Methods for planning and performing thermal ablation
First Claim
1. A method of performing a thermal ablation procedure within a Volume Of Interest (VOI) in a patient comprising the steps of:
- (a) capturing a baseline digital image with an x-ray system of a VOI in a patient, wherein said baseline digital image is comprised of a first set of detected image signal data corresponding with each spatial location in an array of spatial locations throughout said VOI;
(b) performing a thermal ablation procedure on at least a first sub-volume of said VOI according to a first thermal ablation plan, wherein said first thermal ablation plan comprises expected temperature changes at each said spatial location within said array of spatial locations as a function of time during said thermal ablation procedure;
(c) capturing a first temperature differential digital image with said x-ray system of said VOI multiple times during said thermal ablation procedure, wherein each said first temperature differential digital image is comprised of a corresponding second set of detected image signal data corresponding with each said spatial location in said array of spatial locations throughout said VOI;
(d) registering each said first temperature differential digital image to said baseline digital image;
(e) inferring, based at least in part on said baseline digital image and each said first temperature differential digital image, an amount of temperature change at each of said multiple times at each said spatial location within said array of spatial locations throughout said VOI; and
(f) comparing said inferred temperature changes at said multiple times at each said spatial location within said array to said expected temperature changes at each said spatial location within said array as a function of time during said thermal ablation.
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Abstract
A thermal ablation system is operable to perform thermal ablation using an x-ray system to measure temperature changes throughout a volume of interest in a patient. Image data sets captured by the x-ray system during a thermal ablation procedure provide temperature change information for the volume being subjected to the thermal ablation. Intermediate image data sets captured during the thermal ablation procedure may be fed into a system controller, which may modify or update a thermal ablation plan to achieve volume coagulation necrosis targets. The thermal ablation may be delivered by a variety of ablation modes including radiofrequency ablation, microwave therapy, high intensity focused ultrasound, laser ablation, and other interstitial heat delivery methods. Methods of performing thermal ablation using x-ray system temperature measurements as a feedback source are also provided.
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Citations
103 Claims
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1. A method of performing a thermal ablation procedure within a Volume Of Interest (VOI) in a patient comprising the steps of:
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(a) capturing a baseline digital image with an x-ray system of a VOI in a patient, wherein said baseline digital image is comprised of a first set of detected image signal data corresponding with each spatial location in an array of spatial locations throughout said VOI; (b) performing a thermal ablation procedure on at least a first sub-volume of said VOI according to a first thermal ablation plan, wherein said first thermal ablation plan comprises expected temperature changes at each said spatial location within said array of spatial locations as a function of time during said thermal ablation procedure; (c) capturing a first temperature differential digital image with said x-ray system of said VOI multiple times during said thermal ablation procedure, wherein each said first temperature differential digital image is comprised of a corresponding second set of detected image signal data corresponding with each said spatial location in said array of spatial locations throughout said VOI; (d) registering each said first temperature differential digital image to said baseline digital image; (e) inferring, based at least in part on said baseline digital image and each said first temperature differential digital image, an amount of temperature change at each of said multiple times at each said spatial location within said array of spatial locations throughout said VOI; and (f) comparing said inferred temperature changes at said multiple times at each said spatial location within said array to said expected temperature changes at each said spatial location within said array as a function of time during said thermal ablation. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82)
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83. A method of performing a thermal ablation procedure within a Volume Of Interest (VOI) in a patient comprising the steps of:
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(aa) positioning a patient on a bed so that a VOI within said patient is within a field of view of an x-ray imaging device, wherein said imaging device encircles less than all of said VOI; (bb) capturing a baseline digital image of said VOI with said imaging device, wherein said baseline digital image is comprised of a first set of detected image signal data corresponding with each spatial location in an array of spatial locations throughout said VOI; (cc) performing thermal ablation on at least a first sub-volume of said VOI according to a first thermal ablation plan, wherein said first thermal ablation plan comprises expected temperature changes at each said spatial location within said array of spatial locations as a function of time during said thermal ablation procedure; (dd) capturing a first temperature differential digital image of said VOI with said x-ray imaging device multiple times during said thermal ablation procedure, wherein each said first temperature differential digital image is comprised of a corresponding second set of detected image signal data corresponding with each said spatial location in said array of spatial locations throughout said VOI; (ee) registering each said first temperature differential digital image to said baseline digital image; (ff) inferring, based at least in part on said baseline digital image and each said first temperature differential digital image, an amount of temperature change at each of said multiple times at each said spatial location within said array of spatial locations throughout said VOI; and (gg) comparing said inferred temperature changes at said multiple times at each said spatial location within said array to said expected temperature changes at each said spatial location within said array as a function of time during said thermal ablation; and
,(hh) maintaining said position of said patient relative to said bed during and between each of said capturing of said baseline digital image, said performing thermal ablation, and said capturing of said first temperature differential digital image steps, wherein said patient and bed are not moved substantially more than a maximum lineal dimension of said VOI during and between each of said capturing of said baseline digital image, said performing thermal ablation, and said capturing of said first temperature differential digital image steps. - View Dependent Claims (84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103)
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Specification