# US 5,727,554 A · Apparatus responsive to movement of a patient during treatment/diagnosis > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 5,727,554 A - Document ID: US5727554A - Status: Granted - Kind: A - Application number: 08/715,834 - Filed: 1996-09-19 - Granted: 1998-03-17 - Earliest claimed: 1996-09-19 - Assignees: University of Pittsburgh—Of the Commonwealth System of Higher Education - Inventors: Andre M. Kalend; Joel Greenberger; Karun B. Shimoga; Charalambos N. Athanassiou; Takeo Kanade - Web page: https://patentgrep.com/patent/US5727554A ## CPC - A61B 6/08: Auxiliary means for directing the radiation beam to a particular spot, e.g. using light beams - A61B 5/1127: {using markers} - A61N 5/1037: {taking into account the movement of the target, e.g. 4D-image based planning} - A61N 5/1048: {Monitoring, verifying, controlling systems and methods} - A61N 5/1064: {for adjusting radiation treatment in response to monitoring} - 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) ## Abstract A camera generates digital image signals representing an image of one or more natural or artificial fiducials on a patient positioned on treatment or diagnosis equipment. A processor applies multiple levels of filtering at multiple levels of resolution to repetitively determine successive fiducial positions. A warning signal is generated if movement exceeds certain limits but is still acceptable for treatment. Unacceptable displacement results in termination of the treatment beam. Tracking templates can be generated interactively from a display of the digital image signals or through automatic selection of an image having the median correlation to an initial template. A gating signal synchronized to patient breathing can be extracted from the digital image signals for controlling the radiation beam generator. ## Claims ### Claim 1 Apparatus responsive to movement of a patient positioned on a patient positioning assembly during treatment/diagnosis, said apparatus comprising: camera means generating digital image signals representing an image of at least one passive fiducial having a lambertian surface on said patient; and processing means comprising means responsive to actual shape, appearance and lighting conditions of said at least one passive fiducial having a lambertian surface in said image represented by said digital image signals to determine successive positions of said at least one passive fiducial having a lambertian surface, means repetitively determining movement of said at least one passive fiducial having a lambertian surface from said successive positions, and means generating an output in response to predetermined values of said movement. ### Claim 2 Apparatus responsive to movement of a patient positioned on a patient positioning assembly during treatment/diagnosis, said apparatus comprising: a single camera generating digital image signals representing an image of at least one fiducial on said patient; and processing means comprising means responsive to actual shape, appearance and lighting conditions of said at least one fiducial in said image represented by said digital image signals to determine successive positions of said at least one fiducial, means tracking three-dimensional movement of said at least one fiducial from said successive positions and means generating an output in response to predetermined values of said movement. ### Claim 3 (depends on 2) The apparatus of claim 2, wherein said means repetitively determining movement of said at least one fiducial includes means detecting movement associated with patient breathing, and said output means comprises means generating a gating signal synchronized to said patient breathing. ### Claim 4 (depends on 2) The apparatus of claim 2, wherein said processing means comprises means repetitively applying multiple levels of filtering to said digital image signals to determine successive positions of said at least one fiducial. ### Claim 5 (depends on 4) The apparatus of claim 4, wherein said means applying multiple levels of filtering includes means applying bracketing and interpolation to said digital image signals to determine position of said at least one fiducial. ### Claim 6 (depends on 4) The apparatus of claim 4, wherein said means applying multiple levels of filtering includes means applying minima suppression to said digital image signals. ### Claim 7 (depends on 4) The apparatus of claim 4, wherein said means applying multiple levels of filtering include means applying at least two types of filtering selected from a group consisting of correlation, sparse sampling, bracketing and interpolation, and minima suppression. ### Claim 8 (depends on 7) The apparatus of claim 7, wherein said processing means includes means using multiple levels of resolution of said digital image signals to determine successive positions of at least one fiducial and said means applying multiple levels of filtering comprise means applying filtering at each of said multiple levels of resolution. ### Claim 9 (depends on 4) The apparatus of claim 4, wherein said processing means includes means using at least one of templates and interest operators to determine successive positions of said at least one fiducial from said digital image signals. ### Claim 10 (depends on 2) The apparatus of