巴西专利BR112012026233B1 radiation treatment system

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RADIATION TREATMENT SYSTEM. Disclosed are radiation treatment systems with enhanced control architectures that allow more complex treatment plans to be implemented, and radiation treatment systems with enhanced resistance to the neutron effect. An exemplary control architecture comprises: a digital packet network, a supervisor electrically coupled to the digital packet network and having a treatment plan, and a plurality of nodes, each node coupled to the digital packet network and controlling one or more related components a treatment of the radiation treatment system, and in which the supervisor periodically communicates control orders to the nodes through the digital packet network.
公开号:BR112012026233B1
申请号:R112012026233-5
申请日:2011-04-13
公开日:2020-12-29
发明作者:Andres Graf；Hanspeter Felix；Qingxiang Ke；Angi Ye
申请人:Varian Medical Systems, International Ag；Varian Medical Systems, Inc；
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CROSS REFERENCES TO RELATED ORDERS
[001] This application claims priority of provisional patent application US 61 / 323,859, entitled: “Real Time Control Systems for Radiation Treatment Systems”, filed on April 13, 2010. BACKGROUND OF THE INVENTION
[002] Radiosurgery is a medical procedure, which allows non-invasive treatment of benign and malignant tumors. It is also known as stereotactic radiation therapy (SRS) when used to target brain injuries, and stereotactic body radiation therapy (SBRT) when used to target body injuries. In addition to cancer, it has also been shown to be beneficial for the treatment of some non-cancerous conditions, including functional disorders, such as arteriovenous malformations (AVMs) and trigeminal neuralgia. It operates by directing highly focused beams of ionizing radiation (eg, X-rays, gamma rays) with high precision. It was initially developed in 1951, and can be used for ablation, by means of a precise dosage of radiation, intracranial and extracranial tumors and other lesions that are inaccessible using common surgical techniques. There are many nervous diseases for which conventional surgical treatment is difficult or inadvisable, or has deleterious consequences, such as damage to nearby arteries, nerves and other vital structures.
[003] A linear accelerator (LINAC) can be used to distribute radiosurgery. LINAC-based radiosurgery was pioneered at the University of Florida College of Medicine and presented by Betti and Colombo in the mid-1980s. Modern linacs optimized for radiosurgery applications include the Varian Medical Systems Trilogy machine, and the Novalis radiosurgery platform Tx, produced by Varian and BrainLAB. These systems differ from Gamma Knife in a variety of ways. Gamma Knife produces Co-60 decay gamma rays of an average energy of 1.25 MeV. LINAC produces X-rays from the impact of accelerated electrons hitting a metal target (usually tungsten). LINAC, therefore, can generate any number of x-rivers of energy. Gamma Knife has more than 200 sources arranged on the helmet to distribute a variety of treatment angles. In a LINAC, the gantry moves in space to change the distribution angle. Both can move the patient in space to also change the distribution point. Both systems preferably use a stereotaxic frame to restrict the patient's movement, although a structure is not required in the Varian Trilogy and the Novalis Tx radiosurgery platform. The Varian Trilogy can also be used with non-invasive immobilization devices, along with real-time images to detect any movement of the patient during treatment.
[004] Although LINAC systems offer many advantages, they are much more complex to control. For example, as the gantry rotates over the patient, the collimator's claws and leaves must be varied, and the signals for the linear accelerator must be varied, to implement a desired radiation dosing plan. This complexity limits the ability to implement certain types of treatment plans. BRIEF SUMMARY OF THE INVENTION
[005] An invention of the present application encompasses radiation treatment systems that have advanced control architectures that allow a more complex treatment plan to be implemented. In general terms, an exemplary system comprises: a plurality of components related to treatment, with a network of digital packages, a supervisor control entity electrically coupled to the network of digital packages and with a treatment plan, and a plurality of nodes , each node connected to a digital packet network and controlling one or more of the components of the radiation treatment system, and where the supervisor periodically communicates control orders to the nodes in the digital packet network. As used here, the term "radiation" encompasses all forms of particles and electromagnetic radiation, including, but not limited to: ionizing radiation, non-ionizing radiation, electron beams, proton beams, ion beams, atom beams, microwave beams, radio frequency beams, etc.
[006] Another invention of the present application covers control systems for radiation treatment systems. In general terms, an exemplary control system comprises: a digital packet network, a supervisor control entity electrically coupled to the digital packet network and with a treatment plan, and a plurality of nodes, each node being coupled to the digital network of packet communications and controlling one or more components of its host system, and where the supervisor periodically communicates commands to the nodes over the digital packet communications network.
[007] Yet another invention of the present patent application includes radiation treatment systems that have increased the ability to withstand the interfering effects of scattering neutrons and other forms of radiation. In general terms, an exemplary system comprises: a plurality of treatment-related components, a digital packet network, a supervisor control entity electrically coupled to the digital packet network and with a treatment plan, and a plurality of nodes, each node connected to the digital packet communications network and controlling one or more treatment-related components, and where a plurality of treatment-related components are arranged within a treatment compartment, and where the supervisor and control entity at least one node is arranged outside the treatment room.
[008] However, another invention of the present patent application includes radiation treatment systems that have increased the ability to withstand the interfering effects of scattering neutrons and other forms of radiation. In general terms, an exemplary system comprises: a plurality of components related to the treatment, with a network of digital packages, a supervisor control entity electrically coupled to the network of digital packages and with a treatment plan, with a plurality of nodes , each node connected to the digital packet communications network and controlling one or more treatment-related components, and a body of neutron absorbing material disposed between at least one treatment-related component and the supervisor, the body of absorbing material from neutrons by reducing the neutron flux density by passing by itself by a factor of ten or more.
[009] However, another invention of the present patent application includes radiation treatment systems that have increased the ability to withstand the interfering effects of scattering neutrons and other forms of radiation. In general terms, an exemplary system comprises: a plurality of components related to the treatment, with a network of digital packages, a supervisor control entity electrically coupled to the network of digital packages and with a treatment plan, with a plurality of nodes , each node connected to the digital packet communications network and controlling one or more treatment-related components, and a body of neutron absorbing material disposed between at least one treatment-related component and the supervisor, the body of absorbing material from neutrons absorbing neutrons to a greater degree than plaster.
