SYSTEMS AND METHODS FOR OPTIMIZING TRANSSKULL ACOUSTIC TREATMENT
20190344099 ยท 2019-11-14
Inventors
Cpc classification
A61B8/5223
HUMAN NECESSITIES
A61B6/501
HUMAN NECESSITIES
A61B6/5217
HUMAN NECESSITIES
A61B90/10
HUMAN NECESSITIES
G16H50/30
PHYSICS
A61B2034/104
HUMAN NECESSITIES
A61B2034/105
HUMAN NECESSITIES
International classification
A61B5/00
HUMAN NECESSITIES
A61B34/10
HUMAN NECESSITIES
Abstract
Skull inhomogeneity may be quantified in accordance with the skull density measured in skull images acquired using a conventional imager; the quantified inhomogeneity may then be used to determine whether the patient is suitable for ultrasound treatment and/or determine parameters associated with the ultrasound transducer for optimizing transskull ultrasound treatment.
Claims
1-20. (canceled)
21. A method for transskull ultrasound treatment with optimized focusing properties at a target region, the method comprising: obtaining a plurality of images of a patient's skull; computationally determining a plurality of local parameters, each local parameter representing structural characteristics of a local skull region on a beam path from a transducer element; and activating at least some of a plurality of transducer elements with transmission powers determined based at least in part on the local parameters associated therewith.
22. The method of claim 21, wherein the transmission power from each transducer element correlates inversely with the associated local parameter.
23. The method of claim 22, wherein the transmission power from each transducer element satisfies an equation:
24. The method of claim 21, wherein the local parameter comprises a local skull density ratio
25. The method of claim 24, local skull density ratio is determined based on an intensity profile of the images.
26. The method of claim 21, wherein the transducer element is activated if the local parameter associated therewith is above a threshold.
27. The method of claim 26, wherein the threshold is empirically determined based on a retrospective study on skulls of patients who have undergone ultrasound treatment.
28. The method of claim 21, wherein the images are acquired using at least one of a computer tomography (CT) device, a magnetic resonance imaging device, a positron emission tomography (PET) device, a single-photon emission computed tomography (SPECT) device, or an ultrasonography device.
29. The method of claim 21, further comprising: identifying a position of a treatment target area in the images; determining positions of a plurality of ultrasound transducer elements for transmitting ultrasound energy to the target area; and determining the beam path from each transducer element to the skull based on the positions of the transducer element and the target area.
30. A system for transskull ultrasound treatment with optimized focusing properties at a target region, the system comprising: an imaging system for obtaining a plurality of images of a patient's skull; a controller, operably coupled to the imaging system, configured to: identify a position of a treatment target area in the images; and computationally determine a plurality of local parameters, each local parameter representing structural characteristics of a local skull region on a beam path from a transducer element; and drive circuitry, coupled to the controller, for activating at least some of a plurality of transducer elements with transmission powers determined based at least in part on the local parameters associated therewith.
31. The system of claim 30, wherein the drive circuitry is configured to drive each transducer element with a transmission power correlating inversely with the associated local parameter.
32. The system of claim 31, wherein the transmission power from each transducer element satisfies an equation:
33. The system of claim 30, wherein the local parameter comprises a local skull density ratio.
34. The system of claim 33, wherein the controller is further configured to determine the local skull density ratio based on an intensity profile of the images.
35. The system of claim 30, wherein the drive circuitry is configured to activate the transducer element if the local parameter associated therewith is above a threshold.
36. The system of claim 35, wherein the controller is further configured to empirically determine the threshold based on a retrospective study on skulls of patients who have undergone ultrasound treatment.
37. The system of claim 30, wherein the imaging system comprises at least one of a computer tomography (CT) device, a magnetic resonance imaging device, a positron emission tomography (PET) device, a single-photon emission computed tomography (SPECT) device, or an ultrasonography device.
38. The system of claim 30, wherein the controller is configured to: determine positions of a plurality of ultrasound transducer elements for transmitting ultrasound energy to the target area; and determine the beam path from each transducer element to the skull based on the positions of the transducer element and the target area.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0020] The foregoing will be more readily understood from the following detailed description of the invention in conjunction with the drawings, wherein:
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DETAILED DESCRIPTION
[0035]
[0036] The array 102 may have a curved (e.g., spherical or parabolic) shape suitable for placing it on the surface of the skull 114, or may include one or more planar or otherwise shaped sections. Its dimensions may vary, depending on the application, between millimeters and tens of centimeters. The transducer elements 104 of the array 102 may be piezoelectric ceramic elements, and may be mounted in silicone rubber or any other material suitable for damping the mechanical coupling between the elements 104. Piezo-composite materials, or generally any materials capable of converting electrical energy to acoustic energy, may also be used. To assure maximum power transfer to the transducer elements 104, the elements 104 may be configured for electrical resonance at 50 W, matching input connector impedance.
