(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT)
`
`(19) World Intellectual Property Organization
`International Bureau
`
`(43) International Publication Date
`19 April 2001 (19.04.2001)
`
`
`
`URAC
`
`(10) International Publication Number
`WO 01/27939 Al
`
`(74) Agent: BERLINER, Robert; Fulbright & Jaworski
`L.L.P., 29th Floor, 865 S. Figueroa Street, Los Angeles,
`CA 90017-2576 (US).
`(21) International Application Number:©PCT/US00/28023
`
`(51) International Patent Classification’:
`
`G21K 1/04
`
`(22) International Filing Date: 9 October 2000 (09.10.2000)
`
`(25) Filing Language:
`
`(26) Publication Language:
`
`English
`
`English
`
`(30) Priority Data:
`60/158,638
`
`8 October 1999 (08.10.1999)
`
`US
`
`(71) Applicant (for all designated States except US): THE
`REGENTSOF THE UNIVERSITY OF CALIFORNIA
`[US/US]; 1111 Franklin Street, 12th Floor, Oakland, CA
`94607 (US).
`
`(81) Designated States (national): AE, AG, AL, AM, AT, AU,
`AZ, BA, BB, BG,BR, BY, BZ, CA, CH, CN, CR, CU, CZ,
`DE, DK, DM,DZ, EE, ES, FI, GB, GD, GE, GH, GM, HR,
`HU,ID,IL,IN,IS, JP, KE, KG, KP, KR, KZ, LC, LK, LR,
`LS, LT, LU, LV, MA, MD, MG, MK, MN, MW, MX, MZ,
`NO,NZ, PL, PT, RO, RU, SD, SE, SG,SI, SK, SL, TJ, TM,
`TR, TT, TZ, UA, UG, US, UZ, VN, YU, ZA, ZW.
`
`(84) Designated States (regional): ARIPO patent (GH, GM,
`KE, LS, MW, MZ, SD, SL, SZ, TZ, UG, ZW), Eurasian
`patent (AM,AZ, BY, KG, KZ, MD, RU, TJ, TM), European
`patent (AT, BE, CH, CY, DE, DK,ES, FI, FR, GB, GR,IE,
`TT, LU, MC, NL, PT, SE), OAPI patent (BF, BJ, CF, CG,
`CI, CM, GA, GN, GW, ML, MR, NE, SN, TD, TG).
`
`Published:
`
`—|With international search report.
`(72) Inventor; and
`(75) Inventor/Applicant (for US only): WALLACE, Robert,
`E. [US/US]; 3439 Mentone Avenue, #1, Los Angeles, CA
`90034-4713 (US).
`
`For two-letter codes and other abbreviations, refer to the "CGuid-
`ance Notes on Codes andAbbreviations" appearing at the begin-
`ning ofeach regular issue of the PCT Gazette.
`
`(54) Title: MULTIPLE-LAYER, MULTIPLE-LEAF, INTENSITY MODULATING, COMPENSATOR FOR RADIATION THER-
`APY MACHINES
`
`LAACE
`
`
`
` ATEVe
` NO, N2, No
`(RTT
`
`
`
`03Ho
`EEE
`
`
`2 LEEREEN 2825
`LLPLELELLLLLIE =
`L
`JZ,
`34
`
`20, 22, 24 RRR OOS
`iS
`15 15
`16
`LEELARS
`
`‘ 01/27939Al | Mee
`
`(57) Abstract: A general purpose, re-usable, multiple-leaf radiation intensity modulation compensator device comprising of multi-
`© ple layers (14, 24, 34,...N4) that allows manual and/or systematically controlled radiation intensity as a function of position in the
`= cross-section of a radiotherapy beam (2), providing both field shape and cross-field intensity modulation (101) for photon (X-ray
`
`and y-ray) sources.
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`WO 01/27939
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`PCT/US00/28023
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`MULTIPLE-LAYER, MULTIPLE-LEAF, INTENSITY MODULATING,
`
`COMPENSATORFOR RADIATION THERAPY MACHINES
`
`CROSS REFERENCE TO RELATED APPLICATIONS
`
`This application claims the benefit of Provisional Patent Application No.
`
`60/158,638,filed October 8, 1999.
`
`FIELD OF THE INVENTION
`
`Thefield of this invention is compensators for radiation therapy.
`
`BACKGROUND IN COMPARISON TO THE INVENTION
`
`10
`
`Tissue compensation is a well-known and well-described principal and
`
`methodin practiced radiation therapy of tumors . (Geis, et. al., Medical Physics
`
`23(7):1 199-1205 (1996); Ma, et. al., Physics in Medicine and Biology 43(6):1629-
`
`43 (1998); Xia, et. al., Medical Physics 25(8):1424-34 (1998); Ellis, F., Brit. J.
`
`Radiology 33:404, 1960; Hall, E.J. and Oliver, R., Brit. J. Radiology 34:43, 1961;
`
`Sundbom,L., Acta Radiol [Ther] (Stockholm) 2:189, 1964; Van De Geijn, J., Brit. J.
`
`Radiol. 38:865, 1965.) Initially conceived to achieve a uniform intensity dose in a
`
`plane perpendicularto the direction of a radiation beam, compensatordevices have a
`
`long history used in conjunction with collimated rectangular field shaped beams.
`
`Compensator devices have been thus manufactured in set circumstances for a given
`
`20
`
`small numberof radiation beams. Such devices are not, by design, reusable.
`
`Conformal radiation therapy is the established application of multiple,
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`intersecting shaped radiation beams comprisedoffields shaped, in two dimensions,
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`to geometrically conform to the shapeof a target from the viewpointof the origin of
`
`1
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`the radiation beam. A conformal radiation field is a geometrical construct. The
`
`confluence of a numberofsuch fields can lead to a radiation dose distribution that
`
`conformsto the convex hull surface enclosing a targeted tumor volume. Anintensity
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`modulated, compensated beam is a field with cross-field, position dependent,
`
`intensity. The present invention, a multi-layer, multi-leaf compensator, MLMLC,is a
`
`device capable of both formsoffield shaping, by geometry and byintensity. Using
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`forward and inverse treatment planning techniques, intensity mapsin suchafield can
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`be constructed to avoid sensitive non-target structures. The confluence of a number
