The present invention relates to radiation therapy facilities and methods for making and using the same. More particularly, but not exclusively, the present invention relates to a radiotherapy therapy vault module having a base frame for the radiotherapy equipment that is adjustably mounted within the module so as to allow the levelness of the base frame to be adjusted independently from the levelness (or lack thereof) of the surrounding vault module or vault floor.
Radiation emitting equipment has a number of well known applications. Radiation emitting equipment is used to inspect packages and cargo at borders and to perform non-destructive testing. In the medical field, radiation emitting equipment is used in the diagnosis and treatment of a number of diseases. Not surprisingly, the manufacturers of this equipment are continually making improvements. Radiation emitted by equipment of the type described as “therapeutic” or “for treatment” is often referred to as “high energy”, and is typically greater than 1 mv.
For example, radiation therapy (a.k.a. radiotherapy) has become widely used in the treatment of cancer and several other non-malignant conditions, and modern radiotherapy equipment has improved abilities to target and destroy specific tissues while sparing surrounding healthy tissue. As a result, the use of up-to-date radiotherapy equipment can yield improved patient outcomes as well as provide other benefits to the operators of the facility, such as increased ease of use, increased efficiency, and/or increased patient throughput.
Despite these benefits, it has not been practical for many existing radiotherapy facilities to modernize. Existing radiotherapy equipment, like many other types of radiation emitting equipment, is typically housed within a radiation shielding vault so as to protect the surrounding personnel from the harmful effects of the radiation. Because of the high radiation levels involved (i.e. typically greater than 1 MV) existing vaults are often constructed underground and/or with concrete walls that are several feet thick. As a result, the process of removing existing equipment, installing a modern replacement unit, and performing any necessary remodeling and reconfiguration is typically a three to five month process, with some projects taking up to a year. The prospect of a radiotherapy facility being out of service for such an extended duration, with the resultant disruption of treatment to patients, loss of revenue to the facility, and potential loss of referrals, is simply unacceptable to many facility operators. As a result, it is estimated that there are thousands of medical linear accelerators in use today which are technically obsolete and in need of immediate replacement.
One solution to the challenge is the provide a radiotherapy facility that can be rapidly and cost effectively built and utilized for relatively short durations, such as for only a year. U.S. application Ser. No. 13/459,694 describes one such method of construction in which the facility is largely constructed in a factory and brought to the site in a number of modules, one of which is comes preinstalled with the radiotherapy equipment. While the system described was largely successful, there is room for improvement.
In one form, the present invention improves on the approach described in U.S. application Ser. No. 13/459,694 by providing the ability to make fine adjustments to the orientation of the very sensitive radiotherapy equipment after some or all of the facility has been constructed. While described herein in the context of modular construction, it is to be understood that the invention is not so limited, and may be usefully employed in other vault constructions techniques to provide the ability to adjust the levelness of radiotherapy equipment independently from the surrounding vault floor.
The present invention provides systems and techniques for constructing and using integrated radiotherapy treatment facilities which include radiation producing equipment and radiation shielding vaults. While the actual nature of the invention covered herein can only be determined with reference to the claims appended hereto, certain aspects of the invention that are characteristic of the embodiments disclosed herein are described briefly as follows.
According to one aspect, the present invention provides a temporary, building code compliant radiotherapy facility for use during the time when an existing facility is being upgraded or modernized.
According to another aspect, the present invention provides a method of maintaining radiotherapy treatment continuity during an equipment transition.
According to another aspect, the present invention provides a building code compliant temporary radiotherapy facility which can be erected and put into use rapidly and cost effectively.
According to another aspect, the present invention provides a radiation vault module for supporting a radiotherapy device in which the levelness of the equipment's base frame can be adjusted independently from the levelness of the surrounding module.
According to another aspect, the present invention provides a radiation vault with an integrated base frame in which adjustments to the orientation of the base frame can be readily made after the equipment has been in use for a period of time.
Although the characteristic features of this invention will be particularly pointed out in the claims, the invention itself, and the manner in which it may be made and used, may be better understood by referring to the following description taken in connection with the accompanying figures forming a part thereof.
For the purposes of promoting an understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is hereby intended. Alterations and further modifications in the illustrated devices, and such further applications of the principles of the invention as illustrated herein are contemplated as would normally occur to one skilled in the art to which the invention relates.
In one form, the present invention involves the provision of a fully functioning temporary radiotherapy facility intended for short term use. The temporary facility may be provided at a designated site and used to treat patients during the time when an existing radiotherapy facility is being upgraded or modernized. Upon completion of the upgrade, the temporary facility may be removed from the site and redeployed to another site in need of a similar service.
