, wherein the drawing further comprises an isodose contour line and an isodose rate contour line.

12. A non-transitory computer readable storage medium having computer executable instructions for causing a computer system to perform a method for planning radiation processing, the method comprising:

Accessing a radiation treatment plan comprising a number of beams to be directed to a volume into a treatment target, a direction of the beams, and a dose rate range for each of the beams, wherein the volume comprises a plurality of sub-volumes;

calculating a dose for each of the plurality of sub-volumes using the number and direction of the beams and the dose rate range;

calculating a dose rate for each of the plurality of sub-volumes using the number and direction of the beams and the dose rate range;

for different dose levels and different dose rate levels, determining a metric value for the sub-volume calculated to receive at least a respective dose level and at least a respective dose rate level; and

a Graphical User Interface (GUI) including the results of the determination is displayed on a display device of the computer system.

13. The non-transitory computer readable storage medium of claim 12, wherein the GUI includes a visualization of a dose-volume histogram as a first dimension of the GUI, a visualization of a dose-volume histogram as a second dimension of the GUI, and a visualization of the metric as a third dimension of the GUI.

14. The non-transitory computer readable storage medium of claim 12 or 13, wherein the rendering comprises one or more visualizations selected from the group consisting of: a visualization of the calculated dose for each of the plurality of sub-volumes, a calculated dose rate for each of the plurality of sub-volumes, and a visualization of the metric for each of the plurality of sub-volumes.

15. The non-transitory computer readable storage medium of any one of claims 12 to 14, wherein the rendering further comprises one or more visualizations selected from the group consisting of: visualization of the prescribed dose and the prescribed dose rate, visualization of the normal tissue complication probability for each of the plurality of subvolumes, and visualization of the tumor control probability for each of the plurality of subvolumes.

16. The non-transitory computer readable storage medium of any one of claims 12 to 15, wherein the method further comprises:

associating attribute values to the plotted elements corresponding to the calculated dose, the calculated dose rate, and the metric value; and

and displaying the element according to the attribute value.

17. A non-transitory computer readable storage medium having computer executable instructions for causing a computer system to perform a method for planning radiation processing, the method comprising:

generating a dose-volume histogram (DVH) for a volume in a treatment target, wherein the DVH is indicative of a measure of the volume of received dose;

generating a dose rate-volume histogram (DRVH) for the volume, wherein the DRVH indicates a measure of the volume receiving dose rate; and

a Graphical User Interface (GUI) is displayed on a display device of the computer system, the graphical user interface comprising a combined rendering of the DVH and the DRVH, wherein the combined rendering visualizes a measure of the volume calculated to receive a given dose as a function of dose rate, and also visualizes a measure of the volume calculated to receive a given dose rate as a function of dose.

18. The non-transitory computer-readable storage medium of claim 17, wherein the GUI includes a visualization of the DVH as a first dimension of the GUI, a visualization of the DRVH as a second dimension of the GUI, and a visualization of the metric value as a third dimension of the GUI.

19. The non-transitory computer readable storage medium of claim 17 or 18, wherein the rendering comprises one or more visualizations selected from the group consisting of: a visualization of the calculated dose for each of the plurality of sub-volumes, a calculated dose rate for each of the plurality of sub-volumes, and a visualization of the metric for each of the plurality of sub-volumes.

20. The non-transitory computer readable storage medium of claim 17, 18, or 19, wherein the rendering further comprises one or more visualizations selected from the group consisting of: visualization of the prescribed dose and the prescribed dose rate, visualization of the normal tissue complication probability for each of the plurality of subvolumes, and visualization of the tumor control probability for each of the plurality of subvolumes.

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