# US 10,946,218 B2 · Magnetic resonance guided therapy with interleaved scanning

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- Number: US 10,946,218 B2
- Document ID: US10946218B2
- Status: Granted
- Kind: B2
- Application number: 14/400,829
- Filed: 2013-05-08
- Published: 2015-05-07
- Granted: 2021-03-16
- Earliest claimed: 2012-05-14
- Assignees: Koninkluke Philips N.V.
- Applicants: Koninklijke Philips N.V.
- Inventors: Erkki Tapani Vahala
- Web page: https://patentgrep.com/patent/US10946218B2

## CPC

- A61N 5/1037: {taking into account the movement of the target, e.g. 4D-image based planning}
- A61N 5/10: X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy (A61N5/01 takes precedence)
- A61N 5/1039: {using functional images, e.g. PET or MRI}
- A61N 5/1045: {using a multi-leaf collimator, e.g. for intensity modulated radiation therapy or IMRT}
- A61N 5/1049: {for verifying the position of the patient with respect to the radiation beam}
- A61N 5/107: {in real time, i.e. during treatment}
- A61N 5/1077: {Beam delivery systems}
- A61B 2090/374: {NMR or MRI}
- A61N 2005/1055: {using magnetic resonance imaging [MRI]}
- A61N 2005/1072: {taking into account movement of the target}
- A61N 2005/1074: {Details of the control system, e.g. user interfaces}
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A method for controlling a medical apparatus (100) includes receiving a treatment plan (168) specifying a target volume (146) within an imaging volume (138) and a dose rate of radiation emitted by a radiotherapy apparatus (102). The medical apparatus (100) repeatedly acquires the motion tracking magnetic resonance data and the image magnetic resonance data using an interleaved pulse sequence. The radiotherapy apparatus (102) is controlled to radiate the target volume (146) in accordance with the treatment plan (168). A dose distribution map descriptive of a radiation dose received by the subject (144) from the radiotherapy apparatus (102) is calculated using the motion tracking magnetic resonance data, and the treatment plan (168). A diagnostic image is reconstructed using the image magnetic resonance data. A display displays the diagnostic image and the dose distribution map. Treatment plan update data is received from a user interface and the treatment plan (168) is updated in accordance with the treatment plan update data.

## Claims

### Claim 1

A medical apparatus comprising:
a radiotherapy apparatus configured to radiate during a treatment fraction a target volume undergoing motion during a treatment fraction;
a magnetic resonance scanner configured to acquire motion tracking magnetic resonance data and image magnetic resonance data from a subject of which at least a part is located within an imaging volume undergoing subject motion, wherein the target volume is within the imaging volume, the motion tracking magnetic resonance data having a higher temporal resolution than the image magnetic resonance data and being indicative of a path of target volume positions during the subject motion;
a memory configured to store machine executable instructions; and
a processor configured to execute the machine executable instructions, wherein executing the machine readable instructions causes the processor to receive a treatment plan specifying a radiation dose distribution to be delivered to the target volume within the imaging volume and a dose rate of radiation emitted by the radiotherapy apparatus, and to repeatedly during a treatment fraction:
acquire the higher temporal resolution motion tracking magnetic resonance data and the image magnetic resonance data from the imaging volume from a subject undergoing subject motion by controlling the magnetic resonance scanner with an interleaved magnetic resonance pulse sequence that interleaves the higher temporal resolution motion tracking magnetic resonance data and the image magnetic resonance data during the magnetic resonance pulse sequence;
control the radiotherapy apparatus to radiate the target volume in the imaging volume in accordance with the treatment plan;
calculate a dose distribution map descriptive of a radiation dose received by the target volume from the radiotherapy apparatus
reconstruct a higher resolution diagnostic image using the lower temporal resolution image magnetic resonance data;
control a display apparatus to display the higher resolution diagnostic image and the dose distribution map descriptive of a radiation dose received by the target volume and the image volume;
receive treatment plan update data from a user interface; and
update the treatment plan in accordance with the treatment plan update data.

### Claim 2 (depends on 1)

The medical apparatus of claim 1, wherein the treatment plan update data comprises a request to automatically update the treatment plan using the dose distribution map, wherein the treatment plan is updated at least partially in accordance with the dose distribution map.

### Claim 3 (depends on 1)

The medical apparatus of claim 1, wherein the treatment plan is updated during radiation of the target volume according to the treatment plan.

### Claim 4 (depends on 2)

The medical apparatus of claim 2, further comprises a multi-leaf collimator for collimating a radiation beam of the therapeutic apparatus to an irradiation area in match with the target volume, wherein the treatment plan update data comprises a request to automatically update the treatment plan by adjusting the multi-leaf collimator to match the target volume using the motion tracking magnetic resonance data.

