Thermal mapping of a cryoablation volume, for image-guided cryosurgery

• US 20060155267A1
• Filed: 04/15/2005
• Published: 07/13/2006
• Est. Priority Date: 01/10/2005
• Status: Abandoned Application

• Current Assignee: Galil Medical Ltd. (Boston Scientific Corporation)
• Original Assignee: Galil Medical Ltd. (Boston Scientific Corporation)
• Inventors: Berzak, Nir, Amir, Uri, Hillely, Ron, Bliweis, Mordechai, Leybin, Yura
• Application Number:
  US11/106,438
• Publication Number:
  US 20060155267A1
• Time in Patent Office: Days
• US Class Current: 606/20
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 2018/00041 Heating, e.g. defrosting
• CPC Class Codes: A61B 2018/0262 using a circulating cryogenic fluid
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints

Abstract

The present invention relates to systems and methods for rendering visible to a cryosurgeon an estimated border of a cryoablation volume, thereby facilitating accurately delimited cryoablation of pathological tissues. More particularly, the present invention relates to systems and methods for reading temperature and location information from images provided by imaging modalities and optionally from thermal sensors, inferring from that information the three-dimensional shape and position of a volume of tissue considered reliably cryoablated, and presenting this shape and position information to a cryosurgeon by integrating a visual model of that information with one or more images derived from standard imaging modalities, and displaying for a cryosurgeon that integrated image.

Claims

1. A system for estimating size and shape and position of a cryoablation volume during cryosurgery, comprising:

(a) a data-receiving module operable to receive data from at least one data source selected from a group consisting of a thermal sensor, a first imaging modality operable to show position of a cryoprobe within a body of a patient, a second imaging modality operable to show position of a cryoablation target within a body of a patient, a third imaging modality operable to show position of a border of an iceball during a cryoablation procedure, and a user interface operable to receive and record diagnostic information from a user, which diagnostic information serves to specify a position of a cryoablation target within a body of a patient; and

(b) a calculation module operable to calculate a position of a cryoablation volume based on data-received by said data receiving module.

2. The system of claim 1, wherein said data-receiving module is operable to receive data from at least two data sources selected from said group.

3. The system of claim 1, wherein said data-receiving module is operable to receive data from at least three data sources selected from said group.

4. The system of claim 1, wherein said data-receiving module is operable to receive data from at least four data sources selected from said group.

5. The system of claim 1, wherein said data-receiving module is operable to receive data from said first imaging modality, said second imaging modality, and said third imaging modality.

6. The system of claim 1, further comprising a thermal sensor.

7. The system of claim 6, wherein said thermal sensor is positioned within a cryoprobe and is operable to report temperatures within said cryoprobe during cryoablation.

8. The system of claim 6, wherein said thermal sensor is positioned contiguous to a cryoprobe and is operable to report temperature of tissue contiguous to said cryoprobe during cryoablation.

9. The system of claim 6, wherein said thermal sensor is operable to be inserted into the body of a patient at a distance from inserted cryoprobes and to report temperatures of tissues at said distance from said cryoprobes.

10. The system of claim 6, further comprising a plurality of thermal sensors.

11. The system of claim 1, further comprising, a display module operable to display said calculated position of said cryoablation volume.

12. The system of claim 11, wherein said display is operable to display said calculated position of said cryoablation volume in an image which further displays data derived from at least one of a group consisting of said first imaging modality, said second imaging modality, said third imaging modality, and said user interface.

13. The system of claim 11, wherein said display is operable to display said calculated position of said cryoablation volume in an image which further displays data derived from at least two of a group consisting of said first imaging modality, said second imaging modality, said third imaging modality, and said user interface.

14. The system of claim 11, wherein said display is operable to display said calculated position of said cryoablation volume in an image which further displays data derived from at least three of a group consisting of said first imaging modality, said second imaging modality, said third imaging modality, and said user interface.

15. The system of claim 11, wherein said display is operable to display said calculated position of said cryoablation volume in an image which further displays data derived from said first imaging modality and data derived from said second imaging modality and data derived from said third imaging modality.

16. The system of claim 11, wherein said display is operable to display a two-dimensional image.

17. The system of claim 11, wherein said display is operable to display a three-dimensional image.

18. The system of claim 17, wherein said integrated display is operable to display said three-dimensional image stereoscopically.

19. The system of claim 1, wherein said calculated position of said cryoablation volume is calculated as an isotherm.

20. The system of claim 19, wherein said calculated position of said cryoablation volume is calculated as an isotherm at −

40°

C.