[0010] However, another invention of the present patent application includes radiation treatment systems that have increased the ability to withstand the interfering effects of scattering neutrons and other forms of radiation. In general terms, an exemplary system comprises: a plurality of treatment-related components, and a plurality of nodes, each node controlling one or more treatment-related components, where at least one node comprises at least one subnode, where at least one subnode controls at least one aspect of a treatment-related component and receives direction from the node of at least one, where the at least one subnode comprises a processor, a flash memory, a memory volatile, and a parameter stored in three or more different locations in volatile memory.
[0011] The above inventions and their additional modalities are described in the Detailed Description, with reference to the Figures. In the figures, the same reference numbers can refer to elements similar to some elements that cannot be repeated. BRIEF DESCRIPTION OF THE DRAWINGS
[0012] Figure 1 shows an exemplary radiation treatment system according to the present invention.
[0013] Figure 2 shows an exemplary control system according to the present invention.
[0014] Figure 3 shows an exemplary node switch block according to the present invention.
[0015] Figure 4 shows another exemplary node switch block according to the present invention.
[0016] Figure 5 shows another exemplary control system according to the present invention.
[0017] Figure 6 shows another exemplary control system according to the present invention.
[0018] Figure 7 shows another exemplary node switch block according to the present invention.
[0019] Figures 8A-8C show exemplary commands sent from the supervisor to an exemplary node in accordance with the present invention.
[0020] Figures 9A-9B show an exemplary error message sent from the exemplary node to the supervisor according to the present invention.
[0021] Figure 10 is another exemplary control system according to the present invention.
[0022] Figure 11 shows an exemplary radiation treatment system according to another invention of that disclosed by the present application.
[0023] Figure 12 shows an example of a subnode that can be used in a radiation treatment system according to yet another invention disclosed by the present application. DETAILED DESCRIPTION OF THE INVENTION
[0024] Figure 1 shows an exemplary radiation treatment system 10 with an exemplary control system in accordance with the present invention. Like the Trilogy Varian system, the exemplary embodiment comprises a patient support (for example, a patient bed) 1, which can move the patient, a gantry 2, which circles over one end of the patient's bed, a support 3 supporting the gantry, a beam generator 4 mounted on the gantry, a radio frequency (RF) energy source and an RF modulator 5 that supplies power to the beam generator 4, a first image detector 6 mounted on the gantry , and a first image radiation source 7 mounted on the gantry opposite the first image detector 6. The beam generator 4 comprises a linear accelerator, which generates and accelerates electrons in an electron beam, a "bending" magnet that bends the 270-degree electron beam (in turn, results in an effective 90-degree turn), and a tungsten target, which can be selectively used depending on the patient's treatment plan. When the tungsten target is used, the electron beam generated by the linear accelerator hits the target and generates X-rays, which are transported to the patient's treatment area, as described below. When the tungsten target is not used, the electron beam is transported to the patient's treatment area. The linear accelerator has an electron gun, an acceleration structure for the electrode chambers about one meter long, and a magnetron or klystron that generates microwave pulse signals for the electrodes of the acceleration structure. The accelerator electrons or X-rays generated by the target are spatially filtered by an adjustable multi-leaf collimator (MLC) 8 that has a plurality of movable sheets of radiation-absorbing material (for example, 120 sheets). An electron or X-ray treatment beam emerges from the MLC 8, and the beam can have a wide variety of cross-sectional patterns, as defined by the positions of the MLC 8 sheets. Before reaching MLC 8, the beam is passed through a treatment of a set of jaws, which open and close around the beam. When the jaws are closed, the treatment beam does not emerge from the collimator's structure. When the jaws are opened, the treatment beam emerges and reaches the patient. The first image detector and the image radiation source are on a plane that is perpendicular to the treatment beam. The treatment system can also include a second image detector 9 arranged about 6 meters and opposite the treatment beam (in Figure 1, this second image detector is shown in a folded position, folded in a gantry compartment). The second image detector uses radiation from the treatment beam to provide an image that is perpendicular to that provided by the first image detector.
[0025] The support of patient 1 does not need to be mobile, and can be a fixed support. Gantry 2 and support 3 implement a particular form of a beam positioning mechanism, which is capable of retaining and / or displacing the path of the radiation beam (e.g., trajectory) in relation to the patient. Other beam positioning mechanisms are known in the art, and can be used in conjunction with the invention. Mechanisms for positioning beams include, but are not limited to: gantries, ring gantries, devices with robotic arms, beam targeting devices (including those using electric fields and / or magnetic fields), and combinations thereof. The multi-leaf collimator 8 implements a particular form of a beam forming mechanism that is capable of modifying the shape of the cross section of the radiation beam. Beam molding devices include, but are not limited to, multi-leaf collimators, iris collimators, jaw collimators, electric field formatters (eg, “electrostatic” formatters), magnetic field formatters (eg, “lenses” magnetic strips ”), and their combinations. Beam positioning mechanisms, beam formatting mechanisms, patient support 1, gantry 2, support 3, beam generator 4, RF modulator 5, image detector 6, image radiation source 7, multi-leaf collimator (MLC) 8, the collimator's jaws, and the second image detector 9 are referred to herein as related to the treatment of radiation treatment system components 10 to distinguish them from the components of the new control systems of the present invention, described below in more detail. A radiation treatment system encompassed by the present invention does not need to have all the components listed above, but it can have any number of components and any type of components, as is appropriate for the particular treatment to be performed by the system.
[0026] A radiation treatment plan comprises a coordination of the movements of the gantry, supporting the patient, and the MLC sheets, together with the coordinate adjustments for the energy level and dosage of X-rays or other types of radiation generated by the beam generator. The plan was designed to deliver a certain radiation dose from a tumor located in the patient's body, while minimizing the amount of radiation received by the surrounding healthy tissue. The gantry moves the X-ray beam around the patient to minimize the impact on healthy tissue, while continuing to point the beam that passes through the tumor. The positions of the MLC sheets are moved to form the cross section of the X-ray beam that is close to or within the tumor cross section at the special position of the gantry. The entire MLC can be rotated, as well as providing another degree of motion control. The imaging system (for example, the two imaging detectors) can be used to align the patient's tumor system, for example, using the images from the detectors to determine how to move the patient support, to align the MLC with the tumor. Software tools are available to develop a treatment plan for any tumor size and position. The output of such a software tool can be imported into the system shown in Figure 1 and used. Therefore, in general terms, a radiation treatment plan comprises a coordination of the operations of two or more components of radiation treatment in the treatment system, where such operations may include, but are not limited to, positions, movements , and parameter settings (for example, energy, dosages, etc.).
