Systems and methods for thyroid nodule ablation planning and tracking

Abstract

Ablation systems and methods include displaying a representation of a 3D model of tissue, tracking movement of an ablation probe during an ablation pass, determining a result of the ablation pass based on the tracking and an energy setting(s), and displaying a portion of the tissue ablated as a result of the ablation pass and / or a portion of the tissue remaining after the ablation pass. Ablation planning systems and methods include generating a 3D segmentation of tissue, generating a 3D model of the tissue based on the 3D segmentation, displaying a representation of the 3D model, determining a planned ablation pass for moving an energized ablation probe through the tissue, determining a result of executing the planned ablation pass, and displaying one of a planned portion of the tissue to be ablated based on the determined result a planned portion of the tissue remaining after the determined result.

Description

SYSTEMS AND METHODS FOR THYROID NODULE ABLATION PLANNING AND TRACKINGCROSS REFERENCE TO RELATED APPLICATION

[0001] This application claims the benefit of and priority to U. S. Provisional Patent Application No. 63 / 655,799, filed on June 4, 2024, and to U.S. Provisional Patent Application No. 63 / 655,865, filed on June 4, 2024, the entire contents of both of which is hereby incorporated herein by reference.FIELD

[0002] The present disclosure relates to ablation and, more specifically, to systems and methods for planning and performing thyroid nodule ablation.BACKGROUND

[0003] Treatment of certain diseases requires the destruction of abnormal tissue growths, e.g., nodules, while preserving surrounding tissue. Treatment methods for destroying nodules include ablation, wherein energy, e.g., RF energy, microwave energy, thermal energy, etc., is applied to the nodule to destroy the nodule. Such ablation procedures are often performed with the benefit of ultrasound guidance to guide the ablation probe to the target tissue and to monitor the ablation.

[0004] However, despite the use of ultrasound guidance, monitoring ablation can be difficult as the ablation itself negatively impacts the visualization provided by ultrasound. Thus, a high level of skill is required to ensure that the nodule is sufficiently destroyed while surrounding tissue is preserved. This is especially the case in delicate areas involving small working spaces and / or critical structures in close proximity to the nodule to be ablated, such as with respect to thyroid nodule ablation.SUMMARY

[0005] As used herein, the term “distal” refers to the portion that is being described which is farther from an operator (whether a human surgeon or a surgical robot), while the term “proximal” refers to the portion that is being described which is closer to the operator. Terms including “generally,” “about,” “substantially,” and the like, as utilized herein, are meant to encompass variations, e.g., tolerances, measurement variations, design variations, and / or other tolerances andvariations, up to and including plus or minus 10 percent. Further, to the extent consistent, any or all of the aspects detailed herein may be used in conjunction with any or all of the other aspects detailed herein.

[0006] Provided in accordance with aspects of the present disclosure is a system for thyroid nodule ablation including an ablation probe configured to be energized to ablate tissue, a display, at least one processor, and at least one non-transitoiy computer-readable storage medium storing instructions that, when executed by the at least one processor, cause the at least one processor to: display (on the display) a representation of a 3D model of tissue of interest; track movement of the ablation probe during a first ablation pass wherein the ablation probe is energized according to at least one energy setting and moved through the tissue of interest; determine a result of the first ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest based on the movement tracking and the at least one energy setting; and display (on the display) a portion of the tissue of interest ablated as a result of the first ablation pass and / or a portion of the tissue of interest remaining after the first ablation pass.

[0007] In an aspect of the present disclosure, the at least one non-transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to: track movement of the ablation probe during a second ablation pass wherein the ablation probe is energized according to at least one energy setting and moved through the tissue of interest; determine a result of the second ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest based on the movement tracking and the at least one energy setting; and update, as a result of the second ablation pass, the display of the portion of the tissue of interest ablated and / or the portion of the tissue of interest remaining.

[0008] In another aspect of the present disclosure, the at least one non-transitory computer- readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to determine, based upon the results of the first and second ablation passes, whether a threshold amount of the tissue of interest has been ablated and to display an indication of the result of the determination.

[0009] In another aspect of the present disclosure, the display of the portion of the tissue of interest ablated and / or the portion of the tissue of interest remaining includes visuallydistinguishing at least one portion of the displayed 3D model representation from at least one other portion of the displayed 3D model representation.

[0010] In still another aspect of the present disclosure, the display of the portion of the tissue of interest ablated and / or the portion of the tissue of interest remaining includes displaying a percentage of a volume of the tissue of interest that has been ablated and / or a percentage of a volume of the tissue of interest that remains, respectively.

[0011] In another aspect of the present disclosure, the at least one non-transitory computer- readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to display, on the displayed 3D model representation, a representation of a position of the ablation probe relative to the tissue of interest, a trajectory projection of the ablation probe relative to the tissue of interest, and / or a navigation route of the ablation probe through the tissue of interest.

[0012] In still yet another aspect of the present disclosure, the at least one non-transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to display, on the displayed 3D model representation, an indication of a speed of the ablation probe during the first ablation pass relative to a planned speed. In such aspects: a representation of the ablation probe moving relative to the displayed 3D model representation during the first ablation pass may indicate the speed of the ablation probe; and / or an avatar moving relative to the displayed 3D model representation during the first ablation pass may indicate the planned speed.

[0013] A method of thyroid nodule ablation provided in accordance with the present disclosure includes: displaying a representation of a 3D model of tissue of interest; tracking movement of the ablation probe during a first ablation pass wherein the ablation probe is energized according to at least one energy setting and moved through the tissue of interest; determining a result of the first ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest based on the movement tracking and the at least one energy setting; and displaying a portion of the tissue of interest ablated as a result of the first ablation pass and / or a portion of the tissue of interest remaining after the first ablation pass.

[0014] In aspects of the present disclosure, the at least one energy setting may be received from an ablation generator controlling the ablation probe during use such as, for example, via wired or wireless communication, to facilitate determining the result of the ablation pass.

[0015] In an aspect of the present disclosure, the method further includes: tracking movement of the ablation probe during a second ablation pass wherein the ablation probe is energized according to at least one energy setting and moved through the tissue of interest; determining a result of the second ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest based on the movement tracking and the at least one energy setting; and updating, as a result of the second ablation pass, the display of the portion of the tissue of interest ablated and / or the portion of the tissue of interest remaining.

[0016] In another aspect of the present disclosure, the method further includes determining, based upon the results of the first and second ablation passes, whether a threshold amount of the tissue of interest has been ablated, and displaying an indication based on the determination.

[0017] In still another aspect of the present disclosure, displaying the portion of the tissue of interest ablated and / or the portion of the tissue of interest remaining includes visually distinguishing at least one portion of the displayed 3D model representation from at least one other portion of the displayed 3D model representation.

[0018] In another aspect of the present disclosure, displaying the portion of the tissue of interest ablated and / or the portion of the tissue of interest remaining includes displaying at least one of a percentage of a volume of the tissue of interest that has been ablated and / or a percentage of a volume of the tissue of interest that remains, respectively.

[0019] In yet another aspect of the present disclosure, the method further includes displaying, on the displayed 3D model representation, a representation of a position of the ablation probe relative to the tissue of interest, a trajectory projection of the ablation probe relative to the tissue of interest, and / or a navigation route of the ablation probe through the tissue of interest.

[0020] In still yet another aspect of the present disclosure, the method further includes displaying, on the displayed 3D model representation, an indication of a speed of the ablation probe during the first ablation pass relative to a planned speed. In such aspects, a representation of the ablation probe moving relative to the displayed 3D model representation during the first ablation pass may indicate the speed of the ablation probe and / or an avatar moving relative to the displayed 3D model representation during the first ablation pass may indicate the speed associated with the planned ablation pass.

[0021] The systems and methods of the present disclosure also enable navigating the ultrasound probe, e.g., via electromagnetic or optical navigation, to enable relating the positionof the 3D segmentation to the position of the ablation probe (and / or the location of the ablation passes).

