The invention relates to a charged particle therapy system.
More particularly, the invention relates to a therapy system for irradiating a target volume within a patient with a charged particle beam, and comprising a charged particle beam generator, a beam transport system for transporting the charged particle beam, an irradiation device for delivering the charged particle beam to the target volume, and an energy-shaping device placed across a path of the charged particle beam.
The energy-shaping device comprises a plurality of energy-shaping elements that are each designed to modify the energy of incoming particles of a mono-energetic particle beam so that a mix of different particle energies are delivered at their output to form a Spread-Out Bragg Peak (SOBP) in a corresponding region of the target volume, with the aim that the irradiation of the target volume is more or less conform to its 3D shape.
Charged particle therapy systems are well known in the art. Their function is to destroy unhealthy cells in a particular 3D region (hereafter “the target volume”) of a living being (hereafter “the patient”) by irradiating the target volume with a beam of charged particles such as a beam of protons, ions, etc. There currently exist several irradiation techniques for irradiating the target with the particle beam. These techniques can be roughly categorized into scattering techniques and scanning techniques. In the first category, a broad scattered beam irradiates the target volume as a whole, whereas in the second category a narrow beam irradiates the target volume while scanned over it.
Whatever the irradiation technique, an aim has always been to reduce unwanted irradiation of cells of the patient lying outside of the target volume, both laterally (X,Y) and in depth (Z). This aim is often referred to as “improving conformal irradiation”.
With a view to improving conformal irradiation, particularly in the depth direction, several solutions have been proposed, such as the placement of an energy-shaping device (sometimes also called an energy modulator) in the path of the particle beam (e.g. ridge filters, range compensators, energy selection system).
An example of a therapy system comprising such an energy modulator is disclosed in American patent application US2018068753A1. According to such a known system, the energy modulator (called a “ridge filter” in document US2018068753A1) is placed across the beam path between the charged particle beam generator and the patient. A beam spreading device (sometimes called a “scatterer”), located upstream of the energy modulator, spreads the particle beam over the surface of the energy modulator. The energy modulator is made up of a plurality of damping elements, each damping element having a cross-sectional area that changes stepwise along the irradiating direction. When charged particles pass through such a damping element, a specific distribution of particle energies is generated at the output of the damping element, and this specific energy distribution will result in a corresponding specific Spread-Out Bragg Peak profile (SOBP) in the crossed region of the target volume when it is irradiated by the particle beam through the damping element. As is well known, the distribution of particle energies at the output of a damping element will depend on the material and the geometry of the damping element, more particularly on the various widths and heights of its staircase steps. The height of a staircase step will determine the mean particle energy at its output, whereas the width of a staircase step will determine a particle ratio.
Such a known energy modulator is made bespoke to a given patient and to a specific field to be irradiated and hence cannot be reused for another patient or for another beam orientation.
Another example of a known therapy system comprising such an energy modulator is disclosed in Korean patent number KR101546656. According to such a known system, the energy modulator (called a “variable compensator” in document KR101546656) is made up of a plurality of damping elements, each damping element comprising a column of fluid of a certain height extending in the irradiating direction. When charged particles pass through such a damping element, their energy decreases, thereby decreasing the corresponding depth of the Bragg peak in the target volume in relation to the height of fluid in the column.
Furthermore the height of the column of fluid of each damping element is individually controlled by a control unit, allowing for adapting the penetration depth of the charged particles of the irradiating beam to the distal edge of the target volume. Such a known particle therapy system is however not adapted to achieve an SOBP in the target volume.
Another example of a known therapy system comprising such an energy modulator is disclosed in American patent publication number U52008/0260098. Such a known energy modulator is similar to the modulator of KR101546656 and is therefore also meant to modulate the depths of the Bragg peaks in order to conform only to the distal edge of the target volume. It is not capable or at least not configured to deliver patient-specific and planned SOBPs to each 3D region of the target volume when the beam is irradiated according to a single main beam direction to the target. Eventually, SOBPs can be generated with such system by irradiating the target according to various main beam directions while changing the damping power of the various damping elements at a plurality of irradiation angles, though it is not clear from this document how this could concretely be achieved. In any case, having to change the main beam direction and having to change the damping power of the various damping elements in the course of a treatment increases the treatment time, which is not desirable. Furthermore, such approach does not permit to deliver 3D conformal doses to the target with enough degrees of freedom because of the interdependency of the doses delivered at the various irradiation angles.