[0027] As a difference in relation to the previous LINAC systems, the embodiment of the invention represented in Figure 1 comprises an innovative and inventive distributed control system that coordinates the operation of the components shown in the figure, such as the gantry (support), the generator beam, MLC collimator, patient support, and imaging system. The control system comprises a supervisor 20, a plurality of nodes, each of which may have one or more subnodes, for a total of a plurality of subnodes. The nodes are identified with the following labels in Figure 1: “gantry”, “Beam generation”, “collimator”, “Image acquisition”, “bed” and “Image positioning”. The supervisor and the nodes are electrically coupled to each other by a digital packet network, such as a local Ethernet (for example, LAN). The supervisor periodically communicates instructions to the nodes, and periodically receives information about the state of the nodes. Each node controls the operation of one or more of the system's components. For example, the gantry node can direct the operation of the gantry, the collimator node can direct the operation of the leaves, the claws, and the angle of rotation of the collimator, the bed node can control the operation of the patient support, the node beam generation can control the operation of the beam generator (including the linear accelerator and the curvature magnet that curves the beam 90 degrees), and an imaging node can control one or both of the two imaging systems. Each node can control one or more subnodes. For example, the Beam Generation node may have a first subnode that controls the electron gun, a second subnode that controls the magnet or klystron, and a third node that controls the curve magnet.
[0028] With reference to Figure 2, the supervisor comprises a data processor, a non-transitory tangible computer readable memory electrically coupled to the data processor to store data and instructions (for example, codes), a network installation electrically connected to the data processor and the digital packet network, a clock electrically coupled to the data processor, an I / O port installation electrically connected to the data processor, and a tangible, non-transient, computer readable mass storage element electrically coupled to the processor data (for example, magnetic disk storage or a flash drive). Each node comprises a data processor, a non-transitory tangible computer-readable memory electrically coupled to the data processor to store data and processor instructions (for example, codes), a network installation electrically connected to the data processor and the data network. digital packets, a clock electrically coupled to the data processor, and an I / O port facility electrically connected to the data processor, and can comprise a non-transitory, tangible, mass-storage element computer-readily coupled to the data processor ( for example, storage on a magnetic disk or flash drive). The supervisor can provide a periodic time signal on one or more lines on one of its I / O ports, and this periodic time signal can be electrically coupled to one or more corresponding lines on an I / O port on each node . The periodic time signal can be used to synchronize the operation of the nodes for the operation of the supervisors. As another approach, the periodic time signal can be provided by a periodic time signal generator, as shown in Figure 2, in which case the supervisor's I / O port can receive the periodic time signal and use it to coordinate the instructions for the nodes. The processor for each node can be driven by instructions stored in computer-readable memory to configure the I / O port facility to generate an interrupt signal from the processor to the data processor, when the periodic time signal is received at the port of I / O. In response to receiving an interrupt signal, the data processor can be directed by instructions to perform one or more tasks (action orders) previously sent to it by the supervisor, and to send status information back to the supervisor. As yet another approach, the periodic time signal can be transmitted over the digital packet network by the supervisor or periodic time signal generator, as general periodic broadcast packets. Each node can comprise an internal periodic signal generator and can synchronize its internal generator according to the received packet time with the external periodic time signal. In this way, if a node loses the packet of the external periodic time signal, it can invoke its internal clock to define the timing of the action requests that consists of carrying out according to the commands, which it received from the supervisor.
[0029] If a node has one or more subnodes under its control, then the lines of its one or more I / O ports are coupled to the subnodes, as through a CAN bus (Control BUS Area Network - area network) control bus). Each subnode can include digitally controlled circuitry, or it can comprise the same components as a node, depending on the tasks to be performed by the subnode.
[0030] In typical implementations, the system used by the supervisor, nodes and subnodes provides real-time status information to the supervisor for more than 140 “mechanical parameters”, where a mechanical parameter is a generic term used here to cover the position of an element (such as a collimator sheet), the axial position of an element (such as the angle of rotation of the gantry), the electron gun dose output from the accelerator, the energy from the accelerator electron beam, and the force of the curve magnet. (The term “mechanical axes” is also used here to designate these generic mechanical parameters.) The system also provides real-time control over each of the mechanical parameters (or mechanical axes) by the supervisor and nodes. The system also provides real-time status of several dozen electrical sensors to the supervisor, real-time control of multiple static and dynamic magnetic fields (which can be viewed as “mechanical parameters”), zero image data collection to multiple flat panel X-ray detectors and image data collection from zero or more optical imaging cameras. In this context, "real time" means to control all axes and magnetic fields within approximately 30 ms of having received information about the status of all axes and / or electrical sensors.
[0031] Another inventive aspect of this request concerns the commands sent to the nodes by the supervisor. The supervisor periodically sends commands, in the form of data packets in the digital packet network, to the nodes, as every 10 ms (Milliseconds). These packets can be sent right after the periodic time signal emits an active pulse on the I / O ports of nodes. Each command provides a first order of action for the node specifying the task (s) that the node must perform on receiving the next active pulse of the periodic time signal, and a second order of action for the node specifying the task (s) that the node must execute on receiving the second next active pulse of the periodic time signal. For example, if the supervisor issues command packets to all nodes in time = 10 milliseconds (all commands can be sent and received on the digital packet network within about 1 ms), then each command has action orders for the task (s) that the node is doing in time = 20 ms, and for the task (s) that the node is doing in time = 30 ms. Thus, if the node does not receive a command, it still has a redundant back-up order of action since the last command received from the supervisor. A command can provide orders for subsequent time points, as well, as a form of action on the third specification of the task (s) that the node must perform on receiving the next active third pulse of the periodic time signal. Each node monitors incoming commands and detects if a command did not arrive when expected. If a command is missing, its content will have been covered by the previous command (and possibly subsequent commands). If two successive commands are absent, the node can affirm an indication of communication failure through one or both communication paths: a message packet for the supervisor sent through the digital packet network, and which opens one of the communication loops. qualification, as described below.