[0022] A system for thyroid nodule ablation planning provided in accordance with the present disclosure includes an ultrasound probe configured to perform an ultrasound sweep on a patient’s skin above tissue of interest, a display, at least one processor, and at least one non-transitory computer-readable storage medium storing instructions that, when executed by the at least one processor, cause the at least one processor to: generate a 3D segmentation of tissue of interest based on ultrasound image data obtained from the ultrasound sweep; generate a 3D model of the tissue of interest based on the 3D segmentation; display (on the display) a representation of the 3D model of the tissue of interest; determine a first planned ablation pass for moving an energized ablation probe through the tissue of interest; determine a result of an execution of the first planned ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest; and display (on the display) at least one of a planned portion of the tissue of interest to be ablated based on the determined result of the first planned ablation pass or a planned portion of the tissue of interest remaining after the determined result of the first planned ablation pass.

[0023] In aspects of the present disclosing, navigating the ultrasound device during the ultrasound sweep may be utilized to increase the fidelity of the 3D model.

[0024] In an aspect of the present disclosure, the at least one non-transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to: determine a second planned ablation pass for moving the energized ablation probe through the tissue of interest; determine a result of an execution of the second planned ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest; and update, based on the determined result of the second planned ablation pass, the display of the planned portion of the tissue of interest to be ablated and / or the planned portion of the tissue of interest remaining.

[0025] In another aspect of the present disclosure, the at least one non-transitory computer- readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to: determine whether execution of the first and second planned ablation passes would result in ablation of a threshold amount of the tissue of interest; and display an indication of the result of the determination.

[0026] In yet another aspect of the present disclosure, the at least one non-transitory computer- readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to determine an entry point for accessing the tissue of interest. The planned first ablation pass, in such aspects, is constrained by the determined entry point.

[0027] In another aspect of the present disclosure, the at least one non-transitory computer- readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to determine the entry point as an entry point that minimizes a number of planned ablation passes required to be executed to ablate the tissue of interest.

[0028] In still another aspect of the present disclosure, the display of the planned portion of the tissue of interest to be ablated and / or the planned portion of the tissue of interest remaining includes visually distinguishing at least one portion of the displayed 3D model representation from at least one other portion of the displayed 3D model representation.

[0029] In another aspect of the present disclosure, wherein the display of the planned portion of the tissue of interest to be ablated and / or the planned portion of the tissue of interest remaining includes displaying a percentage of a planned volume of the tissue of interest to be ablated and / or a percentage of a planned volume of the tissue of interest that would remain, respectively.

[0030] In still yet another aspect of the present disclosure, the first planned ablation pass is determined at least in part based on a planned speed of movement of the ablation probe through the tissue of interest, at least in part based on a planned energy setting associated with the ablation probe, and / or at least in part based on input received from a clinician. As an alternative to planning a speed of the ablation probe during planning and / or determining an actual speed of the ablation probe in use, in these or any other aspects of the present disclosure, the ablation pass (planned or actual) is determined based at least in part on how long the ablation needle sits (or moves) at a particular point.

[0031] A method of thyroid nodule ablation planning provided in accordance with the present disclosure includes: generating (from ultrasound image data) a 3D segmentation of tissue of interest; generating a 3D model of the tissue of interest based on the 3D segmentation; displaying a representation of the 3D model of the tissue of interest; determining a first planned ablation pass for moving an energized ablation probe through the tissue of interest; determining a result of anexecution of the first planned ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest; and displaying a planned portion of the tissue of interest to be ablated based on the determined result of the first planned ablation pass and / or a planned portion of the tissue of interest remaining after the determined result of the first planned ablation pass.

[0032] In an aspect of the present disclosure, the method further includes: determining a second planned ablation pass for moving the energized ablation probe through the tissue of interest; determining a result of an execution of the second planned ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest; and updating, based on the determined result of the second planned ablation pass, the display of the planned portion of the tissue of interest to be ablated and / or the planned portion of the tissue of interest remaining.

[0033] In another aspect of the present disclosure, the method further includes determining whether execution of the first and second planned ablation passes would result in ablation of a threshold amount of the tissue of interest and displaying an indication of the result of the determination.

[0034] In still another aspect of the present disclosure, the method further includes determining an entry point for accessing the tissue of interest. In such aspects, the planned first ablation pass is constrained by the determined entry point.

[0035] In another aspect of the present disclosure, the entry point is determined as an entry point that minimizes a number of planned ablation passes required to be executed to ablate the tissue of interest.

[0036] In yet another aspect of the present disclosure, displaying the planned portion of the tissue of interest to be ablated and / or the planned portion of the tissue of interest remaining includes visually distinguishing at least one portion of the displayed 3D model representation from at least one other portion of the displayed 3D model representation.

[0037] In another aspect of the present disclosure, displaying the planned portion of the tissue of interest to be ablated and / or the planned portion of the tissue of interest remaining includes displaying a percentage of a planned volume of the tissue of interest to be ablated and / or a percentage of a planned volume of the tissue of interest that would remain, respectively.

[0038] In still yet another aspect of the present disclosure, the first planned ablation pass is determined at least in part based on a planned speed of movement of the ablation probe through the tissue of interest, at least in part based on a planned energy setting associated with the ablation probe, and / or at least in part based on input received from a clinician.BRIEF DESCRIPTION OF THE DRAWINGS

[0039] Various aspects and features of the present disclosure are described hereinbelow with reference to the drawings wherein:

[0040] FIG. 1 illustrates a surgical system for planning and / or tracking ablation of a thyroid nodule in accordance with the present disclosure;

[0041] FIG. 2 is a simplified block diagram of a computer of the system of FIG. 1;

[0042] FIG. 3 is a perspective view illustrating an ultrasound sweep as part of planning a thyroid nodule ablation in accordance with the present disclosure;

[0043] FIGS. 4A-5 are user interfaces facilitating planning of a thyroid nodule ablation in accordance with the present disclosure;

[0044] FIG. 6 is a flow diagram of a thyroid nodule ablation planning method in accordance with the present disclosure;

[0045] FIG. 7 is a perspective view illustrating a thyroid nodule ablation in accordance with the present disclosure;

[0046] FIGS. 8A-11C are user interface displays facilitating a thyroid nodule ablation in accordance with the present disclosure; and

[0047] FIG. 12 is a flow diagram of a thyroid nodule ablation method in accordance with the present disclosure.DETAILED DESCRIPTION

[0048] Referring to FIG. 1, a system provided in accordance with the present disclosure and configured to facilitate ablation planning and / or tracking, e.g., for ablation of a thyroid nodule, is shown generally identified by reference numeral 100. System 100 includes a surgical display 110, a table 120, an ablation probe 130, an ultrasound device 140 connected to an ultrasound workstation 150, an ablation energy generator 170, (e.g., a microwave generator, a Radio Frequency (RF) generator, etc.), and a computer 180. Computer 180 may be, for example, a laptopcomputer, desktop computer, tablet computer, server (e.g., a local server or cloud server), or other suitable computing device or combination of computing devices.

[0049] Table 120 may be, for example, an operating table or other table suitable for use during a surgical procedure. Table 120 may include an electromagnetic (EM) field generator 121 configured to generate an EM field as part of an EM tracking system that is used to track the position of one or more objects relative to a patient lying on table 120, e.g., tracking ablation probe 130 by tracking a position of EM sensor 131 of ablation probe 130 within the EM field generated by EM field generator 121 and / or tracking ultrasound device 140 by tracking a position of EM sensor 141 of ultrasound device 140 within the EM field generated by EM field generator 121. Other suitable tracking systems are also contemplated, as is tracking of additional or alternative objects. In addition or as an alternative to EM tracking, the EM system may be utilized for EM navigation, e.g., of ablation probe 130 as detailed hereinbelow.

[0050] Ablation probe 130 may include a microwave ablation antenna that is used to ablate tissue, although other suitable ablation probes (e.g., RF ablation probes, thermal ablation probes, cryogenic ablation probes, etc.) are also contemplated. Ablation probe 130 may include, or have attached to it, EM sensor 131 enabling, as noted above, the EM tracking system to track the location, position, and orientation (also referred to as the “pose”) of ablation probe 130 and, in aspects, to enable navigation of ablation probe 130 to a target location. Generator 170 is configured to output energy (e.g., microwave energy) to ablation probe 130 and control the output energy according to, for example, power settings and / or other settings associated with the energy supplied from ablation probe 130 to tissue to ablate the tissue.