Referring to
Access to treatment room 20 is via a radiation shielded door 40 and corridor 37. Once inside the treatment room 20, the patient lies on the treatment table 24 and the radiotherapy is administered via radiotherapy device 25 in accordance with the treatment parameters input by the operator at the control station 22. Both the treatment table 24 and the radiotherapy device 25 are mounted to a base frame 26 provided in the floor of the treatment room 20. As is known in the art, the base frame 26 is sufficiently rigid so as to fix the orientation of the device 25 and table 24 relative to each other, though the table 24 and device 25 may themselves be moveable in the conventional fashion relative to the fixed base frame 26. For example, the table 24 is typically mounted to a mounting ring (420 in
When fully constructed, the facility 10 complies with applicable building codes. Further, the facility 10 is “habitable” in the context of supporting patients and medical personnel during the time of use. As used herein, “code compliant” and “building codes” are intended to encompass an ability to construct and configure the basic structural elements of the disclosed combination so as to meet or adhere to what would be required according to applicable building codes. Since the codes of local municipalities might change over time, the structural embodiment disclosed herein is geared toward the code requirements as currently set forth in the 2009 Edition of the ICC International Building Code® (ISBN: 1580017258), including those other codes referenced therein.
Facility 10 has been designed using a number of prefabricated modules so as to speed the process of assembling and disassembling the structure, and may be referred to as a Temporary Radiotherapy Vault (TRV). As shown in
In this illustrated configuration, the treatment room is entirely contained within module 102. Modules 101, 102 and 103 are designed such that, when assembled, they define a number of void spaces 50, 52, 54, 56, 58, and 60 around the treatment room 20. These void spaces (i.e., the vessel) are designed to be filled with a radiation shielding material M, such as a flowable granular fill having a density range of 80-125 lb/ft3. Aligned void spaces (e.g. 50 and 54, 54 and 52, 52 and 58) are in fluid communication such that, once filled with the shielding material, a substantially continuous barrier of the radiation shielding material is created around the treatment room 20. By remaining in a perpetually flowable state, the granular fill (i.e., the shielding material M), cannot crack due to settling or seismic events.
Roof modules 105 and 106 are designed so as to be placed above modules 101, 102 and 103 and to have their trusses 84 and 82 spanning from the shear wall 64 in module 101 to the shear wall 62 in module 103. A supporting panel 80 is then mounted between the trusses 84 and 82, and together with panels 81, 83 integrated into the roof modules 106, 105 supports the shielding material M over the treatment room 20 while maintaining a gap 110 between the underside of the panels 80, 81, 83 and the uppermost portion of the treatment room 20. Alternative configurations and embodiments could incorporate additional roof modules in lieu of supporting panels. As a result, the load of the shielding material directly above the treatment room 20 can be distributed through the trusses to the shear walls 62, 64 rather than bearing on the treatment room itself. This gap isolates the treatment room and protects it from the effects of any foundation shifting or sinking that may occur due to the excessive weight of the shielding material above it. As shown in
While some of the floor space for control station 22 is provided by module 104, it is preferable to have the relevant computer equipment hardwired to the radiotherapy device 25 in module 102. In this case, the computer equipment is provided on a wheeled cart so that it can move into the position shown in
The precise quantity and desired distribution of radiation shielding material is dependent on the characteristics of the radiation emitted from device 25. As illustrated, the facility 10 is configured to employ an isocentrically arranged high energy linear accelerator, which typically operates in the range of 4-25 MV. An example would be Varian Medical Systems Trilogy, Palo Alto, Calif. In order to provide the appropriate level of shielding, the total weight of the shielding material may be 1,000,000 lbs or 2,000,000 lbs or more. To the extent the linear accelerator is operated at high MV energies (i.e. above 10 MV), neutron shielding is provided by lining the treatment room with wood panels and borated polyethylene sheets.
The facility 10 could also be used to perform other types of radiotherapy, such as gamma knife or high dose rate brachytherapy (HDR), which typically operate in the range of 1-3 MV. The facility 10 may also be adapted for use with cyclotrons operating in the range of 10-15 MV or proton accelerators operating in the range of 40-250 MV.
Existing modular vaults corresponding to U.S. Pat. No. 6,973,758 (i.e. the Rad Pro System) have been constructed on a reinforced concrete slab foundation in a number of permanent installations. The base of the Pro System pods was typically elevated several inches above the slab by a series of stub columns 150 as shown in
With reference to
The pattern includes a number of parallel and orthogonal beams and beam segments. These beams underlie various portions of the TRV structure and the layout of
This is significant because beams 220 and 230 are designed to underlie and provide support to the shear walls 62 and 64 in modules 103 and 101 respectively. As explained previously, because of the relationship between platforms 80, 81, 83 and trusses 82, 84, these shear walls 62, 64 bear the load of all the suspended shielding material that is positioned over the treatment room 20. Because this is a large mass of material, it provides significant inertial resistance to any lateral movement that would develop during a seismic event (i.e. earthquake). As a result, in order to satisfy various building codes, it is generally necessary to have a lateral coupling between the foundation and the shear wall that can withstand the significant lateral stresses. The dead load of the suspended shielding material is also positioned far enough away from the therapy room 20, to avoid any impairment to the supporting beams 214, 215, 216 and/or the supporting beams 210a, 212a which may impact the room's geometry and/or the levelness of the base frame 26.
