Ablation planning system

Abstract

A method of operating a medical instrument (100, 200, 400, 500) is disclosed herein. The medical instrument includes a user interface (108) having a display. The method includes receiving (300) an anatomy segmentation (122) that identifies a location of an anatomical structure (416) and receiving (302) a target region segmentation (124) that identifies a location of a volume (416) that is at least partially within the anatomy segmentation. The method further includes displaying (304), using the display, a planning graphical user interface (112). The planning graphical user interface includes a first panel (130) configured for rendering a cross-sectional view of the anatomy segmentation (136) and the target region segmentation (138). The planning graphical user interface includes a second panel (132) configured for displaying a first three-dimensional model (140) of the anatomy segmentation and the target region segmentation. The planning graphical user interface further includes a third panel (134) configured for displaying a second three-dimensional model (142) of a remaining portion of the target region segmentation. The planning graphical user interface further includes an ablation selector (144, 144', 146) configured for providing an ablation region. The method further includes repeatedly: receiving (306) an ablation region from the ablation selector; and updating (308) the remaining portion by removing the ablation region from the remaining portion.

Description

Technical Field

[0001] This invention relates to tissue ablation systems, and more particularly to ablation planning. Background Technology

[0002] In tissue ablation, an ablation probe is inserted into the subject to locally ablate the tissue. Various types of probes exist for ablation. For example, thermal, cold, radiofrequency power, and lasers can all be used to ablate tissue.

[0003] U.S. Patent Application Publication US20150320509A1 discloses a system for assisting in surgical procedures. In one example, a first image of the patient is captured before surgery. A treatment plan is generated based on the first image. The treatment plan includes information related to one or more surgical instruments. A second image of the patient is captured after surgery has begun. The treatment plan is dynamically adjusted based on the posture of any one of the one or more surgical instruments identified from the second image. A third image of the patient is captured after the lesion has been treated by at least one surgical instrument based on the adjusted treatment plan. Based on the third image, it is determined whether further treatment of the lesion is needed. If further treatment is determined to be needed, an updated treatment plan is dynamically generated based on the third image. Summary of the Invention

[0004] This invention provides medical devices, computer programs, and methods as described in the independent claims. Examples are given in the dependent claims.

[0005] A challenging aspect of accurately performing tissue ablation is accurately planning the ablation process. This embodiment provides a system that facilitates ablation planning. Anatomical segments and target region segments are received and then used to render several 3D models on a planning graphical user interface. A first 3D model shows the anatomical segments and target region segments. A second 3D model shows the remaining portion of the target region segment. An ablation region selector on the planning graphical user interface allows selection of ablation regions. The system then updates the remaining portion (the second 3D model) by removing ablation regions from the remaining portion. This process can be repeated to plan the entire ablation.

[0006] In one aspect, the present invention provides a medical device including a user interface. The user interface includes a display. The medical device also includes a memory storing machine-executable instructions. The medical device further includes a computing system configured to control the medical device. In different examples, the medical device may take different forms. In some examples, the medical device is a workstation or a computing system. In other examples, the medical device may include other components such as an ablation system.

[0007] The execution of machine-executable instructions causes the computational system to receive anatomical segmentation that identifies the location of anatomical structures. Anatomical segmentation can be a form of segmentation of a medical image. In other examples, anatomical segmentation is the simple identification of regions of anatomical structures independent of a medical image. The execution of the machine-executable instructions also causes the computational system to receive target region segmentation that identifies the location of a volume at least partially within the anatomical segmentation. This volume may also be referred to as the target region.

[0008] The execution of machine-executable instructions also enables the processor to display a planning graphical user interface (GUI) on a monitor. The GUI includes a first panel configured to render cross-sectional views of anatomical segmentation and target region segmentation. The GUI also includes a second panel configured to display renderings of a first 3D model of the anatomical segmentation and target region segmentation.

[0009] The rendering of the first 3D model can be, for example, a 2D rendering of the 3D model. In other examples, 3D rendering can be used. The planning graphical user interface also includes a third panel configured to render a second 3D model of the remaining portion of the target region segmentation. The planning graphical user interface also includes an ablation selector configured to provide an ablation region describing the volume at least partially within the remaining portion.

[0010] The execution of machine-executable instructions also causes the computing system to repeatedly receive ablation regions from the ablation selector. The execution of machine-executable instructions further causes the computing system to repeatedly update the remaining portion by removing ablation regions from it. This embodiment can be beneficial because it can aid in ablation planning. Displaying the remaining portion can assist in the selection of appropriate ablation regions.

[0011] In another embodiment, the ablation selector is configured to receive a selection of a volume within the remaining portion. Execution of machine-executable instructions further causes the processor to generate an ablation region in response to receiving a volume selection from the ablation selector. For example, a user interface may display the possible volumes that can be ablated.

[0012] In another embodiment, the ablation selector is configured to receive a selection of a trajectory intersecting the remaining portion. Execution of machine-executable instructions also causes the processor to generate an ablation region in response to receiving a selection of a trajectory from the ablation selector. A particular ablation system may have a guide or insertion point into which a probe can be inserted. The user interface may, for example, display possible trajectories from which a physician or other operator can select, and then the ablation can be planned and the projected results can be viewed.

[0013] In another embodiment, the memory also includes an automatic planning module configured to output an ablation region in response to an input remainder. An ablation selector is configured to receive an automatic planning request. Execution of machine-executable instructions further causes the processor to generate an ablation region by inputting the remainder into the automatic planning module in response to receiving the automatic planning request. The automatic planning module can be implemented in various ways, for example. In one example, a neural network can be used to select an ablation region in response to an existing remainder. In other examples, the automatic planning module can use a search algorithm that examines all possible choices and then selects an ablation region that matches predetermined criteria. For example, an ablation region can be selected such that the maximum amount of tissue is ablated.

[0014] In another embodiment, execution of the machine-executable instructions also causes the processor to generate insertion instructions for inserting the ablation probe in response to receiving the ablation region from the ablation selector. Medical devices, for example, can aid in planning ablation procedures. Insertion instructions can be provided for use by physicians or medical technicians during or after planning.

