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EP-4687721-B1 - VISUALIZING SEQUENTIALLY AND SIMULTANEOUSLY ACTIVATED APPLICATORS OF AN ABLATION PLAN

EP4687721B1EP 4687721 B1EP4687721 B1EP 4687721B1EP-4687721-B1

Inventors

  • ISOLA, ALFONSO AGATINO
  • HAUTVAST, GUILLAUME LEOPOLD THEODORUS FREDERIK

Dates

Publication Date
20260513
Application Date
20240329

Claims (15)

  1. A system (12), comprising: a display device (24); a memory (20) comprising instructions (32); and one or more processors (16) configured by the instructions to: receive an ablation plan comprising plural ablation zones corresponding to plural applicators, the plural ablation zones comprising one or more single ablation zones and one or more composite ablation zones; and provide on the display device a representation of the ablation plan (58) and a visual distinction between sequentially activated applicators and simultaneously activated applicators, the plural applicators comprising the sequentially activated and simultaneously activated applicators.
  2. The system of the preceding claim, wherein the one or more processors are further configured by the instructions to provide the visual distinction based on color coding.
  3. The system of any one of the preceding claims, wherein the sequentially activated applicators provide single ablations and the simultaneously activated applicators provide composite ablations, wherein the composite ablations are based on blending implicit functions.
  4. The system of any one of the preceding claims, wherein the one or more processors are further configured by the instructions to make an adjustment to one or more of the plural ablation zones based on a change in state of the ablation plan, wherein the adjustment comprises one or a combination of recomputation of the one or more of the composite ablation zones or the one or more of the single ablation zones.
  5. The system of any one of the preceding claims, wherein the one or more processors are further configured by the instructions to prohibit user-requested adjustments to the ablation plan that are unfeasible to implement.
  6. The system of claim 5, wherein the user-requested adjustments include simultaneously activated applicators for pull-back ablations, an ablation based on an uncommissioned applicator, or simultaneously activated applicators that are greater than a number of available channels.
  7. The system of any one of the preceding claims, wherein the one or more processors are further configured by the instructions to provide a graphical user interface (56A, 56B) that enables a user to control ablations corresponding to the plural ablation zones of the ablation plan.
  8. The system of claim 7, wherein the graphical user interface enables a user to perform one or any combination of the following: mark a planned group of ablations as completed or ablated; start and stop a planned group of ablations; mark a selection of multiple ablations as completed or ablated; start and stop a selection of multiple ablations; start and stop individual ablations within a defined time span; adjust one or more composite ablation blending parameters; or enter or select an exact time of activation, deactivation, or both for each of the plural applicators.
  9. The system of any one of the preceding claims, wherein the one or more processors are further configured by the instructions to receive an indication when each of the plural applicators is activated.
  10. The system of any one of the preceding claims, wherein the one or more processors are further configured by the instructions to determine which of the plural applicators are sequentially activated and simultaneously activated based on a blending parameter.
  11. The system of claim 10, wherein the one or more processors are further configured by the instructions to determine at least one of the plural ablation zones is under sequential activation using a single applicator based on the blending parameter having a first value, and determine at least one of another one of the plural ablation zones is under simultaneous activation using a group of the plural applicators based on the blending parameter having a second value different than the first value.
  12. The system of any one of the preceding claims, wherein the one or more processors are further configured by the instructions to guide ablation therapy treatment to a tumor corresponding to a target region based on the sequentially activated applicators and simultaneously activated applicators.
  13. The system of any one of the preceding claims, wherein the system comprises a medical device.
  14. A method of operating a system of any of the preceding claims, wherein the method comprises: - receiving an ablation plan comprising plural ablation zones corresponding to plural applicators, the plural ablation zones comprising one or more single ablation zones and one or more composite ablation zones; and - providing on a display device a representation of the ablation plan and a visual distinction between sequentially activated applicators and simultaneously activated applicators, the plural applicators comprising the sequentially activated and simultaneously activated applicators.
  15. A non-transitory, computer readable storage medium comprising instructions that when executed by the one or more processors, causes the one or more processors to perform the method of claim 14.

Description

FIELD OF THE INVENTION The present invention is generally related to therapy treatment planning and guidance, and more particularly, to visually representing implementation of an ablation plan. BACKGROUND OF THE INVENTION In the field of interventional oncology, percutaneous ablation, including thermal and non-thermal based ablation, is an interventional cancer treatment option that has seen a significant increase in adoption in the past decade, and is predicted to continue to grow, at least in the near term, at a compound annual growth rate of approximately 8-10%. Thermal ablation can be delivered using various ablation modalities, including e.g., radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), focal laser ablation (FLA), and cryo-ablation. Non-thermal ablation techniques include irreversible electroporation (IRE), which uses non-thermal energy to create permanent nanopores in a cell membrane that disrupts cellular homeostasis and ultimately causes cell damage within an applied electric field. In clinical practice, these ablation procedures consist of placing one or more ablation applicators inside or near a target region with the help of image guidance. Typically, physicians place these needle-like applicators while inspecting real-time ultrasound or interventional radiology images (CT/MR/CBCT), and determine the intended location for the resulting ablation based on information provided from the manufacturer, results in clinical trials, and personal experience. Current ablation planning and guidance relies on pre-defined ablation zone dimensions that were determined in ex-vivo or in-vitro experiments in which a single applicator was activated. However, when activated simultaneously, the cumulative effect of nearby applicators causes achieved ablation zones to merge and cover a larger area. For cryo-ablation in particular, this merging is referred to as the "kissing ice-ball" effect that can be visualized with real-time imaging of the tissue under treatment. An often pursued solution for addressing the merging of ablation zones is the use of biophysical modelling techniques relying on Pennes bioheat equation. These techniques have proven to model the achieved ablation zones more accurately, by incorporating detailed information on the applicator devices themselves, and the tissue within which they are inserted. Yet, to be accurate, these techniques tend to require information that is either clinically unavailable or very specific to certain ablation devices. Examples of information that is clinically unavailable (or difficult to obtain) includes patient core temperature, accurate tissue and vasculature segmentation, patient and tissue specific rates of perfusion and heat absorption, convective flow rates in surrounding vasculature, etc. Device specific information includes detail of the physical design of the ablation device including the location of actuators, shielding etc. Consequently, transitioning the use of biophysical models from the investigational realm to the commercial environment is challenging. Additionally, providing more user control in the implementation of an ablation plan that is based on single and composite ablations is needed. US 2021/007805 teaches a system not allowing for a visual distinction between sequentially and simultaneously activated applicators. SUMMARY OF THE INVENTION One object of the present invention is to improve upon existing systems in the implementation and control of ablation therapy plans that use single and composite ablations. To better address such concerns, in a first aspect of the invention, a system is disclosed that receives an ablation plan comprising plural ablation zones corresponding to plural applicators, the plural ablation zones comprising one or more single ablation zones and one or more composite ablation zones, and provides on a display device a representation of the ablation plan and a visual distinction between sequentially activated applicators and simultaneously activated applicators, the plural applicators comprising the sequentially activated and simultaneously activated applicators. By providing visual distinctions between sequentially activated and simultaneously activated applicators, a user may have more control over the implementation of the ablation therapy plan. In one embodiment, the sequentially activated applicators provide single ablations and the simultaneously activated applicators provide composite ablations, wherein the composite ablations are based on blending implicit functions. Using blending for composite ablations avoids the need for information that is either clinically unavailable or very specific to certain ablation devices function. However, certain embodiments may use composite ablation zones that are determined from biophysical modeling techniques while still benefiting from the visualization of single and composite ablations during implementation of an ablation t