With reference to
While illustrated as having only a single vertical span 166, support 160 may be reconfigured so as to include additional or different vertical spans between top plate 162 and base 168. For example, vertical plates may be added to the ends of the support 160 so as to provide additional coupling between the top plate 162 and the base 168. These end plates would be orthogonal to the vertical span 166 and would increase the overall rigidity of the supports 160.
Supports 260 are similar to supports 160 in that they also have a planar mounting plate 262 and a planar base 264 and the planar base 264 is received in slot 222 of a grade beam 221. However, the slot 222 includes a pair of intersecting slots such that slot 222 is considered to be elongated in two orthogonal directions. The base 264 of support 260 is also of a “+” or intersecting configuration, and in use the base of support 260 is received in slot 222 and engages therewith so as to provide lateral contact coupling in multiple directions.
Supports 260 may also be supplemented with additional vertical plates. In particular, it is contemplated that four vertical end plates would be attached to the four ends of support 260. Two opposing plates would be attached orthogonal to vertical support 266 and two would be orthogonal to vertical support 268.
One contemplated method according to the present invention involves the identification of a radiotherapy facility having an existing radiotherapy device needing to be taken out of service. Typically, a facility would self identify its needs.
Next, a site for a temporary radiotherapy facility is identified. The site should be suitably close to the existing facility so as to minimize disruption, and may be an empty field or parking lot. A foundation for the temporary device is created at the identified site. The foundation can be a simple concrete slab, but preferably it is a pattern of recessed grade beams as described previously.
Next, a temporary radiotherapy facility is assembled on the foundation. The temporary radiotherapy facility typically includes a radiotherapy device within a radiation shielding vault, and it may correspond to the TRV previously described. The vault may include at least about 1,000,000 lbs of radiation shielding material, such as the granular fill or some other type, as previously described, including water.
When the need for the radiotherapy facility ceases to exist, for example because the renovation has been completed, the facility is removed. For a typical replacement, this would be less than 12 months. Removal of the temporary facility may include removal of some or all of the components of the TRV and some or all of the radiation shielding material included in the void spaces.
In one refinement, the TRV is equipped with radiotherapy equipment substantially similar to the equipment to be installed at the existing facility. In this way, the personnel can receive training on the new equipment while operating in the TRV.
Another inventive method contemplated herein involves maintaining treatment continuity to a patient population during the renovation or construction of a radiotherapy facility. This may be accomplished in connection with an existing (first) radiotherapy facility having a first radiotherapy device, wherein services are provided at the existing facility to a patient population by support staff, the support staff including at least one treatment individual. The treatment individual may be, for example, a doctor, a nurse, a therapist, a dosimetrist, or a physicist.
A second radiotherapy facility is constructed to treat the patient population on a temporary basis, the second facility having a second radiotherapy device within a radiation shielding vault, such as the TRV described previously. Upon completion of the temporary facility, the treatment individual is transitioned to the second facility, and he/she provides services at the second facility to the patient population during the renovation and/or upgrade of the first radiotherapy facility. Then, upon completion of the renovation and/or upgrade of the first radiotherapy facility, the treatment individual is transitioned back to the first facility (or to a newly-constructed third facility) where he/she can continue to serve the same patient population. The period of transition may be occasioned by an equipment modernization and/or the construction of a wholly-new facility.
In order to be effectively used, radiotherapy equipment must be carefully calibrated. One of the alignment and/or calibration characteristics is referred to as “isocenter” which is a point in three-dimensional space around which all movable axes of the treatment machine revolve. As would be understood, a stable isocenter is critical. In certain applications, isocenter is defined and specified as a sphere having a radius of no more than 2 mm in diameter, for example 1 mm in diameter. The targeted treatment area, usually a tumor, is placed at isocenter during treatment. As various components of the treatment machine (gantry, collimator, and couch) are moved to different angles during the treatment delivery, it is essential that no part of the machine flex or move in any manner that would cause the target, at isocenter, to be missed.