21. The system of claim 1, further operable to calculate positions of isotherms at selected temperatures.

22. The system of claim 1, where said calculation module calculates said position of a cryoablation volume by:

(a) gleaning information regarding position of a cryoprobe within tissues of said body from an image provided by said first imaging modality;

(b) gleaning information regarding position of a border of an iceball volume formed during a cryoablation procedure froth said third imaging modality;

(c) selecting a distance ratio usable to determine status of subunits of tissue within said iceball;

(d) digitally subdividing said iceball volume into subunits; and

(e) determining for a plurality of said subunits whether each subunit of said plurality of subunits is within an ablation volume by calculating a first distance of said each subunit from a nearest cooling portion of said cryoprobe and a second distance of said each subunit from a nearest border of said iceball, and determining that said subunit is within said ablation volume if said first distance divided by a sum of said first and second distances is less than said selected distance ratio, and determining that said subunit is outside said ablation volume if said first distance divided by a sum of said first and second distances is greater than said selected distance ratio.

23. A method for facilitating accurate cryoablation of a cryoablation target, comprising:

(a) receiving data from at least one data source selected from a group consisting of a thermal sensor, a first imaging modality operable to report position of a cryoprobe within a body of a patient, a second imaging modality operable to report a position of a cryoablation target within a body of a patient, a third imaging modality operable to show position of a border of an iceball during a cryoablation procedure, and a user interface operable to receive and record diagnostic information from a user, which diagnostic information serves to specify a position of a cryoablation target within a body of a patient;

(b) calculating position of a cryoablation volume based on said received data; and

(c) displaying said calculated position of said cryoablation volume in a display which integrate said calculated position with at least one image created by an image source selected from a group consisting of said first imaging modality, said second imaging modality, said third imaging modality, and said user interface, thereby enabling a surgeon to visualize said cryoablation volume in context, thereby facilitating accurate cryoablation of a cryoablation target.

24. The method of claim 23, further comprising receiving data from a plurality of thermal sensors.

25. The method of claim 23, wherein said thermal sensor is positioned within a cryoprobe and is operable to report temperatures within said cryoprobe during cryoablation.

26. The method of claim 23, wherein said thermal sensor is positioned contiguous to a cryoprobe and is operable to report temperature of tissue contiguous to said cryoprobe.

27. The method of claim 23, further comprising inserting a thermal sensor into a body of a patient at a distance from inserted cryoprobes, and utilizing said thermal sensor to report temperatures of tissues at said distance from said inserted cryoprobes.

28. The method of claim 23, further comprising utilizing a display module to display said calculated position of said cryoablation volume.

29. The method of claim 28, further comprising utilizing said display to display said calculated position of said cryoablation volume as a component of an integrated display which further comprises image data derived from at least one of a group consisting of said first imaging modality, said second imaging modality, said third imaging modality, and said user interface.

30. The method of claim 28, further comprising displaying said calculated position of said cryoablation volume as a component of an integrated display which further comprises image data derived from at least two of a group consisting of said first imaging modality, said second imaging modality, said third imaging modality, and said user interface.

31. The method of claim 28, further comprising displaying said calculated position of said cryoablation volume as a component of an integrated display which further comprises image data derived from at least three of a group consisting of said first imaging modality, said second imaging modality, said third imaging modality, and said user interface.

32. The method of claim 28, further comprising displaying said calculated position of said cryoablation volume as a component of an integrated display which further comprises image data derived from said first imaging modality, said second imaging modality, said third imaging modality, and said user interface.

33. The method of claim 28, wherein said calculated position of said cryoablation volume is displayed as a two dimensional image.

34. The method of claim 28, wherein said calculated position of said cryoablation volume is displayed as a three-dimensional image.

35. The method of claim 34, wherein said three-dimensional image is displayed stereoscopically.

36. The method of claim 23, wherein said calculated position of a cryoablation volume is calculated as an isotherm.

37. The method of claim 23, wherein said calculated position of a cryoablation volume is calculated as an isotherm at −

40°

C.

38. The method of claim 23, wherein said calculation of position of a cryoablation volume is performed by:

(a) gleaning information regarding position of a cryoprobe within tissues of said body from an image provided by said first imaging modality;

(b) gleaning information regarding position of a border of an iceball formed during a cryoablation procedure from said third imaging modality;

(c) selecting a distance ratio usable to determine status of subunits of tissue within said iceball;

(d) digitally subdividing tissue within said iceball into subunits; and

(e) determining for each subunit whether it is within an ablation volume by calculating a first distance of said each subunit from a nearest cooling portion of said cryoprobe and a second distance of said each subunit from a nearest border of said iceball, and determining that said subunit is within said ablation volume if said first distance divided by a sum of said first and second distances is less than said selected distance ratio, and determining that said subunit is outside said ablation volume if said first distance divided by a sum of said first and second distances is greater than said selected distance ratio.