[0032] The concepts of redundancy above are illustrated with some examples now for an exemplary node in which actions must be conducted at time points T1, T2, T3 T4, etc. Before the first time point T1, the node receives a first exemplary command from the supervisor having a first order of action for the first time point T1 and a second order of action for the second time point T2, the second point in time T2 being later in time (for example, later) than the first time at point T1. The first command, which is illustrated in Figure 8A, can optionally have a third order of action for the third point in time T3, which is subsequent in time for both T2 and T1. The node performs the action specified in the first action order it received in the first command substantially when the first point in time T1 occurs (for example, within a few milliseconds of T1, or within 20% of the time interval between T1 and T2) , and save the second call to action (and optionally the third call to action) for possible later use. The exemplary node waits for a second command to arrive, after the first command has been received, and before the second point in time T2 is about to occur. If the exemplary node does not receive a second command within a certain period of time before the second point in time T2, such as within a millisecond of T2, proceeds to perform the action specified in the second order of action that it received in the first command substantially when the second point in time T2 occurs, and sends an error message packet (as shown in Figure 9A) to the supervisor via the digital packet network, indicating that it did not receive a command when it should have received one.
[0033] If, instead, the exemplary node received a second command from the supervisor within the selected time period before the second point in time T2, then the exemplary node acts on the second command. The second command has a second order of action for the second point in time T2 and a third order of action for the third point in time T3, the third point in time T3 being later in time (for example, later) than the second point at time T2 and the first point at time T1. The second command, which is illustrated in Figure 8B, can optionally have an action order for the fourth point in time T4, which is subsequent in time for each of the points in time T1-T3. The exemplary node can delete the stored parts of the first command after receiving the second command. The node then performs the action specified in the second order of action that it received in the second command substantially when the second point in time T2 occurred (for example, within a few milliseconds of T2, or within 20% of the time interval between T2 and T3), and save the third order of action (and, optionally, the fourth order of action) for possible later use. The exemplary node then saves a third command to arrive after the second command has been received and, before the third point in time T3 is due to occur. If the exemplary node does not receive a third command within a certain period of time before the third point in time T3, as within a millisecond of T3, it proceeds to perform the action specified in the second order of action that it received in the second command substantially when the third point in time T3 occurs, and sends an error message packet to the supervisor through the digital packet network indicating that it did not receive a command when it should have received one. If the second command was not received, and if the first command containing a third order of action for T3, then the exemplary node proceeds to perform the action specified in the third order of action that it received in the first command substantially when the third point in time T3 occurs, and sends an error message packet (shown in Figure 9B) to the supervisor via the digital packet network, indicating that it did not receive a command when it should have received one.
[0034] If, instead, the exemplary node received a third command from the supervisor within the selected time period before the third point in time T3, then the exemplary node acts on the third command in a manner similar to how behaved in the first and second commands. The node processes subsequent commands in a similar way. If the node does not have an order of action to act at a specific point in time, it can make a selected course of action fail-safe, depending on the components it controls.
[0035] With reference to Figure 2, the system can have one or more “enabled loops” that provide the safety of the operation (for example, guarantee the safety of a single fault or simple fault-proof capacity). Four enabling loops are shown in Figure 2. Each enabling loop can belong to a different security concern and / or control concern. An enabling loop can go to each node, or it can pass through each node in the system, or just the system nodes, which can detect a failure, which is relevant to the concerns (s) pertaining to the control loop, or which it is necessary to react to a fault condition detected by the enabling loop. The system can have the following enabling loops: (1) a beam enabling loop that refers to the beam generation, (2) a movement housing loop that refers to the movements of the gantry, collimator, generation arms image, and patient support, (3) an energy enabling loop that pertains to the driving of components that can become dangerous to the patient, if not controlled (such as motors, pumps, high current power supplies, etc. ), and (4) an image generation beam enabling loop that belongs to the low energy X-ray beams used for image generation. A node can be attached to one or more of these loops, and can cause loops to fail based on different criteria.
[0036] In an implementation, each loop may comprise an electrical signal wire that begins on an output line from a supervisor I / O port (or an R resistor coupled to a Vdc supply voltage), and passes through from one or more electronic switches on one or more matching nodes, and returns back to the input line of a supervisor I / O port. When a node sees no malfunctions, it commands the electronic switch to the closed position, which completes the electrical loop from the supervisor's output line (or a resistor R coupled to a voltage source Vdd) to the line. supervisor input. When a node sees a malfunction, it commands the electronic switch to the open position, which breaks the electrical loop and changes the voltage at the supervisor input line. The supervisor monitors the input line for a voltage level indicative of an interval, which signals a fault condition. A node can command its electronic key through an output line from one of its I / O ports. The nodes further down the loop can monitor the enabling line, and also detect a failure of a node upstream or downstream of a node and react accordingly. More specifically, at each node, an enabling loop can pass through a series combination of a single pole switch and a detection resistor from a circuit pack block identified as “switches” in Figure 2. The switch can be selective, open or closed by the node according to whether or not the node detects a fault condition relevant to the enabling loop. The node processor provides a control signal to the switch through the node's I / O port facility, as shown in the figure.
[0037] Figure 3 shows an exemplary implementation of the switch block. Four enabling loops are shown, which pass four corresponding series combinations of switches S1-S4 and detection resistors R1-R4, respectively. If the node detects a fault condition, the node sends a corresponding command signal C1-C4 from its I / O port facility to the corresponding switch S1-S4 of the relevant enable loop with a value that causes the switch opens (not leading), otherwise the node sends a command signal C1-C4, with a value that keeps the switch closed (leading). Each switch S1-S4 can comprise a transistor, such as a MOSFET transistor. As the current from a enable loop passes through a node, it generates a voltage through the corresponding detection resistance R1-R4, which can be detected by a corresponding differential amplifier OP1-OP4 (for example, “OP- amps ”) that has inputs coupled on each side of the corresponding detection resistor R1-R4, as shown in the figure. The output of the corresponding differential amplifier OP1-OP4 provides a corresponding digital signal F1-F4 that has a value of zero when no current flows in the enabling loop (which indicates a fault condition), and a value of one when the current is flowing in the enabling loop (which indicates a normal, faultless condition). F1-F4 signals are coupled to inputs of the I / O node facility. Each OP1-OP4 differential amplifier can comprise a set of zero displacement circuits, which makes the output have a value of zero, when the difference voltage across its inputs is zero. If not, such circuitry are known in the art, and can easily be added to the circuitry shown in the figure.