`
`of such fields can lead to a radiation dose distribution that conforms to the concave
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`surface <nclosing the volume ofa targeted tumor, while minimizing doseto sensitive
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`normalstructures that are interposed in the applied radiation field(s) and while
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`maximizing the target dose homogeneity. This is a significant goal in clinical
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`radiotherapy whereradiologically involved normaltissue(s) and organs must be
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`spared debilitating radiation dose while delivering tumoricidal radiation dose to a
`
`15
`
`defined target.
`
`Radiation field shaping using full-attenuation, multiple-leaf collimation,
`
`MLC,systems are known that are devised to programmatically block radiation beams
`
`to create fields that geometrically conform to target dimensions. [US5591983 to Yao,
`
`J.Y.; U.S. Patent No.4987309 to Klaser, et. al; U.S. Patent No.4868843 to Nunan,
`
`20
`
`et. al.; U.S. Patent No.4754147 to Maughan,et. al.; U.S. Patent No.4534052 to
`
`Milcamps, J.; European Patent No. 853808A2 to Pastyr, et. al.; European Patent No.
`
`751532A1 to Yao, J.Y.; European Patent No. 387921B1 to Pastyr,et. al.;
`
`International Patent Application No. 9713255A2__to Pastyr, et. al.; U.S. Patent
`
`patent Application No. No.4794629 to Pastyr,et. al.,; U.S. Patent No.4672212 to
`
`25
`
`Brahme,et. aJ.; International Patent Application No. 09917305A1 Ein-Gal, M.) It is
`
`also known to use full-attenuation, multi-leaf collimators in sequentialfield shapes to
`
`approximate spatial intensity modulation through dynamicandstatic multi-step,
`
`temporal modulation offield shape. (Geis,et. al., supra; Ma, et. al., supra; Xia,et.
`
`al., supra.) This procedure requires more elapsed time to deliver radiation from any
`
`30
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`particular direction than for simple conformal irradiation. In the present invention,
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`the MLMLCdevice accomplishes conformal geometric shaping and intensity
`
`modulation in time par with the time takento deliverradiation to a single conformal
`
`shaped field. Therefore, with respect to intensity modulation, operational advantage
`
`is gained by MLMLCdevice(s) over MLC systemsin reducingthe time to optimally
`
`uw
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`treat any specific target with reduced significant dose to normal surroundingtissue(s).
`
`A multi-leaf device, MLC or MLMLC, is a radiation beam collimation device
`
`that provides shaped fields through the agency of independently positioned divergent
`
`or plane parallel plates that provide full or partial attenuation of a photon source
`
`spectrum and that enter a rectangular radiation beam from sides perpendicular to the
`
`direction of a beam central ray-line customarily directed toward a target. Such leave-
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`plates are positioned under programmatic control or by manual techniques. The
`
`MLMLCprovides intensity modulation of a radiation beam within a defined ‘“‘open”
`
`field shape by placement of one or morepartially attenuating leaves into the open
`
`area of a photon beam. In the present invention, full attenuation for shaping is
`
`accomplished by the interposition of all layers of the MLMLC betweentheradiation
`
`source and a test point in space. In the MLC,this is accomplished with the
`
`interposition of full attenuation leaves. In the MLC,field intensity modulation is
`
`accomplished employing one or both of two principal methods: by temporal
`modulation via independently moving leaves, and by temporal modulation via
`superposition of appropriately shaped sub-field segments that may blockparts of the
`
`.
`
`“open”field for a fraction of the time required to deliver the highest intensity portion
`
`of the field. The time to accomplish the numberofsteps for static placement of MLC
`
`leavesor the time required for the dynamic motion of the MLC leavesis generally
`
`greater than the time to deliver a proscribed radiation dose in the highest intensity
`
`portion of the open field. Furthermore, the dynamic orstatic, inter-segment motion
`
`of fully attenuating MLC leaves requires either full servo control or significant
`
`manuallabor in the implementation of a prescribed custom-designed therapy regime.
`
`In contrast, a manually configured MLMLCdevicecan, in principle, provide delivery
`
`20
`
`25
`
`of all modulated doses in time on theorder of the amount of time requiredto deliver
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`30
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`prescribed radiation dose in the openfield, at substantially less costly than a servo
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`controlled MLC device in achieving the same therapeutic goal.
`
`Yao (U.S. Patent No.5591983, European Patent No. 751532A1) described a
`
`two layer multileaf collimator that reduced radiation leakage between adjacent leaves
`
`without the requirement of precise machine fabrication. In the Yao devices,leafs are
`
