# US 2014/0193058 A1 · Method to estimate interfractional and intrafractional organ motion for adaptive external beam radiotherapy > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2014/0193058 A1 - Document ID: US20140193058A1 - Status: Published application - Kind: A1 - Application number: 14/237,227 - Filed: 2012-07-24 - Published: 2014-07-10 - Earliest claimed: 2011-08-16 - Assignees: Koninklijke Philips N.V. - Inventors: Shyam Bharat; Vijay Parthasarathy - Web page: https://patentgrep.com/patent/US20140193058A1 ## CPC - A61B 5/0036: {including treatment, e.g., using an implantable medical device, ablating, ventilating} - A61N 5/103: {Treatment planning systems} - A61N 5/1037: {taking into account the movement of the target, e.g. 4D-image based planning} - A61N 5/1049: {for verifying the position of the patient with respect to the radiation beam} - A61N 5/1071: {for verifying the dose delivered by the treatment plan} - G01T 1/08: Photographic dosimeters {(photometry G01J1/52)} - A61B 5/1126: {using a particular sensing technique} - A61B 5/721: {using a separate sensor to detect motion or using motion information derived from signals other than the physiological signal to be measured} - A61B 2562/0233: Special features of optical sensors or probes classified in A61B5/00 - A61N 5/1038: {taking into account previously administered plans applied to the same patient, i.e. adaptive radiotherapy} - A61N 5/1039: {using functional images, e.g. PET or MRI} - A61N 2005/1051: {using an active marker} - A61N 2005/1072: {taking into account movement of the target} - G06T 2207/30004: Biomedical image processing - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - 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) - G01T: MEASUREMENT OF NUCLEAR OR X-RADIATION (radiation analysis of materials, mass spectrometry G01N23/00; tubes for determining the presence, intensity, density or energy of radiation or particles H01J47/00) - G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL ## Abstract A therapy system (10) includes one or more processors (98, 100). The processors (98, 100) are programmed to receive one or more of: (1) dosimetric data from dosimeters (26, 28, 202, 204, 206, 208, 210, 212) implanted within a patient and/or positioned on a vest (200); and (2) motion data from surrogates (18, 20, 22, 24) implanted within the patient. Based on the motion data, a current location and/or shape of a surrogate (18, 20, 22, 24) is determined and deviations between the current location and/or shape and a reference location and/or shape are determined. Based on the dosimetric data, a delivered dose distribution is compared with a planned dose distribution and deviations therebetween are determined. The deviations determined from the motion data and/or the dosimetric data are employed for adaptive planning, alignment, post treatment analysis, and safety. ## Claims ### Claim 1 A therapy planning system comprising: at least one processor programmed to: receive a planning image of a region of a subject, the subject including a target and/or an organ at risk (OAR), and the subject associated with at least one surrogate and/or a dosimeter, the surrogate acting as a surrogate for the target and/or the OAR, and the dosimeter measuring dose delivered to the target and/or the OAR; determine a reference location and shape in the planning image for one or more of the target and/or the OAR; determine a reference location and/or shape from the planning image of each of the surrogate and/or the dosimeter; determine deviations between one or more of: the reference location and/or shape of the surrogate and a current location and/or shape of the surrogate; and, a planned dose distribution and a delivered dose distribution, the delivered dose distribution determined from dosimetric data and the reference location and/or shape of the dosimeter. ### Claim 2 (depends on 1) The therapy system according to claim 1, wherein the surrogate and/or the dosimeter are implanted within the subject and secured directly to at least one of the target, the OAR and tissue proximate the target and/or the OAR and/or indirectly to the at least one of the target, the OAR and tissue proximate the target and/or the OAR. ### Claim 3 (depends on 1) The therapy system according to claim 1, wherein the surrogate and/or the dosimeter are implanted within the subject and secured indirectly to the at least one of the target, the OAR and tissue proximate the target and/or the OAR using a shrink wrap. ### Claim 4 (depends on 1) The therapy system according to claim 1, wherein the subject includes the surrogate and the processor is further programmed to: determine the reference location and/or shape for the surrogate; receive motion data indicating the current location and/or shape of the surrogate; and, determine deviations between the reference location and/or shape of the surrogate and the current location and/or shape of the surrogate. ### Claim 5 (depends on 4) The therapy system according to claim 4, wherein the processor is further programmed to: determine a current location and shape of the target and/or the OAR in the planning image from deviations between the reference location and shape of the surrogate and the current location and shape of the surrogate; and, determine deviations between the current location and shape of the target and/or the OAR and the reference location and shape of the target and/or the OAR. ### Claim 6 (depends on 4) The therapy system according to claim 4, wherein the processor is further programmed to: receive motion data indicating a current location and/or shape in the planning image for the surrogate during delivery of therapy; and, one or more of: based on deviations of the surrogate, adjust the treatment plan on which the delivery of the therapy is based; and, generate a motion compensated estimate of radiation delivered to the target and/or the OAR from the motion data. ### Claim 7 (depends on 1) The therapy system according to claim 1, wherein the processor is further programmed to: receive a plurality of motion data samples and/or a plurality of dosimetric data samples over a predetermined period of time, each of the motion data samples indicting a location and/or shape in the planning image for the surrogate, and