[0015] In another embodiment, the medical device includes an ablation probe system comprising ablation probes. The medical device also includes an ablation probe tracking system registered to an anatomical segment. The ablation probe tracking system can be implemented in various different ways, for example. For instance, radio frequency tags or other transmitters may be present on the ablation probes, enabling tracking. In other cases, the ablation probe tracking system may use at least partially input medical images, such as those from a CT system or a magnetic resonance imaging system, to track the probes.

[0016] The execution of the machine-executable instructions also causes the computing system to receive probe tracking data from the ablation probe. The execution of the machine-executable instructions further causes the computing system to use the probe tracking data to update the remainder. When the ablation probe is actually inserted into the subject, the actual area reached by the ablation probe may differ from the expected area. In this embodiment, the remainder is updated to match the actual location of the ablation probe.

[0017] In another embodiment, the ablation probe is a radiofrequency ablation probe.

[0018] In another embodiment, the ablation probe is a microwave ablation probe.

[0019] In another embodiment, the ablation probe is a high-intensity focused ultrasound ablation probe.

[0020] In another embodiment, the ablation probe is a focused or focused laser ablation probe.

[0021] In another embodiment, the ablation probe is an irreversible electroporation probe.

[0022] In another embodiment, the ablation probe is a cryoablation probe.

[0023] In another embodiment, the medical device further includes a guided medical imaging system. Execution of the machine-executable instructions also causes the computing system to control the guided medical imaging system to acquire real-time guided medical imaging data during the acquisition of tracking data from the ablation probe. Execution of the machine-executable instructions also causes the computing system to display the real-time guided medical imaging data on a user interface in real time. The real-time guided medical imaging data can be used, for example, to accurately track and locate the probe's position and also to update the remainder.

[0024] In another embodiment, the guiding medical imaging system is a computed tomography (CT) system.

[0025] In another embodiment, the guiding medical imaging system is an ultrasound imaging system.

[0026] In another embodiment, the guiding medical imaging system is a magnetic resonance imaging system.

[0027] In another embodiment, the guiding medical imaging system is an X-ray fluorescence microscope.

[0028] In another embodiment, execution of machine-executable instructions further causes the computing system to receive a planned magnetic resonance imaging (MRI) image describing a region of interest of the subject. Anatomical segmentation identifies the location of anatomical structures within the planned MRI image. The first panel is also configured to render cross-sectional views of the planned MRI image.

[0029] In another embodiment, the memory also stores an automatic segmentation algorithm configured to generate anatomical segmentation and / or target region segmentation in response to an input planning magnetic resonance image. Execution of the machine-executable instructions further causes the processor to generate anatomical segmentation and / or target region segmentation by inputting the planning magnetic resonance image into the automatic segmentation algorithm.

[0030] Automatic segmentation algorithms can be implemented in several ways. In one example, the automatic segmentation algorithm is implemented as a neural network. In other examples, the automatic segmentation algorithm can perform segmentation by using anatomical atlases. In yet another example, the automatic segmentation algorithm uses a deformable shape model to perform segmentation.

[0031] In another embodiment, the medical device further includes a planning magnetic resonance imaging system configured to acquire planned k-space data of a subject. The planning of labels on the planned magnetic resonance images is intended to indicate a specific magnetic resonance imaging system. Similarly, the term "planned k-space data" is intended to refer to specific k-space data, while the word "planned" is used as a label. The memory also includes planning pulse sequence commands configured to control the magnetic resonance imaging system to acquire the planned k-space data.

[0032] The execution of machine-executable instructions also enables the computing system to control the planning magnetic resonance imaging system with planning pulse sequence commands to acquire planning k-space data. The execution of these machine-executable instructions further enables the computing system to reconstruct planning magnetic resonance images from the planning k-space data.

[0033] In another embodiment, the display is a three-dimensional display. This could be, for example, a display provided by goggles or other virtual reality or augmented reality systems. Execution of the machine-executable instructions also causes the processor to use the three-dimensional display to render the first three-dimensional model and the second three-dimensional model in three dimensions.

[0034] In another aspect, the present invention provides a computer program comprising machine-executable instructions for execution by a computing system controlling a medical device. The medical device includes a user interface including a display. Execution of the machine-executable instructions causes the computing system to receive anatomical segments that identify the locations of anatomical structures. Execution of the machine-executable instructions also causes the computing system to receive target region segments that identify the locations of volumes at least partially within the anatomical segments. Execution of the machine-executable instructions further causes the computing system to display a planned graphical user interface on the display.

[0035] The planning graphical user interface includes a first panel configured to render cross-sectional views of the anatomical segmentation and target region segmentation. The planning graphical user interface also includes a second panel configured to display a rendering of the first 3D model of the anatomical segmentation and target region segmentation. The planning graphical user interface further includes a third panel configured to render a second 3D model of the remaining portion of the target region segmentation. The planning graphical user interface also includes an ablation selector configured to provide an ablation region describing the volume at least partially within the remaining portion.

[0036] The execution of machine-executable instructions also causes the computing system to repeatedly receive ablation regions from the ablation selector. Furthermore, the execution of machine-executable instructions causes the computing system to repeatedly update the remainder by removing ablation regions from it.

[0037] In another aspect, the present invention provides a method of operating a medical device. The medical device includes a user interface. The user interface includes a display. The method includes receiving an anatomical segment that identifies the location of anatomical structures. The method also includes receiving a target region segment that identifies the location of a volume at least partially within the anatomical segment. The method further includes displaying a planning graphical user interface on the display. The planning graphical user interface includes a first panel configured to render cross-sectional views of the anatomical segment and the target region segment.

[0038] The planning graphical user interface also includes a second panel configured to display a rendering of the first 3D model of the anatomical segmentation and target region segmentation. The planning graphical user interface also includes a third panel configured to render a second 3D model of the remaining portion of the target region segmentation. The planning graphical user interface also includes an ablation selector configured to provide ablation regions describing volumes at least partially within the remaining portion. The method also includes repeatedly receiving ablation regions from the ablation selector. The method also includes repeatedly updating the remaining portion by removing ablation regions from it.