[0051] Ultrasound device 140 may be an ultrasound wand or other suitable ultrasound device and includes, or has attached to it, an EM sensor 141 enabling, as noted above, the EM tracking system to track the pose of ultrasound device 140. Ultrasound device 140 and ultrasound workstation 150 enable ultrasound imaging for visualization during a surgical procedure, e.g., to enable visual monitoring of the position of ablation probe 130 relative to the patient. Ultrasound device 140 and ultrasound workstation 150, together with the EM tracking system, also enable three-dimensional (3D) segmentation for generating a 3D model of tissue of interest for use in preoperative planning and / or tracking during a surgical procedure. The tissue of interest may include, for example, a thyroid nodule to be ablated, although suitable tissue of interest other than a thyroid nodule and / or suitable purposes other than ablation are also contemplated. Thus,although detailed herein with respect to ablation of a thyroid nodule, it is understood that the aspects and features of the present disclosure may likewise be utilized with other tissue of interest and / or for other treatment and / or diagnostic purposes.

[0052] A 3D segmentation of the thyroid nodule is generated in accordance with the present disclosure by performing an ultrasound sweep, e.g., of a neck region of the patient, using ultrasound device 140. The ultrasound sweep may be performed manually by a clinician, e.g., a surgeon, surgical nurse, surgical technician, etc., although it is also contemplated that the ultrasound sweep may be automated, e.g., using a surgical robot mounting ultrasound device 140 on a robotic arm thereof. The ultrasound image data generated by ultrasound device 140 during the ultrasound sweep and the tracking of EM sensor 141 of ultrasound device 140 during the ultrasound sweep are utilized to generate the 3D segmentation of the thyroid nodule, which is then used to generate a 3D model for surgical planning, tracking, and / or navigation during a surgical procedure in accordance with the present disclosure, as described in greater detail hereinbelow.

[0053] Ultrasound workstation 150 may be used to configure, operate, and view images captured by ultrasound device 140 during use. Alternatively or additionally, computer 180 may be used to configure, operate, and view images captured by ultrasound sensor 140, either directly or relayed via ultrasound workstation 150. Computer 180 is also configured to generate the 3D segmentation of the thyroid nodule, e g., from the ultrasound image data obtained by ultrasound device 140 and the tracking data obtained by EM sensor 141 of ultrasound device 140. A 3D model of the thyroid nodule is generated based on the 3D segmentation, e.g., utilizing computer 180. The 3D model enables surgical planning, tracking, and / or navigation in accordance with the present disclosure, as detailed below, which may likewise be performed via computer 180 and / or any other suitable computer or combination of computers.

[0054] With reference to FIG. 2, a simplified block diagram of computer 180 is shown. Computer 180 includes at least one memory 202, one or more processors 204, a display 206 (in aspects), a network interface 208, one or more input devices 210, and / or an output module 212. Memory 202 may store image data 214 (e.g., from ultrasound device 140 / ultrasound workstation 150 (see FIG. 1)), tracking data 216 (e.g., from ablation probe 130 and / or ultrasound device 140 (see FIG. 1)) and one or more applications 220 that, when executed by processor 204, cause display 206 (and / or any other suitable display in communication with computer 180) to presentuser interface 222. The one or more applications 220, more specifically, may include a planning application to enable the thyroid nodule ablation planning functionalities detailed hereinbelow and a tracking and / or navigation application to enable the thyroid nodule ablation tracking and / or navigation functionalities detailed hereinbelow. However, other suitable software and / or hardware implementations for performing the thyroid nodule ablation planning, tracking, and / or navigation in accordance with the present disclosure are also contemplated. Memory 202 may include any non-transitory computer-readable storage medium for storing data and / or software that is executable by processor 204 and which controls the operation of computing device 180.

[0055] Network interface 208 may be configured to connect to a network such as a local area network (LAN) consisting of a wired network and / or a wireless network, a wide area network (WAN), a wireless mobile network, a Bluetooth network, and / or the internet. Input device 210 may be any device by means of which a user may interact with computer 180, such as, for example, a mouse, keyboard, foot pedal, touch screen, and / or voice interface. Output module 212 may include any connectivity port(s) or bus(es), such as, for example, parallel ports, serial ports, universal serial busses (USB), or any other similar connectivity port(s).

[0056] Turning to FIGS. 3-6, thyroid nodule ablation planning in accordance with the present disclosure is detailed. Thyroid nodule ablation involves working in a relatively confined space surrounded by critical tissue structures such as thyroid tissue, vital nerves and blood vessels, lymph nodes, etc. In order to minimize damage to surrounding tissue structures, thyroid nodule ablation may be performed using a plurality of dynamic ablation passes, wherein each dynamic ablation pass involves actively moving the ablation probe through a portion of the thyroid nodule while applying energy from the ablation probe to the thyroid nodule to ablate the portion of the thyroid nodule. As a result of each dynamic ablation pass, a relatively narrow, substantially cylindrical ablation volume is achieved (rather than a more spherical or ellipsoidal shaped ablation volume typical of static ablation). By performing a plurality of dynamic ablation passes each achieving a substantially cylindrical ablation volume, the overall ablation volume can be precisely controlled, e.g., due to the relatively small radial extent of any one ablation pass, while ablation of substantially the entire thyroid nodule can be achieved, e.g., collectively via the plural ablation passes. Accordingly, thyroid nodule ablation planning in accordance with the present disclosure as detailed below facilitates planning of a plurality of ablation passes to ablatesubstantially an entire thyroid nodule while minimizing or preventing damage to non-nodule tissue.

[0057] Initially, as shown in FIG. 3, and as noted above, an ultrasound sweep of a patient’s neck region is performed using ultrasound device 140 (including EM sensor 141) with the patient lying on table 120 (including EM field generator 121). The ultrasound image data obtained from ultrasound device 140 during the ultrasound sweep together with the tracking data obtained from EM sensor 141 indicating the pose of ultrasound device 140 during the ultrasound sweep are utilized to generate a 3D segmentation of the thyroid nodule to be ablated. More specifically, by capturing a plurality of two-dimensional ultrasound image slices at a plurality of different positions, angles, and / or orientations by maneuvering ultrasound device 140 along the skin in the patient’s neck region during the ultrasound sweep, and based upon the pose of ultrasound device 140 as tracked by the positioning and movement of EM sensor 141 within the EM field generated by EM field generator 121, a 3D segmentation of the thyroid nodule is generated. The data from the 3D segmentation of the thyroid nodule to be ablated is then utilized to generate a 3D model of the thyroid nodule.

[0058] Referring to FIGS. 4A-4C, a representation 410 of the 3D model of the thyroid nodule to be ablated may be displayed on a user interface 400 of a suitable display, e.g., display 110 (FIG. 1). A clinician may interact with user interface 400 via a touch-screen interface, a mouse, a keyboard, voice input, and / or in any other suitable manner to manipulate and interact with the 3D model representation 410 to plan a thyroid nodule ablation procedure in accordance with the present disclosure, as detailed below. More specifically, an entry point for accessing the thyroid nodule with an ablation probe, e.g., ablation probe 130 (FIG. 1), is first determined. The entry point may be determined based on the selection of the entry point by the clinician, e.g., on user interface 400. Alternatively, the entry point may be determined by calculating, e.g., by computer 180, an entry point that enables ablation of the thyroid nodule with a minimal number of ablation passes. The determined entry point may be incorporated into the 3D model such that a representation 420 of the location of the determined entry point is included in the 3D model representation 410 to illustrate the entry point relative to the thyroid nodule. Although it is desirable in some aspects to provide a single entry point to minimize patient trauma and recovery, it is also contemplated that, depending upon a particular situation, multiple entry points may be utilized. The entry point to the thyroid nodule, e.g., through a patient’s skin, defines a safe pathfrom the skin to the nodule and also defines a fulcrum about which the ablation device is manipulated to perform a plurality of ablation passes to ablate the nodule, as detailed below.