`positioned to shape a radiation field. This is an improvementover a two-layer
`
`multileaf collimator described by Nunan (U. S. Patent No.4868844) where the leaves
`
`of each layer occupied the samevertical space, one overthe other, aligned on the
`
`interleaf gaps, and providing norelief of radiation leakage through the gaps.
`
`In the
`
`Nunan devices, a pair of leaves are moved together to block a portion ofthe radiation
`
`beam andrelative to each other so that the upper leaf extends further than the lower
`
`leaf. Therelative position of the leaf ends mitigates broadening of the leaf-end
`
`radiation penumbra by approximating the divergenceofthe radiation beam. Ein-Gal
`
`(International Patent Application No. 09917305A1) described a two layer collimation
`
`system, comprising orthogonal leaf motion in the upperlayer relative to the lower
`
`15
`
`layer, that is described as improving the ability of a MLC system to conform to
`
`complex shaped targets. Similarly, an improvement in spatial sampling of a desired
`
`field shane is achieved by Vilsmeier,et. al. (U. S. Patent No.5889834) using a MLC
`
`having an array ofleaves of selected width, providing greatest resolution nearestfield
`
`center. Pastyr, et. al. (U.S. Patent No.4794629) describe an MLCdevice providing
`
`20
`
`high spatial resolution using uniform leaf width. Siochi, et. al. (U. S. Patent
`
`No.5724403) describe a system using an MLCleaf bank opposed by a monolithic
`
`collimator, which is used in conjunction with a wedgefilter, to provide one-
`
`dimensional intensity modulation across a radiation field.
`
`Swerdlof, et. al. (U.S. Patent No.5351280) describes a two layer multi-leaf
`
`25
`
`collimator similar in conception to that of Yao, yet capable of adjusting beam
`
`intensity in a tomographicteletherapy unit by temporal modulation.
`
`In the Swerdlof,
`
`et. al. devices, full attenuation leafs in each ofthe two layers are construed to move
`
`independently ofall other leafs. Leafs in a given layer are separated by gaps nearly
`
`the dimension ofthe leaf in the layer above or below. This reducesfriction while
`
`30
`
`mitigating inter-leaf radiation leakage. By adjusting the leaf velocity during
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`irradiation, a variable radiation fluence intensity can be obtained via temporal
`
`modulation. Swerdlof, et. al. devices differ from the present invention in several
`
`significant ways. The MLMLCdevice is comprised of several layers of partially
`
`attenuating leafs that, when arranged in the path of a segmentof a radiation beam,
`
`provide a desired intensity. The MLMLCdevice can be realized to provide a greater
`
`latitude of beam intensity than the former in similar elapsed time. The MLMLC
`
`device is comprised of multiple layers of partially attenuating leafs, each leaf bank
`
`offset by at most one half the width of the leaf width, similar to the invention of Yao.
`
`The device can be realized using selected leaf widths providing variable spatial
`
`resolution, similar to that described by Vilsmeier. In the MLMLC, variable
`
`attenuation at positions within the radiation field is accomplished by thestatic or
`
`dynamic arrangementofselected leafs in a stack in the path of the radiation beam.
`
`Maughan,et. al. (U. S. Patent No.4754147) described a device that is in
`
`principle capable of variable attenuation, yet was conceived solely as a field shaping
`
`device using opposedarrays of nested-rod collimating elements. Nunan,et. al. (U.S.
`
`Patent No.4868843) described an MLC invention that provides field shaping through
`
`the agency of multiple leaf collimation, with the addition of wedge shaped
`
`compensatorfinger-leafs articulated along the length of individual leafs of the MLC.
`
`Devices that embody the Nunan et. al. feature, provide two dimensionalintensity
`
`20
`
`modulation and beam compensation in a designthat is similar in conception to the
`
`later device of Siochi, et. al. The MLMLCdevice ofthe present invention differs
`
`significantly in form and in function from that described by Nunan,et. al.
`
`In the
`
`latter device, the compensatorfinger leafs extended from the end ofthe field shaping
`
`collimator leafs, restrict position and effective intensity modulation whenthe field
`
`25
`
`shape dictates that opposing collimator leaf ends reside in close proximity. The
`
`MLMLLCdevice provides for a full range of intensity modulationatall field positions
`
`and may be realized as a mechanical adjunct to the field shaping system.
`
`It is an object of the invention to provide a radiation intensity modulation
`
`compensator which avoidsissues ofradiation leakage andinterleaf friction while
`
`30
`
`improving the ability to accurately define both the desired field shape andthefield
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`intensity distribution.
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`It is a further object of the invention to reduce the time requiredfor the
`
`operational application of intensity modulation techniquesin radiation treatment of
`
`tumors to equivalency with times required for treatment using uncompensated shaped
`
`fields alone.
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`It is a yet further object of the invention to provide intensity modulation in
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`radiation treatment at a reduced cost.
