# US 2019/0168025 A1 · Image-guided radiation therapy > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2019/0168025 A1 - Document ID: US20190168025A1 - Status: Published application - Kind: A1 - Application number: 15/833,919 - Filed: 2017-12-06 - Published: 2019-06-06 - Earliest claimed: 2017-12-06 - Assignees: Varian Medical Systems International AG - Applicants: Varian Medical Systems International AG. - Inventors: Timo KOPONEN; Hanna KOIVUNORO - Web page: https://patentgrep.com/patent/US20190168025A1 ## CPC - A61N 5/107: {in real time, i.e. during treatment} - A61B 6/4014: {arranged in multiple source-detector units} - A61N 5/1049: {for verifying the position of the patient with respect to the radiation beam} - A61N 5/1067: {in real time, i.e. during treatment} - A61B 6/4035: {the source being combined with a filter or grating} - A61B 6/482: {involving multiple energy imaging} - A61N 5/1045: {using a multi-leaf collimator, e.g. for intensity modulated radiation therapy or IMRT} - A61N 5/1047: {with movement of the radiation head during application of radiation, e.g. for intensity modulated arc therapy or IMAT} - A61N 2005/1061: {using an x-ray imaging system having a separate imaging source} - 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 system includes a first source of a radiation treatment beam, a first imager and a second imager, a first imaging beam source that directs a first imaging beam through a target and to the first imager to produce first images, a second imaging beam source that directs a second imaging beam through the target and to the second imager to produce second images, and a controller coupled to the first source, to the first and second imaging beam sources, and to the first and second imagers. The controller uses the first images and the second images to detect a change in position of the target and, in response to the change, adjusts the radiation treatment beam and/or the position of the target to compensate for the change while the radiation treatment beam is on. ## Claims ### Claim 1 A system, comprising: a first source of a radiation treatment beam; a plurality of imagers comprising a first imager and a second imager; a plurality of second sources comprising a first imaging beam source that directs a first imaging beam through a target and to the first imager to produce first images, and a second imaging beam source that directs a second imaging beam through the target and to the second imager to produce second images; and a controller coupled to the first source, to the first and second imaging beam sources, and to the first and second imagers, wherein the controller uses the first images and the second images to detect a change in position of the target and, in response to the change, adjusts at least one of the radiation treatment beam and the position of the target to compensate for the change while the radiation treatment beam is on. ### Claim 2 (depends on 1) The system of claim 1, wherein the first imaging beam is produced at a first voltage and the second imaging beam is produced at a second voltage that is different from the first voltage. ### Claim 3 (depends on 1) The system of claim 1, wherein the first imaging beam is produced alternately at a first voltage and at a second voltage that is different from the first voltage, and wherein the second imaging beam is produced alternately at the first voltage and the second voltage. ### Claim 4 (depends on 1) The system of claim 1, further comprising a first filter positioned between the first imaging beam source and the first imager to filter the first imaging beam, and wherein a second filter positioned between the second imaging beam source and the second imager to filter the second imaging beam. ### Claim 5 (depends on 4) The system of claim 4, wherein the first filter comprises different regions comprising different filter materials, and wherein the second filter comprises different regions comprising different filter materials. ### Claim 6 (depends on 1) The system of claim 1, wherein the change comprises lateral movement of the target orthogonal to a direction of the radiation treatment beam, wherein the controller causes the radiation treatment beam to intersect the target by aiming the radiation treatment beam to follow movement of the target while the radiation treatment beam is on. ### Claim 7 (depends on 1) The system of claim 1, wherein the change comprises lateral movement of the target orthogonal to a direction of the radiation treatment beam, wherein the controller causes the radiation treatment beam to intersect the target by additional movement of the target while the radiation treatment beam is on. ### Claim 8 (depends on 1) The system of claim 1, wherein the change comprises movement of the target along a longitudinal axis of the radiation treatment beam, wherein the controller adjusts the energy of the radiation treatment beam to change the range of the radiation treatment beam to follow the movement of the target while the radiation treatment beam is on. ### Claim 9 A method, comprising: acquiring first images by directing a first imaging beam from a first imaging beam source through a target and to a first imager; acquiring second images by directing a second imaging beam from a second imaging beam source through the target and to a second imager; generating a radiation treatment beam; and in response to movement of the target while the radiation treatment beam is on, adjusting at least one of the radiation treatment beam and a position of the target to compensate for the movement while the radiation treatment beam is on and irradiating the target, wherein the movement of the target and the position of the target is determined using the first images and the second images. ### Claim 10 (depends on 9) The method of claim 9, further comprising: generating the first imaging beam at a first voltage; and generating the second imaging beam at a second voltage that is different from the first voltage. ### Claim 11 (depends on 9) The method of claim 9, further comprising: generating the first imaging beam alternately at a first voltage and at a second voltage that is different from the first voltage; and generating the second imaging beam alternately at the first voltage and the second voltage. ### Claim 12 (depends on 9) The method of claim 9, further comprising: filtering the first imaging beam with a first filter before the first imaging beam reaches the first imager; and filtering the second imaging beam with a second filter before the second imaging beam reaches the second imager. ### Claim 13 (depends on 12) The method of claim 12, wherein the first filter comprises different regions comprising different filter materials, and wherein the second filter comprises different regions comprising different filter materials. ### Claim 14 (depends on 9) The method of claim 9, wherein said adjusting comprises an operation selected from the group consisting of: changing a direction of the radiation treatment beam; changing a position of the target to cause the radiation treatment beam to intersect the target; and adjusting the energy of the radiation treatment beam to change the range of the radiation treatment beam. ### Claim 15 A method, comprising: receiving first images from a first imager, wherein the first images were acquired by directing a first imaging beam from a first imaging beam source through a target and to the first imager; receiving second images from a second imager, wherein the second images were acquired by directing a second imaging beam from a second imaging beam source through the target and to the second imager; directing a radiation treatment beam at the target and, while the radiation treatment beam is on, detecting a change in position of the target based on the first images and the second images; and in response to the change in position of the target, while the radiation treatment beam is on, changing at least one of the radiation treatment beam and the position of the target to cause the radiation treatment beam to intersect the target. ### Claim 16 (depends on 15) The method of claim 15, wherein the first imaging beam is produced at a first voltage and the second imaging beam is produced at a second voltage that is different from the first voltage. ### Claim 17 (depends on 15) The method of claim 15, wherein the first imaging beam is produced alternately at a first voltage and at a second voltage that is different from the first voltage, and wherein the second imaging beam is produced alternately at the first voltage and at the second voltage. ### Claim 18 (depends on 15) The method of claim 15, wherein the first imaging beam is filtered with a first filter before the first imaging beam reaches the first imager, and wherein the second imaging beam is filtered with a second filter before the second imaging beam reaches the second imager. ### Claim 19 (depends on 18) The method of claim 18, wherein the first filter comprises different regions comprising different filter materials, and wherein the second filter comprises different regions comprising different filter materials. ### Claim 20 (depends on 15) The method of claim 15, wherein said changing comprises an operation selected from the group consisting of: changing a direction of the radiation treatment beam; changing the position of the target to cause the radiation treatment beam to intersect the target; and adjusting the energy of the radiation treatment beam to change the range of the radiation treatment beam.