[0059] In surgery, as can be appreciated, the location of each ablation pass relative to the thyroid nodule is physically constrained by the entry point (fulcrum), e.g., whereby the path of each ablation pass is required to intersect the entry point through which the ablation probe is inserted. Thus, this constraint is also implemented during planning such that each planned ablation pass is required to define a path that intersects the determined entry point (or one of the entry points, where multiple entry points are utilized).

[0060] A planned ablation pass, as referred to herein, includes a planned ablation volume and a planned location within the thyroid nodule, which are determined based on, for example, the planned starting point, trajectory, movement speed, energy settings, etc., of the ablation probe during the planned ablation pass. The planned ablation volume and planned location of a planned ablation pass are utilized to determine the would-be impact of that planned ablation pass on the thyroid nodule, if that planned ablation pass were executed as planned. The impact of a planned ablation pass may be conveyed to the clinician by, for example, generating a representation 430 of that ablation pass for inclusion in the 3D model representation 410 displayed to the clinician, and / or in any other suitable manner, such as those detailed hereinbelow.

[0061] The clinician may define one or more of the planned ablation passes, e.g., by indicating a starting location of the ablation probe (typically the location farthest from the entry point), the trajectory of the ablation probe (confined by the determined entry point, as noted above), the movement speed of the ablation probe, energy settings of the ablation probe, etc., for each planned ablation pass. In aspects, the clinician may draw or otherwise simulate one or more ablation passes on the 3D model representation 410 displayed on user interface 400, from which the one or more planned ablation passes are determined. As an alternative to or in conjunction with clinician-defined planned ablation passes, one or more of the planned ablation passes may be computer-defined, e.g., by computer 180, either sequentially, e.g., wherein the planned ablation passes are defined and displayed one at time, or collectively, e.g., wherein the planned ablation passes are defined and displayed all at the same time. As with the clinician-defined planned ablation passes, each computer-defined planned ablation pass includes an associated starting location, trajectory, movement speed, and energy settings associated therewith and from which the resultant ablation volume and location relative to the thyroid nodule are determined.

[0062] Continuing with reference to FIGS. 4A-4C, in addition to including the planned ablation pass representations 430 in the 3D model representation 410 disposed on user interface 400, user interface 400 may provide information relating to the planned ablation procedure. For example, the number of planned ablation passes may be displayed in a window 440 of user interface 400. Alternatively or additionally, the nodule coverage of the planned ablation passes, e.g., the percentage of the nodule volume that would be ablated upon completing the planned ablation passes, may be displayed in a window 450 of user interface 400.

[0063] In aspects, a minimum planned nodule coverage may be set, e.g., by default (adjustable or non-adjustable) or by user setting, such that a thyroid nodule ablation plan may not be finalized until the planned nodule coverage meets or exceeds the minimum planned nodule coverage. Likewise, a maximum collateral damage threshold may be set, e.g., by default (adjustable or non- adjustable) or by user setting, such that a thyroid nodule ablation plan may not be finalized unless damage to tissue outside the nodule is equal to or less than the maximum collateral damage threshold, which may be a threshold volume of tissue, a threshold distance from the nodule, etc. With respect to computer-defined ablation passes, the number and configuration of passes may be determined to minimize the number of passes required to meet the minimum planned nodule coverage (while ensuring the maximum collateral damage threshold, if so provided, is not exceeded). In aspects, the minimum planned nodule coverage may be about 85%; in other aspects, the minimum planned nodule coverage may be about 90%; in still other aspects, the minimum planned nodule coverage may be about 95%; and in yet other aspects, the minimum planned nodule coverage may be adjustable from about 85% (or about 90%) to about 99%.

[0064] Referring to FIG. 5, during planning, in addition or as an alternative to including the planned ablation pass representations 430 in the 3D model representation 410 to illustrate the planned nodule coverage, user interface 400 may include, in the 3D model representation 410, a representation 460 of a volume of the nodule that is not included in the planned ablation volume. Representation 460 may be provided as highlighting, outlining, coloring, or otherwise distinguishing the portion of the 3D model representation 410 that is not covered by the planned nodule ablation volume from the portion of the 3D model representation 410 that is covered by the planned nodule ablation volume. In this manner, the clinician can readily identify the remaining volume to be ablated and, thus, can define one or more additional ablation passes and / or modify one or more previously planned ablation passes in order to cover the remainingvolume. With or without representation 460, previously defined planned ablation passes may be deleted or modified, e.g., repositioned, enlarged / reduced, etc., by altering the starting point and / or settings associated with the planned ablation pass.

[0065] The 3D model representation 410 displayed on user interface 400, including, if displayed, the entry point representation 420, the planned ablation pass representations 430, and / or the uncovered volume representation 460, may be configured for manipulation by the clinician such as, for example, rotation, pan, zoom, sectioning, etc., thus enabling the clinician to view the 3D model representation 410 and / or other representations 420, 430, 460 from various different vantage points and perspectives.

[0066] With reference to FIG. 6, a method of thyroid nodule ablation planning in accordance with the present disclosure is shown generally identified as method 600. Method 600 begins at 610, wherein an ultrasound sweep over a neck region of the patient is performed. A 3D segmentation of the thyroid nodule is generated based upon the ultrasound sweep, as indicated at 620 and, as indicated at 630, a 3D model of the nodule is generated based upon the 3D segmentation.

[0067] At 640, an entry point for accessing the nodule is determined, either by computer calculation or clinician selection. In aspects where computer calculation determines multiple suitable entry points, e.g., wherein several different entry points may be utilized to ablate the nodule with a minimal number of ablation passes (the absolute minimum or below a threshold number of passes), the available entry points may be displayed to the clinician for selection of a desired entry point. Likewise, where clinician selection of the entry point is utilized, the clinician may select plural possible entry points from which the computer calculates, and sets as the entry point, the entry point that enables ablation of the nodule with a minimal number of ablation passes. Additionally or alternatively, where clinician selection of the entry point is utilized, the computer may calculate and display, for acceptance or dismissal, alternative entry points that enable ablation of the nodule with a minimal number of ablation passes or less ablation passes compared to the clinician-selected entry point.

[0068] Once the 3D model is generated and the entry point is determined, method 600 may proceed to 650, where plural planned ablation passes for ablating the nodule are defined, e.g., by a computer, and, subsequently, to 660, where representations of the plural planned ablation passes are included in the representation of the 3D model, either all at once or sequentially. Uponacceptance of the plural planned ablation passes, e.g., by the clinician, ablation planning is completed and ends. If the plural planned ablation passes are not accepted, the clinician may manually delete, edit, add, or otherwise alter one or more planned ablation passes before ultimately accepting the ablation plan and ending ablation planning.

[0069] As an alternative to computer-defined ablation passes at 650, method 600 may proceed, after 640, to 670, wherein a clinician-defined planned ablation pass for ablating the nodule is logged and, then, to 680 where a representation of the clinician-defined ablation pass is included in the 3D model representation. At 690, it is determined whether the planned ablation pass(es), e.g., the ablation passes previously defined by the clinician, cover the nodule volume, e.g., by determining whether the ablation volume resulting from the planned ablation pass(es) meets or exceeds the minimum planned nodule coverage. If the planned ablation pass(es) do not cover the nodule volume, “NO” at 690, 670-690 may be repeated as many times as necessary until the nodule volume is covered by the planned ablation passes. If the planned ablation pass(es) cover the nodule volume, “YES” at 690, the ablation plan is complete and ablation planning ends.

[0070] With respect to defining planned ablation passes, as noted above, the ablation volume resulting from a planned ablation pass depends upon the trajectory of the ablation probe, the energy settings of the ablation probe, and the speed at which the ablation probe is moved during the ablation pass. For example, a cylindrical ablation volume of relatively smaller diameter can be achieved by utilizing a relatively low power setting for the ablation probe and / or moving the ablation probe relatively quickly during the ablation pass. On the other hand, a cylindrical ablation volume of relatively larger diameter can be achieved by utilizing a relatively high power setting for the ablation probe and / or moving the ablation probe relatively slowly during the ablation pass. Whether clinician-defined or computer-defined, the speed of the ablation probe and the energy settings of the ablation probe are factored into determining the resultant ablation volume of a planned ablation pass defined and displayed as detailed above. The speed of the ablation probe and / or the energy settings of the ablation probe may be default settings (fixed or adjustable by the clinician), may be set by the clinician (or sensed based upon clinician input during clinician-defined planned ablation pass creation), or may be selected by the computer. Further, in aspects, different speeds and / or energy settings may be planned for different ablation passes in the same thyroid nodule ablation plan.