`
`It is an even further object of the invention to include methodsforits use, the
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`determination of, and the establishment of leaf patterns.
`
`10
`
`It is a further object of the invention to include methodsfor the design of
`
`devices that embody the invention.
`
`SUMMARYOF THE INVENTION
`
`The present invention comprises a multiple layer multileaf compensator for
`
`selectively attenuating radiation intensity in predetermined regionsofa radiation
`
`beam as used in the practice of medical radiation therapy. The compensator includes
`
`first, second, and further layers of a plurality of elongated radiation blocking leaves,
`
`providing a different degree of beam attenuation in each layer or in combination of
`
`layers. The leaves of each layer are arranged adjacent to one anotherso as to form
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`two opposed rowsofadjacently positioned leaves and are movable in a longitudinal
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`20
`
`direction (Y) which is generally transverse to the direction of the radiation beam so as
`
`to define radiation beam intensity shaping in the field passing through different
`
`combinations of partially attenuating leafs in overlying layers. The layers are
`
`arranged one abovethe other in the beam direction and offset in the lateral direction
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`(X) whichis generally transverse to the beam direction and orthgonalto the
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`25
`
`longitudinal direction (Y) so that spaces between adjacentleaves of any layer are
`
`positioned over and under, respectively, leaves of adjacent layers.
`
`Thefirst advantage of placing the interleaf gaps of one layer below those of
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`anotherlayer and not necessarily in line of sight to the radiation source with the
`
`interleaf gaps of any other layeris that a looser fit between adjacent leaves of any one
`
`layer can be tolerated. The second advantage of such an arrangementoflayers,
`
`leaves, and gapsis that interleaf radiation leakage is minimized for the multiple layer
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`multileaf compensator. This has the salutary effect of reducing interleaffriction,
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`thereby reducing the strength and accuracy requirements on actuators to
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`independently position individual leaves and thereafter maintain the positions. The
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`ability to accurately place leaves of any layer to conform to anyirregular shape is
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`thereby improved. The staggering of leaves amonglayers has the beneficial effect of
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`10
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`providing a smootherrepresentation of a cross-field intensity function, due to the
`
`superposition of radiation penumbrae. Finally, the arrangementof leavesin layers
`
`leads te a modular design that can reduce costs in tooling, manufacturing, and
`
`maintenance.
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`These advantagesas well as other features of the present invention will be
`
`apparent from the description of the preferred embodimentof the invention and by
`
`the claims.
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`For a better understanding of the present invention, reference should be made
`
`to the following detailed description and the accompanying drawings.
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`20
`
`FIG.1 illustrates a perspective view,relative to a radiation source andrelative
`
`to an irradiated volume, of a multiple layer, multileaf compensator device constructed
`
`in accordance with the present invention;
`
`FIG.2 illustrates a multiple layer, multileaf compensator device constructed
`
`in accordance with the present invention, as seen from the leaf ends;
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`FIG. 3 illustrates an elevation view of the device shown in FIG.2;
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`FIG.4 illustrates a view of representative layers comprising the device shown
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`in FIG. 2, as seen from the perspective of the radiation source.
`
`DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
`
`FIG. 1 showsan abstracted view of a radiation therapy unit of conventional
`
`design, having a collimated source of radiation | from which emitted rays 2 diverge
`
`in the direction of the irradiated volume3, typically a patient undergoing a
`
`therapeutic procedure. The rays from the source pass through the multiple layer,
`
`multileaf compensator constructed in accordance with the present invention and
`
`whichis attachedto the realization of the abstracted radiation producing machine. At
`
`each of multiple levels, rays pass unabated through the open areas 16, 26, 36, up to
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`N6 formedby the leaves 10,11, 20,21, 30,31, ... NO, N1 in banks 14,15, 24,25,
`34,35, ... N4,N5, ofthe first, second, third and N"layers of the compensator. A ray