[0039] It should be understood that one or more of the above embodiments of the present invention can be combined, as long as the combined embodiments are not mutually exclusive.

[0040] As will be understood by those skilled in the art, aspects of the present invention can be implemented as apparatus, method, or computer program product. Accordingly, aspects of the present invention can take the form of a completely hardware embodiment, a completely software embodiment (including firmware, resident software, microcode, etc.), or an embodiment combining software and hardware aspects, all of which can be collectively referred to herein as “circuit,” “module,” or “system.” Furthermore, aspects of the present invention can take the form of a computer program product embodied in one or more computer-readable media(s) having computer-executable code implemented thereon.

[0041] Any combination of one or more computer-readable media(s) can be used. A computer-readable medium can be a computer-readable signal medium or a computer-readable storage medium. As used herein, "computer-readable storage medium" includes any tangible storage medium that can store instructions executable by a processor or computing system of a computing device. A computer-readable storage medium can be referred to as a computer-readable non-transient storage medium. A computer-readable storage medium can also be referred to as a tangible computer-readable medium. In some embodiments, a computer-readable storage medium can also store data accessible by a computing system of a computing device. Examples of computer-readable storage media include, but are not limited to: floppy disks, magnetic hard disk drives, solid-state drives, flash memory, USB thumb drives, random access memory (RAM), read-only memory (ROM), optical disks, magneto-optical disks, and register files of computing systems. Examples of optical disks include optical discs (CDs) and digital versatile discs (DVDs), such as CD-ROMs, CD-RWs, CD-Rs, DVD-ROMs, DVD-RWs, or DVD-R discs. The term computer-readable storage medium also refers to various types of recording media accessible by a computer device via a network or communication link. For example, data can be retrieved via a modem, via the Internet, or via a local area network. Computer-executable code embodied on a computer-readable medium may be transmitted using any suitable medium, including but not limited to wireless, wired, fiber optic cable, RF, or any suitable combination thereof.

[0042] A computer-readable signal medium may include, for example, a propagated data signal in which (e.g., in baseband or as part of a carrier wave) embodies computer-executable code. Such a propagated signal may take any of a variety of forms, including, but not limited to, electromagnetic, optical, or any suitable combination thereof. A computer-readable signal medium may be any computer-readable medium that is not a computer-readable storage medium and may communicate, propagate, or transmit programs for use by or in connection with an instruction execution system, apparatus, or device.

[0043] "Computer memory" or "memory" is an example of a computer-readable storage medium. Computer memory is any memory that can be directly accessed by a computing system. "Computer storage" or "storage" is another example of a computer-readable storage medium. Computer storage is any non-volatile computer-readable storage medium. In some embodiments, computer storage can also be computer memory, and vice versa.

[0044] As used herein, "computing system" includes electronic components capable of executing programs or machine-executable instructions or computer-executable code. References to computing systems that include examples of "computing system" should be interpreted as potentially including more than one computing system or processing core. A computing system can be, for example, a multi-core processor. A computing system can also refer to a collection of computing systems within a single computer system or distributed across multiple computer systems. The term "computing system" should also be interpreted as potentially referring to a collection or network of computing devices, each including a processor or computing system. Machine-executable code or instructions can be executed by multiple computing systems or processors, which may be within the same computing device or even distributed across multiple computing devices.

[0045] Machine-executable instructions or computer-executable code may include instructions or programs that cause a processor or other computing system to perform one aspect of the invention. Computer-executable code for performing operations aimed at the aspects of the invention may be written in any combination of one or more programming languages, including subject-oriented programming languages ​​such as Java, Smalltalk, C++, etc., and conventional procedural programming languages ​​such as the "C" programming language or similar programming languages, and compiled into machine-executable instructions. In some cases, the computer-executable code may be in the form of a high-level language or a pre-compiled form, and may be used in conjunction with an interpreter that generates machine-executable instructions on the spot. In other cases, the machine-executable instructions or computer-executable code may be in the form of a programmable gate array.

[0046] Computer executable code can execute entirely on the user's computer, partially on the user's computer, as a standalone software package, partially on the user's computer and partially on a remote computer, or entirely on a remote computer or server. In the latter case, the remote computer can be connected to the user's computer via any type of network, including a local area network (LAN) or a wide area network (WAN), or connected to an external computer (e.g., via the Internet provided by an Internet service provider).

[0047] Various aspects of the invention are described with reference to flowchart illustrations and / or block diagrams of methods, apparatus (systems), and computer program products according to embodiments of the invention. It should be understood that each block or portion of a block in a flowchart, illustration, and / or block diagram may, where applicable, be implemented by computer program instructions in the form of computer-executable code. It should also be understood that combinations of blocks in different flowcharts, illustrations, and / or block diagrams may be combined when not mutually exclusive. These computer program instructions may be provided to a computing system of a general-purpose computer, special-purpose computer, or other programmable data processing apparatus to produce a machine, such that the instructions, executable via the computing system of the computer or other programmable data processing apparatus, create means for implementing the functions / actions specified in one or more blocks of the flowchart and / or block diagram.

[0048] These machine-executable instructions or computer program instructions may also be stored in a computer-readable medium that can instruct a computer, other programmable data processing apparatus or other device to function in a particular manner, such that the instructions stored in the computer-readable medium produce an article of writing, which includes instructions that implement the functions / actions specified in one or more boxes of a flowchart and / or block diagram.

[0049] Machine-executable instructions or computer program instructions may also be loaded onto a computer, other programmable data processing apparatus or other device to cause a series of operational steps to be performed on the computer, other programmable apparatus or other device to produce a computer-implemented process, such that the instructions that execute on the computer or other programmable apparatus provide a process for implementing the function / action specified in one or more boxes of a flowchart and / or block diagram.