It is therefore an object of the invention to provide a therapy system that is adapted to irradiate the target volume in better compliance with a desired 3-D dose distribution in the target volume and whose energy modulator can be reused or reconfigured for different patients and/or for different irradiation fields.
To this end, the invention provides a therapy system for irradiating a target volume within a patient with a charged particle beam, comprising:
Each energy-shaping element of each of the first and second pre-defined groups of energy-shaping elements comprises an individual layer of fluid or of a solid material.
The therapy system further comprises a control unit which is configured:
In the context of the present invention, a “particle energy distribution at the output of a group of energy-shaping elements” is generally to be understood as a probability density function of particle energies, which function gives, for each particle energy value, the ratio of the number of particles having said particle energy value at the output of the group of energy-shaping elements to the total number of particles at the output of the group of energy-shaping elements.
In the context of the present invention, a pre-defined group of neighbouring energy-shaping elements means that such groups are not to be considered as “any group of energy-shaping elements” but are rather groups of neighbouring energy-shaping elements which are well defined and well known in advance to the control unit. A pre-defined group of neighbouring energy-shaping elements generally correspond to a specific pre-defined region of the target volume into which a desired or planned dose distribution and hence a desired or planned SOBP is to be achieved when that specific pre-defined region of the target is irradiated with the charged particle beam after particles of the charged particle beam have crossed the energy-shaping elements of said pre-defined group. The said desired or planned dose distribution may for example come from a Treatment Planning System.
Unlike the system disclosed in document US2018068753A1, a therapy system according to the invention can be re-used for different target volumes by adjusting the thicknesses of the fluids or of the solid materials according to the specific target volume to be treated.
Unlike the invention disclosed in document KR101546656 a therapy system according to the invention is adapted to generate specifically planned SOBPs in the various 3D regions of the target volume and is capable of a better conformal irradiation with a single and configurable device.
Unlike the system disclosed in document U52008/0260098 a therapy system according to the invention is adapted to generate specifically planned SOBPs in the various 3D regions of the target volume while the beam is directed to the target volume according to a single main beam direction and is hence faster and more accurate.
Preferably, the control unit is configured such that:
With such a preferred therapy system, a better irradiation conformity to the distal edge of the target volume can be achieved.
More preferably the control unit is configured such that PRmax1 is different from PRmax2. With such a preferred therapy system, an even better irradiation conformity to the target volume can be achieved.
Preferably the control unit is configured such that Emin1 is different from Emin2. With such a preferred therapy system, a better irradiation conformity to the proximal edge of the target volume can be achieved.
Even more preferably the control unit is configured such that PRmin1 is different from PRmin2. With such a preferred therapy system, an even better irradiation conformity to the target volume can be achieved.
Preferably the control unit is configured such that (Emax1-Emin1) is different from (Emax2−Emin2). With such a preferred therapy system, an even better irradiation conformity to the target volume can be achieved.
Preferably, each energy-shaping element has a cylindrical surface. With such a preferred therapy system, the energy-shaping elements can be aligned close to each other, so saving space and increasing compaction.
More preferably, all energy-shaping elements have the same hexagonal cross section, which allows for a most compact energy-shaping device.
Preferably, each energy-shaping element is a tube containing a fluid or a solid material. With such a preferred therapy system, the thickness of each layer of fluid or solid material can be easily adjusted by the control unit. Also, different energy-shaping elements can hold different fluids or solid materials with different stopping powers.
Preferably, the said fluid is a liquid. Exemplary liquids are furan (C4H4O) and solutions of glucose (C6H12O6).
Preferably, the said solid material is a granular solid material.
Preferably, the energy-shaping elements are aligned with a propagation direction of the particles of the charged particle beam that cross them.
More preferably, each group of energy-shaping elements is aligned with respect to a propagation direction of the particles of the incident charged particle beam.
Preferably, the therapy system comprises a beam scanner to scan the charged particle beam over the target volume, and a spot size of the charged particle beam in front of the energy-shaping device is substantially equal to the cross section of the first pre-defined group of neighbouring energy-shaping elements and substantially equal to the cross section of the second pre-defined group of neighbouring energy-shaping elements.