[0038] If implementations for switches S1-S4 have sufficiently high resistance in the state, then switches S1-S4 can serve as the detection resistors R1-R4, respectively, This embodiment is shown in Figure 4. As in In the previous embodiment, four enabling loops are shown, which pass through four corresponding switches S1-S4, respectively. If the node detects a fault condition, the node sends a corresponding command signal C1-C4 from its I / O port facility to the respective switch S1-S4 of the relevant enable loop with a value that causes the switch opens (not driving), otherwise the node sends a command signal C1- C4, with a value that keeps the switch closed (conductor). Each switch S1-S4 can comprise a transistor, such as a MOSFET transistor. As the current from an enabling loop passes through a node, it generates a voltage through the corresponding switch S1-S4, which can be detected by a corresponding differential amplifier OP1- OP4 (for example, “op-amps” ) which has inputs coupled to both sides of the corresponding switch S1-S4, as shown in the figure. The output of the corresponding differential amplifier OP1-OP4 provides a corresponding digital signal F1-F4 that has a value of zero when no current flows in the enabling loop (which indicates a fault condition), and a value of one when the current is flowing in the enabling loop (which indicates a normal, faultless condition). F1-F4 signals are coupled to I / S node facility inputs. Each OP1-OP4 differential amplifier can comprise a set of zero displacement circuits, which makes the output have a value of zero, when the difference voltage across its inputs is zero. If not, such a circuitry is known in the art, and can easily be added to the circuitry shown in the figure.
[0039] While the example above had the enabling ties that pass through the supervisor, this is not a requirement. Instead, the supervisor can monitor the faults detected by each node using the status messages described above, which can provide more detailed information than the enabling loop. The supervisor can also communicate fault information to nodes to cause the nodes to enter fail-safe operating states. As such, in another application that is illustrated in Figure 5, each enabling loop is separate from the supervisor and is powered by a respective current source. Each enabling loop comprises a set of current circuits that passes through one or more of the nodes as a loop in series, with a respective current source coupled in series with the enabling loop. Four enabling loops are shown in Figure 5, along with four current sources. As before, each enabling loop can belong to a different security concern and / or control concerns, and can pass through each node in the system, or just the system nodes, which can detect a failure, which is relevant to the problems belonging to the control loop, or that are necessary to react to a fault condition detected by the enabling loop. The switch block implementation shown in Figure 5 can be the same as shown in Figure 3, or, as shown in Figure 4.
[0040] As another implementation, which is shown in Figure 6, an enabling loop can also be implemented as a NOR wired NOR gate. In this configuration, a resistor Rs or current source Is supplying power to an enabling line, and each node coupled to the enabling line has its switch connected between the enabling line and the ground. This switch is in a circuit block called “switches” in Figure 6, and can comprise a single pole, single-shot switch. The enabling line can also be coupled to a supervisor input line, but this is not necessary. The electronic switch can be selectively opened or closed by the node according to whether or not the node detects a fault condition relevant to the enabling loop. When a node detects no failure, it commands the electronic switch to the open position. When all electronic switches are in the open position, the potential in the enabling line goes to a high logic value (for example, 3 or 5 volts). When a node detects a fault, it commands the electronic switch to the closed position, which causes the enabling line to be grounded with a low logic value. The supervisor can detect a fault in the enabling line by looking at the line voltage level. In addition, all nodes connected to the enabling line can detect a failure in the enabling line by looking at the voltage level of the line, and can take appropriate measures. The node processor provides a control signal to the switch through the node's I / O port facility, as shown in the figure.
[0041] Figure 7 shows an exemplary implementation of the switch block in Figure 6. Four enabling loops are shown, which are coupled to a terminal of a correspondent of four switches S1-S4, and the other terminals of switches S1- S4 are coupled to the ground. If the node detects a fault condition, the node sends a corresponding command signal C1-C4 from its I / O port facility to the respective switch S1-S4 of the relevant enable loop with a value that causes the switch closes (conductor); otherwise, the node transmits a command signal with a value that keeps the switch open (non-conductive). Each switch S1-S4 can comprise a transistor, such as a MOS-FET transistor. The switch block may comprise a plurality of temporary storage inverters Inv1-Inv4 (for example, four inverters) that have their inputs coupled to the respective enabling lines, and their outputs coupled to the respective node facility input lines I / O port. The output of each of the Inv1-Inv4 inverters provides a corresponding digital signal F1-F4 that has a value of zero, when the voltage in the enabling line is high (which indicates a normal, faultless state), and a value close to of the digital supply voltage Vdd when the enabling line is low (which indicates a fault condition). Optionally, one or more enabling loops can be attached to the supervisor in the same way as a node, but this is not necessary. Instead, the supervisor can monitor the faults detected by each node using the status messages described above, which can provide more detailed information than the enabling loop. The supervisor can also communicate fault information to us, either directly or indirectly to cause the node to enter a fail-safe condition.
[0042] In the above configurations, a CAN bus (control area network bus) is provided for a node to communicate with its subnodes. In other modalities, a "background channel" communication channel is provided for point-to-point communication between the nodes through a CAN bus. An exemplary embodiment of such a deep channel communication channel is illustrated in Figure 10, by the “CAN Nodal Bus” shown in the figure. The CAN Nodal bus is coupled to two or more nodes, which can be coupled to each such node through the node's I / O port facility. Any of the enabling loops previously described can be used in this embodiment. With the CAN Nodal bus, a node can communicate directly with another node to coordinate its actions, if necessary. For example, the collimating node (shown in Figure 1) can send a message to the beam generator node (also shown in Figure 1) about the CAN Nodal bus to stop generating the treatment beam until MLC 8 is in desired position. Point-to-point communication of data packets between nodes can typically be done at intervals of about a millisecond or less, which is shorter than the 10 millisecond communication interval of the supervisor commands to the node. That is, data packets can be transmitted between nodes at a faster rate on the CAN bus than data packets between the supervisor and an individual node. As another example, the bed node (also shown in Figure 1) can have a device for detecting patient movement (for example, a camera), and can send a message to the beam generator node along the CAN bus Nodal to pause the generation of the treatment beam indefinitely, while informing the supervisor of the patient's movement. The supervisor can then act in response to the next command communication to the nodes, which may involve sending commands to the system components to bring the components to a safe state for the patient and instructing the radiologist to reposition the patient.
