Advanced ablation planning

• US 8,267,927 B2
• Filed: 02/22/2010
• Issued: 09/18/2012
• Est. Priority Date: 01/24/2007
• Status: Active Grant

• Current Assignee: Koninklijke Philips N.V.
• Original Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Inventors: Dalal, Sandeep, Trovato, Karen Irene, Kruecker, Jochen, Rusch, Jurgen Jan
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US12/709,542
• Publication Number:
  US 20110015628A1
• Time in Patent Office: 939 Days
• Field of Search: 606 32- 35, 606/41, 606 45- 50
• US Class Current: 606/34
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 6/02 Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
• CPC Class Codes: A61B 8/13 Tomography A61B8/10, A61B8/12 take precedence; tomography for radiation diagnosis A61B6/02

Abstract

In planning an ablation procedure, a planned target volume (PTV) is imported, which is typically selected by a doctor but may be computer-identified. An ablation solution comprising a plurality of ablation volumes is generated or selected using a lookup table. Ablations sharing a common axis along a line of insertion are grouped into blocks. Alternatively, the PTV is enveloped in a sphere, and a pre-computed ablation solution (e.g., a 6- or 14-sphere solution) is identified to cover the PTV sphere. Optionally, a mathematical algorithm is executed to increase an axis through the ablation spheres to generate ellipsoidal ablation volumes that envelop the PTV.

Claims

1. A method for planning an ablation procedure to eliminate a tissue mass in a patient, including:

identifying a tissue mass in the patient;

generating an image representation of an initial planned target volume (PTV) encompassing the tissue mass;

inscribing the initial PTV in a template ellipsoidal enclosing ablation volume;

scaling minor axes of the template ellipsoidal enclosing ablation volume and the initial PTV upward until they are equal in magnitude to a major axis of the template ellipsoidal enclosing ablation volume, to generate an enclosing sphere that encompasses the scaled PTV;

identifying in a lookup table a pre-computed ablation solution having a minimum number of spherical ablation regions that cover the enclosing sphere; and

outputting to a user a graphical representation of the identified precomputed ablation solution overlaid on the sphere.

2. The method according to claim 1, further including:

scaling the minor axes of the ablation regions and the scaled PTV downward to generate ellipsoidal ablation regions that encompass the initial PTV; and

outputting to a user a graphical representation of the ellipsoidal ablation regions and the initial PTV.

3. The method according to claim 1, wherein the ellipsoidal enclosing ablation volume has common relative dimensions and orientation with the initial PTV.

4. The method according to claim 1, further including:

determining a tumor-to-ablation (TA) scaling factor that defines the minimum number of spherical ablation regions that cover the enclosing sphere; and

using the TA factor to identify the precomputed ablation solution.

5. The method according to claim 1, further including:

combining ablation volumes in the precomputed ablation solution that share a common axis into at least one block of ablations that is executed using a pull-back ablation technique.

6. The method according to claim 1, further including:

performing a pilot ablation;

determining a shape of an ablation volume generated during the pilot ablation; and

generating an ablation solution comprising a plurality of ablation volumes having the determined shape to cover the PTV.

7. A method for planning an ablation procedure to eliminate a tissue mass in a patient, including:

identifying a tissue mass in the patient;

generating an image representation of an initial planned target volume (PTV) encompassing the tissue mass;

selecting a bounding polyhedron as a function of a tumor-to-ablation (TA) factor that describes a relationship between radius of a known ellipsoidal ablation volume radius and radius of the PTV;

positioning the bounding polyhedron around the PTV;

positioning an ellipsoidal ablation volume in the bounding polyhedron such that a center of the ellipsoidal ablation volume coincides with a center of the bounding polyhedron;

increasing the TA factor by which axes of the ellipsoidal ablation volume are multiplied until the axes are equal to or greater than corresponding dimensions of the bounding polyhedron;

identifying in a lookup table a pre-computed ablation solution having a minimum number of spherical ablation regions that cover the enclosing sphere; and

outputting to a user a graphical representation of the identified precomputed ablation solution overlaid on the scaled PTV.

8. The method according to claim 7, further including:

scaling the minor axes of the ablation regions and the scaled PTV downward to generate ellipsoidal ablation regions that encompass the initial PTV; and

outputting to a user a graphical representation of the ellipsoidal ablation regions and the initial PTV.

