Volumetric imaging

Abstract

Aspects of the present disclosure include systems and methods for planning and / or performing ablation procedures. Volumetric image data including a needle, such as a tangible ablation needle or a virtual needle, may be analyzed to divide the needle within the volume. A first cross-sectional two-dimensional view of the volume can be generated and displayed showing a first plane on which the axis defined by the needle is located. The view may be manipulated to display a second cross-sectional two-dimensional view of the generated volume, the two-dimensional view showing a second plane through the volume where the longitudinal axis defined by the virtual needle lies, the second plane being different from the first plane. Other partitioned features such as lesions, treatment regions, isotherms, etc. in the image data may be included in views for analysis from multiple views including needles.

Description

(This application is a divisional of 201980028134.5) Background Art

[0001] A variety of surgical ablation modes are available. These surgical ablation modes include, for example, cryoablation, microwave ablation, radiofrequency ablation, and electroporation modes, among others.

[0002] In cryoablation, a cryoprobe or cryoneel is placed in or near the tissue to be ablated, and the temperature of the probe tip is lowered to a freezing temperature, thereby freezing the target tissue. One or more cycles of freezing and thawing the tissue result in ablation of the tissue.

[0003] Cryosurgical system comprises one or more cryoprobes that are connected to one or more sources of freezing fluid.This system is described in the United States Patent No. 8,066,697 of common assignment and is described in open application, i.e., U.S. Patent Application Publication No. 2010 / 0256620A1, and the full disclosure of these patent documents is incorporated herein by reference.In this cryosurgical system, freezing fluid can be delivered to one or more freezing probes from a freezing fluid source.Because the expansion of freezing fluid can cool the freezing probe, the tissue near the freezing probe tip is frozen thus.Some of this systems comprise an electric heater (adopting the form of high resistance wire) inside the probe shaft of each freezing probe, so as to facilitate the removal of freezing probe in order to thaw tissue after freezing.

[0004] Microwave ablation systems typically include a microwave probe having a microwave antenna typically near the probe tip. Energy delivered to the antenna is used to heat tissue to cause ablation. Such systems typically include a microwave energy generator, and one or more microwave needles or probes used to perform ablation.

[0005] In radiofrequency ablation (RFA), tissue is ablated using heat generated by an alternating current passing through the tissue between two electrodes. Typically, at least one of these electrodes is carried on a needle or other probe that is placed in or near the tissue to be ablated; the tissue near the needle is ablated by the heat generated.

[0006] In the electroporation ablation mode, probes are placed in or near the target tissue and a pulsed electric field is generated between the probes. This causes the cell membrane to become permeable, resulting in cell death.

[0007] Percutaneous as well as catheter-based approaches are available, and the technology has been widely used to ablate tumor tissue, particularly in cancer treatment, cardiac tissue (to control arrhythmias), and neural tissue (to control pain), among others.

[0008] Volumetric imaging of patient tissue (e.g., CT scans) is performed in the form of multiple parallel cross-sectional slices. Typically, during visualization of a scan for treatment planning and analysis, several slices of interest that are immediately adjacent to a region of interest (e.g., a patient lesion) are viewed. Such slices may be viewed, for example, to help a physician insert a treatment device into a patient and / or to observe the effects of a treatment.

[0009] However, because the slices generally present parallel planes, objects in the image that intersect these planes at an angle (such as a treatment needle inserted into the tissue at an angle relative to the planes) may be difficult to view. For example, a portion of a needle may be viewed in a cross-sectional slice, but it may be difficult to determine the orientation of the needle (e.g., whether it is tilted up or down relative to the plane). Similarly, the location of the treatment device and / or treatment area may be difficult to analyze and interpret when relying on parallel planes of the image that cannot be easily oriented. Summary of the invention

[0010] Aspects of the present disclosure generally relate to systems and methods for planning and / or performing a procedure such as an ablation procedure. Typically, such a procedure involves the use of at least one ablation probe or needle. In some instances, the methods may include receiving volumetric image data representing a volume of patient tissue, wherein the volumetric image data is comprised of a series of two-dimensional images of the patient tissue and includes a virtual needle. The virtual needle may be positioned, for example, by a system user.

[0011] The method may include demarcating a virtual needle within the volumetric image data such that the virtual needle defines a longitudinal axis extending through the volume and generating a first cross-sectional two-dimensional view of the volume, the first cross-sectional two-dimensional view showing a first plane through the volume in which the axis defined by the virtual needle is located. The first cross-sectional two-dimensional view may be displayed on a display. Similarly, the method may include generating and displaying a second cross-sectional two-dimensional view showing a second plane through the volume in which the longitudinal axis defined by the virtual needle is located, the second plane being different from the first plane. Thus, in some instances, the first and second cross-sectional two-dimensional views may include the needle axis.

[0012] In some examples, the transition between the first cross-sectional two-dimensional view and the second cross-sectional two-dimensional view can be a result of a command received to rotate the volume about the longitudinal axis defined by the virtual needle to adjust the view of the volume.

[0013] Aspects of the present disclosure may include methods for planning an ablation procedure prior to performing the ablation procedure involving a needle inserted into the volume. Some such methods may include: receiving volumetric image data including data representing a position of the needle in the volume; and demarcating the needle in the volumetric image data, including determining the position of the needle in the volume. The method may include: generating and displaying a first cross-sectional two-dimensional view of the volume, the first cross-sectional view showing a first plane through the volume in which the needle is located; and, generating and displaying a second cross-sectional two-dimensional view of the volume. The second cross-sectional view may show a second plane through the volume in which the needle is located, and the second plane may be different from the first plane.

[0014] Aspects of the present disclosure may also include methods for performing an ablation procedure after inserting an ablation needle into a volume of patient tissue. Some such methods may include receiving volumetric image data representing a volume of patient tissue including the ablation needle; and, demarcating the ablation needle in the volumetric image data. The demarcation may include determining a location of the ablation needle in the volume, and the ablation needle may define an axis extending through the volume.

[0015] The method may further include generating and displaying a first cross-sectional view of the volume, the first cross-sectional view showing a first plane through the volume in which the axis defined by the ablation needle is located; and generating and displaying a second cross-sectional view of the volume. The second cross-sectional view may show a second plane through the volume in which the axis defined by the ablation needle is located, wherein the second plane is different from the first plane.

[0016] In various such methods, other features, such as confirmed lesions, treatment volumes (e.g., volumes of ablated tissue and ice balls), simulated treatment volumes, isotherms, simulated isotherms, organ boundaries, etc., can be similarly segmented and displayed in various cross-sectional views. Some aspects of the present disclosure include a non-transitory computer-readable medium containing executable instructions for causing one or more programmable processors to perform one or more such methods.

[0017] Some aspects of the present disclosure include a system (such as an ablation system including an ablation needle or other ablation probe), and includes an imaging system, a display, and a processing system. The processing system can be configured to receive multiple two-dimensional images of patient tissue and generate volumetric image data of the patient tissue based on the received multiple two-dimensional images. The processing system can further demarcate the ablation needle within the volumetric image data of the patient tissue.

[0018] During the ablation procedure, the processing system can be configured to predict a temperature profile of patient tissue proximate to the ablation needle and identify one or more volume isotherm boundaries based on the predicted temperature profile. In some such systems, the processing system can be configured to display a cross-sectional image of the volumetric image data on a display, the cross-sectional image showing a plane including an axis defined by the ablation needle and including the needle and one or more identified one or more volume isotherm boundaries.

[0019] In the present disclosure, although cryoablation is used as an example of an ablation mode, the present invention is equally applicable to any ablation mode in which a certain volume of tissue is ablated. Such modes include: thermal ablation modes (in which the temperature of the tissue is increased in order to perform ablation, such as radiofrequency ablation, microwave ablation and cryoablation), and other modes (including electroporation modes, such as irreversible electroporation and ultrasound-based modes, such as high-intensity focused ultrasound ablation). Although "needle" is mentioned throughout this specification, the present invention is not limited to this, and other ablation probes may also be used. Such a probe may be blunt-ended or adapted to penetrate tissue, such as by having a sharp tip. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] Figure 1A is a schematic diagram of a volumetric imaging-guided cryosurgery system 10 according to one non-limiting exemplary embodiment.

[0021] Figure 1B A schematic communication interface between the processing system and other system components is shown.

[0022] Figure 2 is a front view of an exemplary cryoprobe.

[0023] Figure 3 yes Figure 2 Cross-sectional front view of the cryoprobe.

[0024] Figure 4 is a simple geometric sketch showing an exemplary volume imaging process.

[0025] Figure 5A Exemplary cross-sectional images of a patient and a needle (eg, a cryoneature) inserted into the patient are shown.

[0026] Figure 5B Shown for easy viewing Figure 5A An inverted color version of .

[0027] Figure 6 It shows something like Figure 4 Simple geometric illustration of an example volume.

[0028] Fig. 7A and Figure 7B Exemplary planes are shown within a volume that may be defined by an axis extending therethrough.

[0029] Fig. 8A , Figure 8B and Figure 8C Shows Fig. 7A An exemplary cross-sectional view of plane 714.

[0030] Fig. 9A , Fig. 9B and Fig. 9C Shows Figure 7B An exemplary cross-sectional view of plane 724 in FIG.

[0031] Fig. 10A An exemplary cross-sectional image of a volume of tissue including a pair of needles inserted therein is shown.

[0032] Fig. 10B Shows Fig. 10A The cross-sectional image and the divided parts of the emphasized image.

[0033] Fig. 10C Shows a graph including other demarcated objects (such as a puck) Fig. 10B sectional view of .

[0034] Fig.11 is a process flow diagram illustrating an exemplary process for displaying volumetric image data.

[0035] Fig.12 is a process flow diagram illustrating an exemplary control method for controlling a surgery based on analysis of volumetric image data.

[0036] Fig.13A Cross-sectional views of exemplary volumetric image data (eg, obtained from a volumetric imaging scanner) are shown.

[0037] Fig. 13B A cross-sectional view of the segmented volumetric image data is shown.

[0038] Fig. 13C are exemplary cross-sectional images showing the virtual needle and results of a simulated treatment procedure.

[0039] Fig.14A An ice ball formed by a single needle is shown.