[0043] Each of the nodes described above and the supervisor can be implemented with any combination of hardware, firmware and software that provides the functions described above of the nodes and the supervisor. Taking this disclosure into account, a person versed in the technique can build modalities of the nodes and the supervisor, without undue experimentation. The use of processors, computer-readable media, network facilities, I / O port facilities, and clocks for the supervisor and nodes, as shown in the figures, simplifies implementations, since the implementation of the supervisor's functions and nodes can be more easily implemented in software. As is known in the art, the communication channels between the processor and the other components mentioned above is generally provided by an operating system. In this regard, the use of a real-time operating system can further simplify the implementations of the supervisor and the nodes, giving a person skilled in the art more flexibility in writing the code that implements the functions of the supervisor and the nodes. In this regard, the commonly used Vx Works Vx operating system developed by Wind River Systems, now acquired by Intel, can be used.
[0044] Each of the subnodes described above can be implemented with a conventional built-in processor (also called an "integrated system"). A typical embedded processor comprises a microprocessor, a flash memory (non-volatile memory), volatile memory, a CAN bus interface, and one or more I / O facilities, such as serial buses, A / D converters and D / A converters An example of an embedded processor is the Texas Instruments TMS320F2812 digital signal controller (DSC). The flash memory stores the microprocessor's operating instructions, and these instructions can be easily loaded into flash memory, an external processor via the CAN bus, or another communication connection. These instructions can be executed on top of a “miniature” operating system for the Texas Instruments DSP TMS-2812, which can understand the Texas Instruments DSP-BIOS in real time from the multitasking kernel. The operating system is stored in flash memory. A real-time operating system has the characteristic of executing a requested task in a deterministic manner in a predictable amount of time. The definition of an operating system in real time is well known in the art.
[0045] As a result of carrying out experiments with the invention, using high-energy treatment beams, it was found that neutrons were being dispersed generated by the target under these energy conditions and, as an unexpected result, the scattered neutrons reached the supervisor , nodes, and subnodes of the system and that affect the functioning of the system. These results were not found for low to moderate energy treatment bundles. In response, applicants have developed the following additional inventions for high energy treatment beam applications (but the inventions can be used for low to moderate energy treatment beams as well). As a first invention, furthermore, as illustrated in Figure 11, the supervisor, the nodes and the network equipment associated with the digital packet network are located outside the treatment room, and the subnodes located inside the treatment room. treatment, together with the components related to the treatment of the radiation treatment system. In some cases, it is also possible to locate some of the subnodes outside the treatment room. Because of the radiation generated by the treatment system, the walls, ceiling, floor, and doors in the treatment room comprise materials that absorb radiation. As you can see, these materials also absorb neutrons. Materials normally used for this purpose of absorption include concrete and lead. These materials absorb neutrons to a greater degree than the common materials used in dry-wall construction (for example, plaster). Borated polyethylene is also effective for absorbing neutrons. A suitable thickness of polyethylene, lead or boron polyethylene can absorb neutrons to a degree such that the density of the neutron flux (the number of neutrons per unit area per second square), reaches the material outside the treatment room is reduced by a factor of ten or more, thereby effectively attenuating neutrons, so that the probability of a neutron event in the equipment is negligible. As such, for high energy treatment applications, it is advantageous to have a body of neutron absorbing material (for example, such as on a wall, ceiling, door, etc.), between the equipment and the components related to the treatment of the system (in particular the radiation-producing components) and the above-mentioned components of the control system (for example, the supervisor, the nodes and, optionally, some sub-nodes and auxiliary control logic), in which the body of neutron-absorbing material reduces the neutron flux density by a factor of ten or more.
[0046] As an additional invention, the supervisor and the nodes may be located in the treatment room, but with a body of neutron-absorbing material, arranged between them and at least the treatment-related components that emit neutrons.
[0047] Yet another invention, a subnode may comprise a processor, a flash memory (which is a non-volatile memory), attached to the processor, and which maintains the operating system (for example, kernel) for the subnode and instructions for direct the processor, and a volatile memory for storing one or more parameters that the subnodes use in their operations. An exemplary subnode is shown in Figure 12. In addition, each of the parameters is stored in three or more different non-volatile memory locations, in three or more respective different memory addresses. A parameter is a data item that uses the subnode in its operation, and the value of the parameter can change over time, and can be modified by the subnode itself or the node that controls the subnode. Whenever the subnode needs to use such a parameter, it has instructions stored in flash memory, which directs the subnode processor to read the three or more volatile memory locations for the parameter, and directs the data processor to compare the three or more values to determine if at least two of the reading locations have the same value, and preferably, if most of the reading locations have the same value. If two or more are the same, or more, preferably, if most are the same, the instructions direct the data processor to use the same value. If none of the three or more reading locations have the same value, or more preferably if most reading locations do not have the same value, then the instructions direct the data processor to send an error message to the node for the subnode that informs the node of the lack of a good value for the parameter and a request for a new copy of the parameter value. Whenever nodes send a new parameter value to the subnode, the subnode has instructions stored in flash memory that direct the processor of the subnode to write the received parameter value to the three or more locations in volatile memory that are allocated to store the parameter. Note that flash memory is less sensitive to some forms of radiation (for example, photon and neutron emissions) compared to static semiconductor random access memory (SRAM) and dynamic random access memory (DRAM) , so that the stored instructions are relatively safe against exposure to radiation and neutrons compared to the parameters stored in volatile memory. However, non-volatile memory means a greater number of rewrites in memory locations for the parameters before the memory fails (in other words, flash memories have the disadvantage of a limited number of write operations to a memory location).
[0048] Despite all the complexity described above, the control architecture can be implemented at low cost, off-the-shelf communication protocol components (UDP over Ethernet) so that many easy-to-use development tools are available.
[0049] In summary, at a high level, the supervisor maintains a view from above over all the activities and movements of the system. The supervisor knows the complete treatment plan and is able to break it into 10 ms path steps for all axes (mechanical parameters). In general, the treatment plan carried out by the supervisor 20 comprises a coordination of the operation of the components related to the treatment of the radiation treatment system 10 over a selected period of time, in which the coordination can be described by a group of action orders for the nodes, one set per node. At a medium level, numerous nodes (each with processors) manage the unique information for each subsystem; these nodes communicate directly with the supervisor of a digital packet network (for example, an Ethernet local area network). In addition, a rear channel communication channel is available for point-to-point nodal communication over a CAN bus. Each node only needs to know what it has to do for the next 20 and 30 milliseconds (the next two active pulses in the periodic time signal); he doesn't need to know the treatment plan. At a low level, several sub-nodes (each with control logic and / or processors) manage information unique to some components (for example, power sources, target coils, tuning magnets). Subnodes communicate directly to your control node; there is no point-to-point communication.
