Therapeutic apparatus, computer program product, and method for determining an achievable target region for high intensity focused ultrasound
US-9192788-B2 · Nov 24, 2015 · US
US10751125B2 · US · B2
| Field | Value |
|---|---|
| Publication number | US-10751125-B2 |
| Application number | US-201414763684-A |
| Country | US |
| Kind code | B2 |
| Filing date | Jan 29, 2014 |
| Priority date | Jan 29, 2013 |
| Publication date | Aug 25, 2020 |
| Grant date | Aug 25, 2020 |
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A focused-ultrasound or other procedure for treating a target within a tissue region can be planned iteratively by creating a treatment plan specifying a treatment location pattern and stimuli applied thereto, simulating the treatment, computationally predicting an effect of the simulated treatment, comparing the predicted effect against one or more treatment constraints (such as efficacy and/or safety thresholds), and, if a constraint is violated, repeating the simulation for an adjusted treatment plan.
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What is claimed is: 1. A method of performing focused-ultrasound treatment of a target tissue within a tissue region using a treatment system comprising a plurality of transducer elements each emitting a beam, the beams converging at a focal point or along a focus path, the method comprising: (a) creating a treatment plan at least in part by specifying (i) a focus pattern comprising a plurality of focal points or a plurality of focus paths where the beams of the treatment system will converge, each focal point or focus path corresponding to a different subregion of the target tissue to be treated, (ii) temporally variable ultrasound stimuli to be applied sequentially to create the plurality of focal points or the plurality of focus paths along the focus pattern, each ultrasound stimulus being associated with a focal point or a focus path, and (iii) at least one treatment constraint; (b) simulating treatment in accordance with a portion of the plan at least in part by computationally applying a first one of the temporally variable ultrasound stimuli to create a first one of the focal points or a first one of the focus paths corresponding to a first subregion of the target tissue; (c) computationally predicting an effect of the simulated treatment based, at least in part, on a physical model computationally modeling propagation of the effect; (d) comparing the predicted effect against the at least one treatment constraint; (e) when the at least one treatment constraint is violated, prior to simulating treatment in accordance with a remaining portion of the plan at least in part by computationally applying a second one of the temporally variable ultrasound stimuli to create a subsequent one of the focal points or a subsequent one of the focus paths specified in the treatment plan and corresponding to a second subregion of the target tissue different from the first subregion, altering the treatment plan, without altering the at least one treatment constraint, by adjusting at least one of the temporally variable ultrasound stimuli associated with a preceding focal point or a preceding focus path created prior to step (b) and corresponding to a third subregion of the target tissue different from the first and second subregions; (f) repeating steps (b) through (e) for the altered treatment plan; and (g) operating the treatment system to conduct the focused-ultrasound treatment in accordance with the altered treatment plan. 2. The method of claim 1 , further comprising: (h) using the treatment system to conduct a first portion of the treatment in accordance with a first portion of the treatment plan; (i) experimentally monitoring the effect of the conducted treatment; (j) comparing the experimentally monitored treatment effect with the predicted treatment effect; and (k) upon detection of a discrepancy between the experimentally monitored treatment effect and the predicted treatment effect, adjusting the physical model and revising the treatment plan based on the adjusted model; and (l) conducting a second portion of the treatment in accordance with the revised treatment plan. 3. The method of claim 2 , wherein adjusting the model comprises adjusting at least one parameter thereof. 4. The method of claim 3 , wherein revising the treatment plan comprises repeating steps (a) through (g) with the adjusted model. 5. The method of claim 3 , wherein the treatment plan is revised based on the adjusted model without repeating steps (a) through (g). 6. The method of claim 1 , wherein creating the treatment plan further comprises defining parameters of a complementary treatment procedure. 7. The method of claim 6 , wherein the complementary treatment procedure comprises active heating or cooling. 8. The method of claim 1 , wherein steps (a) through (g) are successively carried out for a plurality of subregions of the target tissue. 9. The method of claim 1 , wherein predicting the effect of the simulated treatment comprises modeling propagation of the effect into a different subregion of the target tissue or a non-target tissue within the tissue region. 10. The method of claim 1 , wherein altering the treatment plan comprises altering at least one of the focus pattern or at least one of the ultrasound stimuli applied thereto. 11. The method of claim 1 , wherein, following a comparison of the predicted effect against the at least one treatment constraint, the simulation is repeated for only a portion of the focus pattern and adjustments to the temporally variable ultrasound stimuli are confined to stimuli to be applied along that portion. 12. The method of claim 1 , wherein the ultrasound stimuli vary between the focal points. 13. The method of claim 1 , wherein the ultrasound stimuli vary along at least one of the focal paths. 14. The method of claim 1 , wherein the at least one treatment constraint comprises at least one efficacy constraint and at least one safety constraint. 15. The method of claim 1 , wherein the at least one treatment constraint comprises at least one of a tissue damage threshold, a treatment efficacy threshold, or geometric parameters of heat-sensitive tissues. 16. The method of claim 1 , wherein the effect comprises heating of the tissue region due to ultrasound absorption and heat transport. 17. The method of claim 1 , wherein the model comprises parameters of the tissue region. 18. The method of claim 17 , wherein the model comprises at least one equation modeling ultrasound absorption and heat transport in the tissue region. 19. The method of claim 1 , further comprising simulating treatment by computationally applying a third one of the temporally variable ultrasound stimuli so as to create said one of the focal points or one of the focus paths, the third one of the temporally variable ultrasound stimuli being applied in at least one preceding iteration. 20. The method of claim 19 , further comprising altering the treatment plan by adjusting the third one of the temporally variable ultrasound stimuli associated with all preceding focal points or focus paths created prior to step (b). 21. The method of claim 1 , wherein the at least one of the temporally variable ultrasound stimuli adjusted in step (e) is the same as the first one of the temporally variable ultrasound stimuli. 22. The method of claim 1 , wherein the at least one of the temporally variable ultrasound stimuli adjusted in step (e) is different from the first one of the temporally variable ultrasound stimuli. 23. The method of claim 1 , wherein in step (b), the effect of the simulated treatment is predicted by computationally modeling propagation of the effect into (i) non-target tissue within the tissue region and/or (ii) a subregion of the target tissue different from the first subregion. 24. A system for performing focused-ultrasound treatment of a target tissue within a tissue region, the system comprising: a treatment system comprising a plurality of transducer elements each emitting a beam, the beams converging at a focal point or along a focus path; a processor; and memory storing (i) data descriptive of a model of the tissue region and at least one treatment constraint, (ii) a treatment plan specifying a focus pattern comprising a plurality of focal points or a plurality of focus paths where the beams of the treatment system will converge, each focal point or focus path corresponding to a different subregion of the target tissue to be treated and tempor
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