Alternatively, the energy-shaping elements are arranged transversely with respect to a propagation direction of the particles of the charged particle beam, preferably perpendicularly with respect to a propagation direction of the particles of the charged particle beam. With such an alternative, energy-shaping elements can pile up across a propagation direction of the particles and the number of piled layers of energy-shaping elements, their respective orientations, their respective heights and cross-sections as well as the fluids or solid materials they contain can be adapted to achieve a desired SOBP in the target volume.
Preferably the charged particle beam generator is a cyclotron or a synchrotron. Preferably a nominal beam energy at an output of the charged particle beam generator is in the range of 70 MeV to 250 MeV.
These and further aspects of the invention will be explained in greater detail by way of examples and with reference to the accompanying drawings in which:
Unless otherwise indicated, the figures are not drawn to scale. Generally, identical components are denoted by the same reference numerals in the figures.
Such a therapy system may apply various target irradiation techniques such as beam scattering, beam wobbling, beam scanning, or other methods. The energy-shaping device (10) is placed downstream of the device performing the said beam scattering, beam wobbling or beam scanning. The irradiation device (5) may be mounted on a gantry for rotation of said device about an isocenter or it may be of the fixed beam line type or of any other type. Such systems are well known in the art and will therefore not be described in further detail.
Of interest here is the energy-shaping device (10) which comprises a first pre-defined group (12) of neighbouring energy-shaping elements (11) that is adapted to deliver a first desired particle energy distribution at an output of said first pre-defined group (12) of energy-shaping elements when crossed by particles of the charged particle beam (6) and at least a second pre-defined group (22) of neighbouring energy-shaping elements (21) which is adapted to deliver a second desired particle energy distribution at an output of said second pre-defined group (22) of energy-shaping elements when crossed by particles of the charged particle beam, said second desired particle energy distribution being different from said first desired particle energy distribution.
In this example, each energy-shaping element comprises an individual layer of fluid (13), or of a solid material, having a thickness. Preferably, the said fluid is a liquid. Exemplary liquids are furan (C4H4O) and solutions of glucose (C6H12O6). Preferably, the solid material is a granular material or a material in the form of powder. Exemplary granular solid materials are granules of polymethyl methacrylate (PMMA), granules of polystyrene, granules of Lexan, granules of high-density polyethylene.
The system further comprises a control unit (14) which is configured:
In the context of the present invention, the said thickness of each fluid or solid material, is a thickness of said fluid or solid material in a propagation direction of the charged particles.
The thickness of each fluid or solid material of each individual layer of fluid or solid material of the first pre-defined group of energy-shaping elements is adjusted by the control unit according to a first desired spatial dose distribution in that first region of the target volume (1) which will be irradiated by the charged particles outputting the first pre-defined group of energy-shaping elements. The said desired first spatial dose distribution is for example a dose distribution as prescribed by a treatment plan for the said first region of the concerned target volume (1).
The thickness of each fluid or solid material of each individual layer of fluid or solid material of the second pre-defined group of energy-shaping elements is adjusted by the control unit according to a second desired spatial dose distribution in that second region of the target volume (1) which will be irradiated by the charged particles outputting the second pre-defined group of energy-shaping elements. The said desired second spatial dose distribution is for example a dose distribution as prescribed by the treatment plan for the said second region of the concerned target volume (1).
Preferably, the control unit (14) adjusts the thickness of each fluid or solid material, of each individual layer of fluid or solid material of the first and second pre-defined groups of energy-shaping elements before the particle beam (6) is turned on.