9. The method according to claim 7, wherein the ellipsoidal ablation volume has common relative dimensions and orientation with the initial PTV.

10. The method according to claim 7, further including:

combining ablation volumes n the precomputed ablation solution that share a common axis into at least one block of ablations that is executed using a pull-back ablation technique.

11. The method according to claim 7, further including:

performing a pilot ablation;

determining a shape of an ablation volume generated during the pilot ablation; and

generating an ablation solution comprising a plurality of ablation volumes having the determined shape to cover the PTV.

12. A system for planning an ablation procedure for ablation of a tissue mass in a patient, including:

a graphical user interface that presents a representation of the tissue mass to a user; and

an optimization component that generates a planned target volume (PTV), which includes the tissue mass, receives image data related to the tissue mass, generates an enclosing ellipsoid ablation volume that encompasses the PTV, identifies a polyhedron shape that encompasses the enclosing ellipsoid, identifies a plurality of spheroid ablation regions to cover the enclosing ellipsoid having respective centroids positioned on centers respective sides of the polyhedron shape, executes a mathematical algorithm to lengthen an axis of the spherical ablation regions to form ellipsoid ablation regions therefrom, and outputs graphical information to the user displaying the ellipsoid ablation regions overlaid on the PTV.

13. The system according to claim 12, wherein the optimization component generates an initial list of candidate ablation regions, each having a characteristic point at which a probe associated with the ablation component is positioned to treat a portion of the tissue mass in each ablation region, and determines a unique coverage area (UCA) for a predetermined number of candidate ablation regions such that the UCA for a given candidate ablation region includes a portion of the PTV that is covered solely by the given candidate ablation region.

14. The system according to claim 13, wherein the optimization component removes a candidate ablation region from the list of candidate ablation regions if the candidate ablation region does not have a UCA, executes a binary search algorithm to determine whether the characteristic points of the given candidate ablation region can be moved closer to a centering point of the PTV without compromising coverage of the UCA of the given candidate ablation region, and continues to optimize the model for tumor mass ablation until no candidate ablation region can be moved closer to the centering point and all UCAs are covered.

15. The system according to claim 12, wherein the optimization component executes a ray marching algorithm to generate at least one candidate insertion point on the skin of the patient, through which an ablation probe associated with the ablation component is inserted along a trajectory to the PTV while avoiding one or more critical regions.

16. The system according to claim 12, wherein the optimization component includes:

a routine that selects an initial set of candidate ablation regions that cover a planned target volume (PTV);

a routine that selects a centering point of the PTV;

a routine that determines whether one or more candidate ablation regions in the initial set of candidate ablation regions remain to be evaluated;

a routine that selects a candidate ablation region and evaluates a unique coverage area (UCA) there for;

a routine that determines whether the UCA for the candidate ablation region is equal to zero;

a routine that removes the candidate ablation region from the initial set of candidate ablation regions if the UCA is equal to zero;

a routine that identifies a closest position to the centering point, to which the candidate ablation region is moved, while still covering the UCA, if the UCA is not equal to zero;

a routine that determines that all candidate ablation regions are ready for reevaluation if one or more candidate ablation regions has been moved closer to the centering point; and

a routine that causes all candidate ablation regions to be reevaluated.

17. The system according to claim 12, wherein the optimization component:

optimizes an ablation plan as a function of at least one of functional data associated with the mass, location of one or more heat sinks near the tissue mass, a shape of an ablation probe selected to perform the ablation, a size of the ablation probe selected to perform the ablation, and a number of different ablation probes utilized during ablation;

optimizes an ablation plan as a function of at least one of candidate ablation points, ablation probe entry angles, ablation temperature, ablation time, and critical regions; and

utilizes a priori knowledge of at least one of a proximity of a PTV to a critical region, an ablation time associated with a selected ablation probe, an ablation temperature associated with the selected ablation probe, and one or more heat sinks located near the PTV.

18. The system according to claim 12, wherein the optimum number of ablation regions is a minimum number of ablation regions that covers the tissue mass, and wherein a user inputs a planned target volume (PTV), which encompasses the tissue mass, by outlining boundaries on one or more different views of the representation of the tissue mass, and the optimization component generates 3D voxels representing the planned target volume.