[0050] Advantages over prior art systems. The distributed structure of the present invention approach allows the software to be compartmentalized so that it does not force software engineers to become experts for the entire system. It is easier to manage a software development team where people can know only one subsystem or component, rather than the entire system. The use of off-the-shelf networking technologies (eg, Ethernet and UDP) together with back-up security enable loop technology allows engineers to develop and modify the system quickly and safely - engineers will not be reinventing the wheel. Once the supervisor understands the acceleration profiles of all axes, he is able to break an entire plane in stages that coordinate according to the slowest speed of the axis. Because of this, there will be no more treatments in which the beam is maintained while the mechanical movement captures (such as in cases where the X-ray beam is performed while the MLC sheets are kept in the plane). Since the supervisor knows where each mechanical axis is, multiple axes can move at the same time (in previous systems, in order to avoid collisions, only a limited set of axes can move at the same time). Once the supervisor coordinates the movement of the beam, and the images, it is easier to create advanced techniques in which several things occur at the same time ("dynamic treatments"). Examples include: (1) Wide-field IMRT and RapidArc, (2) MV interface sheet treatment & KV imaging, (3) fluoroscopy-guided treatments (before treatment, KV fluoroscopy images are correlated with respiratory movement induced by an infrared reflector, this correlation allows subsequent precise beam according to the movement of the organ), (4) Dynamic tracking - these types of planes involve moving the system according to the patient's movement (for example, moving the MLC sheets as the patient breathes).
[0051] Any recitation of "one", "one", and "him / her" is understood to mean one or more unless specifically stated otherwise.
[0052] The computer-readable medium and the memory devices described herein are preferably tangible and / or non-transitory.
[0053] The terms and expressions that have been used here are used as terms of description and not of limitation, and there is no intention, in the use of such terms and expressions, to exclude equivalents of the characteristics shown and described, being recognized that several modifications are possible within the scope of the claimed invention.
[0054] In addition, one or more features of one or more embodiments of the inventions can be combined with one or more features of other embodiments of the invention without departing from the scope of the invention.
[0055] Although the present invention has been particularly described in relation to the illustrated modalities, it will be appreciated that various changes, modifications, adaptations and equivalent provisions can be made based on the present disclosure, and are intended to be within the scope of the inventions and of the attached claims.

权利要求:
Claims (29)
[0001]
1. Radiation treatment system, characterized by the fact that it comprises: a plurality of components related to the treatment; a digital packet communications network; a supervisor control entity electrically coupled to the digital packet communications network and having a treatment plan, and a plurality of nodes, each node coupled to the digital packet communications network and controlling one or more components related to the treatment, and where the supervisor control entity is configured to: periodically communicate commands to the nodes via the digital packet communications network, a command to a node specifying one or more actions to be performed by the node at a given point in time in the plan of treatment; and periodically provide timing signals to the nodes, in order to synchronize the actions performed by the nodes to provide the treatment plan.
[0002]
2. Radiation treatment system according to claim 1, characterized by the fact that the nodes periodically provide status information to the supervisor control entity through the digital packet communications network.
[0003]
3. Radiation treatment system according to claim 1, characterized by the fact that each command comprises orders of action for two or more distinct points in time.
[0004]
4. Radiation treatment system according to claim 1, characterized by the fact that one or more commands from the supervisor control entity received by one of the nodes comprises orders of action for two or more distinct points in time, in which the node receives a first command having a first order of action for a first point in time and a second order of action for a second point in time, the second point in time being subsequent to the first point in time; and where the node still receives a second command after receiving the first command, the second command having the second order of action for the second point in time and a third order of action for a third point in time, the third point in time subsequent to each of the first and second points in time.
[0005]
5. Radiation treatment system according to claim 4, characterized by the fact that the node executes the first order of action from the first command at the first point in time; where the node executes the second order of action from the second command at the second point in time; and where the node executes the third order of action of the second command at the third point in time, when the node has not received a subsequent command from the supervisor control entity within a selected period of time from the receipt of the second command.
[0006]
6. Radiation treatment system according to claim 4, characterized by the fact that the node sends a message packet to the supervisor control entity through the digital packet communications network, when the node has not received a command from of the supervisor control entity within a selected period of time.
[0007]
7. Radiation treatment system according to claim 1, characterized by the fact that it also comprises an enabling loop electrically coupled to the supervisor control entity and at least one node, in which the enabling loop comprises an enabling line .
[0008]
8. Radiation treatment system according to claim 7, characterized by the fact that the at least one node coupled to the enabling loop has an electronic switch coupled in series with the loop, and in which said node places the electronic switch in a non-conducting state to signal a fault to the supervisor control entity.
[0009]
9. Radiation treatment system according to claim 7, characterized by the fact that the at least one node coupled to the enabling loop has an electronic switch connected between the enabling line and a potential source, and in which said node positions the electronic switch in a driving state to signal a fault condition.
[0010]
10. Radiation treatment system according to claim 1, characterized by the fact that it also comprises an enabling loop electrically coupled to at least two nodes, in which the enabling loop comprises an enabling line, at least one of the nodes being able to signal the fault condition on the enabling line, and at least one of the other nodes being able to detect the fault condition.
[0011]
11. Radiation treatment system according to claim 10, characterized by the fact that each node coupled to the enabling loop has an electronic switch coupled in series with the loop, and in which said node positions the electronic switch in a state not conductor to signal a fault condition.
[0012]
12. Radiation treatment system according to claim 10, characterized by the fact that each node connected to the enabling line has an electronic switch connected between the enabling line and a potential source, and in which said node positions the switch electronic in a driving state to signal a fault condition.
[0013]
13. Radiation treatment system according to claim 1, characterized by the fact that at least one node controls at least one of: a multi-leaf collimator of a radiation treatment system, a linear accelerator of a radiation treatment system and a portico of a radiation treatment system.
[0014]
14. Radiation treatment system according to claim 1, characterized by the fact that it also comprises a communication bus coupled to at least two nodes, in which the communication bus comprises a control area network bus, in which the supervisor control entity communicates to a first node, via the digital packet communications network at a first communication rate, and where the first node is configured to send data packets to a second node via the communications bus at a second communication rate which is faster than the first communication rate, and where the first node is configured to send a data packet to a second node via the communication bus which causes the second node to pause a a treatment-related component.