[0050] The term "user interface" as used herein refers to an interface that allows a user or operator to interact with a computer or computer system. A "user interface" can also be referred to as a "human-machine interface device." A user interface can provide information or data to and / or receive information or data from an operator. A user interface enables the computer to receive input from the operator and to provide output from the computer to the user. In other words, a user interface allows an operator to control or manipulate a computer, and the interface allows the computer to indicate the effects of the operator's control or manipulation. The display of data or information on a monitor or graphical user interface is an example of providing information to an operator. Receiving data via a keyboard, mouse, trackball, touchpad, pointing stick, graphics tablet, joystick, gamepad, webcam, headset, pedal, wired gloves, remote control, and accelerometer are all examples of user interface components that enable the reception of information or data from an operator.

[0051] As used herein, "hardware interface" includes interfaces that enable a computer system to interact with and / or control external computing devices and / or devices. A hardware interface may allow the computing system to send control signals or instructions to external computing devices and / or devices. A hardware interface may also enable the computing system to exchange data with external computing devices and / or devices. Examples of hardware interfaces include, but are not limited to: Universal Serial Bus (USB), IEEE 1394 port, parallel port, IEEE 1284 port, serial port, RS-232 port, IEEE-488 port, Bluetooth connectivity, wireless LAN connectivity, TCP / IP connectivity, Ethernet connectivity, control voltage interface, MIDI interface, analog input interface, and digital input interface.

[0052] As used herein, “display” or “display device” includes output devices or user interfaces suitable for displaying images or data. Displays can output visual, audio, and / or tactile data. Examples of displays include, but are not limited to: computer monitors, television screens, touchscreens, tactile electronic displays, Braille screens, cathode ray tubes (CRTs), memory tubes, bistable displays, electronic paper, vector displays, flat panel displays, vacuum fluorescent displays (VFs), light-emitting diode (LED) displays, electroluminescent displays (ELDs), plasma display panels (PDPs), liquid crystal displays (LCDs), organic light-emitting diode (OLED) displays, projectors, and head-mounted displays.

[0053] K-space data are defined in this paper as the recorded measurement of radio frequency signals emitted by atomic spins using the antenna of a magnetic resonance imaging (MRI) device during a magnetic resonance imaging (MRI) scan. MRI data is an example of tomographic medical image data.

[0054] Magnetic resonance imaging (MRI), MR, or MRI data are defined herein as a two-dimensional or three-dimensional visualization of reconstructed anatomical data included within MRI data. This visualization can be performed using a computer. Attached Figure Description

[0055] In the following description, preferred embodiments of the invention will be illustrated by way of example only and with reference to the accompanying drawings, in which:

[0056] Figure 1 An example of a medical device is shown;

[0057] Figure 2 Another example of a medical device is shown;

[0058] Figure 3 The instructions are shown. Figure 1 or Figure 2 A flowchart of a method for manufacturing medical devices;

[0059] Figure 4 Another example of a medical device is shown;

[0060] Figure 5 Another example of a medical device is shown;

[0061] Figure 6 An example of a planned magnetic resonance imaging is shown;

[0062] Figure 7 It shows having Figure 6 Segmented ultrasound images;

[0063] Figure 8 The rendering of the second 3D model is shown;

[0064] Figure 9 Further rendering of the second 3D model is shown; and

[0065] Figure 10 The rendering of the perineal mesh template is shown. Detailed Implementation

[0066] Elements with the same numbers in these figures are equivalent elements or perform the same function. If the functions are equivalent, elements already discussed above need not be discussed in the following figures.

[0067] Figure 1 An example of a medical device 100 is shown. The medical device 100 is shown to include a computer 102 in this particular example. The computer 102 is shown to include an optional hardware interface 104. The hardware interface 104 can, for example, be used to control other components of the medical device 100 (if they are present). The medical device 100 is also shown to include a computing system 106. The computing system 106 is intended to represent one or more computing systems or devices (such as the processor of another computer). The computing system 106 may also be distributed across multiple locations. The medical device 100 is also shown to include a user interface 108. The user interface includes a graphical user interface 112. The medical device 100 is also shown to include memory 110. Memory 110 represents any memory accessible to the computing system 106.

[0068] Figure 1 The medical device 100 shown can be a component or part of various types of systems. In one example, the medical device 100 is a workstation or computing device for planning. In another example, the medical device 100 can be integrated with an ablation probe or ablation probe system. In yet another example, the medical device 100 can be integrated with magnetic resonance imaging or other medical imaging systems.

[0069] Memory 110 is also shown to include an optional auto-planning module 126. The auto-planning module can be configured to output a selected ablation region in response to the remaining input. Memory 128 is also shown to include insertion instructions 128, which can be presented on an optional display for insertion instructions 148. For example, insertion instructions 128 may include instructions on where and how far to insert the ablation probe.

[0070] The graphical user interface 112 is shown to include a first panel 130, a second panel 132, and a third panel 134. The first panel is configured to render cross-sectional views of anatomical segment 136 and target region segment 138. The first panel 130 can also be configured to display cross-sections of medical images, such as magnetic resonance imaging, using these two cross-sectional views of segments 136 and 138.

[0071] The second panel 132 is configured to display a rendering of the first 3D model 140. The first 3D model 140 is a 3D model of the anatomical segmentation 122 and the target region segmentation 124. The second panel 132 can be useful because it can display the 3D models of segments 122 and 124 without any other medical imaging data, and also in a 3D manner.

[0072] The third panel 134 displays a second three-dimensional model 142, showing the remaining portion of the target region segment 124. Displayed within panel 134 are multiple ablation region selectors 144, which represent volumes. These correspond to volumes in the target region 124 that the operator can select for further ablation. Various actions can occur after the ablation region selector 144 is removed. For example, the region can be removed from the target region segment 124 to reveal a smaller volume or area that still needs ablation. It can also cause an insertion instruction 128 to be generated. In some examples, the medical device 100 can be used purely for planning purposes. For example, the insertion instruction 128 can be followed at a later time. In other examples, the medical device 100 can be integrated with an ablation probe and / or a medical imaging system for tracking and real-time updating of the remaining portion 142.

[0073] An optional auto-planning request control 146 is also shown on the planning graphical user interface 112. For example, when the operator activates the button 146, the auto-planning module 126 can automatically select one of the ablation region selectors 144.

