Systems and methods for stimulation-related volume analysis, creation, and sharing

• US 9,925,382 B2
• Filed: 08/09/2012
• Issued: 03/27/2018
• Est. Priority Date: 08/09/2011
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Carlton, Keith, Cassidy, Jim, Chen, Dean, Moffitt, Michael A., Zottola, Dennis
• Primary Examiner(s): Vanni, G. Steven
• Application Number:
  US13/571,078
• Publication Number:
  US 20130116929A1
• Time in Patent Office: 2,056 Days
• CPC Class Codes: A61N 1/36128 Control systems
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 40/63 for local operation

Abstract

A computer implemented system and method facilitates a cycle of generation, sharing, and refinement of volumes related to stimulation of anatomical tissue, such as brain or spinal cord stimulation. Such volumes can include target stimulation volumes, side effect volumes, and volumes of estimated activation. A computer system and method also facilitates analysis of groups of volumes, including analysis of differences and/or commonalities between different groups of volumes.

Claims

1. A computer-implemented method for determining anatomical tissue regions that are relevant to stimulation, comprising:

receiving a selection of a stimulation effect, wherein the selected stimulation effect is either a therapeutic effect or a side effect;

obtaining, by a computer processor, a first collection of a first plurality of anatomical tissue volumes for which previous stimulation of each of the first plurality of anatomical tissue volumes for a plurality of patients produced the selected stimulation effect;

obtaining, by the computer processor, a second collection of a second plurality of anatomical tissue volumes for which previous stimulation of each of the second plurality of anatomical tissue volumes for a plurality of patients did not produce the selected stimulation effect, the first and second plurality of anatomical tissue volumes being registered to a common reference space;

comparing, by the processor, the first plurality of anatomical tissue volumes to the second plurality of anatomical tissue volumes;

based on the comparing, finding, by the processor, a target volume for the selected stimulation effect, wherein the target volume comprises a plurality of volume elements that each meet two criteria;

(a) the volume element is included in either a threshold number or a threshold percentage of the first plurality of anatomical tissue volumes and (b) the volume element is not included in either a threshold number or a threshold percentage of the second plurality of anatomical tissue volumes;

subsequent to the comparing, outputting, by the processor, a representation of the target volume found in the finding step, wherein the representation represents the target volume as an anatomical region and indicates, when the selected stimulation effect is the therapeutic effect, that the target volume is to be stimulated or, when the selected stimulation effect is the side effect, that stimulation is to be avoided in the target volume;

comparing the target volume with a plurality of volumes of activation (VOAs), wherein each the VOAs corresponds to an estimate of a volume of tissue stimulated using a corresponding set of stimulation parameters;

selecting one of the volumes of activation based on the comparison with the target volume where the selected VOA either (a) overlaps with the target volume by a threshold amount when the target volume is to be stimulated because the selected stimulation effect is the therapeutic effect or (b) does not overlap with the target volume by a threshold amount when stimulation is to be avoided in the target volume because the selected stimulation effect is the side effect; and

stimulating a patient using the corresponding set of stimulation parameters for the selected VOA.

2. The method of claim 1, wherein the obtaining steps include, prior to the comparing of the first plurality of anatomical tissue volumes to the second plurality of anatomical tissue volumes, registering the first and second pluralities of anatomical tissue volumes to the common reference space, the common reference space being a common atlas space.

3. A computer-implemented method for determining anatomical tissue regions that are relevant to stimulation, comprising:

receiving a. selection of a stimulation effect, wherein the selected stimulation effect is either a therapeutic effect or a side effect;

obtaining, by a computer processor, a first collection of a first plurality of anatomical tissue volumes for which previous stimulation of each of the first plurality of anatomical tissue volumes for a plurality of patients produced the selected stimulation effect;

obtaining, by the computer processor, a second collection of a second plurality of anatomical tissue volumes for which previous stimulation of each of the second plurality of anatomical tissue volumes for a plurality of patients did not produce the selected stimulation effect, the first and second plurality of anatomical tissue volumes being registered to a common reference space;

comparing, by the processor, the first plurality of anatomical tissue volumes to the second plurality of anatomical tissue volumes;

based on the comparing, finding, by the processor, an area for the selected stimulation effect, wherein the area meets two criteria