`
`maypass throughaleaf in a bank of leaves in each layer of the device and thereby be
`
`reducedin intensity due to absorption in the intervening material of the occluding
`
`leaves. In this manner, a source of high energy photonradiation having
`
`representative uniform intensity 100 within the collimated aperture, may bealtered in
`
`the regionofthe irradiated volume 3 to have a representative compensated intensity
`
`distribution 101 through the agencyofthe present invention.
`
`FIGURES2, 2a, and 2b show perspective viewsof the device as seen from
`
`the ends of the leaves. Rays 2 emanating from the radiation source | and passing
`
`20
`
`through the multiple layer multileaf compensator having all leaves retracted form a
`
`field on some maximal dimension 5 at a plane within the irradiated volume 3. A
`
`nominal maximum field dimension of 26cm by 40cm,at the field definition distance,
`
`would be applicable to a large majority of radiation therapeutic applications. Using
`
`uniform 1cm wide leaves, the maximalfield can be accomplished using 26 leaves.
`
`25
`
`Layers of leaves are supported by plates and standards 4. As shown,the deviceis
`
`comprised of N layers of leaves of either non-uniform thickness, as shown in FIG 2
`
`and 2a, or of uniform thickness, FIG 2b, each arrangement providing variable
`
`attenuation in different quantized steps yet by the sameprinciple of the present
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`invention. In each layer, leaves 10,11, 20,21, 30,31, ... NO,N1, in two banks 14,15,
`
`24,25, 34,35, ... N4,N5, move in opposition acrossthe field transverse dimension.
`
`In
`
`eachlayer, leaves may have uniform width, w,,, = w,,, or variable width in accord
`with the principle of Vilsmeier, et. al. (U. S. Patent No.5889834). Leaves of adjacent
`
`layers may have gaps arranged to minimize leakage 8 using variable widths, or by
`
`using uniform widths 9. Leaves are constructed of a suitable material, for example
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`tungsten,that is both effective in attenuating high energy photon, but also that can be
`
`manufactured in a standardized manner.
`
`FIG. 3 showsan elevation view from the side of the multiple layer multileaf
`
`10
`
`compensator whereit is apparent that individual leaves 10,11, 20,21, 30,31, ...
`
`NO,N1, of uniform or non-uniform thickness, can be placed independentof leaves in
`
`any ofthe layers in the device. Positioning of leaves using mechanical cut-out bucks
`
`has been described by Maughan,et. al. (U. S. Patent No.4754147) and by Pastyr,et.
`
`al. (U.S. Patent No.4794629) or using automated meanssimilar in conceptionto that
`
`of Leavitt, et. al. (U. S. Patent No.5160847). The application of a buck 17,18, 27,28,
`
`37,38, ... N7,N8, to banks 14,15, 24,25, 34,35, ... N4,NS, in layers, positions leaves
`
`10,11, 20,21, 30,31, ... NO,N1 in pre-determined positions appropriate for a given
`
`componentradiation field in a treatment. The figure also shows an arrangement of
`
`leaves that provides differential compensation along individual rays 2 emanating
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`20
`
`from the radiation source through both leaves and open areas 16, ... N6.
`
`FIG. 4 showsthe shapes ofirregular open areas 16, ... N6 in each layerofthe
`
`device, as seen from the source ofradiation, and the shaped mechanical bucks 17,18,
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`... N7,N8 forsetting the device manually. Although the leaves are shown as being
`
`set by manual means, actuators of a previously described type may be used to
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`25
`
`position and hold in place, the individual leaves of each layer. The operation of
`
`leaves in any layeris as is conventional in prior art single layer multileaf collimator
`
`arrangements.
`
`What has been shown and described herein is a novel radiation treatment
`
`system that both overcomesproblemsin prior art and improvesthe functionality of
`
`30
`
`automated radiation compensation for intensity modulatedradiation therapy.
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`9
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`Changes, modifications, variations, and other uses and applications of the subject
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`invention will become apparentto those skilled in the art after considering the
`
`specification and its accompanying drawings, which disclose preferred embodiments
`
`thereof. For example, in an alternate embodiment, leaf thickness in each layer may
`
`5
`
`be selected to provide at most fractional attenuation significantly different from that
`
`required for field shaping. In a further additional alternate embodiment, the nested
`
`rod collimator of Maughan,et. al. (U. S. Patent No.4754147) can be madeto provide
`
`compensation through the use of two dimensionally milled bucks. Additionally,
`
`various design changes can be madeto leaf shape and dimension. All such changes,
`
`10 modifications, variations, and other uses and applications which do not depart from
`
`the spirit and scope of the invention are deemed to be covered bythis patent, which is
`
`limited only by the claimsthat follow.
`
`10
`
`ViewRay Exhibit 1013
`Page 11 of 20
`
`ViewRay Exhibit 1013
`Page 11 of 20
`
`