[0071] Turning to FIGS. 7-12, thyroid nodule ablation in accordance with the present disclosure is detailed. As detailed above with respect to thyroid nodule ablation planning (see FIGS. 3-6), thyroid nodule ablation may be performed using a plurality of dynamic ablation passes. Thyroid nodule ablation in accordance with the present disclosure is thus detailed hereinbelow with respect to use of a plurality of ablation passes to ablate substantially an entire thyroid nodule while minimizing or preventing damage to non-nodule tissue. Thyroid nodule ablation may be performed after planning, as detailed above (see FIG. 3-6), although ablation without ablation pass planning is also contemplated.

[0072] Thyroid nodule ablation in accordance with the present disclosure is illustrated in FIG. 7, wherein ablation probe 130 is shown inserted through an entry point “E” (e.g., an entry point determined during planning, as detailed above) in the patient’s skin to enable positioning of a distal tip of ablation probe 130 within the thyroid nodule to be ablated. In aspects, ultrasound device 140 is utilized for ultrasound visualization of the thyroid nodule during the ablation such as, for example, via display of real time ultrasound images 712 generated by ultrasound device 140 on a user interface 710, e.g., of display 110 (FIG. 1) or other suitable display. Further, EM tracking of ablation probe 130, e.g., via tracking the position and movement of EM sensor 131 of ablation probe 130 within the EM field generated by EM field generator 121, is utilized to enable the inclusion of a representation 722 of ablation probe 130 on a user interface 720, e.g., of display 110 (FIG. 1), a display of computer 180 (FIG. 1), or any other suitable display, relative to the 3D model representation 410 of the thyroid nodule, thus illustrating the position of ablation probe 130 relative to the thyroid nodule to be ablated. EM navigation may also be employed to facilitate maneuvering ablation probe 130 to a target location, e.g., to begin an ablation pass, guide ablation probe 130 during an ablation pass, and / or to enable maneuvering ablation probe 130 to a next ablation pass. In aspects where ablation pass planning is not performed prior to the ablation, an ultrasound sweep may still be performed prior to the ablation to enable generation of a 3D segmentation and, from the 3D segmentation, the 3D model, e.g., for display as the 3D model representation 410.

[0073] Thyroid ablation in accordance with the present disclosure, as noted above, is performed by completing a plurality of dynamic ablation passes through the nodule to ablate the nodule, e.g., such that at least 85%, at least 90%, at least 95%, or any other suitable ablation volume threshold is reached. Each dynamic ablation pass may be performed by moving ablationprobe 130 to the starting point (typically the location farthest from the entry point “E”), energizing ablation probe 130, e.g., with appropriate energy settings, and moving ablation probe 130 through the nodule, e.g., at an appropriate speed, along the appropriate trajectory to complete the ablation pass. In aspects where a single entry point is utilized, since the pass may start from a location farthest from the entry point “E,” the trajectory can be readily followed by maintaining the orientation of ablation probe 130 and moving ablation probe 130 proximally towards the clinician (as the trajectory of ablation probe 130 is constrained by the entry point “E”).

[0074] Due to the fact that plural ablation passes are often required to ablate a thyroid nodule, it can be challenging for a clinician to recall which ablation passes have been completed, the location(s) (and volume(s)) of the completed ablation pass(es), which ablation passes have yet to be completed, and / or the location(s) (and volume(s)) of remaining nodule tissue portions. While ultrasound imaging, e g., via display of real time ultrasound images 712 generated by ultrasound device 140 on user interface 710, can be helpful, tracking ablation remains challenging in that maintaining the nodule (or portions thereof) and / or ablation probe 130 within the two- dimensional imaging plane of the ultrasound device 140 requires a high level of skill and, even if ultrasound visualization can be maintained, the two-dimensional imaging plane of the ultrasound device 140 cannot provide a complete indication of the ablated volume and / or remaining volume of the nodule. Accordingly, the above-detailed thyroid nodule ablation planning and / or the thyroid nodule ablation tracking / navigation detailed below may be utilized to facilitate completing a plural ablation passes to ensure sufficient ablation of the thyroid nodule.

[0075] Referring to FIGS. 8A-8C, the 3D model representation 410 is shown displayed on user interface 720. User interface 720 may further include, as noted above, a display of the probe representation 722 (FIG. 7) and may additionally or alternatively include a display of the entry point representation 420, and / or a display of representations 730 of the planned ablation passes (as determined during ablation planning). The planned ablation pass representations 730, together with the probe representation 720, may serve as a guide for the clinician, allowing the clinician to select a planned ablation pass and track positioning and movement of the ablation probe along the planned ablation pass to ablate tissue and achieve an ablation volume in accordance with that of the planned ablation pass. As each ablation pass is completed, whether or not following (or displaying) planned ablation passes, a representation 740 of the latest completed ablation pass is added to the 3D model representation 410 to illustrate the cumulative ablation volume created byeach successive ablation pass. Representations 730, 740, where both are provided, are distinguishable from one another, e.g., in color, brightness, highlighting, etc., to enable the clinician to readily identify the ablation passes that have been completed and the planned ablation passes that remain.

[0076] The resultant ablation volume for each completed ablation pass is calculated and, based upon the size and position of the ablation volume, the corresponding completed ablation pass representation 740 is displayed. The calculation of a resultant ablation volume from a completed ablation pass is based on the starting location of the ablation probe, the trajectory of the ablation probe, the movement speed of the ablation probe, and the energy settings of the ablation probe, such that each representation 740 accurately represents the resultant ablation volume. Thus, the clinician can readily determine which ablation passes have been completed, which ablation passes remain, the ablated volume and location of the ablated volume for the completed ablation passes, and / or the remaining nodule volume and / or location of the remaining nodule volume after each completed ablation pass. In aspects, user interface 720 may be configured for manipulation by the clinician such as, for example, rotation, pan, zoom, sectioning, etc., thus enabling the clinician to view the 3D model representation 410, completed ablation pass representations 740, and ablation / remaining volumes from various different vantage points and perspectives.

[0077] In aspects, user interface 720 may display information relating to the progress of the ablation procedure. For example, the number of ablation passes completed may be displayed in a window 750 of user interface 720. In aspects, window 750 displays the number of completed ablation passes relative to the number of planned ablation passes. Alternatively or additionally, the nodule ablation coverage, e.g., the percentage of the nodule volume that has been ablated, may be displayed in a window 760 of user interface 720. The remaining nodule volume, e.g., the unablated portion of the nodule, may also be displayed in place of or in addition to the nodule ablation coverage.

[0078] With reference to FIGS. 9A and 9B, during the ablation procedure, in addition or as an alternative to including representations 730, 740 in the 3D model representation 410, user interface 720 may include a representation 770 of a volume of the nodule that has been ablated (FIG. 9A), e.g., the ablation volume, and / or a representation 780 of a volume of the nodule that remains (FIG. 9B), e.g., the volume of the nodule that has not been ablated, in the 3D model representation 410. Either or both representations 770, 780 may be provided as highlighting,outlining, coloring, lack thereof, or in any other suitable manner to distinguish portions of the 3D model representation 410 corresponding to ablated from those portions corresponding to remaining or unablated tissue. In this manner, the clinician can readily identify the remaining volume to be ablated and, thus, can perform one or more additional ablation passes to ablate the remaining volume.