### Claim 5 (depends on 1)

The medical apparatus of claim 1, wherein the processor is configured to control the magnetic resonance scanner to continuously monitor a position of the target volume during a treatment fraction.

### Claim 6 (depends on 4)

The medical apparatus of claim 4, wherein the dose distribution map and the diagnostic image are displayed side by side.

### Claim 7 (depends on 1)

The medical apparatus of claim 1, wherein the high temporal resolution images of the dose distribution map and the high resolution diagnostic image are displayed overlaid.

### Claim 8 (depends on 6)

The medical apparatus of claim 6, wherein the execution of the instructions further causes the processor to acquire the higher temporal resolution image magnetic resonance data during a pre-determined part of a cyclic motion of the subject by controlling the magnetic resonance scanner.

### Claim 9 (depends on 4)

The medical apparatus of claim 4, wherein the update of the treatment plan occurs during radiation of the target volume based on a current position of the target volume.

### Claim 10 (depends on 9)

The medical apparatus of claim 9, wherein the radiotherapy apparatus comprises a linear accelerator (LINAC) configured to irradiate the target volume.

### Claim 11

A non-transitory computer-readable medium carrying machine executable instructions for execution by a processor controlling a medical apparatus, wherein the medical apparatus comprises a radiotherapy apparatus for radiating a target volume; a magnetic resonance module for acquiring two types of data namely motion tracking magnetic resonance data and image magnetic resonance data from a subject of which at least a part is located within an imaging volume, wherein the target volume is within the imaging volume; wherein execution of the machine executable instructions causes the processor to receive a treatment plan specifying the target volume, the imaging volume and a dose rate of radiation emitted by the radiotherapy apparatus, and in each of a plurality of fractions to repeatedly:
acquire the motion tracking magnetic resonance data and the image magnetic resonance data by controlling the magnetic resonance module with an interleaved pulse sequence which interleaves motion tracking magnetic resonance data acquisition with image magnetic resonance data acquisition to continuously monitor a motion path of the target volume, the motion tracking magnetic resonance data has a higher temporal resolution than the image magnetic resonance data;
control the radiotherapy apparatus to radiate the target volume in accordance with the treatment plan;
calculate a radiation dose distribution map descriptive of a radiation dose received by the subject from the radiotherapy apparatus;
reconstruct a diagnostic image using the lower temporal resolution image magnetic resonance data;
control a display to display the diagnostic image and the dose distribution map;
receive treatment plan update data from a user interface; and
update the treatment plan in accordance with the treatment plan update data.

### Claim 12

A method of controlling a medical apparatus, wherein the medical apparatus comprises a radiotherapy apparatus configured to irradiate a target volume; a magnetic resonance scanner configured to acquire motion tracking magnetic resonance data and image magnetic resonance data from a subject of which at least a part is located within an imaging volume, wherein the target volume is within the imaging volume, wherein the motion tracking magnetic resonance data has a higher temporal resolution than the image magnetic resonance data, wherein the method comprises receiving a treatment plan specifying the target volume within the imaging volume and a dose rate of radiation emitted by the radiotherapy apparatus, and in each of a plurality of fractions repeatedly:
controlling the radiotherapy apparatus to radiate the target volume in accordance with the treatment plan;
acquiring in an interleaved manner the higher temporal resolution motion tracking magnetic resonance data and the image magnetic resonance data by controlling the magnetic resonance scanner with an interleaved magnetic resonance pulse sequence;
calculating a dose distribution map descriptive of a radiation dose received by the subject from the radiotherapy apparatus;
reconstructing a diagnostic image using the image magnetic resonance data;
controlling a display to concurrently display the diagnostic image and the dose distribution map;
receiving treatment plan update data from a user interface; and
updating the treatment plan in accordance with the treatment plan update data during the radiation of the target volume.

### Claim 13 (depends on 12)

The method of claim 12, wherein the treatment plan update data includes a request to automatically update the treatment plan using the dose distribution map.

### Claim 14 (depends on 13)

The method of claim 13, wherein the radiotherapy apparatus includes a multi-leaf collimator for collimating a radiation beam from the radiotherapy apparatus and wherein the treatment plan update data includes adjustments to the multi-leaf collimator to match the target volume.

### Claim 15 (depends on 14)

The method of claim 14, wherein the step of acquiring the image magnetic resonance data is performed during a predetermined part of a cyclic cycle of the subject by controlling the magnetic resonance scanner.

### Claim 16 (depends on 15)

The method of claim 15, wherein each repetition of the interleaved pulse sequence generates both the motion tracking magnetic resonance data and the image magnetic resonance data in an interleaved fashion.

### Claim 17 (depends on 16)

The method of claim 16, wherein the image magnetic resonance data is acquired in a coronal view and positions of the target volume are continuously monitored in the coronal view.