`

`WO 01/27939
`
`PCT/US00/28023
`
`CLAIMS
`
`1. A radiation emitting apparatus, comprising:
`
`a source ofradiation for providing a substantially unshaped and un-
`
`compensated radiation beam in a given beam direction, and
`
`a compensator for shaping and modulating said radiation beam, said
`
`compensator comprising a plurality of layers, each having a plurality of elongated
`
`radiation blocking leaves, a frame for supporting said leaves, and moving meansfor
`
`movingsaid leaves, said leaves being arranged in layers so as to form paired opposed
`
`rowsof adjacently positioned leaves being movable by said moving meansina
`
`10
`
`longitudinal direction (Y) which is generally transverse to the beam direction so as to
`
`define a radiation beam attenuating field through the leaves and the area between the
`
`opposed endsofthe leaves, the leaves of said layers being arranged one abovethe
`
`other in the beam direction and offset in the lateral (X) direction generally transverse
`
`to the beam direction and orthogonalto the longitudinal direction (Y), so that spaces
`
`between adjacent leaves of any two adjacent layers are positioned over or under the
`
`leaves of the mating level and so that no spaces of a layer align with those of any
`
`other layer;
`
`2.
`
`The radiation emitting apparatus of claim 1, wherein each row ofsaid
`
`compensator leaves comprises a plurality of adjacently positioned relatively narrow
`
`20
`
`leaves of divergent geometry.
`
`3.
`
`The radiation emitting apparatus of claim 1, wherein said compensator leaves
`
`are of uniform width.
`
`4.
`
`Theradiation emitting apparatus of claim 1, wherein said compensator leaves
`
`25
`
`are of non-uniform width.
`
`ViewRay Exhibit 1013
`Page 12 of 20
`
`ViewRay Exhibit 1013
`Page 12 of 20
`
`