(I) the area is included in either (a) at least a predetermined number of the first plurality of anatomical tissue volumes or (b) at least a predetermined percentage of the first plurality of anatomical tissue volumes; and

(II) the area is not included in either (a) at least a predetermined number of the second plurality of anatomical tissue volumes or (b) at least a predetermined percentage of the second plurality of anatomical tissue volumes;

for each of a plurality of sub-areas of the area, assigning, by the processor, the respective sub-area a respective score, wherein the assigning is performed by executing code that uses as input an identification of those of the first plurality of anatomical tissue volumes in which the respective sub-area is included;

executing, by the processor, code that uses the assigned scores as input to select a subset of the sub-areas, wherein the subset of sub-areas includes at least two of the sub-areas;

combining, by the processor, the sub-areas of the subset;

outputting, by the processor, a representation of the combined sub-areas as a target volume, wherein the target volume is indicated, when the selected stimulation effect is the therapeutic effect, to be stimulated or, when the selected stimulation effect is the side effect, where stimulation is to be avoided;

comparing the target volume with a plurality of volumes of activation (VOAs) wherein each of the VOAs corresponds to an estimate of a volume of tissue stimulated using a corresponding set of stimulation parameters;

selecting one of the volumes of activation based on the comparison with the target volume where the selected VOA either (a) overlaps with the target volume by a threshold amount when the target volume is indicated to be stimulated because the selected stimulation effect is the therapeutic effect or (b) does not overlap with the target volume by a threshold amount when the target volume is indicated as where stimulation is to be avoided because the selected stimulation effect is the side effect; and

stimulating a patient using the corresponding set of stimulation parameters for the selected VOA.

4. The method of claim 3, wherein:

when the selected stimulation effect is the side effect, the assigning includes computing the score for the respective sub-area using as input a respective quantified severity of the side effect recorded as being produced by stimulation of each of the first plurality of anatomical tissue volumes; and

each of the first plurality of anatomical tissue volumes is recorded as producing the side effect.

5. The method of claim 4, wherein:

the computing includes lowering the score for the respective sub-area in response to a determination that the respective sub-area is included in the second plurality of anatomical tissue volumes; and

each of the second plurality of anatomical tissue volumes is not recorded as producing the side effect.

6. A computer-implemented method for determining anatomical tissue regions that are relevant to stimulation, comprising:

receiving a selection of a stimulation effect, wherein the selected stimulation effect is either a therapeutic effect or a side effect;

obtaining, by a computer processor, a first collection of a first plurality of anatomical tissue volumes for which previous stimulation of each of the first plurality of anatomical tissue volumes for a plurality of patients produced the selected stimulation effect;

obtaining, by the computer processor, a second collection of a second plurality of anatomical tissue volumes for which previous stimulation of each of the second plurality of anatomical tissue volumes for a plurality of patients did not produce the selected stimulation effect, the first and second plurality of anatomical tissue volumes being registered to a common reference space;

comparing, by the processor, the first plurality of anatomical tissue volumes to the second plurality of anatomical tissue volumes;

based on the comparing, finding, by the processor, an area for the selected stimulation effect, wherein the area meets two criteria

(I) the area is included in either (a) at least a predetermined number of the first plurality of anatomical tissue volumes or (b) at least a predetermined percentage of the first plurality of anatomical tissue volumes; and