39. An integrated image displaying a cryoablation site in a body of a patient, said integrated image comprising a common virtual space wherein are displayed:

(a) a first component image derived from source selected from a group consisting of a first imaging modality operable to report position of a cryoprobe within said body of said patient, a second imaging modality operable to report a position of a cryoablation target within said body of said patient, a third imaging modality operable to report position of a border of an iceball formed within said body during a cryoablation procedure, and a user interface operable to receive and record diagnostic information from a user, which diagnostic information serves to specify a position of a cryoablation target within said body of said patient; and

(b) a representation of a calculated position of a cryoablation volume.

40. The integrated image of claim 39, wherein said first component image presents a view of a portion of said body of said patient, which view is created by an imaging modality subsequent to insertion of cryoprobes into said body and prior to freezing of tissues in proximity to said cryoprobes.

41. The integrated image of claim 39, wherein said first image comprises a view of an iceball formed around a functioning cryoprobe inserted in said body of said patient.

42. The integrated image of claim 39, wherein said first image comprises diagnostic information provided by a user.

43. The integrated image of claim 39, wherein said first image comprises a view of a cryoablation target in said body of said patient.

44. The integrated image of claim 39, wherein said first image comprises at least two of a group consisting of:

(a) a view of a portion of said body of said patient, which view is created by an imaging modality subsequent to insertion of a cryoprobe into said body and prior to freezing of tissues in proximity to said cryoprobe;

(b) a view of an iceball formed around a functioning cryoprobe inserted in said body of said patient;

(c) a view of a portion of said body of said patient showing diagnostic information provided by a user; and

(d) a view of a cryoablation target in said body of said patient.

45. The integrated image of claim 39, wherein said first image comprises at least three of a group consisting of:

(a) a view of a portion of said body of said patient, which view is taken subsequent to insertion of cryoprobes into said body of said patient and prior to freezing of tissues in proximity to said cryoprobes;

(b) a view of an iceball formed around a functioning cryoprobe inserted in said body of said patient;

(c) a view of a portion of said body of said patient showing diagnostic information provided by a user; and

(d) a view of a cryoablation target in said body of said patient.

46. The integrated image of claim 39, wherein said first image comprises:

(a) a view of a portion of said body of said patient, which view is taken subsequent to insertion of cryoprobes into said patent and prior to freezing of tissues in proximity to said cryoprobes;

(b) a view of an iceball formed around a functioning cryoprobe inserted in said body of said patient;

(c) a view of a portion of said body of said patient showing diagnostic information provided by a user; and

(d) a view of a cryoablation target in said body of said patient.

47. The integrated image of claim 39, wherein said first image is derived from one of a group consisting of x-ray photography, magnetic resonance imaging, CT imaging, ultrasound imaging, and fluoroscopic imaging.

48. The integrated image of claim 39, wherein said integrated image is presented as a two-dimensional plane view of a portion of a body of a patient.

49. The integrated image of claim 39, wherein said integrated image is presented as a three-dimensional view of a portion of a body of a patient wherein said first component image and said representation of calculated position of a cryoablation volume are presented in a common perspective.

50. The integrated image of claim 39, wherein said integrated image is presented as a stereoscopic three-dimensional image.

51. A method for facilitating cryosurgery by providing to a surgeon feedback showing effective boundaries of a cryoablation procedure, comprising:

(a) acquiring tissue temperature and cryoprobe placement information from at least one source selected from a group consisting of MRI-derived tissue temperature information, an MRI image, an x-ray image, a CT image, an ultrasound image, a thermal sensor internal to a cryoprobe, a thermal sensor contiguous to and external to a cryoprobe, and a thermal sensor distanced from all cryoprobes and inserted in body tissues;

(b) inferring from said information a three-dimensional shape and position of a cryoablation volume; and

(c) displaying to the surgeon an integrated image showing, in a common virtual space;

(i) a first image derived form an imaging modality; and

(ii) a visualization of said inferred three-dimensional shape and position of said cryoablation volume,

thereby facilitating cryosurgery by providing to the surgeon real-time feedback showing effective boundaries of a cryoablation procedure.

52. A method for guiding guided cryosurgery by calculating an estimated border of a cryoablation volume within the body of a patient, comprising:

(a) recording a position of a cryoprobe within tissues of said body prior to creating an iceball surrounding said probe;

(b) cooling said probe to form an iceball surrounding said probe, and recording positions of a three-dimensional borders of said iceball;

(c) selecting a distance ratio usable to determine status of subunits of tissue within said iceball;

(d) digitally subdividing tissue within said iceball into subunits; and

(e) determining for each subunit whether it is within an ablation volume by calculating a first distance of said each subunit from a nearest cooling portion of said cryoprobe and a second distance of said each subunit from a nearest border of said iceball, and determining that said subunit is within said ablation volume if said first distance divided by a sum of said first and second distances is less than said selected distance ratio, and determining that said subunit is outside said ablation volume if said first distance divided by a sum of said first and second distances is greater than said selected distance ratio.

53. The method of claim 52, further comprising displaying an image of at least a portion of said estimated cryoablation volume border.