`

`WO 01/27939
`
`PCT/US00/28023
`
`5.
`
`The radiation emitting apparatus of claim 1, wherein each row ofsaid
`
`compensator leaves comprises a plurality of adjacently positionedrelatively narrow
`
`leaves of divergent geometry and of uniform or non-uniform width.
`
`6.
`
`The radiation emitting apparatus of claim 1, wherein each row ofsaid
`
`compensatorleavesis a source of radiation for providing a substantially unshaped
`
`and un-compensated radiation beam in a given beam direction.
`
`
`
`7. A compensator for shaping and modulatingaradiation beam, said
`
`compensator comprising a plurality of layers, each having a plurality of elongated
`
`radiation blocking leaves, a frame for supporting said leaves, and moving means for
`
`moving said leaves, said leaves being arranged in layers so as to form paired opposed
`
`rowsof adjacently positioned leaves being movable by said moving means in a
`
`longitudinal direction (Y) whichis generally transverse to the beam direction so as to
`
`define a radiation beam attenuating field through the leaves and the area between the
`
`opposed endsofthe leaves, the leaves ofsaid layers being arranged one abovethe
`
`other in the beam direction and offset in the lateral (X) direction generally transverse
`
`to the beam direction and orthogonal to the longitudinal direction (Y), so that spaces
`
`between adjacent leaves of any two adjacent layers are positioned over or under the
`
`leaves of the mating level and so that no spacesof a layer align with those of any
`
`other layer;
`
`20
`
`8.
`
`The compensator of claim 7, wherein each row of said compensator leaves
`
`comprises a plurality of adjacently positionedrelatively narrow leaves of divergent
`
`geomeiry.
`
`9.
`
`The compensator of claim 7, wherein said compensator leaves are of uniform
`
`width.
`
`25
`
`10.|The compensator of claim 7, wherein said compensator leaves are of non-
`
`ViewRay Exhibit 1013
`Page 13 of 20
`
`ViewRay Exhibit 1013
`Page 13 of 20
`
`

`

`WO 01/27939
`
`PCT/US00/28023
`
`uniform width.
`
`11.
`
`The compensator of claim 7, wherein each row of said compensator leaves
`
`comprises a plurality of adjacently positionedrelatively narrow leaves of divergent
`
`geometry and of uniform or non-uniform width.
`
`12.
`
`The compensator of claim 7, wherein each row of said compensator leavesis
`
`a source of radiation for providing a substantially unshaped and un-compensated
`
`radiation beam in a given beam direction.
`
`13.
`
`A method for shaping and modulatinga radiation beam, comprising:
`
`arranginga plurality layers, each having a plurality of elongated radiation
`
`blocking leaves, in layers one abovethe otherso as to form paired opposed rows of
`
`adjacently positioned leaves;
`
`movingsaid plurality of leaves in a longitudinal direction (Y) whichis
`
`generally transverse to the beam direction so as to define a radiation beam attenuating
`
`field through the leaves and the area between the opposed endsofthe leaves, said
`
`layers being arranged in the beam direction andoffset in the lateral (X) direction
`
`generally transverse to the beam direction and orthogonal to the longitudinal
`
`direction (Y), so that spaces between adjacent leaves of any two adjacentlayers are
`
`positioned over or underthe leaves of the mating level and so that no spaces of a
`
`20
`
`layer align with those of any otherlayer;
`
`14,
`
`The method of claim 13, wherein in each said row, the compensator leaves
`
`are relatively narrow leaves of divergent geometry.
`
`15.|The method of claim 13, wherein said compensatorleaves are of uniform
`
`width.
`
`25
`
`16.
`
`The method of claim 13, wherein said compensator leaves are of non-uniform
`
`13
`
`ViewRay Exhibit 1013
`Page 14 of 20
`
`ViewRay Exhibit 1013
`Page 14 of 20
`
`