[0079] As noted above, the thyroid nodule ablation in accordance with the present disclosure involves completing a plurality of dynamic ablation passes through the nodule to ablate the nodule, e.g., such that at least 85%, at least 90%, at least 95%, or any other suitable ablation volume threshold is reached. Accordingly, in aspects, a minimum nodule ablation volume threshold may be set, e.g., by default (adjustable or non-adjustable) or by user setting, to indicate when the thyroid nodule ablation is complete. In aspects, the minimum nodule ablation volume may be about 85%; in other aspects, the minimum nodule ablation volume may be about 90%; in still other aspects, the minimum nodule ablation volume may be about 95%; and in yet other aspects, the minimum nodule ablation volume may be adjustable from about 85% (or about 90%) to about 99%. In such aspects, regardless of the particular threshold set, an indication is displayed on user interface 720 or otherwise output (e.g., an audio indication output from a speaker) to indicate to the clinician whether or when the minimum nodule ablation volume has been reached. The indication may be, for example, a display of the ablation volume window 760, the ablated volume representation 770, and / or the remaining volume representation 780 in a first manner if the ablation volume threshold has not been reached and a display of the of the ablation volume window 760, the ablated volume representation 770, and / or the remaining volume representation 780 in a second, different manner if the ablation volume threshold has been reached. The first and second manners of display may include (or lack) highlighting, outlining, coloring, symbols, text, combinations thereof, etc. to enable the clinician to readily identify whether or not the ablation volume threshold has been reached. For example, red coloring or highlighting of the ablation volume window 760, the ablated volume representation 770, and / or the remaining volume representation 780 may be utilized to indicate that the ablation volume threshold has not been reached and green coloring or highlighting of the ablation volume window 760, the ablated volume representation 770, and / or the remaining volume representation 780 may be utilized to indicate that the ablation volume threshold has been reached.

[0080] The ablation volume and / or the remaining nodule volume may be calculated, e.g., for display as representations 770, 780, respectively, similarly as detailed above. That is, the resultant ablation volume for each completed ablation pass is calculated based upon the starting location of the ablation probe, the trajectory of the ablation probe, the movement speed of the ablation probe, and the energy settings of the ablation probe. In aspects, any ablation volume determined to be outside the nodule volume is not included in the computed ablation volume. The computed ablation volumes (within the nodule volume) of the plurality of ablation passes are summed to determine the total ablation volume. In aspects, overlap between ablation volumes for different ablation passes, e.g., resulting from overlapping and / or intersect ablation passes, may be accounted for by, for example, subtracting or excluding an overlapped ablation volume from the later ablation pass such that an accurate total ablation volume can be determined.

[0081] Overlap between ablation pass volumes may likewise be taken into account during ablation planning in accordance with the present disclosure, similarly as detailed above. Alternatively or additionally, overlapping (or overlapping beyond an overlapping threshold) planned ablation passes may be inhibited during ablation planning and / or warnings may be provided during ablation planning to alert the clinician of the overlapping planned ablation passes.

[0082] Continuing with reference to FIGS. 9A and 9B, user interface 720 may display a trajectory projection 790 extending from the probe representation 722, thus indicating the trajectory of the ablation probe given its current position and orientation. Trajectory projection 790 may be included in the 3D model representation 410 alone or, in aspects, may be included in the 3D model representation 410 together with and any one or more of representations 730, 740, 770, 780 and / or windows 750, 760. Trajectory projection 790 may include a series of symbols 792 spaced-apart along the trajectory (see FIGS. 9A and 9B), a pair of guide lines 794 defining the boundary of the ablation probe along the trajectory (see FIG. 7), combinations thereof, and / or any other suitable representation of the trajectory of the ablation probe given its current position and orientation.

[0083] Referring to FIG. 10, as an alternative or in addition to display of a trajectory of the ablation probe based on the current position and orientation of the ablation probe, user interface 720 may display a navigation path 1000 to facilitate navigation of the ablation probe, e.g., to the starting point for a selected ablation pass and / or along a selected ablation pass. The selected ablation pass may be, for example, a next ablation pass in sequence based upon the ablation plan,the closest remaining ablation pass from the ablation plan, or a clinician-selected ablation pass (e.g., via selection of a displayed representation 730 corresponding to a planned ablation pass). The navigation path 1000 may include a plurality of symbols 1010 leading to the target location, a continuous line, a broken line or lines, or any other suitable navigation path 1000 included in the 3D model representation 410 (and with the probe representation 722) to facilitate navigation to a target location and / or along a target path. A symbol representing the target location 1020 may be provided (and differentiated from other symbols) to thus enable the clinician to determine the target location while navigating to the target location.

[0084] Turning to FIGS. 11A-11C, user interface 720 may also display features in the 3D model representation 410 to facilitate performing an ablation pass in accordance with a planned ablation pass. For example, user interface 720 may include a moving indicator 1100, e.g., an avatar of at least a portion of the probe, in the 3D model representation 410 during an ablation pass to indicate a path and speed of the probe according to the planned ablation pass. Thus, the clinician can readily identify if the path and speed of the ablation probe during the ablation pass is in accordance with that of the planned ablation pass. As shown in FIG. 11A, for example, the path and speed of the probe generally equals that of the planned ablation pass. FIG. 1 IB illustrates a scenario where the probe is moving faster during the ablation pass compared to the speed of the probe in the planned ablation pass. FIG. 11C illustrates a scenario where the probe is moving slower during the ablation pass compared to the speed of the probe in the planned ablation pass. Moving indicator 1100 thus enables the clinician to adjust the speed and / or position of the ablation probe to conform the ablation pass being performed to the corresponding planned ablation pass. As detailed above, the speed of the probe during the application of energy impacts the size, e.g., diameter, of the resultant ablation volume; thus, controlling the speed of the probe helps ensure the planned ablation volume is achieved for each ablation pass.

[0085] With reference to FIG. 12, a method of thyroid nodule ablation in accordance with the present disclosure is shown generally identified as method 1200. Although not illustrated in FIG. 12, method 1200 may begin by inserting the ablation probe through the entry point, into the thyroid nodule to be ablated, and maneuvering, guided by navigation in aspects, to the starting point of the first ablation pass. Further, if ablation planning was not utilized, an ultrasound sweep may initially be performed to generate a 3D segmentation of the thyroid nodule and, based on the 3D segmentation, a 3D model of the thyroid nodule.

[0086] With the ablation probe at the starting point for the first ablation pass, the ablation probe is energized and moved along the path of the first ablation pass, e.g., in a distal-to-proximal direction, through the thyroid nodule to ablate a portion of the thyroid nodule. At 1210, as the energized ablation probe moves from the starting point along the path of the first ablation pass to ablate a portion of the thyroid nodule, the starting position, movement (direction and speed), and energy settings of the ablation probe are tracked. Based on this tracked data, a resultant ablation volume from the first ablation pass is computed, as indicated at 1220. A representation of the ablation volume from the first ablation pass may be included in the 3D model representation of the nodule on a user interface (e.g., display), as indicated at 1230, and / or a representation of the remaining volume of the nodule (after the first ablation pass) may be included in the 3D model representation of the nodule on the user interface (e.g., display), as indicated at 1240.

[0087] The above is then repeated for another ablation pass. More specifically, the ablation probe may be repositioned (guided by navigation, in aspects) to the starting point of another ablation pass and, thereafter, energized and moved along the path of the ablation pass. At 1250, as the energized ablation probe moves from the starting point along the path of the ablation pass to ablate another portion of the thyroid nodule, the starting position, movement (direction and speed), and energy settings of the ablation probe are tracked to compute a resultant ablation volume, as indicated at 1260. A representation of the ablation volume from the ablation pass may be included in the 3D model representation (and representations of any prior ablation passes), as indicated at 1270, and / or a displayed representation of the remaining volume of the nodule may be updated to take into account the ablation pass (and any prior ablation passes not previously accounted for), as indicated at 1280.

[0088] After one or more ablation passes, it is determined whether the aggregate ablation volume from all prior ablation passes covers the nodule volume, as indicated at 1290. More specifically, it is determined whether the minimum ablation volume threshold has been reached. If the minimum ablation volume threshold has been reached, “YES” at 1290, the ablation of the thyroid nodule is complete and the ablation procedure ends. If the minimum ablation volume threshold has not been reached, “NO” at 1290, the method reverts to 1250 wherein 1250-1290 are repeated until it is determined that the minimum ablation volume threshold has been reached, indicating that the ablation of the thyroid nodule is complete and may be ended.