[0037] The transducer array 102 is coupled to the beamformer 106, which drives the individual transducer elements 104 so that they collectively produce a focused ultrasonic beam or field. For n transducer elements, the beamformer 106 may contain n driver circuits, each circuit including or consisting of an amplifier 118 and a phase delay circuit 120; drive circuit drives one of the transducer elements 104. The beamformer 106 receives a radio frequency (RF) input signal, typically in the range from 0.1 MHz to 1.0 MHz, from the frequency generator 110, which may, for example, be a Model DS345 generator available from Stanford Research Systems. The input signal may be split into n channels for the n amplifiers 118 and delay circuits 120 of the beamformer 106. In some embodiments, the frequency generator 110 is integrated with the beamformer 106. The radio frequency generator 110 and the beamformer 106 are configured to drive the individual transducer elements 104 of the transducer array 102 at the same frequency, but at different phases and/or different amplitudes.
[0038] The amplification or attenuation factors al-an and the phase shifts al-an imposed by the beamformer 106 serve to transmit and focus ultrasonic energy through the patient's skull 114 onto a selected region of the patient's brain, and account for wave distortions induced in the skull 114 and soft brain tissue. The amplification factors and phase shifts are computed using the controller 108, which may provide the computational functions through software, hardware, firmware, hardwiring, or any combination thereof. For example, the controller 108 may utilize a general-purpose or special-purpose digital data processor programmed with software in a conventional manner, and without undue experimentation, in order to determine the phase shifts and amplification factors necessary to obtain a desired focus. In certain embodiments, the computation is based on detailed information about the characteristics (e.g., structure, thickness, density, etc.) of the skull 114. Such information may be obtained from the imager 112. Image acquisition may be three-dimensional or, alternatively, the imager 112 may provide a set of two-dimensional images suitable for reconstructing a three-dimensional image of the skull 114 from which thicknesses and densities can be inferred. Image-manipulation functionality may be implemented in the imager 112, in the controller 108, or in a separate device.
[0039] System 100 may be modified in various ways within the scope of the invention. For example, for diagnostic applications, the system may further include a detector device (not shown) that measures transmitted or reflected ultrasound, and which may provide the signals it receives to the controller 108 for further processing. The reflection and transmission signals may also be used as feedback for the phase and amplitude adjustments of the beamformer 106. The system 100 may contain a positioner for arranging the array 102 of transducer elements 104 with respect to the patient's skull 114. In order to apply ultrasound therapy to body parts other than the brain, the transducer array 102 may take a different, e.g., a cylindrical, shape. In some embodiments, the transducer elements 104 are mounted movably and rotatably, providing mechanical degrees of freedom that can be exploited to improve focusing properties. Such movable transducers may be adjusted by conventional actuators, which may be driven by a component of controller 108 or by a separate mechanical controller.
[0040] Referring to
[0041] For example, the indicator may be a quantified skull density ratio (SDR) created using a skull CT intensity profile obtained from CT images.
for each transducer element i. Thus, the local SDR may be used to create a local geometric characteristic mapping of the skull 114.
[0042] To determine the efficiency and effectiveness of ultrasound treatment, the structural inhomogeneity of the entire skull region covered by the transducer array 102 may be evaluated. In one embodiment, a local SDR for each transducer element 104 covering a skull region is obtained and analyzed, and a similarity level associated with the local SDR is assigned based on the comparison with SDR statistics of the skulls of patients who have successfully undergone the ultrasound treatment previously. If a majority (e.g., more than 50%) of the local SDRs for the transducer array 102 has similarity levels above a threshold, the patient is considered to be a candidate for effective ultrasound treatment within applicable safety guidelines. In another embodiment, a single value, such as a global SDR, is calculated based on a collection of the local SDRs; the global SDR can then be used to determine a likelihood of successful ultrasound treatment.