[0040] Fig. 14B An ice ball formed by a pair of cryoneed needles is shown.

[0041] Fig. 14C An ice ball formed by three cryoneed needles is shown.

[0042] Fig.15is a process flow diagram illustrating an exemplary process for generating and displaying a simulation treatment plan.

[0043] Fig.16 is a process flow diagram illustrating an exemplary method for generating a virtual treatment volume using delineated needles in volumetric image data.

[0044] Fig.17 is a process flow diagram illustrating an exemplary process for planning and executing a treatment procedure. DETAILED DESCRIPTION

[0045] Cryosurgical systems can be used to perform cryoablation on target tissues (e.g., tumors). Typically, such systems include: one or more cryoprobes, one or more cryofluid sources, and a control system. The cryofluid source can supply gas, such as argon, nitrogen, air, krypton, CO2, CF4, xenon, and various other gases that can reach freezing temperatures (e.g., temperatures below 190 Kelvin) when expanding from a pressure greater than about 1000 psi (pounds per square inch). "Cryofluid" as used herein can refer to any fluid that reaches a low temperature (e.g., below 190 Kelvin) when expanding from a pressure greater than about 1000 psi (e.g., typically about 3500 pounds per square foot (psi)). The cryosurgical system can also include a control system having one or more sensors, flow meters, timers, analog-to-digital converters, wired or wireless communication modules, etc. In addition, the control system can also adjust the flow, temperature, and pressure of the cryofluid supplied to the cryoprobe.

[0046] During cryosurgery, for example, a surgeon may deploy one or more cryoprobes to cryoablate a target area of ​​a patient's anatomical structure by placing the cryoprobe at or near the target area of ​​the patient's anatomical structure. In one example, the cryoprobe provides cooling or heating using the Joule-Thomson effect. In this case, the cryofluid in the cryoprobe expands from a higher pressure to a lower pressure. The expansion of the cryofluid results in a temperature equal to or lower than the temperature necessary for cryoablating the tissue near the cryoprobe tip. Heat transfer between the expanded cryofluid and the outer wall of the cryoprobe can be used to form an ice ball and subsequently cryoablate the tissue.

[0047] Figure 1A is a schematic diagram of a volume imaging guided cryosurgery system 10 according to a non-limiting exemplary embodiment. The system includes a volume imaging scanner 14, such as a computed tomography (CT) scanning system, a magnetic resonance imaging (MRI) system, etc., which can be configured to accommodate a patient 20.

[0048] In some examples, the volumetric imaging system can image the patient prior to inserting one or more surgical tools 34 in order to visualize a target area of ​​the patient, such as a tumor or a patient cavity. In addition, imaging can be performed during insertion to guide the surgical tools to a predetermined location on the patient's face. In addition, imaging can be performed after insertion and during and after surgery.

[0049] The system 10 may include a control system 40 that communicates with the surgical tool 34 (e.g., via the connector interface 30) and is configured to simplify the operation of the surgical tool 34. There may be a variety of electrical and fluid connections between the control system 40 and the surgical tool 34 to facilitate the operation of the surgical tool 34. In an exemplary embodiment, the control system 40 may be electrically connected to the junction box 52 via a first electrical connection 54. In addition, the junction box 52 may include a second electrical connection 56 for connecting to an electrical device and / or imaging device 57 (such as an imaging router and filter). A third electrical connection 58 may connect the electrical device and / or imaging device 57 to the connector interface 30 and / or the mobile cart 50. The junction box 52 may enable detachable electrical connections between various components.

[0050] Refer again Figure 1A In some instances, the systems may be used to perform many types of surgical procedures, and the systems and methods disclosed herein should not be construed as limited to any one type of surgical procedure (eg, cryosurgery procedures).

[0051] In some instances, the surgical system can be a cryosurgical system (e.g., a cryoablation system). Thus, in some instances, the system can include one or more cryofluid sources 60, for example, under the control of a control system 40. For example, the control system 40 can communicate with one or more components (such as pumps and / or valves) to direct cryofluid from the cryofluid source 60 to various locations within the system (e.g., surgical tool 34). The cryofluid source can be a liquid or gas container.

[0052] The cryogenic fluid may be delivered to the surgical tool 34 (eg, cryoprobe) at cryogenic temperature and pressure. The cryogenic fluid source may be a cooling gas such as argon, nitrogen, air, krypton, CF4, xenon, or N2O.

[0053] The control system may be configured to deliver freezing fluid to the freezing probe at a freezing temperature for cooling and / or for freezing the patient's tissue, and to cool the freezing probe or a portion or component thereof at a non-freezing temperature. In some freezing probes, the freezing fluid may be delivered to a freezing fluid supply device, as described elsewhere herein. In various embodiments, exemplary connections and / or communications between various components may be employed, such as described in U.S. Provisional Patent Application No. 62 / 585,262, entitled "Cryoablation System with Magnetic Resonance Imaging Detection," filed on November 13, 2017, which is assigned to the assignee of this patent application and is incorporated herein by reference.

[0054] Reference again Figure 1A The system may also include a visualization system 86 operably coupled to the volume imaging scanner 14 (e.g., a CT scanner) for generating and / or displaying images representative of anatomical features of the patient 20, for example, to provide guidance to a surgeon during surgery. The visualization system 86 may include or communicate with one or more displays configured to provide such information to a user of the system and may include an interface for receiving input from the user.

[0055] In various examples, the visualization system 86 and the control system 40 can operate independently or can operate together. For example, in some embodiments, the visualization system 86 and the control system 40 can interact with each other and / or perform similar functions to each other. This configuration can facilitate system control (e.g., control of surgical tools 34) and visualization (e.g., visualization of information related to operating conditions and / or data generated by the overall system) performed by a user of the system. In this case, the visualization system 86 can enable the surgeon to select desired images, such as to monitor the progress of the surgical procedure, guidance-related images, and / or current information related to one or more surgical tools 34.

[0056] In some examples, the processing system 90 may include the visualization system 86 and / or the control system 40. In some embodiments, the processing system 90 may generally include one or more processors configured to perform one or more operations described with respect to the visualization system 86 and / or the control system 40. For example, the processing system 90 may be configured to interact with the surgical tool 34 to perform a surgical procedure and interact with the volume imaging scanner to receive volume imaging data. In some examples, the processing system includes separate visualization system 86 and control system 40 portions, which may be in separate distributed components. In other examples, both the visualization system 86 and the control system 40 may be embodied as a single component.

[0057] In general, the processing system may include or be embodied as one or more processors configured to process information such as volumetric image data (e.g., from the volumetric image scanner 14) and to control the operation of one or more system tools (such as the surgical tool 34, the volumetric image scanner 14, etc.), for example, in response to one or more commands.

[0058] One or more processors configured to process and / or control the process may be embodied as a stand-alone computer. In some such embodiments, such a stand-alone computer may be configured to receive volume image data, either directly from the volume image scanner or via upload or download of such data. Additionally or alternatively, such a stand-alone computer may be configured to control the operation of one or more system components (such as the volume image scanner 14 and / or the surgical tool 34).

[0059] In various examples, one or more processors in the processing system can be embodied as one or more components located on-site (e.g., at the same location as the volume imaging scanner 14 and the surgical tool 34). Such components can include, but are not limited to, application specific integrated circuits (e.g., ICs), microcontrollers, microprocessors, field programmable gate arrays (FPGAs), or any other suitable structure capable of receiving and processing data. Additionally or alternatively, one or more processors can be distributed throughout a network and configured to receive and process treatment volume imaging data and control system operations from a remote location, as described herein. For example, in some examples, the processors can include cloud-based computing capabilities.

[0060] Figure 1B An exemplary communication interface between the processing system and other system components is shown. In the illustrated example, the processing system 90 communicates with the surgical tool 34, the volume imaging scanner 14, and the user interface 92. In some embodiments, the processing system 90 can be configured to control the operation of the surgical tool 34, for example, by controlling the application of electrical power, cryogenic fluid, or other resources flowing to the surgical tool 34. In some examples, the processing system 90 can be configured to start, stop, or adjust the operation of the surgical tool 34. As described elsewhere herein, in some examples, the processing system 90 includes a control system 40 configured to control the surgical tool 34.

[0061] As shown, the processing system 90 is further in communication with the volume imaging scanner 14. In various examples, the processing system 90 can be configured to control the operation of the volume imaging scanner 14, such as by initiating a volume imaging scan (e.g., of a patient). Control of the volume imaging scanner 14 can be initiated, such as via the control system 40 of the processing system 90. In the illustrated example, the processing system 90 includes a visualization system 86 in communication with the volume imaging scanner 14. The visualization system 86 can be configured to receive volume imaging data from the volume imaging scanner 14 and process the received volume imaging data for display on a display.

[0062] The processing system 90 communicates with a user interface 92, which can enable communication between the processing system 90 and the user. For example, in various embodiments, the user can control one or more operating parameters of the surgical tool 34 via the user interface 92. In addition or alternatively, the user interface 92 can be used to transmit information from the processing system 90 to the user, for example, via a display. In various examples, the user interface 92 can be embodied as a computer workstation (e.g., including the control system 40 and / or the visualization system 86) that provides input (e.g., via a standard mouse and keyboard) and output (e.g., via a display) capabilities to the system. In addition or alternatively, the user interface 92 can include a remote device (such as a smartphone or tablet interface) to allow the user to interact with the system 10. In general, the user interface 92 can include one or more components that communicate (e.g., wired or wireless communications) with other system components to interact with the system.

[0063] As described elsewhere herein, in one non-limiting exemplary embodiment, the surgical tool may be a cryoprobe 100 . Figure 2 is a front view of the cryoprobe 100. Figure 3 yes Figure 2 100 is a cross-sectional front view of the cryoprobe 100. Figure 2 and Figure 3 , the cryoprobe 100 may include an elongated body. The components of the cryoprobe 100 may be located inside the probe shaft 102. In some cases, the cryoprobe may be a cryo-needle. The probe shaft 102 may terminate at a distal operating end 104 disposed at a distal portion 106 of the cryoprobe 100, which is used to penetrate through the patient's 20 tissues during deployment. In the embodiment in which the cryoprobe is configured as a cryo-needle, the distal operating tip 104 may penetrate the patient's skin. In an alternative embodiment, the cryoprobe may be a flexible probe and may be inserted using a catheter. A proximal coupling 108 may facilitate the cryoprobe 100 being connected to a connector interface 30, a control system 40 and / or a source of freezing fluid.