[0089] Aspects of this disclosure may be further described by reference to the following numbered paragraphs:

[0090] 1. A system for thyroid nodule ablation, comprising: an ablation probe configured to be energized to ablate tissue; a display; at least one processor; and at least one non-transitory computer-readable storage medium storing instructions that, when executed by the at least one processor, cause the at least one processor to: display, on the display, a representation of a 3D model of tissue of interest; track movement of the ablation probe during a first ablation pass wherein the ablation probe is energized according to at least one energy setting and moved through the tissue of interest; determine a result of the first ablation pass based on the movement tracking and the at least one energy setting, the result of the first ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest; and display, on the display, at least one of a portion of the tissue of interest ablated as a result of the first ablation pass or a portion of the tissue of interest remaining after the first ablation pass.

[0091] 2. The system according to paragraph 1, wherein the at least one non-transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to: track movement of the ablation probe during a second ablation pass wherein the ablation probe is energized according to at least one energy setting and moved through the tissue of interest; determine a result of the second ablation pass based on the movement tracking and the at least one energy setting, the result of the second ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest; and update, as a result of the second ablation pass, the display of the at least one of the portion of the tissue of interest ablated or the portion of the tissue of interest remaining.

[0092] 3. The system according to paragraph 2, wherein the at least one non-transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to: determine, based upon the results of the first and second ablation passes, whether a threshold amount of the tissue of interest has been ablated; and display an indication of the result of the determination.

[0093] 4. The system according to paragraph 1 or 2, wherein the display of the at least one of the portion of the tissue of interest ablated or the portion of the tissue of interest remaining includes visually distinguishing at least one portion of the displayed 3D model representation from at least one other portion of the displayed 3D model representation.

[0094] 5 The system according to any preceding paragraph, wherein the display of the at least one of the portion of the tissue of interest ablated or the portion of the tissue of interest remaining includes displaying at least one of a percentage of a volume of the tissue of interest that has been ablated or a percentage of a volume of the tissue of interest that remains, respectively.

[0095] 6. The system according to any preceding paragraph, wherein the at least one non- transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to display, on the displayed 3D model representation: a representation of a position of the ablation probe relative to the tissue of interest, a trajectory projection of the ablation probe relative to the tissue of interest, and / or, a navigation route of the ablation probe through the tissue of interest.

[0096] 7. The system according to any preceding paragraph, wherein the at least one non- transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to display, on the displayed 3D model representation, an indication of a speed of the ablation probe during the first ablation pass relative to a planned speed.

[0097] 8. The system according to paragraph 7, wherein a representation of the ablation probe moving relative to the displayed 3D model representation during the first ablation pass indicates the speed of the ablation probe; and an avatar moving relative to the displayed 3D model representation during the first ablation pass indicates the planned speed.

[0098] 9 A system for thyroid nodule ablation planning, comprising: an ultrasound probe configured to perform an ultrasound sweep on a patient’s skin above tissue of interest; a display; at least one processor; and at least one non-transitory computer-readable storage medium storing instructions that, when executed by the at least one processor, cause the at least one processor to: generate a 3D segmentation of tissue of interest based on ultrasound image data obtained from the ultrasound sweep; generate a 3D model of the tissue of interest based on the 3D segmentation; display, on the display, a representation of the 3D model of the tissue of interest; determine a first planned ablation pass for moving an energized ablation probe through the tissue of interest; determine a result of an execution of the first planned ablation pass, the result including an ablation volume and a location of the ablation volume within the tissue of interest; and display, on the display, at least one of a planned portion of the tissue of interest to be ablated based on thedetermined result of the first planned ablation pass or a planned portion of the tissue of interest remaining after the determined result of the first planned ablation pass.

[0099] 10. The system according to paragraph 9, wherein the at least one non-transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to: determine a second planned ablation pass for moving the energized ablation probe through the tissue of interest; determine a result of an execution of the second planned ablation pass, the result including an ablation volume and a location of the ablation volume within the tissue of interest; and update, based on the determined result of the second planned ablation pass, the display of at least one of the planned portion of the tissue of interest to be ablated or the planned portion of the tissue of interest remaining.

[0100] 11. The system according to paragraph 10, wherein the at least one non-transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to: determine whether execution of the first and second planned ablation passes would result in ablation of a threshold amount of the tissue of interest; and display an indication of the result of the determination.

[0101] 12. The system according to any one of paragraphs 9-11, wherein the at least one non- transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to determine an entry point for accessing the tissue of interest, wherein the planned first ablation pass is constrained by the determined entry point.

[0102] 13. The system according to paragraph 12, wherein the at least one non-transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to determine the entry point as an entry point that minimizes a number of planned ablation passes required to be executed to ablate the tissue of interest.

[0103] 14. The system according to any one of paragraphs 9-13, wherein the display of the at least one of the planned portion of the tissue of interest to be ablated or the planned portion of the tissue of interest remaining includes: visually distinguishing at least one portion of the displayed 3D model representation from at least one other portion of the displayed 3D model representation, or displaying at least one of a percentage of a planned volume of the tissue of interest to be ablated or a percentage of a planned volume of the tissue of interest that would remain, respectively.

[0104] 15. The system according to any one of paragraphs 9-14, wherein the first planned ablation pass is determined at least in part based on a planned speed of movement of the ablation probe through the tissue of interest, a planned energy setting associated with the ablation probe, and / or input received from a clinician.

[0105] 16. A method of thyroid nodule ablation includes: displaying a representation of a 3D model of tissue of interest; tracking movement of the ablation probe during a first ablation pass wherein the ablation probe is energized according to at least one energy setting and moved through the tissue of interest; determining a result of the first ablation pass based on the movement tracking and the at least one energy setting, the result of the first ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest; and displaying at least one of a portion of the tissue of interest ablated as a result of the first ablation pass or a portion of the tissue of interest remaining after the first ablation pass.

[0106] 17. The method of paragraph 16, wherein the method further includes: tracking movement of the ablation probe during a second ablation pass wherein the ablation probe is energized according to at least one energy setting and moved through the tissue of interest; determining a result of the second ablation pass based on the movement tracking and the at least one energy setting, the result of the second ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest; and updating, as a result of the second ablation pass, the display of the at least one of the portion of the tissue of interest ablated or the portion of the tissue of interest remaining.

[0107] 18. The method of paragraphs 16-17, wherein the method further includes: determining, based upon the results of the first and second ablation passes, whether a threshold amount of the tissue of interest has been ablated; and displaying an indication based on the determination.

[0108] 19. The method of paragraphs 16-18, wherein displaying the at least one of the portion of the tissue of interest ablated or the portion of the tissue of interest remaining includes visually distinguishing at least one portion of the displayed 3D model representation from at least one other portion of the displayed 3D model representation.

[0109] 20. The method of paragraphs 16-19, wherein displaying the at least one of the portion of the tissue of interest ablated or the portion of the tissue of interest remaining includesdisplaying at least one of a percentage of a volume of the tissue of interest that has been ablated or a percentage of a volume of the tissue of interest that remains, respectively.

[0110] 21. The method of paragraphs 16-20, wherein the method further includes: displaying, on the displayed 3D model representation, a representation of a position of the ablation probe relative to the tissue of interest.

[0111] 22. The method of paragraphs 16-21, wherein the method further includes: displaying, on the displayed 3D model representation, a trajectory projection of the ablation probe relative to the tissue of interest.

[0112] 23. The method of paragraphs 16-22, wherein the method further includes: displaying, on the displayed 3D model representation, a navigation route of the ablation probe through the tissue of interest.

[0113] 24. The method of paragraphs 16-23, wherein the method further includes: displaying, on the displayed 3D model representation, an indication of a speed of the ablation probe during the first ablation pass relative to a planned speed.

[0114] 25. The method of paragraphs 16-24, wherein a representation of the ablation probe moving relative to the displayed 3D model representation during the first ablation pass indicates the speed of the ablation probe; and an avatar moving relative to the displayed 3D model representation during the first ablation pass indicates the speed associated with the planned ablation pass.