claim 2, wherein said pressing means comprises means using a template to successively determine position of said at least one fiducial and means selecting said template. ### Claim 11 (depends on 10) The apparatus of claim 10, wherein said at least one fiducial comprises a plurality of fiducials, and said means selecting a template includes means generating an initial template, means generating template matches for each of said plurality of fiducials from said digital image signals using said initial template, and means selecting one of said template matches for use in determining positions of each of said plurality of fiducials. ### Claim 12 (depends on 11) The apparatus of claim 11, wherein said means selecting said one of said template matches includes means generating a value for each of said templates matches, and means selecting a template match having a median value as said one template match. ### Claim 13 Apparatus responsive to movement of a patient positioned on a patient positioning assembly during treatment/diagnosis, said apparatus comprising: camera means generating digital image signals representing an image of at least one fiducial on said patient; and processing means comprising means responsive to actual shape, appearance and lighting conditions of said at least one fiducial in said image represented by said digital image signals to determine successive positions of said at least one fiducial at a rate of at least 20 Hz, means tracking movement of said at least one fiducial from said successive positions, and means generating an output in response to predetermined values of said movement. ### Claim 14 (depends on 13) The apparatus of claim 13, wherein said means generating an output includes means generating an indication of movement relative to at least one selected level of displacement. ### Claim 15 (depends on 14) The apparatus of claim 14, wherein said means generating said indication of movement indludes means providing a warning that said movement exceeds a first displacement and means providing a signal for terminating radiation treatment/diagnosis when said movement exceeds a second displacement greater than said first displacement. ### Claim 16 (depends on 14) The apparatus of claim 14, wherein said means generating an indication of movement comprises display means generating an image of said fiducials and an indication of said movement relative to said first and second displacements. ### Claim 17 (depends on 16) The apparatus of claim 16, wherein said camera means includes means generating digital image signals for a plurality of fiducials, said means repetitively determining movement determines movement of each of said plurality of fiducials, and said display means includes indicator means indicating a fiducial with the greatest movement. ### Claim 18 (depends on 14) The apparatus of claim 14, wherein said means repetitively determining movement includes means detecting movement associated with patient breathing and random movement, and wherein said means generating an indication of movement indicates said random movement. ### Claim 19 Apparatus responsive to movement of a patient positioned on a patient positioning assembly during treatment/diagnosis, said apparatus comprising: camera means generating digital image signals representing an image of at least one fiducial on said patient; and processing means comprising means responsive to actual shape, appearance and lighting conditions of said at least one fiducial in said image represented by said digital image signals to determine successive positions of said at least one fiducial, means repetitively determining movement of said at least one fiducial from said successive positions, and means generating an output in response to predetermined values of said movement; said processing means further comprising means using a template to successively determine position of said at least one fiducial and means selecting said template comprising display means, means generating on said display means an image of said at least one fiducial from said digital image signals and user interface means for selection of a template from said image of said at least one fiducial. ### Claim 20 Apparatus responsive to movement of a patient positioned on a patient positioning assembly, said apparatus comprising: camera means generating digital image signals representative of an image of said patient; and processing means comprising means determining movement of said patient from said digital image signals, including movement associated with breathing by said patient, and gating means generating gating signals synchronized with said movement associated with breathing by said patient. ### Claim 21 (depends on 20) The apparatus of claim 20, wherein said camera means generates said digital image signals representing an image of at least one fiducial on said patient, and said means determining movement of said patient includes means determining movement of said at least one fiducial. ### Claim 22 (depends on 20) The apparatus of claim 20 adapted for use during treatment of said patient with a radiation beam generated by a beam generator, wherein said gating means comprises means generating said gating signals synchronized to actuate said beam generator in synchronism with patient breathing.