[0043]
[0044] Additionally, it is known that a gradual degradation in both ultrasound energy transmission through the skull 114 and accuracy of phase prediction at the target region 214 may occur as the incidence angle increases; as a result, ultrasound waves having incidence angles below the critical angle by a few degrees may still contribute little to the focal intensity. Therefore, to further improve the skull evaluation criterion, the step weight function as described above may be replaced with a function that has a smooth, continuous form at the critical angle. In one embodiment, the weight function, W.sub.i, is defined as:
where N is the total number of the transducer elements, and L.sub.i is a logistic function that can be expressed as:
where .sub.i denotes the incidence angle of the ultrasound wave transmitted from transducer element i to the skull, is a steepness factor representing the curve deviation of the logistic function from a step function, and is the inflection point of the curve. The values of and may be empirically determined based on retrospective study of the patients experienced ultrasound treatment. In some embodiments, can be chosen in a range between 1 and infinity and can be chosen in a range between 8 and 18.
[0045] In a preferred embodiment, each transducer element 104 transmits ultrasound waves onto a skull patch having an area of 55 mm.sup.2. Because the skull structure on the patch may vary at different places, each patch may be divided into multiple segments, each corresponding to a CT region passed by the acoustic ray; a local SDR for each patch may then be computed as an average of the local SDRs of the multiple patch segments (or CT regions), i.e.,
where M is the number of segments in each patch and SDR.sub.ij denotes the local SDR of each patch segment. Accordingly, the global SDR may be computed as:
The number of segments, M, on each patch may depend on the distance correlation of the anatomical structure of different skull segments and/or the resolution of images acquired using imager 112. In a preferred embodiment, the area of each segment is equal to the square of the image resolution; as a result, M is derived by dividing the patch area by the square of the image resolution. For example, if a CT image has a resolution of 1 mm, a patch having an area of 55 mm.sup.2 may be divided into 25 segments, each having a local SDR.sub.ij.
[0046] The global SDR of a patient may be compared with the global SDRs of patients who have been previously treated with ultrasound in order to determine the likelihood of successful treatment. For example, referring again to
[0047] A representative method 400 illustrating the approach of estimating the likelihood of successful ultrasound treatment for individual patients in accordance with various embodiments of the current invention is shown in
[0048] In various embodiments, once the patient is determined to be suitable for an ultrasound treatment, an optimal treatment plan may be prepared based on the local SDRs of the patient's skull. Referring to
[0049] Accordingly, in one embodiment, if the local SDR is below a threshold (e.g., 0.3, or another value that may be determined based on a retrospective study of the patients who have undergone ultrasound treatment), the ultrasound traversal through the skull 114 is deemed ineffective. Therefore, the transducer element 104 corresponding to the small local SDR is deactivated to optimize the transducer efficiency. Deactivation of the non-contributing elements may have other benefits, such as minimizing skull heating and reducing overall transmission power required by the transducer array 102. For the transducer elements 104 that are determined to be active, their associated local SDRs may be used to obtain approximately equal-intensity contributions at the focus, thereby creating a symmetric focus shape. To achieve this, an SDR-weighted approach may be used. For example, transducer elements having lower local SDRs (i.e., facing denser areas of the skull and having less energy transmitted therethrough) may transmit higher powers than those having higher local SDRs. In one embodiment, the power transmitted from each transducer element 104 may inversely correlate to the local SDR and be determined in accordance with the following formula:
where Power.sub.i denotes the power transmitted by the transducer element i.
[0050]
[0051] A representative method 700 illustrating an approach for obtaining uniform power contributions from each transducer element at the focus in accordance with various embodiments of the current invention is shown in
[0052] The controller 108 used herein may be implemented in hardware, software or a combination of the two. For embodiments in which the functions are provided as one or more software programs, the programs may be written in any of a number of high level languages such as FORTRAN, PASCAL, JAVA, C, C++, C#, BASIC, various scripting languages, and/or HTML. Additionally, the software can be implemented in an assembly language directed to the microprocessor resident on a target computer. The software may be embodied on an article of manufacture including, but not limited to, a floppy disk, a jump drive, a hard disk, an optical disk, a magnetic tape, a PROM, an EPROM, EEPROM, field-programmable gate array, or CD-ROM. Embodiments using hardware circuitry may be implemented using, for example, one or more FPGA, CPLD or ASIC processors.
[0053] The terms and expressions employed herein are used as terms and expressions of description and not of limitation, and there is no intention, in the use of such terms and expressions, of excluding any equivalents of the features shown and described or portions thereof. In addition, having described certain embodiments of the invention, it will be apparent to those of ordinary skill in the art that other embodiments incorporating the concepts disclosed herein may be used without departing from the spirit and scope of the invention. Although the present invention has been described with reference to specific details, it is not intended that such details should be regarded as limitations upon the scope of the invention, except as and to the extent that they are included in the accompanying claims. Accordingly, the described embodiments are to be considered in all respects as only illustrative and not restrictive.