`

`WO 01/27939
`
`PCT/US00/28023
`
`width.
`
`17.
`
`The method of claim 13, wherein the compensatorleaves are of uniform
`
`width.
`
`5
`
`18.
`
`The method of claim 13, wherein the compensator leaves are of non-uniform
`
`width.
`
`19.
`
`The method of claim 7, wherein each row of said compensatorleavesis a
`
`source of radiation for providing a substantially unshaped and un-compensated
`
`radiation beam in a given beam direction.
`
`ViewRay Exhibit 1013
`Page 15 of 20
`
`ViewRay Exhibit 1013
`Page 15 of 20
`
`

`

`LILEDSIIDSALaXWYNSA 6E6L7/T0OM
`
`£7087/00SN/LOd
`
`r/1
`
`ViewRay Exhibit 1013
`Page 16 of 20
`
`

`

`WO 01/27939
`
`PCT/US00/28023
`
`2/4
`
`COl
`
`
`
`ao|!c0c
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`oh
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`
`SUBSTITUTE SHEET (RULE 26)
`
`ViewRay Exhibit 1013
`Page 17 of 20
`
`ViewRay Exhibit 1013
`Page 17 of 20
`
`
`
`
`

`

`PCT/US00/28023
`
`ViewRay Exhibit 1013
`Page 18 of 20
`
`WO 01/27939
`
`3/4
`
`sa O S
`
`+
`lJ
`OQ
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`&z1£Ol
`
`UBSTITUTE SHEET (RULE 26)
`
`ViewRay Exhibit 1013
`Page 18 of 20
`
`

`

`WO 01/27939
`
`PCT/US00/28023
`
`4/4
`
`4
`
`FIG.
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`SUBSTITUTE SHEET (RULE 26)
`
`ViewRay Exhibit 1013
`Page 19 of 20
`
`ViewRay Exhibit 1013
`Page 19 of 20
`
`

`

`INTERNATIONAL SEARCH REPORT
`
`International application No.
`PCT/US00/28023
`
`Minimum documentation searched (classification system followed by classification symbols)
`
`U.S.
`
`:
`
`378/65, 147, 150, 152, 160, 250/505.1
`
`
`
`
` A. CLASSIFICATION OF SUBJECT MATTER
`
`
`
`IPC(7)
`:G21K 1/04
`US CL :378/65, 152
`
`
`According to International Patent Classification (IPC) or to both national classification and IPC
`
`
`
`B.
`FIELDS SEARCHED
`
`
`
`Documentation searched other than minimum documentation to the extent that such documentsare included in the fields searched
`
`
`
` C.
`
`
`
`
`Electronic data base consulted during the international search (name of data base and, where practicable, search terms used)
`
`DOCUMENTS CONSIDERED TO BE RELEVANT
`
`Citation of document, with indication, where appropriate, of the relevant passages
`
`Relevant to claim No.
`
`US 5,591,983 A (YAO) 07 January 1997 (07.01.1997), figure 4.
`
`
`
`7,
`6,
`1,3,
`12,13, 15,17,19
`
`9,
`
`
`
`2,4,5,8,10,11,14,
`16, 18
`
`
`
`US 5,889,834 A (VILSMEIERetal.) 30 March 1999 (30.03.1999),
`4,5,10,16,18
`figure 1.
`
`
`
`US 4,987,309 A (KLASENetal.) 22 January 1991 (22.01.1991),
`2,5,8,11,14
`figure 2.
`
`
`
`[| Further documents are listed in the continuation of Box C. [|
`
`document defining the generai state of the art whichis not considered
`to be of particular relevance
`earlier document published on orafter the international filing date
`document which may throw doubts on priority claim(s) or which is
`cited to establish the publication date of anothercitation or other
`special reason (as specified)
`documentreferring to an oral disclosure, use, exhibition or other
`means
`
`"yr
`x
`
`“yr
`
`"A"
`
`"E"
`"L
`
`"oO"
`
`"Pp"
`
`document memberofthe