In the example of
With such cylindrical tubes oriented in the Z-direction (or according to a propagation direction of the charged particles that cross the said tubes) as energy-shaping elements, the thickness of liquid of a particular tube can for example be adjusted by using a first piston placed inside the tube to separate the liquid from a gas such as air for example. In this example, the first piston will move in the tube according to the pressures of the liquid and gas on both sides of the first piston until equilibrium of their respective pressures is achieved. The liquid and the gas may each be held in a dedicated tank, each tank being fluidly connected respectively to opposite ends of the tube, wherein their respective pressures are adjusted by the control unit (14), for example by moving a second piston in the liquid tank. The piston in the liquid tank can for example be moved back and forth by means of a stepper motor acting on the second piston via a shaft, each step of the motor eventually translating into a variation of liquid thickness in the tube. The liquid tank may for example be a syringe, the stepper motor being connected to the piston of the syringe. The connection between an end of the tube and a tank is adapted to have the tank out of the path of the particle beam. The said connection can for example be shaped as an elbow with a 90° bend and have sufficient length to arrange the tank out of the path of the particle beam. In this example all the tubes are equipped in the same way, the lengths of the various connections being adapted to accommodate the number of tubes, and their stepper motors are each controlled individually by the control unit (14). A similar system can be used to adjust the thickness of a granular solid material in a tube instead of a liquid.
The number of tubes belonging to a given group (12, 22) of neighbouring energy-shaping elements and their respective cross-sections must be chosen so as to achieve a desired SOBP between the frontal and distal edges of the target volume (1) along the path of the charged particles that will output that given group of neighbouring energy-shaping elements.
In the exemplary case where each tube of a given group of energy-shaping elements is filled by the control unit with a different thickness of a same liquid or of a same solid material, each tube of that given group of neighbouring energy-shaping elements will output charged particles of a different energy, each energy being at the origin of a particular Bragg curve (and then Bragg Peak) of the desired SOBP in the target volume. The fraction of charged particles of a particular energy that will output that first pre-defined group (12) of neighbouring energy-shaping elements is approximately proportional to the cross-section of the tube belonging to that given group (12) of neighbouring energy-shaping elements which fluid or solid material thickness has been adjusted by the control unit (14) to output charged particles of that particular energy. The control unit (14) turns the desired/planned particle energy distribution at the output of a given group of neighbouring energy-shaping elements into individual liquid or solid material thicknesses and fills the various energy-shaping elements of that group accordingly.
The number of tubes in the first or second pre-defined groups of energy-shaping elements and their respective sections must also comply with the diameter of a corresponding cylindrical sub-volume to be irradiated in the target volume, as defined for example by the said treatment plan (spatial dose distribution). Indeed the overall cross-section of the first pre-defined group (12) of energy-shaping elements must fit, as much as possible, the cross section of the said corresponding cylindrical sub-volume in the target volume. The same holds of course for the second pre-defined group of neighbouring energy-shaping elements (22).
In the case of pencil beam scanning (PBS), the overall cross-section of the first pre-defined group (11) of neighbouring energy-shaping elements must also fit, as much as possible, the size and shape of the PBS spot at the input of said first pre-defined group (11) of neighbouring energy-shaping elements. The same holds of course for the second pre-defined group (22) of neighbouring energy-shaping elements.
In these examples, each tube (11, 21) has for example a diameter comprised between 2 mm and 10 mm, the first pre-defined group of tubes comprises for example between 5 and 15 tubes (11), and the second pre-defined group of tubes comprises for example between 5 and 15 tubes (21).
Such an energy-shaping device (10) is specially designed to reduce the energy of incident charged particles, so that a desired particle energy distribution will be present at the output of a pre-defined group of neighbouring energy-shaping elements.
When the charged particles outputting a given group of neighbouring energy-shaping elements enter the target volume (1), several Bragg Peaks are generated in a corresponding region of the target volume (1), the combination of which will result in a so called “Spread Out Bragg Peak” (SOBP). In themselves, the function and basic operation of such an energy shaping device are well known in the art and will therefore also not be described further.
The corresponding desired first distribution of particle energies to be produced at the output of the first pre-defined group (12) of neighbouring energy-shaping elements (11) is shown in
As shown on
From this desired first distribution of particle energies, the specific thicknesses of the layers of fluids or solid material of the first pre-defined group (12) of neighbouring energy-shaping elements (11) can be computed according to known methods and then set by the control unit before irradiation of the target volume is started.
From this desired second distribution of particle energies, the specific thicknesses of the layers of fluids or solid materials of the second pre-defined group (22) of neighbouring energy-shaping elements can also be computed according to known methods and then set by the control unit before irradiation of the target volume is started.
As will moreover be understood, the filtering effect of several neighbouring energy-shaping elements filled with a same height of the same fluid or solid material is more or less equivalent to the filtering effect of a single energy-shaping element of a larger cross-section (i.e. the cross-section multiplied by the number of tubes) filled with that same height of that same fluid or solid material.
