System and method for guided adaptive brachytherapy

Patent metadata

Field	Value
Publication number	US-10850126-B2
Application number	US-201113703750-A
Country	US
Kind code	B2
Filing date	May 27, 2011
Priority date	Jun 30, 2010
Publication date	Dec 1, 2020
Grant date	Dec 1, 2020

Abstract

A system and methods for adaptive placement of a treatment element include a placement device (134), and a localization system (120) configured to track progress of the placement device such that a position of a treatment element (146, 132) placed by or to be placed by the placement device is stored in memory. A computer system (142) includes a program (104) implemented in computer readable storage media and configured to compute an effect of the treatment element at the position and determine whether a dosage amount has been achieved by the treatment element for treatment of an organ.

First claim

The invention claimed is:

1. A system for adaptive placement of treatment elements in an organ of a subject in accordance with a target dosage plan for treatment of the organ, the system comprising:
a placement device configured to place a treatment element at a first actual location in the organ, the treatment element corresponding to a virtual treatment element at a planned location in a model of the organ;
a tracking system configured to track the placement of the treatment element by identifying a trajectory of the placement device for guiding a tip of the placement device toward a planned location of the treatment element according to the target dosage plan, and to identify the first actual location at which the treatment element is placed;
an ultrasound imaging device configured to generate a planning image of the organ with the subject in an initial pose for determining the target dosage plan and to generate a real-time image of the organ after the placement of the treatment element; and
a computer system comprising:
computer readable storage media configured to store the first actual location of the treatment element provided by the tracking system; and
a processor programmed to compute an effect of the treatment element at the first actual location on the target dosage plan for treatment of the organ as compared to an effect of the virtual treatment element at the planned location, to adapt another planned location of another virtual treatment element in the model of the organ in response to the computed effect of the treatment element to achieve the target dosage plan, and to superimpose the planning image onto the real-time image of the organ to enable repositioning of the subject to the initial pose for placing another treatment element,

wherein the placement device is further configured to place the another treatment element, corresponding to the another virtual treatment element, in a second actual location in the organ corresponding to the adapted another planned location.

2. The system as recited in claim 1 , wherein the placement device includes one of a needle, a probe, and an applicator.

3. The system as recited in claim 1 , wherein each of the treatment element and the another treatment element includes a radioactive seed.

4. The system as recited in claim 1 , wherein each of the virtual treatment element and the another virtual treatment element includes a virtual seed.

5. The system as recited in claim 1 , wherein the ultrasound imaging device comprises a transrectal ultrasound (TRUS) device.

6. The system as recited in claim 1 , wherein the tracking system includes a fiber Bragg grating system.

7. The system as recited in claim 1 , wherein the processor is further programmed to compute a dosage of the another virtual treatment element, and to determine a simulated dosage effect of the another virtual treatment element on the target dosage plan.

8. A treatment method, comprising:
acquiring an ultrasound planning image of a subject positioned in an initial pose,
computing virtual seed locations of virtual seeds in a model of the subject in the initial pose to determine a target dosage plan;
identifying a trajectory of a seed delivery device inserted in the subject to guide the seed delivery device to target locations of actual seeds corresponding to at least some of the virtual seed locations, respectively, determined in the target dosage plan;
depositing the actual seeds in the subject at or close to the respective target locations using the seed delivery device;
generating real-time ultrasound images of the subject after depositing the actual seeds in the subject;
recording actual locations of the deposited actual seeds, using a localization method based on positions of the seed delivery device;
comparing the real-time ultrasound images of the subject with multi-planar reconstruction (MPR) of the acquired ultrasound planning image to enable repositioning of the subject from a current pose to the initial pose; and
based on the recorded actual locations of the deposited actual seeds, again computing virtual seed locations in the model of remaining virtual seeds, corresponding to target locations at which the actual seeds were not deposited, in accordance with the target dosage plan, and depositing remaining actual seeds corresponding to the remaining virtual seeds with the subject in the initial pose.

9. The method as recited in claim 8 , wherein generating the real-time ultrasound images comprises performing three-dimensional reconstruction of two-dimensional ultrasound images of the subject.

10. The method as recited in claim 9 , wherein identifying the trajectory of the seed delivery device includes tracking the seed delivery device using the ultrasound images.

11. The method as recited in claim 8 , further comprising:
providing sensory feedback related to distances between the respective target locations and current positions of the seed delivery device, wherein depositing the actual seeds at or close to the respective target locations is based on the sensory feedback.

12. The method as recited in claim 8 , further comprising:
providing a template grid for assisting in guiding the seed delivery device to a planned template grid coordinate of each of the actual seeds; and
providing a warning if the seed delivery device is inserted in an incorrect grid coordinate.

13. The method as recited in claim 8 , wherein the seed delivery device includes an empty needle without a seed, the method further comprising constraining virtual seeds to a trajectory of the empty needle.

14. The method as recited in claim 13 , wherein depositing the actual seeds comprises depositing at least one of the actual seeds at the trajectory of the empty needle.

15. The method as recited in claim 8 , further comprising:
determining swelling of an organ of the subject by relative movement of needles of the seed delivery device measured using the localization method; and
when the determined swelling exceeds a threshold, providing a set of ultrasound images for computing new locations of the virtual seeds in the model of the subject to achieve the target dosage plan.

16. The method as recited in claim 8 , wherein the localization method comprises electromagnetic (EM) tracking or fiber Bragg grating (FBG) localization.

17. A treatment method, comprising:
placing seeds at actual seed locations in a subject, using a seed delivery device guided by a tracking system, at or close to target locations corresponding to planned virtual seed locations in a model to reach a target dosage plan determined with the subject in an initial pose;
determining the actual seed locations of the seeds in the subject by localizing a tip of the seed delivery device when placing the seeds using the tracking system, and recording the actual seed locations;
computing revised virtual seed locations in the model based on the recorded actual seed locations to provide a dosage in accordance with the target dosage plan;
performing ultrasound imaging of the subject after placing the seeds at the actual seed locations in the subject;
comparing the ultrasound imaging of the subject in a current pose to multi-planar reconstruction (MPR) of an ultrasound planning image of the subject acquired with the subject in the initial pose to enable repositioning of the subject to the initial pose; and
placing additional seeds at additional actual seed locations in the subject at or close to revised target locations corresponding to the revised virtual seed locations, using the seed delivery device guided by t

Assignees

• Binnekamp Dirk
• Gutierrez Luis Felipe
• Glossop Neil David
• Kruecker Jochen
• Sethuraman Shriram
• Koninklijke Philips Nv

Inventors

• Binnekamp Dirk
• Gutierrez Luis Felipe
• Glossop Neil David
• Kruecker Jochen
• Sethuraman Shriram

Classifications

• A61B6/02 Primary

  Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis · CPC title

• A61N5/1038

  taking into account previously administered plans applied to the same patient, i.e. adaptive radiotherapy · CPC title

• A61N5/107

  in real time, i.e. during treatment · CPC title

• A61N2005/1058

  using ultrasound imaging · CPC title

• A61N5/1048

  Monitoring, verifying, controlling systems and methods · CPC title