[0064] The probe shaft 102 can have a generally thinner cross section to allow deployment in the tissue of the patient 20. In one example, the cryoprobe can be a cryoprobe having a probe shaft 102 with an outer diameter of about 2.1 millimeters. Probe shafts 102 of other sizes are also conceivable. For example, the probe shaft 102 can have an outer diameter between about 1.5 millimeters and about 2.4 millimeters. In addition, in the embodiment in which the cryoprobe is a cryoprobe, the distal operating tip 104 can be made of a flexible material, thereby being flexible (for example, relative to the proximal end of the cryoprobe 100) in order to penetrate soft tissue. Alternatively, a large portion of the cryoprobe can be generally flexible and can not pierce the patient's skin, and can be flexible around its central axis (bendable) to a desired angle.

[0065] like Figure 3 As seen in FIG. 1 , the cryoprobe 100 includes a cryofluid supply 112 extending substantially along its length for supplying high pressure cryofluid to the distal operative tip 104. The cryofluid supply 112 can be coaxially / concentrically located within the probe shaft 102. The cryofluid supply 112 can be configured to supply cryofluid so as to form an ice ball on the outer surface of the probe shaft 102 at the distal portion 106 (e.g., in the exemplary embodiment). Figure 2 In some cases, the cryogenic fluid supply device 112 may be a capillary tube.

[0066] Continue to refer to Figure 3 In some examples, the cryoprobe 100 includes a cryocooler. For example, in the illustrated example, the cryofluid supply 112 may terminate at a Joule-Thomson orifice 114. The Joule-Thomson orifice 114 may be located near the distal operating tip 104, thereby allowing the cryofluid exiting the Joule-Thomson orifice 114 to expand in an expansion chamber. Thus, the high-pressure cryofluid supplied via the cryofluid supply 112 exits through the Joule-Thomson orifice 114 and expands in the expansion chamber. As the cryofluid expands in the expansion chamber, it rapidly cools and forms ice balls of different shapes and / or sizes on the outer surface of the distal operating tip 104. The expansion of the cryofluid may cause the cryofluid to be colder than the entering cryofluid when expanding. Although an exemplary cryocooler (e.g., Joule-Thomson orifice 114) is shown, it should be understood that other types of cryocoolers (such as cryo-Dewars, Stirling-type coolers, pulse tube refrigerators (PTRs), Gifford-McMahon (GM) coolers, etc.) are also conceivable within the scope of the present disclosure. Additionally, as briefly described above, cryogenic fluids that may be used for cooling include argon, liquid nitrogen, air, krypton, CF4, xenon, or N2O.

[0067] For illustrative purposes, refer again to Figure 3In some examples, a heater 116 may be optionally disposed within the probe shaft 102 to facilitate thawing and / or cauterizing tissue. In some such examples, the heater 116 is operated after cooling and ice ball formation to thaw the frozen tissue to facilitate separation of the cryoprobe 100 therefrom. As shown in this exemplary embodiment, an electric heater 116 may be disposed coaxially with the cryofluid supply 112 and the probe shaft 102 to facilitate heating the distal portion 106 of the cryoprobe 100. Alternatively, the electric heater 116 may be located elsewhere in the cryoprobe 100 to heat the distal portion 106 of the cryoprobe 100. The electric heater 116 may be a resistive heater 116 and may include a spirally wound wire that may generate heat that is proportional to the current passing therethrough and the resistance of the electric heater 116. In this case, as mentioned above, the control system 40 ( Figure 2 ) can supply and / or regulate the current provided to the electric heater 116 inside the cryoprobe 100.

[0068] In some systems, the control system includes one or more temperature sensors or communicates with one or more temperature sensors, and the temperature sensor is configured to measure the temperature of the surgical tool or its parts. For example, the control system may include a temperature sensor or communicate with a temperature sensor, and the temperature sensor is used to measure the temperature of the distal portion 106 of the cryoprobe 100 or the cryoprobe shaft or an electronic chip or an electric heater. Before, during or after being placed inside the patient, temperature measurement is performed to monitor the temperature of the probe or the temperature of any of its parts, such as measurement can be performed during placement and / or during surgery (for example, thawing or cautery) or before surgery, while the system is being prepared or ready to use. In an example, the temperature sensor may include a resistive material whose resistance can change (for example, a positive temperature coefficient material) when its temperature changes. The change in resistance can be measured by the control system 40, and finally the temperature change is determined by the control system 40 based on the known correlation between the resistance and temperature of a specific type of material. Similarly, the temperature of the electric heater can also be determined in this way.

[0069] As described elsewhere herein, the cryoprobe 100 includes an electric heater 116. Thus, in certain preferred embodiments, the material of the electric heater 116 (such as a heating wire 116) can perform the dual functions of resistively heating the probe shaft 102 when an electric current is passed therethrough and providing temperature feedback to the control system 40 during probe heating. The electric heater can also be provided with a needle heating element fault detection circuit. Such a circuit can be operably connected to the control system for the purpose of fault detection. The control system can be configured to "ignore" or ignore signals from this fault detection circuit in the presence of a surgical magnetic resonance system, as further described herein.

[0070] In some preferred embodiments, again referring to Figure 1A , the surgical tool 34 may include electronic components that allow it to be identified when connected to the connector interface 30 and / or the mobile cart 50. In one example, the surgical tool is such as Figure 2 and Figure 3 . The cryoprobe 100 shown in . The cryoprobe 100 may include an electronic chip 120 that may be located at the proximal end of the surgical tool (e.g., near the proximal connector). However, in various examples, the surgical tool may include an electronic chip 120 at any location along its body. The electronic chip 120 may include a non-transitory data storage medium that may be machine-readable. The electrical connection between the connector interface 30 and / or the mobile cart 50 and the control system 40 may allow the control system 40 to have read / write access to the electronic chip 120.

[0071] The electronic chip 120 can allow identification of surgical tools when multiple surgical tools are connected to the mobile cart 50. For example, each electronic chip 120 can store a unique surgical tool identifier in its memory, thereby allowing identification of the surgical tool connected to a specific connector port on the connector interface 30. In addition, the electronic chip 120 can store other information, such as the duration of performing a specific surgical procedure, the total time during which the surgical tool is used. In addition, such information can be transmitted (e.g., via an electrical connection) to the control system 40.

[0072] In various embodiments, a volumetric imaging system may be used simultaneously or periodically at various time points during cryosurgery, such as described in U.S. Provisional Patent Application No. 62 / 585,262 regarding magnetic resonance imaging and cryosurgery, the contents of which are incorporated herein by reference. In general, many different volumetric imaging techniques may be employed. As described above, volumetric imaging techniques may be used to obtain imaging information before, during, and / or after surgery. However, conventional imaging procedures are limited by the information provided to the user and require specialized knowledge and / or assumptions to obtain the desired information (even from volumetric image data).

[0073] Figure 4 4 is a simple geometric sketch illustrating an exemplary volume imaging process. In the illustrated example, a volume (or solid or three-dimensional body) 410 includes an object 420 contained therein. A plane 412 is illustrated extending through the volume 410 and intersecting the object 420. In an exemplary volume imaging process, the volume 410 is represented by a stack including a plurality of parallel two-dimensional slices (such as the planes 412). Thus, each image corresponds to a different "depth" within the volume 410. Observing an object within the volumetric image often corresponds to selecting one of such slices and observing a cross-sectional image at that depth, or going up and down within the volume to different depths to observe different cross sections.

[0074] However, if each cross-sectional slice is generally parallel to the other cross-sectional slices, it may be difficult to view objects having a dimension of interest (e.g., longest dimension and / or cross-sectional plane) that are positioned at an angle relative to the image slices generally available for viewing. Figure 4 The object 420 in the volume 410 is a square pyramid, and the intersection of the plane 412 and the object 420 will be approximately square. In addition, each cross-section of the object 420 taken in a plane parallel to the plane 412 (e.g., a two-dimensional slice) will also show a substantially square cross-section. Therefore, it is necessary to observe several such images taken in several planes in order to deduce the approximate shape of the volume 410.

[0075] During an exemplary treatment procedure, this limited viewing capability may not only limit the ability to view structures (e.g., object 420) within the volume, but may also prevent the ability to view various other features that may be within the volume, such as for a treatment procedure. FIG5 shows an exemplary cross-sectional image of a patient and a needle (e.g., a cryoneature) inserted into the patient.

[0076] In the illustrated example of FIG5 , a cross-sectional image 500 shows a needle 502 inserted into a patient volume 504, e.g., to perform one or more procedures associated with a lesion 506 (e.g., to biopsy or apply treatment to the lesion 506). In the cross-sectional view 500, the view of the needle 502 includes a first portion 512 and a second portion 522. The first portion 512 appears in a darker color, while the second portion 522 appears in a lighter color. The color difference between the first portion 512 and the second portion 522 corresponds to the portion of the needle 502 that is within or outside the imaging plane of the cross-sectional image 500. That is, in the exemplary view, the first portion 512 of the needle 502 is located within the plane of the cross-sectional image 500. However, the second portion 522 of the needle 502 is located outside the plane and therefore appears differently than the first portion 512 of the needle 502 that is located within the plane.

[0077] Thus, when viewing the cross-sectional image 500, a system user (e.g., a physician) may not be able to tell where the needle 502 terminates within the volume, such as whether the tip of the needle is located above or below the plane of the image. This may reduce the ability to perform a desired operation (e.g., a biopsy, a tissue destruction procedure, etc.) using the needle 502. Switching between different cross-sectional viewing planes (e.g., up and down within the volume) may help the user understand more information, such as whether the needle 502 is tilted upward or downward, however, in some such instances, if the needle 502 is not parallel to the imaging plane, the user may not be able to view the entire needle within the cross-sectional image. Figure 5B Shows Figure 5A Inverted color version of the image for easier viewing.