As one can see on
Such desired particle energy distributions can be achieved, for example, while scanning the particle beam (6) over the energy-shaping device (10) after the control unit (14) has adjusted the thickness of each fluid or solid material of each individual layer of fluid or solid material of the energy-shaping elements to achieve said desired particle energy distributions.
In such a case, the therapy system preferably comprises a beam scanner to scan the charged particle beam over the energy-shaping device. Such a beam scanner is well known in the art and may for example comprise electromagnets placed around the beam line for deviating the particle beam (6) in the X and Y directions. Hence, when scanning a particle beam (6) having for example a fixed energy over the energy-shaping device (10), a good depth-conformal irradiation of the target volume can be achieved, preferably in a single scan, namely a scan wherein the particle beam passes only once over each pre-defined group of energy-shaping elements.
In case the therapy system scans the beam, such as when using the known Pencil Beam Scanning (PBS) technique for example, the energy-shaping elements are sized such that a spot size of the charged particle beam (6) in front of the energy-shaping device (10) is substantially equal to the cross section of the first pre-defined group (12) of neighbouring energy-shaping elements (11) and substantially equal to the cross section of the second pre-defined group (22) of neighbouring energy-shaping elements (21).
Such desired particle energy distributions can also be achieved with single or double scattering of the charged particle beam before it reaches the energy-shaping device. In such an embodiment the beam is scattered so that substantially all the pre-defined groups of energy-shaping elements are crossed by scattered charged particles. A final collimator may optionally be used to ensure that the scattered beam is conformant to the lateral border of the target volume (1).
In the case of pencil beam scanning (PBS), and as shown on
In this example, the energy-shaping elements (11) are tubes of rectangular sections arranged side-by-side in piled layers, each layer being in a plane perpendicular to the main propagation direction (Z) of the particles of the charged particle beam (in
More generally, the energy-shaping elements of a pre-defined group are positioned individually with a view to defining various piles of layers of fluids or of solid material along the paths of incident charged particles, each fluid or solid material featuring a possibly different stopping power, and each pile featuring a possibly different area intersecting the incident charged particle beam. So each pile of layers of fluids or of solid material outputs particles of a given energy (or energies within a range which width is similar to the width of the range of incident particle beam) which will result from the different thicknesses and stopping powers of the layers of fluids or of solid material making the pile, while the fraction of the incident charged particles that will have that given energy (or energies) will depend on the intersected area of the pile of layers of fluids or of solid material (i.e. the area intersecting the charged particles of the incident charged particle beam). For the embodiment illustrated in
What is discussed above and illustrated in
Energy-shaping elements made of tubes filled with solid materials can be arranged in an appropriate treatment configuration by the control unit, for example by controlling stepper motors pushing rods of solid materials in the tubes from one end or from the other end of each tube.
The present invention has been described in terms of specific embodiments, which are illustrative of the invention and not to be construed as limiting. Reference numerals in the claims do not limit their protective scope. Use of the verbs “to comprise”, “to include”, “to be composed of”, or any other variant, as well as their respective conjugations, does not exclude the presence of elements other than those stated. Use of the article “a”, “an” or “the” preceding an element does not exclude the presence of a plurality of such elements.
The invention may also be described as follows: a particle therapy system that is adapted to irradiate a target volume (1) with charged particles in compliance with a desired 3-D dose distribution. Such a desired 3-D dose distribution is achieved while delivering a plurality of particle energy distributions at the output of an energy-shaping device (10) crossed by an incident mono-energetic charged particle beam (6). The energy-shaping device comprises a plurality of pre-defined groups (12, 22) of energy-shaping elements (11, 21), each energy-shaping element of each group comprising an individual layer of fluid or of solid material (13), which thickness is adapted individually by a control unit (14) prior to irradiation in order to obtain said desired 3-D dose distribution while the target volume is thereafter irradiated according to a single main beam direction (Z).
Number | Date | Country | Kind |
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20184077.4 | Jul 2020 | EP | regional |
Filing Document | Filing Date | Country | Kind |
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PCT/EP2021/067393 | 6/24/2021 | WO |