[0115] 26. A method of thyroid nodule ablation planning, includes: generating, from ultrasound image data, a 3D segmentation of tissue of interest; generating a 3D model of the tissue of interest based on the 3D segmentation; displaying a representation of the 3D model of the tissue of interest; determining a first planned ablation pass for moving an energized ablation probe through the tissue of interest; determining a result of an execution of the first planned ablation pass, the result including an ablation volume and a location of the ablation volume within the tissue of interest; and displaying at least one of a planned portion of the tissue of interest to be ablated based on the determined result of the first planned ablation pass or a planned portion of the tissue of interest remaining after the determined result of the first planned ablation pass.

[0116] 27. The method of paragraph 26, wherein the method further includes: determining a second planned ablation pass for moving the energized ablation probe through the tissue of interest; determining a result of an execution of the second planned ablation pass, the resultincluding an ablation volume and a location of the ablation volume within the tissue of interest; and updating, based on the determined result of the second planned ablation pass, the display of at least one of the planned portion of the tissue of interest to be ablated or the planned portion of the tissue of interest remaining.

[0117] 28. The method of paragraphs 26-27, wherein the method further includes: determining whether execution of the first and second planned ablation passes would result in ablation of a threshold amount of the tissue of interest; and displaying an indication of the result of the determination.

[0118] 29. The method of paragraphs 26-28, wherein the method further includes: determining an entry point for accessing the tissue of interest, wherein the planned first ablation pass is constrained by the determined entry point.

[0119] 30. The method of paragraphs 26-29, wherein the method further includes: determining the entry point as an entry point that minimizes a number of planned ablation passes required to be executed to ablate the tissue of interest.

[0120] 31. The method of paragraphs 26-30, wherein displaying the at least one of the planned portion of the tissue of interest to be ablated or the planned portion of the tissue of interest remaining includes visually distinguishing at least one portion of the displayed 3D model representation from at least one other portion of the displayed 3D model representation.

[0121] 32. The method of paragraphs 26-31, wherein displaying the at least one of the planned portion of the tissue of interest to be ablated or the planned portion of the tissue of interest remaining includes displaying at least one of a percentage of a planned volume of the tissue of interest to be ablated or a percentage of a planned volume of the tissue of interest that would remain, respectively.

[0122] 33. The method of paragraphs 26-32, wherein the first planned ablation pass is determined at least in part based on a planned speed of movement of the ablation probe through the tissue of interest.

[0123] 34. The method of paragraphs 26-33, wherein the first planned ablation pass is determined at least in part based on a planned energy setting associated with the ablation probe.

[0124] 35. The method of paragraphs 26-34, wherein the first planned ablation pass is determined at least in part based on input received from a clinician.

[0125] It will be understood that various modifications may be made to the aspects and features disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of various aspects and features. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended thereto.

Claims

WHAT IS CLAIMED IS:

1. A system for thyroid nodule ablation, comprising: an ablation probe configured to be energized to ablate tissue; a display; at least one processor; and at least one non-transitory computer-readable storage medium storing instructions that, when executed by the at least one processor, cause the at least one processor to: display, on the display, a representation of a 3D model of tissue of interest; track movement of the ablation probe during a first ablation pass wherein the ablation probe is energized according to at least one energy setting and moved through the tissue of interest; determine a result of the first ablation pass based on the movement tracking and the at least one energy setting, the result of the first ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest; and display, on the display, at least one of a portion of the tissue of interest ablated as a result of the first ablation pass or a portion of the tissue of interest remaining after the first ablation pass.

2. The system according to claim 1 , wherein the at least one non-transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to: track movement of the ablation probe during a second ablation pass wherein the ablation probe is energized according to at least one energy setting and moved through the tissue of interest; determine a result of the second ablation pass based on the movement tracking and the at least one energy setting, the result of the second ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest; and update, as a result of the second ablation pass, the display of the at least one of the portion of the tissue of interest ablated or the portion of the tissue of interest remaining.

3. The system according to claim 2, wherein the at least one non -transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to: determine, based upon the results of the first and second ablation passes, whether a threshold amount of the tissue of interest has been ablated; and display an indication of the result of the determination.

4. The system according to claim 1, wherein the display of the at least one of the portion of the tissue of interest ablated or the portion of the tissue of interest remaining includes visually distinguishing at least one portion of the displayed 3D model representation from at least one other portion of the displayed 3D model representation.

5. The system according to claim 1, wherein the display of the at least one of the portion of the tissue of interest ablated or the portion of the tissue of interest remaining includes displaying at least one of a percentage of a volume of the tissue of interest that has been ablated or a percentage of a volume of the tissue of interest that remains, respectively.

6. The system according to claim 1, wherein the at least one non-transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to display, on the displayed 3D model representation, a representation of a position of the ablation probe relative to the tissue of interest.

7. The system according to claim 1, wherein the at least one non-transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to display, on the displayed 3D model representation, a trajectory projection of the ablation probe relative to the tissue of interest.

8. The system according to claim 1, wherein the at least one non-transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to display, on the displayed 3D model representation, a navigation route of the ablation probe through the tissue of interest.

9. The system according to claim 1, wherein the at least one non -transitory computer-readable storage medium stores instructions that, when executed by the at least one processor, further cause the at least one processor to display, on the displayed 3D model representation, an indication of a speed of the ablation probe during the first ablation pass relative to a planned speed.

10. The system according to claim 9, wherein: a representation of the ablation probe moving relative to the displayed 3D model representation during the first ablation pass indicates the speed of the ablation probe; and an avatar moving relative to the displayed 3D model representation during the first ablation pass indicates the planned speed.

11. A method of thyroid nodule ablation, comprising: displaying a representation of a 3D model of tissue of interest; tracking movement of the ablation probe during a first ablation pass wherein the ablation probe is energized according to at least one energy setting and moved through the tissue of interest; determining a result of the first ablation pass based on the movement tracking and the at least one energy setting, the result of the first ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest; and displaying at least one of a portion of the tissue of interest ablated as a result of the first ablation pass or a portion of the tissue of interest remaining after the first ablation pass.

12. The method according to claim 11, further comprising: tracking movement of the ablation probe during a second ablation pass wherein the ablation probe is energized according to at least one energy setting and moved through the tissue of interest; determining a result of the second ablation pass based on the movement tracking and the at least one energy setting, the result of the second ablation pass including an ablation volume and a location of the ablation volume within the tissue of interest; and updating, as a result of the second ablation pass, the display of the at least one of the portion of the tissue of interest ablated or the portion of the tissue of interest remaining.

13. The method according to claim 12, further comprising: determining, based upon the results of the first and second ablation passes, whether a threshold amount of the tissue of interest has been ablated; and displaying an indication based on the determination.

14. The method according to claim 11, wherein displaying the at least one of the portion of the tissue of interest ablated or the portion of the tissue of interest remaining includes visually distinguishing at least one portion of the displayed 3D model representation from at least one other portion of the displayed 3D model representation.

15. The method according to claim 11, wherein displaying the at least one of the portion of the tissue of interest ablated or the portion of the tissue of interest remaining includes displaying at least one of a percentage of a volume of the tissue of interest that has been ablated or a percentage of a volume of the tissue of interest that remains, respectively.

16. The method according to claim 11, further comprising displaying, on the displayed 3D model representation, a representation of a position of the ablation probe relative to the tissue of interest.

17. The method according to claim 11, further comprising displaying, on the displayed 3D model representation, a trajectory projection of the ablation probe relative to the tissue of interest.

18. The method according to claim 11, further comprising displaying, on the displayed 3D model representation, a navigation route of the ablation probe through the tissue of interest.

19. The method according to claim 11, further comprising displaying, on the displayed 3D model representation, an indication of a speed of the ablation probe during the first ablation pass relative to a planned speed.

20. The method according to claim 19, wherein: a representation of the ablation probe moving relative to the displayed 3D model representation during the first ablation pass indicates the speed of the ablation probe; and an avatar moving relative to the displayed 3D model representation during the first ablation pass indicates the speed associated with the planned ablation pass.

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