[0078] Figure 6 is shown similar to Figure 4 A simple geometric illustration of an exemplary volume (or solid or three-dimensional body). Figure 6 In the illustrated example of , volume 610 includes object 620 contained therein. Axis 602 extends through volume 610 and intersects object 620. In some examples, instead of being parallel to planes (e.g., Figure 4 In the example of FIG. 6A and FIG. 6B , axis 602 may define a volume divided by volume 410 in FIG. 4 and a plane parallel to plane 412 (i.e., a volume 410 in FIG. 4 and a plane parallel to plane 412), and axis 602 may define a number of planes (e.g., a plane rotated about axis 602, where axis 602 is located) inside volume 610. In various volume imaging procedures, axis 602 may be defined virtually or may be defined by an object in the imaged volume, such as a needle inside a patient.

[0079] Fig. 7A and Figure 7B Exemplary planes in a volume that may be defined by an axis extending therethrough are shown. Fig. 7A An axis 701 extending through a three-dimensional object 712 having a pyramidal shape is shown. As depicted in the figure, the axis extending through the volume can define multiple planes within the volume. Fig. 7A In the example of , axis 701 lies in plane 714 , which intersects object 712 at intersection line 722 .

[0080] In the context of volumetric imaging, particularly in a medical setting, a needle 702 is positioned along an axis 701. The needle 702 may be a virtual needle placed in the volume, or may be a physical needle present inside the imaged tissue of the patient. In the case of a virtual needle 702, in some instances, the virtual needle 702 may be manually or automatically placed at a location inside the volume, and the location where the needle 702 is placed may define the axis 701. In the case of a physical needle 702 being imaged, image (e.g., volumetric image) processing techniques may be used to identify and delineate the needle 702 in the image data to thereby identify the axis 701 along which the needle 702 extends.

[0081] As described above, axis 701 may define multiple planes in which axis 701 lies, such as by rotating plane 714 about axis 701, as indicated by arrow 703. Fig. 7A In the illustrated example of , plane 714 intersects volumetric object 712 at intersection line 722. In this example, the intersection of plane 714 and object 712 is triangular in shape, axis 701 extends through the triangular intersection 722, and needle 702 extends into the triangular intersection 722.

[0082] exist Figure 7BIn the example of Fig. 7A As depicted, the needle extends along axis 701 into volume object 712. However, unlike Fig. 7A In comparison, Figure 7B In the example of , a different plane (plane 724) including axis 701 and needle 702 is shown as intersecting object 712. Figure 7B The object 712 in Fig. 7A The same pyramid shape as shown in FIG. 7 is shown in FIG. 7 , and the intersection 732 of plane 724 and object 712 is a square. Figure 7B The cross-sectional image taken at plane 724 in FIG. 7 will show object 712 having a square shape, while Fig. 7A A cross-sectional image taken at plane 714 in FIG. 7 will show object 712 having a triangular shape. However, because the plane is defined to include axis 701 and therefore needle 702, the full length of the needle will exist within plane (414, 724) and any corresponding cross-sectional image.

[0083] exist Fig. 7A and Figure 7B Switching between views allows viewing the volume surrounding needle 702 from various perspectives while maintaining the view of the needle itself. Fig. 7A and Figure 7B The user of the cross-sectional images will be provided with information representing the volume surrounding the needle 702, including the volumetric shape of the object 712, which is difficult to interpret by viewing parallel cross-sectional images or requires a lot of expertise in volumetric image viewing and analysis.

[0084] As described elsewhere herein, in some examples, the processing system (e.g., including the visualization system 86) may include one or more processors configured to process volumetric image data, such as volumetric image data generated by the volumetric image scanner 14. In some examples, the processing of the volumetric image data includes processing the volumetric image data as volumetric data rather than a plurality of separate two-dimensional image slices. For example, the volumetric image data processing may include steps such as intercepting the volumetric image data in any of a plurality of planes to form a customized two-dimensional visualization of a portion of the volumetric image data. The volumetric image processing may further include steps such as identifying features (e.g., feature boundaries) and demarcating such features within the volumetric image data (e.g., determining which three-dimensional pixels in the volumetric image data belong to a given feature). In various examples, feature recognition may be performed using one or more techniques, such as any of a plurality of feature / boundary detection image processing techniques. In some examples, a user may manually identify one or more features in the volumetric image data.

[0085] For example, about Fig. 7A and Figure 7B , a visualization system may receive volumetric image data of a volume including object 712, needle 702, and planes 714 and 724. In some embodiments, the visualization system may be configured to analyze the volumetric image data and demarcate one or more objects therein (such as needle 702, object 712, etc.). In some examples, the visualization system may demarcate needle 702 and determine an axis 701 extending through the volume that approximates the longitudinal dimension of needle 702. In some such examples, a completely straight needle 702 may extend directly along axis 701, however if needle 702 is slightly bent, such as during insertion, then axis 701 may be determined to approximate the longitudinal direction of needle 702.

[0086] In some examples, the visualization system can be configured to generate a two-dimensional cross-section of the volume, the cross-section showing a plane of the image data in which the defined axis 701 lies. Fig. 7A , the visualization system can be configured to identify the axis 701 and can generate a cross-sectional image showing the plane 714 in which the axis 701 and the needle 702 are located. Similarly, the visualization system can be configured to identify the axis 701 and can generate a cross-sectional image showing the plane 724 in which the axis 701 and the needle 702 are located. In other examples, the visualization system includes an interface (e.g., user interface 92) or communicates with the interface, and the user can manipulate the displayed cross-sectional image through the interface by selecting the plane in which the identified axis 701 is located. For example, in an exemplary embodiment, the user can effectively rotate the view around the axis 701, as represented by arrow 703, to select a new cross-sectional image in which the axis 701 is located.

[0087] refer to Fig. 7A and Figure 7B The user can rotate the view from plane 714 to plane 724 to change the view from plane 714 to plane 724. Fig. 7A The cross-sectional view of the display plane 724 is converted to Figure 7B A cross-sectional view of the Fig. 7A and Figure 7B In the case where the volume includes object 712, transitioning from observation plane 714 to observation plane 724 will result in an observed change from intersection 722 of object 712 and plane 714 to intersection 732 of object 712 and plane 724.

[0088] In some embodiments, the visualization system can display the cross-sectional image including the axis in a variety of ways, including, for example, a plan view, a perspective view, etc. In some examples, the user can adjust the orientation and elevation of the view of the cross-sectional image. Figure 8A-8C Shows Fig. 7A800a, 800b, and 800c each illustrate the needle 702, and the intersection 722 of the object 712 with the plane 714. In various embodiments, the visualization system can be configured to provide a default view (e.g., one of the views 800a-c), or can prompt the user to select a view (e.g., from a list of available views).

[0089] Similarly, Figure 9A-9C Shows Figure 7B 900a, 900b, and 900c each illustrate the needle 702 and the intersection 732 of the object 712 with the plane 724. During operation, the user may choose to rotate the cross-sectional plane (e.g., as indicated by Fig. 7A and Figure 7B 703 in the figure) in order to, for example, switch from view 800a to view 900a. The two views (800a, 900a) show plan views of the cross-sectional image and include cross-sectional views of the needle 702 and the object 712. However, because the cross sections of views 800a and 900a are taken at different planes (714, 724, respectively), the cross-sectional shape of the object 712 appears different between views 800a and 900a. In this example, the object appears triangular in view 800a, but square in view 900a. Therefore, the change between view 800a and view 900a allows the user to observe the object 712 within the volume from different perspectives while keeping the needle 702 in the image to fully observe the position of the needle within the volume and relative to the object.

[0090] As described above, rotation of the cross-sectional plane (e.g., from plane 714 to plane 724) can occur about the axis in which the needle is located. For example, volumetric image data of a patient with a needle inserted can be processed to demarcate the needle within the volumetric image data and define the needle axis about which the plane rotates. Rotation of the volumetric image data about the needle axis both increases the likelihood that the needle will be completely or nearly completely visible in the cross-sectional image during plane rotation and maintains the needle in a substantially fixed position. Such image processing and manipulation can make it easier for a user to identify where a needle is located in a volume and to understand and interpret the environment of the needle within the volume, compared to simply observing parallel plane slices (e.g., from a stack of images) as in a typical imaging system.

[0091] As shown in Figure 1- Figure 3As described, in some instances, the visualization system can be incorporated into a cryosurgical system, such as where the needle (e.g., 702) comprises a cryoneer needle configured to freeze tissue so as to form an ice ball within a patient, or other ablation needles or probes configured to ablate tissue via an alternative ablation mode. When used in real time during a cryosurgical procedure (e.g., during cryoablation or other ablation), the visualization system can be used to visualize in various directions the extent of a cross-section of an ice ball formed or being formed around the needle, or the extent of ablated tissue, or the extent of a volume of tissue (predicting tissue death within it).

[0092] For example, with respect to the cross section at plane 724, views 900a-900c include an exemplary ice ball outline 750 within the image data. This may also represent the extent of ablated tissue, or the extent of a tissue volume within which tissue death is predicted.

[0093] In the cross section in plane 724, puck 750 surrounds object 712. Thus, if object 712 is a lesion, cross-sectional views 900a-900c in plane 724 would indicate coverage of the lesion by puck 750. However, when rotated to display any view 800a-800c in plane 714, puck 750 does not surround the entire object 712 in plane 714. That is, due to the different sizes of the object 712 and / or puck 750 in different dimensions, puck 750 may surround object 712 in one plane (e.g., 724) but not in another plane (e.g., 714). Thus, a user who is observing real-time cryosurgery may advantageously rotate the cross-sectional plane through multiple views (e.g., 800a-c, 900a-c) to compare the size of object 712 (e.g., lesion) with the size of puck 750 in multiple dimensions. The user can then make an informed judgment as to when a desired amount of the object 712 has been surrounded by the puck 750, for example to decide whether to end or continue the cryosurgery procedure.

[0094] The progress of ablation in other ablation modes may be tracked in the same manner (optionally in real time) by monitoring and displaying the ablated tissue volume formed within the patient's tissue volume.The volume of ablated tissue may be tracked in microwave or radiofrequency ablation, for example by ultrasound or thermographic imaging.