[0074] Figure 2 Another example of medical device 200 is shown. Figure 2 Medical devices 200 in the middle are similar to Figure 1In the medical device 100, instead of an ablation region selector for selecting volume in this example, the ablation region selector selects a trajectory 144'. These could be, for example, selections for different insertion points of the ablation probe. Once trajectory 144' is selected, the ablation region to be ablated can be determined, and this region can be removed or subtracted from the remaining portion 142.

[0075] Figure 3 The instructions are shown. Figure 1 Medical devices 100 or Figure 2 The flowchart describes a method for using a medical device 200. First, in step 300, an anatomical segment 122 is received, identifying the location of anatomical structures. Next, in step 302, a target region segment 124 is received, identifying the location of volumes at least partially within the anatomical segment. Next, in step 304, a planning graphical user interface 112 is displayed. The planning graphical user interface 112 includes a first panel 130 configured to render cross-sectional views of the anatomical segment 136 and the target region segment 138. The planning graphical user interface 112 also includes a second panel 132 configured to display renderings of a first three-dimensional model 140 of the anatomical segment 122 and the target region segment 124.

[0076] The planning graphical user interface 112 also includes a third panel 134 configured to render a second 3D model 142 of the remaining portion of the target region segmentation. The planning graphical user interface also includes ablation selectors 144, 144' configured to provide ablation regions describing volumes at least partially within the remaining portion. The method then proceeds to step 306. In step 306, ablation regions are received from the ablation region selectors 144, 144'. Then, in step 308, the remaining portion 142 is updated by removing ablation regions from the remaining portion. This makes the remaining portion smaller. The method then proceeds to decision box 310. In this step, it queries whether the iteration is complete. If the answer is no, the method returns to step 306 and selects another ablation region. If the answer is yes, the method proceeds to step 312, and... Figure 3 The method shown is now complete.

[0077] Figure 4 Another example of medical device 400 is shown. Figure 4 Medical devices 400 in the middle are similar to Figure 1 and Figure 2Medical devices 100 and 200 are depicted. Medical device 400 additionally includes a guided medical imaging system 402 and an ablation probe tracking system 412. An ablation probe system 406 is also shown. The guided medical imaging system 402 can represent any number of different medical imaging modalities, which can be used to track the insertion of the ablation probe 406. The guided medical imaging system 402 has an imaging region 404 from which guided medical image data 422 can be acquired. A subject 408 is shown on a subject support 410 and supported such that anatomical structures 416 and target areas 418 are within the imaging region 404.

[0078] The graphical user interface 112 is also shown as having a real-time rendering 424 of guided medical image data 422 acquired by the guided medical imaging system 402. It clearly shows the position of the ablation probe 406. The medical device 400 is also shown to include an ablation probe tracking system 412. This may include, for example, electronics capable of locating and orienting the ablation probe 406, thereby allowing for better determination of which area of ​​the subject 408 was actually ablated by the probe 406. This can be used to update or correct the remaining portion 142.

[0079] Figure 5 Another example of medical device 500 is shown. In addition to medical device 500, it also includes a planned magnetic resonance imaging system 502. Figure 5 Medical device 500 is similar to medical devices 100 and 200. The planned magnetic resonance imaging system 502 is a magnetic resonance imaging system. The term "planned" in the context of the planned magnetic resonance imaging system simply refers to a label. Similarly, planning labels are used for pulse sequence commands, k-space data, and images from this planned magnetic resonance imaging system 502. Figure 5 Features can be compared with Figure 4 The features can be freely combined. In some cases, the planning magnetic resonance imaging system 502 can be the same as the guiding medical imaging system 402.

[0080] The planned magnetic resonance imaging system 502 includes a magnet 504. Magnet 504 is a superconducting cylindrical magnet with a hole 506 passing through it. Different types of magnets can also be used; for example, separate cylindrical magnets and so-called open magnets can also be used. Separate cylindrical magnets are similar to standard cylindrical magnets, except that the cryostat is divided into two parts to allow access to the isoplanar surface of the magnet; such magnets can be used, for example, in conjunction with charged particle beam therapy. Open magnets have two magnet sections, one on top of the other, with a space in the middle large enough to accommodate the subject: the arrangement of the two sections is similar to the arrangement of Helmholtz coils. Open magnets are popular because the subject is less restricted. Inside the cryostat of the cylindrical magnet is an assembly of superconducting coils.

[0081] An imaging region 508 exists within the aperture 506 of a cylindrical magnet 504, wherein the magnetic field is sufficiently strong and homogeneous to perform magnetic resonance imaging. A region of interest 509 is shown within the imaging region 508. The acquired k-space data is typically acquired for the region of interest. A subject 408 is shown supported by a subject scaffold 520 such that at least a portion of the subject 408 is within both the imaging region 508 and the region of interest 509. Anatomical structures 416 and the target region 418 are within the field of view 509, which is also within the imaging region 508.

[0082] Within the aperture 506 of the magnet, there is also a set of magnetic field gradient coils 510, which are used to acquire preliminary magnetic resonance data for spatial encoding of magnetic spins within the imaging region 508 of the magnet 504. The magnetic field gradient coils 510 are connected to a magnetic field gradient coil power supply 512. The magnetic field gradient coils 510 are intended to be representative. Typically, the magnetic field gradient coils 510 comprise three separate sets of coils for spatial encoding in three orthogonal spatial directions. The magnetic field gradient power supply supplies current to the magnetic field gradient coils. The current supplied to the magnetic field gradient coils 510 is controlled as a function of time and can be ramped or pulsed.

[0083] Adjacent to the imaging region 508 is an RF coil 514, which is used to manipulate the orientation of magnetic spins within the imaging region 508 and to receive radio transmissions from spins within the imaging region 508. The RF antenna may include multiple coil elements. The RF antenna may also be referred to as a channel or antenna. The RF coil 514 is connected to an RF transceiver 516. The RF coil 514 and the RF transceiver 516 may be replaced by separate transmit and receive coils and separate transmitters and receivers. It should be understood that the RF coil 514 and the RF transceiver 516 are representative. The RF coil 514 is also intended to represent a dedicated transmit antenna and a dedicated receive antenna. Similarly, the transceiver 516 may also represent a separate transmitter and receiver. The RF coil 514 may also have multiple receive / transmit elements, and the RF transceiver 516 may have multiple receive / transmit channels. For example, if a parallel imaging technique such as SENSE is performed, the RF coil 514 will have multiple coil elements.

