Feedback system for integrating interventional planning and navigation
Inventors
Kruecker, Jochen • Dalal, Sandeep • Xu, Sheng • Wood, Bradford J.
Assignees
Koninklijke Philips NV • US Department of Health and Human Services
Publication Number
US-9144461-B2
Publication Date
2015-09-29
Expiration Date
2029-11-05
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Abstract
A therapy planning and image guidance and navigation for an interventional procedure are combined in one system. The system includes: a radio frequency ablation therapy planning component (1) capable of creating an initial treatment plan, adjusting the treatment plan to take into account data received during a procedure and transferring a treatment plan to a navigation component, a navigation system component (2) to guide an ablation probe (6) and a feedback sub-system (3) for determining actual ablation probe positions/orientations and actual ablation size/shape via imaging (4) and/or tracking (5) systems, and enabling exchange of information between the planning component and the navigation component. By combining and integrating procedure planning and navigation, and by providing feedback from the navigation component back to the planning component about actual electrode position and orientation and ablation volume, complex procedures can be carried out more accurately, efficiently, and potentially with better clinical outcomes.
Core Innovation
The invention integrates therapy planning and image guidance navigation for interventional procedures such as radiofrequency ablation (RFA) into one combined system. It includes components for planning a three-dimensional treatment plan comprising multiple ablation probe placement positions and orientations, navigation to guide the probe according to the plan, imaging for obtaining planning and treatment images, and feedback to determine actual probe position and ablation volume using imaging and tracking systems. This feedback permits updating the treatment plan iteratively during the procedure, enhancing accuracy and efficiency.
The problem addressed is the difficulty in optimal planning and execution of complex ablation procedures, particularly for larger tumors requiring multiple overlapping ablations. Current challenges include planning optimal three-dimensional positions of individual ablations to cover the planned target volume (PTV) while sparing healthy tissue, and accurately positioning the electrode during treatment under conventional imaging guidance. Non-integrated planning and navigation systems impede workflow and reduce accuracy, and patient-specific ablation size information is often unavailable, leading to suboptimal plans.
By combining planning and navigation into an integrated system with a feedback subsystem that provides real-time information about actual electrode position, orientation, and ablation volume, the invention enables iterative refinement of treatment plans during procedures. This integration facilitates guiding an ablation probe to planned target locations, updating plans based on actual ablations performed, and continues iterations until the entire planned target volume is treated. This system supports multiple ablation types, including thermal and non-thermal therapies like RFA, cryo-ablation, microwave ablation, and ultrasound ablation.
Claims Coverage
The patent contains multiple independent claims covering a system, method, and control system for ablation therapy, each having several inventive features related to planning, navigation, feedback, and iterative treatment updating.
Integrated system for ablation treatment with iterative feedback
A system comprising an ablation probe, a planning component calculating a 3D treatment plan with probe positions, orientations, and estimated ablation volumes to treat a planned target volume (PTV), a navigation component with a tracking system providing treatment instructions, an imaging system for planning and treatment images, and a feedback component determining actual probe position, orientation, and ablation volume using imaging or navigation. The feedback component updates the planning component during treatment; the planning component determines treatment iterations providing revised instructions until treatment completion.
Feedback component obtaining combined imaging and tracking data to update plan
The feedback component is configured to obtain both imaging feedback and tracking feedback about the actual probe location and provides this combined information to the planning component. The planning component updates the 3D treatment plan by subtracting measured ablation size and shape at the measured probe position from the segmented planned target volume and computes a new plan for the remaining target volume.
Use of various imaging modalities and tracking sensors
The system utilizes imaging modalities such as ultrasound, CT, MRI, ultrasound elastography, and Doppler ultrasound. The navigation component includes tracking based on electromagnetic, optical, acoustic, or magnetic sensors to spatially track the therapy probe or imaging device.
User interface for displaying treatment iteration instructions
A user interface displays treatment instructions and iterations from the navigation component for access and guidance by a human operator during the procedure.
Calculation of local micro-vascular perfusion and macro-vascular blood flow parameters
The feedback component can calculate local perfusion and blood flow parameters near the ablation site and provide this information to the planning component, incorporating it into treatment iterations to refine treatment plans.
Registration of treatment images with planning images to update positions
The feedback component registers treatment images with planning images to calculate actual probe position and orientation and tumor position and orientation, using this data to update the 3D treatment plan. Planning uses center positions of individual ablations for calculation.
Improvement of registration between imaging and tracking systems
The feedback component obtains both imaging and tracking feedback about the actual probe location and uses this combined information to update and improve registration accuracy between the imaging system and the tracking system for enhanced navigation.
The independent claims collectively disclose an integrated system and methods for ablation therapy that involve detailed planning, real-time navigation, comprehensive feedback integrating imaging and tracking data, iterative treatment plan updates based on actual ablation results, and support for multiple imaging and tracking modalities, thereby enhancing accuracy and treatment efficacy.
Stated Advantages
Improved accuracy and efficiency in carrying out complex ablation procedures by integrating planning and navigation with iterative feedback.
Potential to achieve better clinical outcomes through more precise execution and real-time treatment adjustments.
Reduction in ionizing radiation use due to better guidance and planning integration.
Improved patient outcomes and reduced procedure costs resulting from optimized treatment planning and navigation.
Documented Applications
Ablative therapy of tissue, specifically radiofrequency ablation (RFA) of tumors, with extensions to other ablative therapies including cryo-ablation, microwave ablation, ultrasound ablation, and other thermal or non-thermal ablations.
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