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A device and a process for performing high temporal- and spatial-resolution MR imaging of the anatomy of a patient during intensity modulated radiation therapy (IMRT) to directly measure and control the highly conformal ionizing radiation dose delivered to the patient for the treatment of diseases c

A device and a process for performing high temporal- and spatial-resolution MR imaging of the anatomy of a patient during intensity modulated radiation therapy (IMRT) to directly measure and control the highly conformal ionizing radiation dose delivered to the patient for the treatment of diseases caused by proliferative tissue disorders. This invention combines the technologies of open MRI, multileaf-collimator or compensating filter-based IMRT delivery, and cobalt teletherapy into a single co-registered and gantry mounted system.

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1. A radiation treatment system, comprising, a device to deliver ionizing radiation from one or more radioisotope sources,a magnetic resonance imaging system, anda controller in communication with the device to deliver ionizing radiation and the magnetic resonance imaging system such that the contro

1. A radiation treatment system, comprising, a device to deliver ionizing radiation from one or more radioisotope sources,a magnetic resonance imaging system, anda controller in communication with the device to deliver ionizing radiation and the magnetic resonance imaging system such that the controller substantially simultaneouslya) controls the device to deliver ionizing radiation to deliver ionizing radiation; andb) controls the magnetic resonance imaging system to acquire magnetic resonance imaging data. 2. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged such that magnetic resonance imaging data identifies regions of tracer uptake substantially simultaneously to the delivery of ionizing radiation. 3. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged such that magnetic resonance imaging data identifies regions of contrast enhancement substantially simultaneously to the delivery of ionizing radiation. 4. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged to acquire spectroscopic information substantially simultaneously to the delivery of ionizing radiation. 5. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged to acquire metabolic or physiological information substantially simultaneously to the delivery of ionizing radiation. 6. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged such that magnetic resonance angiography data, lymphangiography data, or both is acquired substantially simultaneously to the delivery of ionizing radiation. 7. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged to employ the magnetic resonance imaging data acquired to monitor the subject's response to therapy substantially simultaneously to the delivery of ionizing radiation. 8. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged to enable the employment of methods of deformable image registration with the magnetic resonance imaging data acquired substantially simultaneously to the delivery of ionizing radiation to track the motion of anatomy and radiotherapy targets during irradiation. 9. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged to enable the employment of methods of dose computation with the magnetic resonance imaging data acquired substantially simultaneously to the delivery of ionizing radiation to determine a dose to the subject in the presence of motion during irradiation. 10. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged to enable the employment of methods of deformable image registration and dose computation with the magnetic resonance imaging data acquired substantially simultaneously to the delivery of ionizing radiation to determine a dose to the subject in the presence of motion during irradiation. 11. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged to enable the employment of methods of deformable image registration, dose computation, and Intensity Modulated Radiation Therapy optimization with the magnetic resonance imaging data acquired substantially simultaneously to the delivery of ionizing radiation to reoptimize a subject's IMRT treatment. 12. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged to employ the magnetic resonance imaging data acquired substantially simultaneously to the delivery of ionizing radiation to perform in vivo thermometry. 13. The radiation treatment system of claim 1, wherein the system is constructed and arranged to perform ablative therapy under substantially simultaneous image guidance. 14. The radiation treatment system of claim 1, wherein the system is constructed and arranged to control proliferative tissue under substantially simultaneous image guidance. 15. The radiation treatment system of claim 14, wherein the system is constructed and arranged to control vascular proliferative tissue under substantially simultaneous image guidance. 16. The radiation treatment system of claim 1, wherein the radioisotopic source or sources of radiation are coupled with one or more multileaf-collimator intensity modulated radiation delivery system. 17. The radiation treatment system of claim 16, wherein the one or more multileaf-collimator intensity modulated radiation delivery system comprises a doubly divergent multileaf-collimator system employing independent leafs constructed and arranged to block interleaf leakage and allow for completely blocking a source radiation when closed. 18. The radiation treatment system of claim 1, wherein the system is constructed and arranged such that a delivered dose determined from the magnetic resonance imaging data is used to reoptimize an intensity modulated radiation therapy for a subject. 19. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged such that magnetic resonance imaging data identifies regions of tracer uptake substantially simultaneously to the delivery of ionizing radiation. 20. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is constructed and arranged such that high diagnostic quality magnetic resonance imaging is performed before the start of therapy, after the start of therapy, or both; andlow quality magnetic resonance imaging system is performed for anatomy and target tracking during substantially simultaneous delivery of ionizing radiation from the device to deliver ionizing radiation. 21. The radiation treatment system of claim 1, wherein the one or more radioisotope sources are selected from a group consisting of: cobalt 60;iridium 192;cesium 137;ytterbium 169; andthulium 170. 22. The radiation treatment system of claim 1, wherein a magnetic resonance imaging magnetic field generated by the magnetic resonance imaging system is orthogonal to a radiation beam of the ionizing radiation. 23. The radiation treatment system of claim 1, wherein the magnetic resonance imaging system is configured to operate at a field strength below 1.0T. 24. The radiation treatment system of claim 23, wherein the magnetic resonance imaging system is configured to operate at a field strength of between 0.2 and 0.5T. 25. A method for guiding the delivery of ionizing radiation to a patient using a magnetic resonance imaging system, the method comprising: delivering ionizing radiation from one or more external radioisotope sources; andacquiring magnetic resonance imaging data from the magnetic resonance imaging system, wherein the delivering and acquiring steps are executed substantially simultaneously. 