[0095] In some embodiments, the visualization system can be used to demarcate other items within the volume image data. For example, in some embodiments, the visualization system can be used to demarcate objects, such as lesions and / or organ boundaries within the patient's tissue (e.g., to identify three-dimensional pixels in the volume image data corresponding to the object). In addition or alternatively, although illustrated as including a single needle in some instances, various processes may involve placing multiple needles (e.g., cryo-needles, microwave or RF probes, ultrasound probes, or electroporation probes) within the patient's tissue for adjusting the tissue affected by various operations (e.g., ablations, such as cryo-ablation). The visualization system can be used to demarcate each needle or probe in a plurality of needles or probes (e.g., automatically or via manual selection). In some such instances, a user can select which needle of the plurality of needles is used to define a needle axis, around which the volume image can be rotated to establish various cross-sectional views showing the plane in which the selected needle is approximately located. In addition, in some instances, the user can change which needle is selected, thereby adjusting the rotation axis and observing other cross-sectional images based on the needle axis defined by the needle subsequently selected from the plurality of needles.

[0096] Fig. 10A An exemplary cross-sectional image of a tissue volume including a pair of needles inserted therein is shown. Fig. 10A The image 1000a shows a first needle 1002a, a second needle 1002b, and a lesion 1006 within the tissue. As discussed elsewhere herein, the visualization system can be configured to delineate such structures within the tissue, for example to identify which three-dimensional pixel in the volumetric image data and / or which pixel in a cross-sectional image (e.g., 1000a) from the volumetric image data corresponds to such a structure.

[0097] Fig. 10B Shows Fig. 10A A cross-sectional image of a , where the demarcated parts of the image are emphasized. For example, Fig. 10BA cross-sectional image 1000b is shown, wherein needles 1002a and 1002b and lesions 1006 within the volume are demarcated in the volumetric image data. In some embodiments, the visualization system can display the demarcated objects in a contrast display mode (such as using contrasting colors, etc.) compared to other volumetric image data. In the illustrated example, the entire needle 1002a is visible inside the cross-sectional image 1000b, while needle 1002b is only partially visible. This indicates that needle 1002b is not located in the plane of the cross-sectional image 1000b, while needle 1002a is located in the plane. Therefore, according to some embodiments, needle 1002a defines a selected (e.g., automatically or manually) needle axis for selecting a cross-sectional plane for generating the cross-sectional image 1000b. As described elsewhere herein, a user can rotate the volumetric image data around the needle axis, such as represented by arrow 1003, to select other or alternative planes and generate cross-sectional image data for them.

[0098] Other objects that may be delineated within the volumetric image data include an ice ball that has formed and / or is forming within the tissue, or a volume of ablated tissue that is forming due to any pattern or a volume of tissue within which tissue death is predicted. Fig. 10C Shows Fig. 10B A cross-sectional view of a portion of the image may include other delineated objects (such as an ice ball), but this may equally be an ablated tissue volume or a tissue volume within which tissue death is predicted, for example based on actual or predicted temperature or based on model delineation. Fig. 10C In the example of , the treatment region 1050 (e.g., formed by needles 1002a, 1002b) is illustrated as being formed within the cross-sectional image 1000c. In some embodiments, the visualization system can be configured to identify the treatment region 1050 within the volume and display the treatment region 1050 in a contrasting color in the cross-sectional image (e.g., 1000c).

[0099] In some embodiments, the presentation of the treatment 1050 may include multiple regions (e.g., 1052, 1054) that may be used to indicate other information to the user. For example, in some embodiments, the treatment region may include the outline of a demarcated puck, or a demarcated volume of ablated tissue, or a demarcated volume of tissue predicted to have tissue death inside 1054, and an edge 1052 surrounding the puck or tissue volume 1054. In various examples, the identified edge 1052 may be located at a fixed distance from the perimeter of the puck or the volume of ablated tissue, or the volume 1054 of tissue predicted to have tissue death inside. For example, in some such embodiments, the visualization system may be configured to identify dimensions within the volume image and measure a predetermined distance from the perimeter of the demarcated puck or demarcated volume of tissue 1054 in order to determine the edge 1052. In some embodiments, the distance of the edge 1052 from the perimeter of the puck or tissue volume 1054 may be adjusted by the user, such as via a user interface.

[0100] In addition or alternatively, as described elsewhere herein, the system may include one or more temperature sensors located at or proximate to the needle or probe (e.g., a cryo-needle) that can provide temperature information representative of the temperature of the tissue proximate to the needle. Thus, in some embodiments, the treatment region 1050 may include one or more isotherms or other temperature representations that distinguish the temperature inside the volume. In an exemplary embodiment, the ice ball 1054 may represent a volumetric region equal to or below -10°C, while the edge 1052 may represent a volumetric region between -10°C and 0°C. In a mode in which the temperature is raised to cause ablation, the isotherms may represent the boundaries of the tissue volume within which tissue death is predicted, while the edges may represent temperatures where complete ablation or death is not expected, or may be lower probabilities. In some methods, each isotherm may represent the boundaries of an area with a certain probability of tissue death, such as a 75%, 80%, 90%, or 100% probability of tissue death. Thus, within these isotherms may be a probability of 80-90% or 90-100% tissue death between 75% and 80%. In general, a processing system (e.g., a visualization system and / or a control system) can be configured to receive and / or determine volumetric temperature information to establish temperature data for a plurality of three-dimensional pixels (e.g., three-dimensional pixels adjacent to needles 1002a, 1002b) to visually represent temperature values ​​and / or ranges in a cross-sectional image (e.g., 1000c). In some embodiments, the temperature values ​​and / or ranges displayed by a visualization system and / or a contrasting color scheme displaying such temperature information can be selected by a user. For example, in an exemplary embodiment, a user may wish to view a plurality of isotherms representing temperature values ​​within a tissue, which may or may not include a text representation of an ice ball, an ablated tissue volume, or a tissue volume predicted to have tissue death within it. In another example, a visualization system may demarcate an ice ball or tissue volume and display the ice ball or tissue volume in a color scheme (e.g., in a particular contrasting color), and may further present the selected temperature value (e.g., isotherm) in a separate color scheme. In various examples, convenient isotherms may include one or more of 60°C (e.g., in a thermal ablation treatment system), 0°C, -20°C, and / or -40°C. In some examples, the isotherm may represent a volume range within which tissue death is predicted, for example based on a model of a given tissue survival rate at a specific temperature / time. This may be, for example, cryoablation or may be a system such as microwave or radiofrequency.

[0101] In some embodiments, the processing system can receive temperature values ​​from one or more temperature probes inserted into the visualized tissue (e.g., on or near needles 1002a, 1002b), thereby determining temperature data representing the temperature values ​​in the volume. In some such instances, the processing system can be configured to use the temperature values ​​received from such probes indicating the temperature values ​​at one or more locations and calculate the predicted temperature values ​​of the area immediately adjacent to the location where its temperature is measured. Such calculated temperature can be based on, for example, volume tissue data, which can be used to estimate the thermal behavior of tissue at a location where the temperature probe is not present.

[0102] Additionally or alternatively, temperature data for a plurality of three-dimensional pixels in the volumetric image data can be calculated without using a temperature probe to physically measure the temperature. In some embodiments, operational data for one or more surgical tools, such as power data representative of electrical power consumed by one or more cryoneed needles, can be used to determine an approximate temperature value in close proximity to the surgical tool. Furthermore, in some instances the volumetric image data can be used together with such operational data to predict the thermal behavior of surrounding tissue in order to estimate a temperature profile for the volume.

[0103] In some embodiments, the visualization system can be configured to analyze various delineated regions within the volumetric image data to determine overlap of such regions. Fig. 10C ,like Fig. 10B The lesion 1006 shown in FIG is decomposed into three regions (a first region 1016, a second region 1026, and a third region 1036) based on the overlap of the lesion 1006 with portions of the treatment region 1050. In the illustrated example, the first region 1016 of the lesion 1006 does not overlap with the identified treatment region 1050, the second region 1026 of the lesion 1006 partially overlaps with an edge 1052 of the treatment region 1050, and the third region 1036 of the lesion 1006 partially overlaps with an ice ball 1054 of the treatment region 1050. As shown in FIG. Fig. 10C As shown in the example of FIG. 1 , such regions (1016, 1026, 1036) of the lesion 1006 can be visually distinguished in the cross-sectional image 1000c so that the user can quickly and easily identify the volume extent of the treatment (e.g., treatment volume 1050) relative to the delineated lesion 1006. For example, the user can quickly see whether the ice ball, the volume of ablated tissue, or the volume of tissue in which tissue death is predicted (e.g., 1054) has adequately surrounded the lesion 1006.

[0104] As described elsewhere herein, for example with respect to Figure 7A-7B , Figure 8A-8C and Figure 9A-9CIn various embodiments, the visualization system can be configured to facilitate rotation of the cross-sectional plane about an axis (e.g., a needle axis). For example, Figure 10A-10C The cross-sectional images (1000a-1000c) in which the needle 1002a is located are shown. Figure 10B-Figure 10C , the visualization system can demarcate the needle 1002a within the volume image data, and can form cross-sectional images 1000a-1000c showing the plane in which the needle is located. As described elsewhere herein, the view can be rotated to one or more other planes in which the needle is located, for example by rotating the volume image around the needle 1002a while maintaining the position of the needle 1002a in the same position. That is, in some embodiments, when the volume image data is rotated around the needle axis (e.g., from a first cross-sectional view to a second cross-sectional view), the pixel coordinates of the needle in the first and second cross-sectional views are substantially the same.

[0105] Rotating the view of a cross-sectional image allows the user to view various displayed information from multiple perspectives, such as Fig. 10C For example, by rotating the view in accordance with arrow 1003, the user can view the overlap of the treatment area 1050 with the lesion 1006 in multiple planes and from multiple perspectives. This can allow for a more complete determination of the extent of the treatment volume 1050 relative to the extent of the lesion 1006. For example, with respect to Figure 8A-8C and Figure 9A-9C , in some views (e.g., 900a-900c), the puck 750 encompasses the entire outline 732 of the object 712. However, in other views (e.g., 800a-800c), the puck 750 does not encompass the entire outline 722 of the object 712. Thus, different perspective views can provide more detailed information representing the relationship between the treatment volume area 1050 and the lesion 1006.