[0084] Transceiver 516 and gradient controller 512 are shown as hardware interface 104 connected to computer system 102.

[0085] Memory 110 is also shown to include planning pulse sequence commands 530. Planning pulse sequence commands 530 are pulse sequence commands. Planning pulse sequence commands 530 are data or commands that can be converted into commands that control the planning magnetic resonance imaging system 502 to acquire planning k-space data 532. Planning k-space data 532 is k-space data. Memory 110 is also shown to include planning magnetic resonance images 534. Planning magnetic resonance images are reconstructed from planning k-space data 532 and can be segmented. Memory 110 is also shown to include an automatic segmentation algorithm 536 capable of automatically generating anatomical segments 122 and / or target region segments 124 using the planning magnetic resonance image 534 as input. In some cases, these segments can also be provided manually using the planning graphical user interface 112.

[0086] In thermal tumor ablation procedures (and potentially other types of ablation), it is beneficial to completely cover the tumor to eradicate the disease without ablating surrounding critical structures. For this purpose, planning can be created in advance, but a real-time feedback mechanism is lacking during the placement of the ablation applicator and the execution of the ablation.

[0087] Examples can provide feedback mechanisms to help clinicians assess tumor coverage, and in particular, identify untreated areas within the tumor. The system includes visualization of untreated areas in 2D and 3D, along with associated interactive mechanisms.

[0088] Examples are often particularly relevant to the field of thermal ablation and specifically address the need to support the identification of untreated areas. However, the disclosures below also relate to many other types of ablation.

[0089] Percutaneous thermal ablation is an interventional cancer treatment option that has seen a significant increase in adoption over the past decade and is projected to continue growing at a CAGR of 8%–10% through 2024. Various ablation modalities can be used to deliver thermal ablation, including radiofrequency (RF), microwave (MW), high-intensity focused ultrasound (HIFU), focused laser ablation (FLA), irreversible electroporation (IRE), cryoablation, and more.

[0090] In clinical practice, these ablation procedures involve placing one or more ablation applicators (ablation probes 406) within or near the target area (target area 418) with the aid of image guidance. Typically, physicians place these needle applicators based on information provided by the manufacturer while reviewing real-time ultrasound or interventional radiology images (CT / MR), leading to clinical trial results and personal experience. The use of more advanced ablation therapy planning systems (ATPS) for planning ablation and guide needle placement, similar to radiation therapy planning systems (RTPS) used in brachytherapy, has not been widely adopted due to its limited availability.

[0091] In current ablation procedures, quality assurance is limited. Most procedures are performed without planning, and if planning is defined, it is visualized by showing the covered / treated areas, rather than directly reflecting the existence of small untreated areas (“gaps”) between individual ablations within the target area.

[0092] An example could provide an ablation therapy guidance system capable of displaying the untreated area (remaining portion 142) within the target area. This display (planning graphical user interface 112) is an interactive 3D rendering that allows the user to determine where to place additional applicators to cover the untreated area.

[0093] Given the discrete binary representations of the lesion L (target region 418) to be treated and the ablation region Z (600), the untreated region U (remaining portion 142) can be calculated using the following equation:

[0094]

[0095] For visualization purposes, it may be necessary to convert the binary region U into a mesh or contour structure. For this purpose, calculations may include traveling squares or traveling cubes as post-processing steps.

[0096] Untreated areas can be visualized in 2D, for example, on top of a multi-plane reformatization (MPR) visualization of a 3D image volume covering the area to be treated, or on a real-time US image registered to the applicator plan via real-time tracking.

[0097] the following Figure 6 and Figure 7 An example of 2D visualization of untreated areas is provided. Figure 6 An example of a planned magnetic resonance image 534 is shown. A visible anatomical segmentation 122 exists, featuring a target region segmentation 124 and an ablation region 600.

[0098] Figure 7 The locations of the same segments 122, 124 and ablation region 600 in ultrasound image 700 are shown. The location of the suggested position for ablation probe 702 is also shown.

[0099] The untreated area (remaining portion 142) can be visualized in 3D, for example, by revealing the relative position of the untreated area with respect to the surrounding tissue through a shaded surface combined with other anatomical parts.

[0100] Figure 8 and Figure 9 Two views of the third panel 134 are shown. Figure 8In the remaining portion 142, the entire target region is segmented 124. An ablation region 144 has been selected. After selecting the ablation region 144, the volume of the ablation region is removed from the remaining portion 142. Figure 9 The remaining portion 142 after the ablation region 144 has been removed is shown.

[0101] In transperineal prostate surgery, visualization may include a transperineal mesh template (needle-guided device) through which the applicator is inserted. This allows the user to determine the correct method for covering untreated areas.

[0102] Figure 10 Visualized alternative devices are shown. Figure 10 The image shown is a rendering of a perineal mesh template, which is arranged in a matrix of circles labeled AM and I-13. These represent different locations where ablation probes can be inserted. Below this mesh 1000, the ablation area 600 and the remaining portion 124 are shown. The overlay of 600 within 124 on mesh 1000 helps the operator visualize the correct placement of the ablation probe.

[0103] When including areas targeting both healthy tissue and at-risk organs, these 3D surface renderings may be generated using advanced techniques such as glass rendering.

[0104] When untreated areas are visualized in 3D rendering, the system can incorporate navigation assistance, along with MPR visualization of the 3D image volume of the areas to be treated, to locate the MPR viewer based on the clicked untreated areas visualized in the 3D rendering.

[0105] In some examples, when the untreated area is visualized, users can plan ablation within the untreated area using the following clicks:

[0106] By clicking on a location in the untreated area (in the MPR view or 3D rendering),

[0107] By clicking through the needle trajectory across the untreated area (e.g., clicking through the mesh holes in prostate surgery), and

[0108] Start automatic planning by clicking the button.