(II) the area is not included in either (a) at least a predetermined number of the second plurality of anatomical tissue volumes or (b) at least a predetermined percentage of the second plurality of anatomical tissue volumes;

for each of a plurality of sub-areas of the area, assigning, by the processor, the respective sub-area a respective score, wherein the assigning is performed by executing code that uses as input an identification of those of the first plurality of anatomical tissue volumes in which the respective sub-area is included;

executing, by the processor, code that uses the assigned scores as input to select a subset of the sub-areas, wherein the subset of sub-areas includes at least two of the sub-areas;

combining, by the processor, the sub-areas of the subset; and

generating and outputting, by the processor and executing code that uses the combined sub-areas of the subset as input, a representation of the combined sub-areas as a target volume, wherein the target volume is indicated, when the selected stimulation effect is the therapeutic effect, to be stimulated or, when the selected stimulation effect is the side effect, where stimulation is to be avoided;

comparing the target volume with a plurality of volumes of activation (VOAs) wherein each of the VOAs corresponds to an estimate of a volume of tissue stimulated using a correspoding set of stimulation paramenters;

selecting one of the volumes of activation based on the comparison with the target volume where the selected VOA either (a) overlaps with the target volume a threshold amount when the target volume is indicated to be stimulated because the selected stimulation effect is the therapeutic effect or (b) does not overlap with the target volume by a threshold amount when the target volume is indicated as where stimulation is to be avoided because the selected stimulation effect is the side effect; and

transmitting to a stimulation device the corresponding set of stimulation parameters for the selected VOA.

7. The method of claim 6, wherein:

when the selected stimulation effect is the side effect, the assigning includes computing the score for the respective sub-area using as input a respective quantified severity of the side effect recorded as being produced by stimulation of each of the first plurality of anatomical tissue volumes; and

each of the first plurality of anatomical tissue volumes is recorded as producing the side effect.

8. The method of claim 7, wherein:

the computing includes lowering the score for the respective sub-area in response to a determination that the respective sub-area is included in the second plurality of anatomical tissue volumes; and

each of the second plurality of anatomical tissue volumes is not recorded as producing the side effect.

9. A computer-implemented method for determining anatomical tissue regions that are relevant to stimulation, comprising:

receiving a selection of a stimulation effect, wherein the selected stimulation effect is either a therapeutic effect or a side effect;

obtaining, by a computer processor, a first collection of a first plurality of anatomical tissue volumes for which previous stimulation of each of the first plurality of anatomical tissue volumes for a plurality of patients produced the selected stimulation effect;

obtaining, by the computer processor, a second collection of a second plurality of anatomical tissue volumes for which previous stimulation of each of the second plurality of anatomical tissue volumes for a plurality of patients did not produce the selected stimulation effect, the first and second plurality of anatomical tissue volumes being registered to a common reference space;

comparing, by the processor, the first plurality of anatomical tissue volumes to the second plurality of anatomical tissue volumes;

based on the comparing, finding, by the processor, a target volume for the selected stimulation effect, wherein the target volume comprises a plurality of volume elements that each meet two criteria;

(a) the volume element is included in either a threshold number or a threshold percentage of the first plurality of anatomical tissue volumes and (b) the volume element is not included in either a threshold number or a threshold percentage of the second plurality of anatomical tissue volumes;

subsequent to the comparing, outputting, by the processor, a representation of the target volume found in the finding step, wherein the representation represents the target volume as an anatomical region and indicates, when the selected stimulation effect is the therapeutic effect, that the target volume is to be stimulated or, when the selected stimulation effect is the side effect, that stimulation is to be avoided in the target volume;

comparing the target volume with a plurality of volumes of activation (VOAs) wherein each of the VOAs corresponds to an estimate of a volume of tissue stimulated using a corresponding set of stimulation parameters;

selecting one of the volumes of activation based on the comparison with the target volume where the selected VOA either (a) overlaps with the target volume by a threshold amount when the target volume is to be stimulated because the selected stimulation effect is the therapeutic effect or (b) does not overlap with the target volume by a threshold amount when stimulation is to be avoided in the target volume because the selected stimulation effect is the side effect; and

transmitting to a stimulation device the corresponding set of stimulation parameters for the selected VOA.

10. The method of claim 9, wherein the obtaining steps include, prior to the comparing of the first plurality of anatomical tissue volumes to the second plurality of anatomical tissue volumes, registering the first and second pluralities of anatomical tissue volumes to the common reference space, the common reference space being a common atlas space.