[0106] This can help increase the likelihood that the entire lesion 1006 receives appropriate treatment in all directions and reduce the likelihood of inadequate treatment based on only a single observation or a few parallel views. Similarly, viewing such a volume in multiple planes enables the user to view the location of the treatment volume 1050 in relation to other anatomical features of the patient (e.g., the edge 1052 surrounding the ice ball, the volume of ablated tissue, or the tissue volume 1054 where tissue death is predicted). For example, in one instance, a user can view the treatment volume as it grows (e.g., during application of treatment) and choose to stop or adjust the treatment process if the treatment volume becomes too close (e.g., inside the ice ball, or tissue volume edge 1052) to a patient anatomical structure (such as an organ boundary) that is not desired to be affected by the treatment.

[0107] Fig.11is a process flow diagram illustrating an exemplary process for displaying volumetric image data. Fig.11 The method includes receiving volumetric image data (1100) representing a volume, such as from a volumetric image scanner (e.g., a CT scanning system). The volumetric image data can be demarcated (1102) to determine volumetric locations (e.g., three-dimensional pixel coordinates) corresponding to different structures in the volume. A visualization system can be configured to display a first cross-sectional view (1104), which can display a first plane including a needle axis based on the demarcated needle (e.g., from step 1102). The visualization system can be further configured to display one or more demarcated features (1106) on a display with a contrast display scheme. For example, demarcated needles, lesions, organs, etc. can be displayed with one or more colors that contrast with a display scheme for traditional volumetric image data, such as colored demarcated objects in a black and white or grayscale cross-sectional image. In addition or alternatively, the contrast display scheme can include flashing boundaries / regions, emphasized contours, etc.

[0108] The method further includes the steps of rotating the volumetric image data about the needle axis (1108) and displaying an updated cross-sectional view showing an updated plane including the needle axis (1110). Fig. 7A and Figure 7B , the visualization system can rotate the first cross-sectional view showing the first plane 714 to an updated cross-sectional view showing the updated plane 724, for example by rotating the volume image data about the axis 701. After rotating to the updated cross-sectional view, the one or more delineated features (1106) can be displayed in a visual contrast display scheme, as described elsewhere herein. In various examples, such as when a user analyzes the volume image data from multiple perspectives, the steps of rotating the volume image data (1108) and displaying the updated cross-sectional view (1110) can be performed as many times as desired.

[0109] In various instances, Fig.11Some steps of the method shown in can be performed manually by the user, automatically by the processing system, or can be distributed between the user and the processing system. For example, in some embodiments, the processing system (e.g., via a visualization system) can automatically receive volumetric image data, such as from a volumetric image scanner for analysis. In other examples, the user can manually upload the volumetric image data to the processing system for analysis. In some examples, the division of volumetric image data can be performed automatically, or can be performed based on one or more manual inputs. For example, in some examples, the user can add a mark (e.g., "lesion") to the automatically divided volume to help the division process. In various examples, rotating the volumetric image data around the needle axis (1108) can be performed manually, such as by the user rotating the view via a user interface. In addition or alternatively, the processing system (e.g., via a visualization system) can be configured to automatically rotate the volumetric image data around the axis, such as at a programmable rotation speed (e.g., in degrees / second).

[0110] In some such embodiments, the segmented volumetric image data and associated analysis (e.g., in Fig. 10C As shown in and about Fig. 10C As discussed above) can be used to control the operation of one or more surgical tools. In an exemplary embodiment, the processing system (e.g., via a visualization system) can be configured to demarcate items in the volumetric image data in substantially real time during an operation (such as during a cryosurgery operation). The processing system can be configured to automatically compare one or more operation results (e.g., ice ball size, volume of ablated tissue, or volume of tissue in which tissue death is predicted, or one or more isotherms, etc.) with the size of the demarcated lesion within the volumetric image data. In some such instances, the processing system (e.g., via a control system) can be configured to automatically stop the surgical operation (e.g., to stop freezing or other ablation) when the treatment volume (e.g., ice ball, volume of ablated tissue or predicted tissue death, ice ball, or respective tissue edge volume, etc.) reaches a predetermined size relative to the lesion size.

[0111] For example, in an exemplary embodiment, when the ice ball, ablated tissue volume, or predicted tissue death volume reaches a predetermined size relative to the demarcated lesion, such as when the volume boundary of the ice ball or the volume of tissue surrounds the volume boundary of the entire lesion, the treatment can be automatically stopped. In various examples, the processing system can be programmed with instructions for performing one or more analyses that can be used to initiate various system operations (e.g., determine when the treatment process should be stopped). In some such examples, such instructions can be based on instructions programmed by a user, such as via a user interface. For example, in an exemplary embodiment, a user can define a relationship between an ice ball, ablated tissue, or predicted tissue death volume and the lesion volume, which, when satisfied, will cause the system to stop the ablation (e.g., cryoablation) process (e.g., via control system 40). In addition or alternatively, a user can define a relationship between an ice ball ablation tissue volume or a predicted tissue death volume boundary or edge and an organ boundary, which, when satisfied, causes the system to stop the ablation (e.g., cryoablation) process (e.g., via control system 40).

[0112] Fig.12 1 is a process flow diagram illustrating an exemplary control method for controlling a procedure based on analysis of volumetric image data. The method includes the steps of receiving volumetric image data (1200) and demarcating features (1202) (e.g., one or more treatment volumes, lesions, organs, etc.) within the volumetric image data. The method may include the steps of comparing the size and / or boundary position of one or more demarcated features (1204) and determining, for example, based on the comparison, whether one or more predetermined conditions are met (1206). If not met, the procedure may be performed (if the procedure has not yet begun) or continued (e.g., if the condition is determined during the procedure) (1208), and the process may be repeated. However, if the predetermined condition is met (e.g., at step 1206), the procedure (e.g., surgical procedure) may be stopped.

[0113] In various instances, such predetermined conditions may be related to the relative size and / or boundary position of one or more delineated features relative to other features. In an exemplary embodiment, determining whether the predetermined condition is met includes determining whether the boundary of the ice ball, the ablated tissue volume, or the predicted tissue death volume completely overlaps with the boundary of the lesion. In addition or alternatively, determining whether the predetermined condition is met includes determining whether the edge surrounding the ice ball, the ablated tissue volume, or the predicted tissue death volume overlaps with the boundary of the patient's organ. In general, one or more predetermined conditions can be implemented to ensure that, for example, during a surgical operation (e.g., cryosurgery), sufficient treatment is performed and no undesirable damage is performed. In some instances, the predetermined conditions may include multiple conditions, such as one or more Boolean combinations of different conditions (e.g., condition A and condition B). In some embodiments, multiple predetermined conditions may be stored in a memory and / or may be customized by a user.

[0114] In various embodiments, Fig.12 Certain steps in the method of can be automatically performed by the system (e.g., via a processing system), manually performed by a user, or performed by a combination of the system and the user. For example, as described elsewhere herein, in some embodiments, the visualization system can automatically receive volumetric image data (e.g., from a volumetric image scanner) and / or can receive volumetric image data via manual upload. In addition, the system can automatically segment features within the volumetric image data, or this can also be done with input from a user, as described elsewhere herein.

[0115] In some embodiments, the processing system may be configured to automatically detect whether a predetermined condition is met, such as whether an ice ball, an ablated tissue volume, or a predicted tissue death volume boundary surrounds a lesion boundary. In other examples, the processing system may display the demarcated ice ball, ablated tissue volume, or predicted tissue death volume and demarcate the lesion in one or more cross-sectional views, as described elsewhere herein, so that the user can confirm whether the predetermined condition is met based on the visualized volume image data. If the user confirms that the predetermined condition is met, the user can start the operation, allow the operation to continue, or stop the operation. If the processing system confirms that one or more predetermined conditions are met, the processing system can start the operation, allow the operation to continue, stop the operation, or inform the user of the predetermined condition so that the user can take appropriate measures. Informing the user can include notifying the user of the predetermined condition, such as via a visual alarm, a voice alarm, etc. The processing system can give the user an alarm that the predetermined condition is met or not met and / or can give the user one or more recommended measures in view of the conditions that are met or not met.

[0116] In various examples, such a process can be used to analyze and / or simulate needle placement within any volume of patient tissue. In addition, while several features have been described herein with respect to partitioning volumetric image data including a needle inserted into patient tissue, similar techniques can be used in other areas, such as endoscopic procedures, in which CT or magnetic resonance imaging is used to assist in guiding instruments within a patient. Additionally or alternatively, in some examples, the system can perform techniques similar to those described herein to plan treatment (ablation, such as cryoablation) of a patient.

[0117] Fig.13A A cross-sectional view of exemplary volumetric image data, such as obtained from a volumetric imaging scanner, is shown.As described elsewhere herein, in some embodiments, a processing system (eg, via a visualization system) can be used to segment out volumetric image data. Fig. 13B A cross-sectional view of the scribed volumetric image data is shown. Fig. 13B The cross-sectional view of 1300b in 1300b includes the demarcated lesion 1306. The demarcated object (e.g., lesion 1306) is displayed from other volume image data in a contrast display scheme. In some embodiments, the visualization system can be configured to position the virtual needle 1322 inside the volume image data. The virtual needle 1322 can be manually positioned by the user or can be automatically positioned, for example, at a position suggested by the system. In some examples, the user can adjust the position of the virtual needle 1322 inside the volume image data in real time.

[0118] Similar to the processes discussed elsewhere herein with respect to a ruled needle / probe (eg, a cryoneuresistor), the virtual needle 1322 may define a virtual needle axis extending through the volumetric imaging data. Fig. 13B The cross-sectional image 1300b in FIG. 1 can be taken in a plane at a virtual needle axis defined by the virtual needle 1322. In some examples, the volumetric image data can be rotated around the virtual needle axis, as indicated by arrow 1303, similar to the process described elsewhere herein. This can enable different cross-sectional views of the volumetric image data, including the lesion 1306.