26. The method of claim 25, further comprising: determining a treatment plan for the delivery of ionizing radiation prior to the delivering step; andaltering the treatment plan based at least partially upon the magnetic resonance imaging data acquired during the acquiring step. 27. The method of claim 25, wherein the one or more radioisotope sources are selected from a group consisting of: cobalt 60;iridium 192;cesium 137;ytterbium 169; andthulium 170. 28. A computer program product for simultaneously controlling a device for delivering ionizing radiation and a magnetic resonance imaging system so as to guide the delivery of ionizing radiation using magnetic resonance imaging data, the computer program product comprising a non-transitory computer-readable storage medium having computer-readable program code portions stored therein, the computer-readable program code portions comprising: a first set of computer instructions for delivering ionizing radiation from one or more external radioisotope sources; anda second set of computer instructions for acquiring magnetic resonance imaging data from the magnetic resonance imaging system substantially simultaneously with the delivery of ionizing radiation. 29. The computer program product of claim 28, further comprising: a third set of computer instructions for determining a treatment plan for the delivery of ionizing radiation prior to the delivering step;a fourth set of computer instructions for altering the treatment plan based at least partially upon the magnetic resonance imaging data acquired during the acquiring step. 30. A radiation treatment apparatus for image guided radiotherapy comprising: an irradiating apparatus configured to deliver ionizing radiation to a subject from one or more external radioisotope source;a magnetic resonance imaging apparatus operably engaged with the irradiating apparatus, the magnetic resonance imaging system configured to acquire magnetic resonance imaging data from the subject; anda controller in communication with the irradiating apparatus and the magnetic resonance imaging apparatus, the controller configured to control the irradiating apparatus to deliver ionizing radiation to the subject, and substantially simultaneously, control the magnetic resonance imaging system to acquire magnetic resonance imaging data from the subject at a frequency sufficient to account for intra-fractional organ movement. 31. The radiation treatment apparatus of claim 30, wherein the magnetic resonance imaging apparatus is further configured to acquire magnetic resonance imaging data from the subject prior to or after the delivery of ionizing radiation at a field strength sufficient to produce diagnostic quality image data and wherein the magnetic resonance imaging apparatus is also configured to acquire magnetic resonance imaging data from the subject substantially simultaneously with the delivery of ionizing radiation at a lower field strength. 32. The radiation treatment apparatus of claim 31, wherein the lower magnetic field strength is below 1.0T. 33. The radiation treatment apparatus of claim 32, wherein the lower magnetic field strength is between 0.2 and 0.5T. 34. The radiation treatment apparatus of claim 33, wherein the magnetic resonance imaging magnetic field is substantially orthogonal to the radiation beam. 35. A radiation treatment apparatus for simultaneous radiation treatment and imaging of a subject, said apparatus comprising: a split solenoid magnetic resonance imaging system; anda shielded co-registered isotopic radiation source with a multi-leaf collimator intensity modulated radiation therapy unit for axillary rotation about said subject configured for simultaneous radiation treatment and imaging. 36. The radiation treatment apparatus of claim 35, wherein said co-registered isotopic radiation source with a multi-leaf collimator comprises: a fixed primary collimator;a secondary doubly divergent multileaf collimator; anda tertiary multi-leaf collimator configured to block interleaf leakage from the secondary multi-leaf collimator. 37. The radiation treatment apparatus of claim 35, wherein the magnetic resonance imaging system is configured to operate at a field strength below 1.0T. 38. The radiation treatment apparatus of claim 37, wherein the magnetic resonance imaging system is configured to operate at a field strength of between 0.2 and 0.5T, and wherein the magnetic resonance imaging magnetic field is orthogonal to the radiation beam. 39. A radiation treatment system, comprising: an irradiating device configured to deliver ionizing radiation to a subject from one or more external radioisotope sources;a magnetic resonance imaging system operably engaged with the irradiating device, the magnetic resonance imaging system configured to acquire a sequence of 3D images of the subject fast enough to capture intra-fraction organ motions;a controller in communication with the irradiating device and the magnetic resonance imaging system such that the controller can substantially simultaneously a) control the irradiating device to deliver ionizing radiation to the subject and record delivered radioisotope beam fluences; andb) control the magnetic resonance imaging system to acquire the 3D images of the subject; anda processor configured to determine an actual dose deposition in the subject from the 3D images and the delivered radioisotope beam fluences. 40. The radiation treatment system of claim 39, wherein the controller is configured to reoptimize radiation delivery based on the determined actual dose deposition. 41. The radiation treatment system of claim 39, wherein the controller is configured to stop the delivery of ionizing radiation if the actual dose deposition evidences a dosimetric error. 42. The radiation treatment system of claim 39, further comprising a multi-leaf collimator configured to rapidly adjust radiation delivery to account for intra-fraction organ motions. 43. A method of radiation treatment, the method comprising: delivering ionizing radiation to a subject from one or more external radioisotope sources of an irradiating device;acquiring, by a magnetic resonance imaging system operably engaged with the irradiating device, a sequence of 3D images of the subject fast enough to capture intra-fraction organ motions;substantially simultaneously a) controlling the irradiating device to deliver ionizing radiation to the subject and record delivered radioisotope beam fluences; andb) controlling the magnetic resonance imaging system to acquire the 3D images of the subject; anddetermining, by a processor, actual dose deposition in the subject from the 3D images and the delivered radioisotope beam fluences. 44. The method of claim 43, further comprising reoptimizing radiation delivery based on the determined actual dose deposition. 45. The method of claim 43, further comprising stopping the delivery of ionizing radiation if the actual dose deposition evidences a dosimetric error. 46. The method of claim 43, further comprising rapidly adjusting, by a multi-leaf collimator, radiation delivery to account for intra-fraction organ motions.