[0015]
15. Radiation treatment system according to claim 1, characterized by the fact that the supervisor control entity comprises a data processor, a non-transitory tangible computer-readable medium, and a real-time operating system incorporated in the readable medium by computer, and in which at least one node comprises a data processor, a non-transitory tangible computer-readable medium, and a real-time operating system incorporated into the computer-readable medium.
[0016]
16. Radiation treatment system according to claim 1, characterized by the fact that a plurality of treatment-related components are arranged within a treatment compartment, and in which the supervisor control entity and at least one node are arranged outside the treatment compartment.
[0017]
17. Radiation treatment system to provide radiation to a patient, characterized by the fact that the radiation treatment system comprises: a plurality of treatment-related components that coordinate to deliver radiation to the patient according to a treatment plan treatment; a digital packet communications network; a supervisor control entity electrically coupled to the digital packet communications network and having the treatment plan, and a plurality of nodes, each node coupled to the digital packet communications network and controlling one or more components related to the treatment, each node controlling a different set of one or more of the treatment-related components, where the plurality of nodes implements the treatment plan for the patient, and where the supervisor control entity is configured to periodically communicate commands to the nodes over the network digital packet communications, and an enabling loop electrically coupled to at least two nodes, at least one of the nodes being able to signal a fault condition on an enabling line of the enabling loop and at least one of the other nodes being able to detect the fault condition, in which a plurality of treatment-related components are arranged within a compartment d and treatment, and where the supervisor control entity and at least one node are arranged outside the treatment compartment.
[0018]
18. Radiation treatment system according to claim 16 or claim 17, characterized by the fact that a body of material that absorbs neutrons to a greater degree than plaster is arranged between the supervisor control entity and the related components with the treatment, which are arranged in the treatment compartment, and wherein said body is further arranged between the at least one knot and the treatment-related components, which are arranged in the treatment compartment.
[0019]
19. Radiation treatment system according to claim 18, characterized by the fact that the material body reduces the neutron flux density that passes through itself by a factor of ten or more.
[0020]
20. Radiation treatment system according to claim 18, characterized by the fact that the digital packet communications network is arranged outside the treatment compartment, and in which said body is further disposed between the communications network digital package and treatment related components that are arranged in the treatment compartment.
[0021]
21. Radiation treatment system, characterized by the fact that it comprises: a plurality of components related to the treatment; a digital packet communications network; a supervisor control entity electrically coupled to the digital packet communications network and having a treatment plan; a plurality of nodes, each node coupled to the digital packet communications network and controlling one or more treatment-related components, and a body of neutron-absorbing material disposed between at least one treatment-related component and the control entity supervisor, the body of material that absorbs neutrons, reducing the density of the neutron flux that passes through itself by a factor of ten or more, where the supervisor control entity is configured to: periodically communicate commands to nodes over the network digital packet communication, a command for a node specifying one or more actions to be performed by the node at a given point in time in the treatment plan; and periodically provide timing signals to the nodes, in order to synchronize the actions performed by the nodes to provide the treatment plan.
[0022]
22. Radiation treatment system according to claim 21, characterized by the fact that said body is further arranged between at least one node and at least one component related to the treatment.
[0023]
23. Radiation treatment system according to claim 18 or claim 21, characterized by the fact that said body is further disposed between the digital packet communications network and at least one treatment related component.
[0024]
24. Radiation treatment system according to any one of claims 1, 16, 18 and 21, characterized by the fact that it additionally comprises at least one subnode, in which the at least one subnode comprises a processor and a flash memory, and in that the at least one subnode controls at least one aspect of a treatment-related component and receives instruction from a node.
[0025]
25. Radiation treatment system according to claim 24, characterized by the fact that the at least one subnode further comprises a non-volatile memory, and a parameter stored in three or more different locations in the volatile memory.
[0026]
26. Radiation treatment system to provide radiation to a patient, characterized by the fact that the radiation treatment system comprises: a plurality of treatment-related components that coordinate to deliver radiation to the patient according to a treatment plan treatment, and a plurality of nodes, each node controlling one or more components related to treatment, each node controlling a different set of one or more of the components related to treatment, where the plurality of nodes implements the treatment plan for the treatment. patient, where at least one node comprises at least one subnode, in which the at least one subnode controls at least one aspect of a treatment-related component and receives guidance from at least one node, where the at least one a subnode comprises a processor, a flash memory, a volatile memory, and a parameter stored in three or more different locations in the volatile memory.
[0027]
27. Radiation treatment system according to claim 25 or claim 26, characterized by the fact that it also comprises instructions stored in the flash memory of at least one subnode, which guide the processor of at least one subnode to read the three or more volatile memory locations for the parameter, and direct the data processor to compare values read from three or more locations to determine if at least two of the values read are the same.
[0028]
28. Radiation treatment system according to claim 25 or claim 26, characterized by the fact that it further comprises instructions stored in the flash memory of at least one subnode, which guide the processor of at least one subnode to read the three or more volatile memory locations for the parameter, and direct the data processor to compare values read from three or more locations to determine whether most of the values read are the same.
[0029]
29. Radiation treatment system according to claim 25 or claim 26, characterized by the fact that it also comprises instructions stored in the flash memory of at least one subnode, which guide the processor of at least one subnode to receive a value for the parameter and to write the value received from the parameter to the three or more locations in volatile memory that are allocated to store the parameter.

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法律状态:
2017-11-28| B25A| Requested transfer of rights approved|Owner name: VARIAN MEDICAL SYSTEMS, INTERNATIONAL AG (US) , VA |

2018-12-26| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

2019-10-29| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

2020-11-03| B09A| Decision: intention to grant|

2020-12-29| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 13/04/2011, OBSERVADAS AS CONDICOES LEGAIS. |

2021-04-13| B16C| Correction of notification of the grant|Free format text: REF. RPI 2608 DE 29/12/2020 QUANTO AO ENDERECO. |

优先权:

申请号 | 申请日 | 专利标题

US32385910P| true| 2010-04-13|2010-04-13|

US61/323,859|2010-04-13|

PCT/US2011/032327|WO2011130412A2|2010-04-13|2011-04-13|Radiation treatment systems|

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