[0119] In some embodiments, the processing system can be further configured to simulate treatment (ablation, such as cryoablation) and display the results of the simulated treatment. For example, with respect to a cryoablation or other ablation procedure, the processing system (e.g., via a visualization system) can be configured to simulate the formation of an ice ball, ablated tissue volume or predicted tissue death volume, and / or a temperature rise in a volume proximate to the virtual needle 1322 based on the position of the virtual needle. In some instances, such simulated treatment results can be based on one or more other input parameters, such as input parameters in input power, treatment duration, input power versus time curves, etc.

[0120] Fig. 13C 1 is an exemplary cross-sectional image showing the results of a virtual needle and a simulated treatment process. In this illustrated example, a virtual needle 1322 is located within the volumetric image data of the patient's tissue adjacent to the delineated lesion 1306. As shown, a virtual treatment area 1350 is illustrated adjacent to the virtual needle 1322. As described above, the virtual treatment area 1350 can be a function of multiple inputs, such as needle position, needle operation power, operation time, etc.

[0121] Virtual treatment area 1350 includes a first region 1352 and a second treatment region 1354. In some examples, first region 1352 may correspond to a virtual edge surrounding a virtual ice ball, or a virtual ablated tissue volume represented by second region 1354. Additionally or alternatively, regions 1352, 1354 may represent virtual isotherms and / or temperature ranges within the volume.

[0122] Similar to About Fig. 10C As described, the visualization system may be configured to analyze the location of a virtual treatment region (e.g., an ice ball, a virtual tissue ablation volume, a margin, etc.) relative to a delineated object in the actual volumetric image data (e.g., a lesion, an organ boundary, etc.). The visualization system may be configured to identify overlaps between such regions and visually represent portions of such delineated features that overlap with the virtual treatment volume.

[0123] exist Fig. 13C In the example of , lesion 1306 is illustrated as having three regions. First region 1316 does not overlap with any treatment region, second region 1326 overlaps with first region 1352 of treatment volume 1350, and third region 1336 overlaps with second region of treatment volume 1350. Thus, the effect of the simulated treatment on lesion 1306 can be easily observed by a user viewing the simulation results. In addition, when performing virtual treatment on volumetric imaging data, the cross-sectional view can be rotated about an axis (e.g., a virtual needle axis defined by virtual needle 1302), such as indicated by arrow 1303. As described elsewhere herein, this allows visualization of the cross-sectional extent of various features (e.g., lesion 1306, virtual treatment region 1350) in multiple planes, each plane containing virtual needle 1322.

[0124] The user may adjust one or more virtual treatment parameters to visualize the effects of such adjustments, such as for applying treatment (e.g., cryo or other ablative techniques) at different time periods and / or different amounts of applied power, frequency, etc. Additionally, while illustrated with a single virtual needle 1322, it should be understood that multiple virtual needles may be inserted into the volume to affect the virtual treatment. Figure 14A-Figure 14CThermal gradients are shown for exemplary ice ball formation and multiple needle configurations, but the examples are equally applicable to the formation of a volume of ablated tissue or a volume of predicted tissue death.

[0125] Fig.14A An ice ball 1450 is shown that is formed by a single needle 1402. Fig.14A In the example of , ice ball 1450 grows approximately symmetrically around the needle. Ice ball 1450 includes three regions 1452, 1454, 1456, which can, for example, correspond to different temperature ranges. In an exemplary embodiment, region 1452 corresponds to temperatures between -20°C and 0°C, region 1454 corresponds to temperatures between -40 and -20°C, and region 1456 corresponds to temperatures below -40°C.

[0126] Fig. 14B An ice ball 1460 is shown which is formed by a pair of cryo-needles 1412a, 1412b. Fig.14A The ice ball 1450 includes three regions 1462, 1464, 1466, which may correspond to different temperature ranges, for example. In an exemplary embodiment, region 1462 corresponds to temperatures between -20°C and 0°C, region 1464 corresponds to temperatures between -40°C and -20°C, and region 1466 corresponds to temperatures below -40°C. However, due to the presence of two needles (1412a, 1412b) (rather than one needle) that cause the ice ball to form (1402), Fig. 14B The cross-section of puck 1460 and regions 1462 , 1464 , 1466 have shapes that are different from those of puck 1450 and regions 1452 , 1454 , 1456 .

[0127] Fig. 14C An ice ball 1470 is shown consisting of three cryo-needles 1422a, 1422b, 1422c. Fig.14A The ice ball 1450 includes three regions 1472, 1474, 1476, which may correspond to different temperature ranges, for example. In an exemplary embodiment, region 1472 corresponds to temperatures between -20°C and 0°C, region 1474 corresponds to temperatures between -40°C and -20°C, and region 1476 corresponds to temperatures below -40°C. However, due to the presence of three needles (1422a, 1422b, 1422c) instead of one needle causing the ice ball to form (1402), Fig. 14B The cross-section and regions 1472 , 1474 , 1476 of puck 1470 have shapes that are different from regions 1452 , 1454 , 1456 of puck 1450 .

[0128] If Figure 14A-Figure 14CAs shown in the different ice ball shapes / temperature distributions in FIG. 1 , adjusting the number and / or location of treatment needles (e.g., cryo-needles) can affect the volume affected by the treatment. Thus, in some examples, when performing the Fig. 13C In the described virtual treatments, a user (or a system configured to recommend a specific treatment) can place multiple virtual needles into the volumetric tissue data, thereby simulating a treatment plan for any ablation mode.

[0129] Fig.15 is a process flow diagram illustrating an exemplary process for generating and displaying a simulation treatment plan. Fig.15 The method includes receiving volumetric image data (1500), such as from a volumetric image scanner or from a memory in which image data is stored. The method includes the steps of positioning one or more virtual needles in the volumetric image data (1502) and delineating features within the volumetric image data (1504).

[0130] The method includes displaying a cross-sectional view (1506) in a plane containing a virtual needle axis based on a virtual needle. In some cases, such as when multiple virtual needles are inserted in step 1502, the needle axis can be based on a selected one of the multiple virtual needles. The method includes the steps of receiving one or more operating parameters (1508), such as operating parameters of a treatment (such as operating power or frequency or treatment duration), and generating and displaying a treatment volume (1510) on a cross-sectional view. In some instances, the generated treatment volume can be based on the one or more received operating parameters. Such a virtual treatment volume can be used to determine whether a simulated treatment (e.g., based on one or more received parameters) has a desired effect on the volume, such as whether a particular portion of the treatment volume completely overlaps with a demarcated lesion.

[0131] In various examples, a cross-sectional view including the generated virtual treatment volume can be generated to display various portions with a contrasting display scheme, such as contrasting colors, etc. For example, one or more demarcated features (such as lesions, organ boundaries) and the virtual treatment volume can be displayed with one or more contrasting colors relative to other volumetric image data shown in the cross-sectional view. In addition or alternatively, an overlap between one or more such regions can be displayed with a contrasting display scheme, such as in Fig. 13C In some embodiments, a user may manually select which features to display in the comparison display scheme, and in some such instances, may select how to display one or more such features.

[0132] In some embodiments, after displaying the virtual treatment volume, the method may include receiving one or more operating parameters (1508), such as to update the virtual treatment volume. For example, in one exemplary embodiment, a user may view the virtual treatment volume along with the demarcated lesion and / or organ boundaries, and may wish to adjust one or more operating parameters that affect the virtual treatment volume. Such parameter adjustments may be used to fine-tune the virtual treatment to achieve a desired treatment volume, and in some instances achieve treatment volume features (e.g., isotherms, etc.).

[0133] Fig.15 The method further includes the step of updating the cross-sectional view (1512) of the volume image data. In some instances, updating the cross-sectional view includes rotating the volume image data about a virtual needle axis (1514), as described elsewhere herein. Additionally or alternatively, in a process in which multiple virtual needles are inserted into the volume, updating the cross-sectional view (1512) may include selecting a new virtual needle and changing the virtual needle axis included in the cross-sectional plane (1516). In either case, after updating the cross-sectional view, the method may return to the step of displaying the cross-sectional view in a plane containing a virtual needle axis based on the selected (and possibly updated) virtual needle.

[0134] It should be understood that in various embodiments, Fig.15 The steps of the exemplary method may be omitted or altered, and may include other steps. For example, in another exemplary embodiment, the steps of positioning one or more virtual needles in the volume image data (1502) and demarcating features within the volume image data (1504) may be altered, wherein the features (e.g., one or more lesions, organ boundaries) are demarcated before positioning the one or more virtual needles. These processes may include steps to adjust the positioning and / or number of virtual needles within the volume image data.

[0135] In addition to treatment planning processes (e.g., visualizing a virtual needle and a virtual treatment volume in the volumetric image data of the actual environment) and treatment monitoring processes (e.g., visualizing an actual needle and an actual treatment volume in the volumetric image data), a combination of such processes may also be performed in some instances. For example, in some embodiments, the system may be configured to use an actual needle demarcated in the volumetric image data to generate a virtual treatment volume based on the likely progress of a treatment process for a given position of the needle in the volume.

[0136] Fig.161 is a process flow diagram illustrating an exemplary method for generating a virtual treatment volume using delineated needles in volumetric image data. The method includes receiving volumetric image data (1600) and delineating features within the volumetric image data that include one or more needles (1602). The method further includes displaying a first cross-sectional view (1604) based on a needle axis of one (e.g., a selected one) of the one or more delineated needles, such as described elsewhere herein.

[0137] The method includes the steps of receiving one or more operating parameters (1606) (e.g., operating power, operating time, etc.) and generating and displaying a virtual treatment volume (1608) on a cross-sectional view. The virtual treatment volume can be based on the received one or more operating parameters, and in some embodiments, based on the volumetric image data itself. For example, in addition to the received operating parameters, one or more demarcated features (e.g., organ boundaries, vascular structures, etc.) can affect the virtual treatment volume. In some cases, such demarcated features can affect the thermal properties of tissue proximate to the demarcated needle, and thus affect the thermal effect on the proximate tissue.

[0138] Fig.16 The method further includes the steps of updating the cross-sectional view of the volume image data (1610), such as by rotating the volume image data about the needle axis (1612), and displaying the updated cross-sectional view (1604). Other processes may be used to update the cross-sectional view, such as selecting a different one of a plurality of needles used to define the needle axis, thereby adjusting the plane of the cross-sectional image to include the new needle axis.