each of the dosimetric data samples indicating dose delivered to the target and/or the OAR; and, one or more of: generate a cumulative motion pattern for the target and/or the OAR from the plurality of motion data samples; and, through correlation and analysis of the plurality of motion data samples and the plurality of dosimetric data samples, one or more of: determine a position of the target (and/or the OAR with maximum dosimetric deviation; and, determine a patient-specific relationship between motion patterns and dosimetric deviations. ### Claim 8 (depends on 1) The therapy system according to claim 1, wherein the subject includes an implanted optical fiber which defines an optical fiber structure (OFS), the surrogate being the implanted optical fiber. ### Claim 9 (depends on 1) The therapy system according to claim 1, wherein the processor is further programmed to: receive reference optical motion data indicating a reference location and shape of the OFS; determine the reference location and shape of the OFS in the planning image from the reference optical motion data; receive current optical motion data indicating a current location and shape of the OFS; determine the current location and shape of the OFS in the planning image from the current optical motion data; and, determine deviations between the determined reference location and shape of the OFS and the determined current location and shape of the OFS. ### Claim 10 (depends on 1) The therapy system according to claim 1, wherein the surrogate is an optical fiber and one or more of: (1) the reference location and/or shape of the surrogate; and (2) the current location and/or shape of the surrogate, are determined using fiber Bragg gratings of different Bragg wavelengths along the length of the optical fiber. ### Claim 11 (depends on 1) The therapy system according to claim 1, wherein the subject includes the dosimeter and the processor is further programmed to: determine the reference location and/or shape for the dosimeter; receive dosimetric data indicating dose delivered to the target and/or the OAR from the dosimeter; and, determine deviations between the planned dose distribution and the delivered dose distribution. ### Claim 12 (depends on 11) The therapy system according to claim 11, wherein the processor is further programmed to: receive dosimetric data indicating dose delivered to the target and/or the OAR from the dosimeter during delivery of therapy; and, one or more of: in response to deviations between the planned dose distribution and the delivered dose distribution being beyond select criteria, stop delivery of therapy; based on deviations of the planned dose distribution and the delivered dose distribution, align the subject in the treatment; and, based on deviations of the planned dose distribution and the delivered dose distribution, adjust a treatment plan on which the delivery of therapy is based. ### Claim 13 (depends on 1) The therapy system according to claim 1, wherein the deviations are used for delivery of therapy, the therapy including one of ablation therapy, brachytherapy, x-ray therapy, proton therapy, and high-intensity focused ultrasound (HIFU) therapy. ### Claim 14 A therapy system comprising: a structure which carries one or more dosimeters, the dosimeters positioned to measure dose delivered to a target and/or an organ at risk (OAR) of a subject; and, at least one processor programmed to: receive dosimetric data indicating dose delivered to the target and/or the OAR from the dosimeters; and, determine deviations between a planned dose distribution and a delivered dose distribution, the delivered dose distribution determined from the dosimetric data. ### Claim 15 (depends on 14) The therapy system according to claim 14, further comprising: a vest including the dosimeter, the dosimeter positioned on the vest to coincide with beam directions of a therapy delivery apparatus. ### Claim 16 (depends on 15) The therapy system according claim 15, wherein the dosimeters include at least one pair, each pair including a dosimeter positioned at an entry of a specific beam and/or a dosimeter positioned at an exit of the specific beam. ### Claim 17 (depends on 14) The therapy system according to claim 14, further comprising: a shrink wrap including the dosimeter, the shrink wrap positioning the dosimeter on one of the target, the organ at risk, and tissue proximate the target and/or the organ at risk. ### Claim 18 (depends on 14) The therapy system according to claim 14, wherein the processor is further programmed to: one or more of: in response to deviations between the planned dose distribution and the delivered dose distribution being beyond select criteria, stop delivery of therapy; based on deviations of the planned dose distribution and the delivered dose distribution, align the subject in a treatment couch; and, based on deviations of the planned dose distribution and the delivered dose distribution, adjust a treatment plan on which the delivery of therapy is based. ### Claim 19 A method for therapy planning comprising: receiving a planning image of a region of a subject, the subject including a target and/or an organ at risk (OAR), and the subject associated with at least one surrogate and/or a dosimeter, the surrogate acting as a surrogate for the target and/or the OAR, and the dosimeter measuring dose delivered to the target and/or the OAR; determining a reference location and shape in the planning image for one or more of the target and/or the OAR; determining a reference location and/or shape from the planning image of each of the surrogate and/or the dosimeter; and determining deviations between one or more of: the reference location and/or shape of the surrogate and a current location and/or shape of the surrogate; and, a planned dose distribution and a delivered dose distribution, the delivered dose distribution determined from dosimetric data and the reference location and/or shape of the dosimeter. ### Claim 20 (depends on 19) The method according to claim 19, further including: receiving one or more of: motion data indicating a current location and/or shape in the planning image for the surrogate; and, dosimetric data indicating dose delivered to the target and/or the OAR from the dosimeter.