[0109] Visualization of untreated areas plays a crucial role during two decision-making moments in the ATPS-guided ablation process.

[0110] The first step is the review and approval of the plan to be implanted by the user. Before starting, the user can review their plan to assess whether there are any remaining uncovered areas in the target lesion.

[0111] The second step is after the applicator is placed, where small deviations from the plan are unavoidable. This deviation may introduce small untreated areas between applicators, which can now be easily visualized. If gaps exist, the user can decide to plan additional ablation, placing the applicator in the untreated area, or accept the gap as is. Examples may provide medical devices with one or more of the following characteristics:

[0112] A medical device capable of calculating and displaying untreated areas within the target area for ablation therapy.

[0113] Medical devices that enable visualization of untreated areas relative to needle-guided devices.

[0114] Medical devices capable of calculating new ablation plans to cover untreated areas.

[0115] Medical devices that use 2D rendering technology to display untreated areas.

[0116] Medical devices that use 3D rendering technology to display untreated areas.

[0117] Although the invention has been described and illustrated in detail in the accompanying drawings and the foregoing description, such description and illustration should be considered illustrative or exemplary rather than restrictive; the invention is not limited to the disclosed embodiments.

[0118] By studying the accompanying drawings, the disclosure, and the appended claims, those skilled in the art can understand and implement other variations of the disclosed embodiments when practicing the claimed invention. In the claims, the word "comprising" does not exclude other elements or steps, and the indefinite articles "a" or "an" do not exclude a plurality. A single processor or other unit can perform the functions of several items described in the claims. The mere fact that certain measures are recited in mutually different dependent claims does not indicate that combinations of these measures cannot be advantageously used. Computer programs can be stored / distributed on suitable media, such as optical storage media or solid-state media supplied with or as part of other hardware, but can also be distributed in other forms, such as via the Internet or other wired or wireless telecommunications systems. Any reference numerals in the claims should not be construed as limiting the scope.

[0119] List of reference numerals

[0120] 100 Medical Devices

[0121] 102 Computer

[0122] 104 Hardware Interfaces

[0123] 106 Computing System

[0124] 108 User Interface

[0125] 110 Memory

[0126] 112 Planning the Graphical User Interface

[0127] 120 Machine-executable instructions

[0128] 122 Anatomical segmentation

[0129] 124 Target Region Segmentation

[0130] 126 Automatic Planning Module

[0131] 128 Insertion Command

[0132] 130 First Panel

[0133] 132 Second Panel

[0134] 134 Third Panel

[0135] 136. Cross-sectional view of anatomical segmentation

[0136] 138 Cross-sectional view of target region segmentation

[0137] 140 First 3D Model

[0138] 142 The second three-dimensional model of the remaining part

[0139] 144 Ablation Region Selector (Volume Selector)

[0140] 144' Ablation Region Selector (Trajectory Selector)

[0141] 146 Automatic Planning Request Control

[0142] 148 Display for insert instructions

[0143] 200 Medical Devices

[0144] 300 Anatomical segmentation for receiving and identifying the location of anatomical structures

[0145] 302 Receive and identify the target region segmentation that is at least partially located within the volume of the anatomical segmentation.

[0146] 304 Use a monitor to display the planning graphical user interface

[0147] 306 Receive ablation area from ablation selector

[0148] 308 Update the remaining portion by removing the ablation region from the remaining portion.

[0149] 310 iterations complete?

[0150] 312 End

[0151] 400 Medical Devices

[0152] 402 Guided Medical Imaging System

[0153] 404 Imaging Area

[0154] 406 Ablation Probe System

[0155] 408 subjects

[0156] 410 bracket

[0157] 412 Ablation Probe Tracking System

[0158] 416 Anatomical Structure

[0159] 418 Target Area

[0160] 420 probe tracking data

[0161] 422 Guiding medical image data

[0162] 424 Guided Real-Time Rendering of Medical Image Data

[0163] 500 Medical Devices

[0164] 502 Planning Magnetic Resonance Imaging System

[0165] 504 magnet

[0166] 506 The hole of the magnet

[0167] 508 Imaging Area

[0168] 509 Areas of Interest

[0169] 510 Magnetic Gradient Coil

[0170] 512 Magnetic Gradient Coil Power Supply

[0171] 514 RF coil

[0172] 516 transceiver

[0173] 520 Subject Stents

[0174] 530 Planning Pulse Sequence Command

[0175] 532 Planning k-space data

[0176] 534 Planned Magnetic Resonance Imaging Images

[0177] 536 Automatic Segmentation Algorithm

[0178] 600 ablation area 700 ultrasound image

[0179] Location of the 702 ablation probe

[0180] 1000 Perineal Grid Template

Claims

1. A medical device (100, 200, 400, 500), comprising: - User interface (108), including display; - Memory (110), storing machine-executable instructions (120); - A computing system (106) is configured to control the medical device, wherein the execution of machine-executable instructions causes the computing system to perform the following steps: - Receive anatomical segments (122), which identify the location of anatomical structures (416); - Receive target region segmentation (124), said target region segmentation (124) identifying the location of a volume at least partially within the anatomical segmentation; and - The display shows a planning graphical user interface (112); wherein the planning graphical user interface includes a first panel (130) configured to render cross-sectional views of the anatomical segmentation and the target region segmentation; wherein the planning graphical user interface also includes a second panel (132) configured to display a rendering of a first three-dimensional model (140) of the anatomical segmentation and the target region segmentation; wherein the planning graphical user interface also includes a third panel (134) configured to render a second three-dimensional model (142) of the remaining portion of the target region segmentation; wherein the planning graphical user interface also includes an ablation selector configured to provide a plurality of ablation regions selectable by the user, each ablation region describing at least part of the volume of the target region segmentation that the user can select to ablate; The execution of the machine-executable instructions further causes the computing system to repeatedly perform the following steps: - Receive ablation regions from the multiple user-selectable ablation regions provided by the ablation selector; as well as - The remaining portion is updated by removing the ablation region from the remaining portion.