[0139] The visualization techniques described herein, including demarcating volumetric image data and rotating the volumetric image data around a needle (e.g., actual or virtual) axis, can be used to plan and / or perform operations, such as cryoablation procedures using one or more cryoneedles. In some instances, the various techniques described herein can be performed continuously to help plan and perform surgery.

[0140] Fig.171700 is a process flow diagram illustrating an exemplary process for planning and performing a procedure. The method includes receiving volumetric imaging data (1700), positioning one or more virtual needles in the volumetric imaging data (1702), and receiving one or more operating parameters (1704). The method further includes generating a virtual treatment volume (1706), which can be based on, for example, the position and number of virtual needles, and / or the received one or more operating parameters. As described elsewhere herein, a cross-sectional view of the volumetric imaging data including the virtual treatment volume can be generated / displayed (1708). Similarly, the cross-sectional view can be updated if the position of the needle and / or the operating parameters are adjusted (e.g., by a user).

[0141] In some embodiments, a cross-sectional image including a virtual treatment volume can be used to plan a treatment process, wherein a system operator is able to observe the treatment volume together with the volumetric image data. As described elsewhere herein, in some instances, various features (e.g., one or more lesions, organ boundaries, etc.) can be demarcated virtual treatment volumes, and such demarcated features and / or virtual treatment areas can be presented within the volumetric image data in a contrast display scheme. The cross-sectional display can be used to facilitate analysis of virtual needle positions and / or operating parameters used to generate the virtual treatment volume. In addition, as described above, the cross-sectional view can be rotated, such as around the axis of the virtual needle, such as to observe the relative position and size of the virtual treatment volume relative to the volumetric image data, and in some cases observe one or more demarcated features therein.

[0142] Fig.17 The method further includes the step of inserting one or more needles into the volume (1710), such as into the patient tissue represented by the volumetric image data. In some cases, the one or more needles can be inserted approximately at the location in the volume where the one or more virtual needles are located (e.g., at step 1702). Thus, the virtual treatment volume based on the virtual needle locations provides a prediction of the treatment results performed by the inserted one or more actual needles.

[0143] The method further includes receiving updated volumetric image data including one or more needles (1712), and demarcating the inserted needles in the updated volumetric image data (1714). In various embodiments, the virtual needles can be deleted from the volumetric image data, or can remain in the volumetric image data along with the demarcated needles. In some such instances, the system can provide the remaining virtual needles in a contrast display scheme relative to the demarcated needles in the volume.

[0144] In some examples, the method includes the steps of receiving one or more operating parameters (1716) and generating a virtual treatment volume (1718). In some embodiments, the one or more operating parameters in step 1716 are the same as those received in step 1704 and, along with the number and / or positions of inserted needles, may be used to generate the virtual treatment volume (1718). In some such examples, any differences between the treatment volume generated in step 1706 and the treatment volume generated in step 1718 are due to differences in the number and / or positions of actual needles inserted in step 1710 and the number and / or positions of virtual needles positioned in step 1702.

[0145] The method may include the step of generating / updating a cross-sectional view (1720) of volumetric imaging data including a virtual treatment volume. In some such instances, the cross-sectional view of the volumetric imaging data includes one or more delineated insertion needles and / or other delineated features from the volumetric imaging data. In some cases, such a cross-sectional view may be used to confirm a predicted outcome of a surgery for a given needle position in the insertion volume. Similarly, a user may observe a virtual treatment volume based on one or more insertion needle positions and determine that the position of the needle should be adjusted to achieve a desired surgical outcome and / or prevent an undesirable treatment outcome. As described elsewhere herein, the cross-sectional view may be updated, for example by rotating the volumetric imaging data about a needle axis defined by one or more inserted needles to observe cross-sections of the virtual treatment volume in multiple planes.

[1146] If the virtual treatment volume is satisfactory, the method may include performing a treatment procedure (1722) (e.g., cryoablation), for example, identifying and / or demarcating a treatment volume (1724), and generating / updating a cross-sectional view of volumetric image data including the treatment volume (1726). Thus, in an exemplary embodiment, a user operating a surgical instrument (such as a cryonephrase) may view the treatment volume in the volumetric image data, for example, to determine whether adequate treatment is being applied and / or whether treatment is progressing as expected (e.g., based on a previously viewed virtual treatment volume).

[0147] As about Fig.11 , Fig.15 and Fig.16 As described, Fig.17 Various steps in the method of may be omitted or altered, and / or various other steps may be added. Additionally or alternatively, Fig.17The various steps in the method may be performed manually or automatically. For example, in some embodiments, the processing system (e.g., via a control system) may be configured to control the operation of one or more surgical tools (such as ablation probes / needles), and the procedure (e.g., cryotherapy or other ablative procedures) may continue to be performed until the treatment volume (e.g., ice ball, ablated tissue volume, tissue death volume, ice ball or other respective edges, one or more isotherm areas, etc.) satisfies one or more conditions (e.g., sufficiently overlaps with the demarcated lesion, etc.).

[0148] In some instances, in addition or alternatively, the system can be configured to automate the placement or movement of one or more needles (e.g., virtual needles) within the volume and / or adjust one or more treatment (e.g., cryo or other ablation) parameters, such as during treatment planning. For example, in some embodiments, the system can be configured to determine an optimized position of one or more needles and / or one or more treatment parameters (e.g., ablation power, frequency, duration, etc.) for a simulated treatment. The optimized position and / or parameters can correspond to parameters that result in effective treatment while minimizing undesirable results (e.g., undesirable tissue damage).

[0149] As described elsewhere herein, several steps in a treatment simulation process (e.g., using a virtual needle and / or an actual needle) and / or a treatment process (e.g., ice ball formation via a cryoablation process) can be automatically performed by the system, for example, via a processing system 90. Although various steps are discussed with reference to a control system and a visualization system, it should be understood that in various embodiments, such system steps may be performed by a single processor or a distributed network of processors (e.g., via a processing system). That is, the visualization system and the control system need not be separate or distinguishable entities. On the other hand, in some instances, the visualization system and the control system may be embodied as separate independent components, such as separate computer workstations, etc. In some such embodiments, such systems may communicate with each other or have common processing components, such as for performing control processes (e.g., starting or stopping cryoablation or other ablation) in response to analyzed image data.

[0150] In addition, although often described with respect to cryoablation, the various processes described herein can be applied to a variety of systems. For example, other tissue destruction processes (e.g., thermal ablation) can result in a treatment volume identifiable in the volumetric imaging data, such as a volume of ablated tissue or a volume of tissue in which tissue death is predicted to occur. Such a treatment volume can be demarcated (as described herein) to facilitate visual analysis of treatment progress. Similarly, a virtual treatment volume (as described herein) can be generated to assist in treatment planning. In some cases, the various processes described herein can be used for other purposes, such as ultrasound therapy or other processes in which visualization from multiple directions would be advantageous.

[0151] In addition, the visualization techniques described herein (e.g., identifying the needle axis, taking a cross-section in a plane including the needle axis, rotating the cross-sectional view about the needle axis, etc.) can be used to visualize data from various perspectives. This can help ensure that adequate treatment is being performed (e.g., during a treatment course), that the prescribed treatment will likely be effective (e.g., during treatment planning), and can reduce the risk of inadvertently damaging or negatively affecting undesirable tissue (e.g., an organ immediately adjacent to a lesion).

[0152] Various examples have been described above. The drawings and descriptions herein are exemplary in nature and do not limit the scope of the present invention in any way. Instead, such examples are intended to disclose various possible configurations and embodiments within the scope of the appended claims.

Claims

1. An ablation system, comprising: an ablation needle configured to be inserted into patient tissue to adjust the temperature of the patient tissue via an ablation procedure; an imaging system configured to generate a plurality of two-dimensional images of said patient tissue; monitor; and A processing system configured to: receiving a plurality of two-dimensional images of patient tissue; generating volumetric image data of patient tissue based on the received plurality of two-dimensional images; demarcating the ablation needle within the volumetric image data of the patient tissue; predicting a temperature profile of patient tissue proximate to the ablation needle during an ablation procedure; identifying one or more volume isotherm boundaries based on the predicted temperature profile; and A cross-sectional image of the volumetric image data is displayed on the display, the cross-sectional image showing a plane including an axis defined by the ablation needle and including the needle and one or more of the identified one or more volume isotherm boundaries.

2. The system of claim 1, wherein the processing system is further configured to delineate one or more lesions within the volumetric image data; and wherein the cross-sectional image includes a display of the one or more delineated lesions.

3. A system according to claim 1 or 2, wherein the system comprises a cryoablation system.

4. The system of claim 1 or 2, wherein the system comprises a microwave ablation system.

5. The system of claim 1 or 2, wherein the system comprises a radiofrequency ablation system.

6. The system of claim 1 or 2, wherein the system comprises an electroporation ablation system.

7. The system of claim 1 or 2, wherein the system comprises an ultrasound ablation system.

8. The system of claim 1 or 2, wherein the one or more volume isotherm boundaries include at least isotherms at 0°C, -20°C, or -40°C.

9. The system of claim 1 or 2, wherein the one or more volume isotherm boundaries include at least an isotherm at 60°C.

10. The system of claim 1 or 2, wherein the one or more volume isotherm boundaries include isotherms corresponding to at least a volume range within which tissue death is predicted.

11. A system according to claim 1 or 2, wherein the cross-sectional image showing the plane includes a first cross-sectional image showing the first plane, and wherein the processing system is further configured to display a second cross-sectional image of the volumetric image data on the display, the second cross-sectional image showing a second plane and including the needle and one or more of the confirmed one or more volume isotherm boundaries, the second plane including an axis defined by the ablation needle.

12. The system of claim 11, further comprising a user interface in communication with the processing system, and wherein the processing system is configured to switch between the first cross-sectional image and the second cross-sectional image in response to a command received via the user interface.

13. The system of claim 12, wherein the processing system is configured to receive a command from the user interface to rotate the volumetric image data about an axis defined by the needle to switch between the first cross-sectional image and the second cross-sectional image.

Images