All structures can sink, shift, or even move. They are engineered to do this without any overall impairment to the structure. A shift in a wall, floor or ceiling in a therapy room, however, has consequences not normally part of the engineer's design challenge. With a slab foundation, soil settlement is controlled since the slab can bridge over settlement areas, just like a sheet of plywood would bridge your shoe depressions in the mud. If there is any settlement, it will be mitigated by the slab, or at least slowed down so as to happen over a longer period of time, typically years.
Rapid settlement in localized areas can have an effect on grade beams, since they do not have the benefit of the monolithic slab. The disclosed approach, as set forth herein, is to build in tolerance by making the therapy room an independent structural sanctuary that is not impacted by any settlement caused by the huge shielding mass, especially the mass directly above the treatment room. This is achieved by creating a six inch gap between the therapy room structure and the supported shielding mass above. Further contributing to this achievement is allowing the grade beams to move independently and further, separating the shielding mass load from the therapy room load by a suitable distance on independent grade beams.
Turning now to
As noted above, the treatment room module 102, or vault module, is made up of a freestanding outer frame assembly. The floor structure of this frame includes lateral side members 102a, 102b. These side members 102a, 102b extend the length of the module 102 and are positioned over the grade beams 210, 212 as shown in FIG. 4. The floor structure of module 102 also includes a pair of cross members 102c, 102d that extend between the side members 102a and 102b so as to be positioned over the grade beams 214 and 216 respectively. For clarity, side member 102a and its underlying grade beam 210 have been omitted from
The base frame 26 is provided with a number of mounting flanges 412, only one of which is shown in the detail of
With reference to
It is to be understood that the adjustments to the orientation of the base frame 26 made possible by the present invention can have a number of beneficial applications, for example, by allowing for adjustments to be made at the time of initial installation or after a period of use, for example to compensate for any adverse effects due to settling. To facilitate access to the adjustable supports 400 after initial installation, trap doors may be provided in the floor of the treatment room above each of the supports, thereby enabling access to each support with minimal disruption to any floor finishing that may be installed.
The process of leveling the base frame 26 may proceed as follows. The base frame 26 is adjustable mounted with the outer frame assembly of module 102. This outer frame assembly is then placed on a foundation. Preferably the radiotherapy machine 25 and treatment table 24 have already been mounted to the base frame 26 at the factory, but if not, they may be brought to the site and mounted to the base frame independently. As the module 102 is typically large and difficult to maneuver, the process of placing it on the foundation is typically accomplished with a container mover, such as a crane. As noted above, the foundation may be a concrete slab or a pattern of grade beams, and the outer frame assembly/module 102 may be placed directly on the foundation or onto supports extending from the foundation.
Once the module 102 has been placed on the foundation, the levelness of the base frame is checked, which may be accomplished using conventional leveling equipment (i.e. bubble levels). If the base frame is determined to be out of level, the mounting bolts 410 securing the base frame 26 the outer fame (i.e. cross members 102c and 102) are loosened and the adjustable supports 400 are used to raise portions of the base frame 26 as described above. Any number of the supports 400 may be utilized to bring the base frame 26 to level, such as one, two, three or all four of the supports, and the levelness of the base frame may be continually checked during the leveling process. Because the base frame 26 is being leveled with the adjustable supports 400, there is no need to make fine adjustments to the overall orientation of the large and difficult to maneuver outer frame assembly/module 102, as would be the case if the base frame 26 were not adjustable within the module 102.
While the invention has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character. Only certain embodiments have been shown and described, and all changes, equivalents, and modifications that come within the spirit of the invention described herein are desired to be protected. Thus, the specifics of this description and the attached drawings should not be interpreted to limit the scope of this invention to the specifics thereof. Rather, the scope of this invention should be evaluated with reference to the claims appended hereto.
In reading the claims it is intended that when words such as “a”, “an”, “at least one”, and “at least a portion” are used there is no intention to limit the claims to only one item unless specifically stated to the contrary in the claims. Further, when the language “at least a portion” and/or “a portion” is used, the claims may include a portion and/or the entire items unless specifically stated to the contrary. Likewise, where the term “input” is used in connection with a device or system component, such as a fluid processing unit or electrical device, it should be understood to comprehend singular or plural and one or more signal channels or fluid lines as appropriate in the context. Finally, all publications, patents, and patent applications cited in this specification are herein incorporated by reference to the extent not inconsistent with the present disclosure as if each were specifically and individually indicated to be incorporated by reference and set forth in its entirety herein.
This application claims the benefit of U.S. Application No. 61/891,286, filed Oct. 15, 2013. The technology described herein is also related to commonly owned U.S. application Ser. No. 13/459,694 filed Apr. 30, 2012, and U.S. Pat. No. 6,973,758, the disclosures of which are incorporated by reference herein.
Number | Date | Country | |
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61891286 | Oct 2013 | US |