2. The medical device of claim 1, wherein the ablation selector is configured to receive a selection of a volume within the remaining portion, and wherein execution of the machine-executable instructions further causes the computing system to generate the ablation region in response to receiving the selection of the volume from the ablation selector.

3. The medical device of claim 1 or 2, wherein the ablation selector is configured to receive selection of a trajectory intersecting the remaining portion, and wherein execution of the machine-executable instructions further causes the computing system to generate the ablation region in response to receiving the selection of the trajectory from the ablation selector.

4. The medical device according to claim 1 or 2, wherein the memory further comprises an automatic planning module (126) configured to output the ablation region in response to inputting the remaining portion, wherein the ablation selector is configured to receive an automatic planning request, wherein execution of the machine-executable instructions further causes the computing system to generate the ablation region by inputting the remaining portion into the automatic planning module in response to receiving the automatic planning request.

5. The medical device according to claim 1 or 2, wherein the execution of the machine-executable instructions further causes the computing system to generate an insertion instruction (128) for inserting an ablation probe in response to receiving the ablation region from the ablation selector.

6. The medical device of claim 1 or 2, wherein the medical device includes an ablation probe system (406) comprising an ablation probe, wherein the medical device further includes an ablation probe tracking system registered to the anatomical segment, and wherein execution of the machine-executable instructions further causes the computing system to perform the following steps: - Receive probe tracking data (420) from the ablation probe; and - Update the remaining portion using the probe tracking data.

7. The medical device according to claim 6, wherein the ablation probe is any one of the following: radiofrequency ablation probe, microwave ablation probe, high-intensity focused ultrasound ablation probe, focused laser ablation probe, irreversible electroporation probe, and cryoablation probe.

8. The medical device of claim 6, wherein the medical device further comprises a guiding medical imaging system (402), and wherein the execution of the machine-executable instructions further causes the computing system to perform the following steps: - Control the guided medical imaging system to acquire real-time guided medical image data during the acquisition of tracking data from the ablation probe (422); and - The real-time guided medical image data is displayed on the user interface in real time.

9. The medical device of claim 8, wherein the guided medical imaging system is any one of the following: a computed tomography system, an ultrasound imaging system, a magnetic resonance imaging system, and an X-ray fluorescence microscope.

10. The medical device according to claim 1 or 2, The execution of the machine-executable instructions causes the computing system to receive a planned magnetic resonance image (534) describing a region of interest of the subject (408), wherein the anatomical segmentation identifies the location of the anatomical structures within the planned magnetic resonance image, and wherein the first panel is further configured to render a cross-sectional view of the planned magnetic resonance image.

11. The medical device of claim 10, wherein the memory further stores an automatic segmentation algorithm (536) configured to generate the anatomical segmentation and / or the target region segmentation in response to input of the planned magnetic resonance image, wherein execution of the machine-executable instructions further causes the computing system to generate the anatomical segmentation and / or the target region segmentation by inputting the planned magnetic resonance image into the automatic segmentation algorithm.

12. The medical device of claim 10, wherein the medical device further comprises a planning magnetic resonance imaging system (502) configured to acquire planning k-space data (532) describing the subject, wherein the memory further comprises a planning pulse sequence command (530) configured to control the magnetic resonance imaging system to acquire the planning k-space data, wherein execution of the machine-executable instructions further causes the computing system to perform the following steps: - Use the planned pulse sequence command to control the planned magnetic resonance imaging system to acquire the planned k-space data; and - Reconstruct the planned magnetic resonance image from the planned k-space data.

13. The medical device of claim 1 or 2, wherein the display is a three-dimensional display, and the execution of the machine-executable instructions further causes the computing system to render the first three-dimensional model and the second three-dimensional model in three dimensions using the three-dimensional display.

14. A computer program product comprising machine-executable instructions (120) for execution by a computing system (106) controlling a medical device (100, 200, 400, 500), wherein the medical device includes a user interface (108) including a display; The execution of the machine-executable instructions causes the computing system to perform the following steps: - Receive anatomical segments (122), which identify the location of anatomical structures (416); - Receive target region segmentation, said target region segmentation (124) identifying the location of a volume at least partially within the anatomical segmentation; and - The display shows a planning graphical user interface (112); wherein the planning graphical user interface includes a first panel configured to render cross-sectional views of the anatomical segment and the target region segment; wherein the planning graphical user interface also includes a second panel (132) configured to display renderings of a first three-dimensional model (140) of the anatomical segment and the target region segment; wherein the planning graphical user interface also includes a third panel (134) configured to render a second three-dimensional model (142) of the remaining portion of the target region segment; wherein the planning graphical user interface also includes an ablation selector configured to provide a plurality of ablation regions selectable by the user, each ablation region describing at least part of the volume of the target region segment that the user can select to ablate; The execution of the machine-executable instructions further causes the computing system to repeatedly perform the following steps: - Receive ablation regions from the multiple user-selectable ablation regions provided by the ablation selector; as well as - The remaining portion is updated by removing the ablation region from the remaining portion.

15. A method of operating a medical device (100, 200, 400, 500), wherein the medical device includes a user interface (108), wherein the user interface includes a display. The method includes: - Receive anatomical segments (122), which identify the location of anatomical structures (416); - Receive target region segmentation (124), said target region segmentation identifying the location of a volume at least partially within the anatomical segmentation; and - The display shows a planning graphical user interface (112); wherein the planning graphical user interface includes a first panel (130) configured to render cross-sectional views of the anatomical segmentation and the target region segmentation; wherein the planning graphical user interface also includes a second panel (132) configured to display a rendering of a first three-dimensional model (140) of the anatomical segmentation and the target region segmentation; wherein the planning graphical user interface also includes a third panel (134) configured to render a second three-dimensional model (142) of the remaining portion of the target region segmentation; wherein the planning graphical user interface also includes an ablation selector configured to provide a plurality of ablation regions selectable by the user, each ablation region describing at least part of the volume of the target region segmentation that the user can select to ablate; The method includes repeatedly performing the following steps: - Receive ablation regions from the multiple user-selectable ablation regions provided by the ablation selector; as well as - The remaining portion is updated by removing the ablation region from the remaining portion.

Images