PLANNING THERAPEUTIC ULTRASOUND TREATMENT

Abstract

According to a computer-implemented method for planning therapeutic ultrasound treatment of a three-dimensional tissue region, a tissue model containing a material parameter relating to deformability and/or elasticity of a corresponding material of the tissue region is provided in spatially resolved and/or directionally resolved form. Based on the tissue model, part of the tissue region is determined as a treatment region, and, depending on the tissue model and the treatment region, a therapeutic plan is generated to change the at least one material parameter. The therapeutic plan includes at least one characterization parameter that characterizes a plurality of lesions with respect to spatial arrangement and/or pose and/or shape and/or at least one configuration parameter of the plurality of lesions for a therapeutic ultrasound apparatus for generating the plurality of lesions.

Claims

1. A computer-implemented method for planning therapeutic ultrasound treatment of a three-dimensional tissue region, the computer-implemented method comprising: providing a three-dimensional tissue model of the three-dimensional tissue region containing at least one material parameter relating to deformability, elasticity, or deformability and elasticity of a corresponding material of the three-dimensional tissue region in spatially resolved, directionally resolved, or spatially and directionally resolved form; determining, based on the three-dimensional tissue model, part of the tissue region as a treatment region; and depending on the three-dimensional tissue model and the treatment region, generating a therapeutic plan for the therapeutic ultrasound treatment, such that the at least one material parameter is changed in a predefined manner, wherein the therapeutic plan includes: at least one characterization parameter that characterizes a plurality of lesions that are generatable by a therapeutic ultrasound apparatus in the treatment region with respect to spatial arrangement, respective pose, respective shape, or any combination thereof; at least one configuration parameter for the therapeutic ultrasound apparatus for generating the plurality of lesions; or a combination thereof.

2. The computer-implemented method of claim 1, further comprising: determining, based on the three-dimensional tissue model, a load variable relating to a mechanical force acting on one or more parts of the tissue region, relating to a mechanical stress present in the tissue region, or relating to a combination thereof in a spatially resolved manner, in a directionally resolved manner, or in a spatially resolved and directionally resolved manner; and determining the treatment region depending on the load variable determined in the spatially resolved manner, in the directionally resolved manner, or in the spatially resolved and the directionally resolved manner.

3. The computer-implemented method of claim 2, wherein the load variable is determined in the spatially resolved manner, in the directionally resolved manner, or in the spatially resolved manner and in the directionally resolved manner based on the three-dimensional tissue model and a predefined movement of the tissue region.

4. The computer-implemented method of claim 2, further comprising comparing the load variable determined in the spatially resolved manner, in the directionally resolved manner, or in the spatially resolved manner and the directionally resolved manner with a prespecified load limit, wherein the treatment region is determined as part of the tissue region within which the load variable is determined in the spatially resolved manner, in the directionally resolved manner, or in the spatially resolved manner and in the directionally resolved manner is greater than the prespecified load limit.

5. The computer-implemented method of claim 2, wherein generating the therapeutic plan comprises: minimizing the load variable, minimizing the load variable comprising varying the at least one characterization parameter, the at least one configuration parameter, or a combination thereof; or reducing the load variable, reducing the load variable comprising varying the at least one characterization parameter, the at least one configuration parameter, or a combination thereof to a value that is smaller than a prespecified maximum load limit.

6. The computer-implemented method of claim 2, further comprising: applying a function trained by machine learning to input data that is dependent on the three-dimensional tissue model and the treatment region, such that output data that determines the at least one characterization parameter, the at least one configuration parameter, or a combination thereof is generated; and generating the therapeutic plan based on the output data.

7. The computer-implemented method of claim 6, further comprising: modifying the three-dimensional tissue model according to the therapeutic plan; determining the load variable again in the spatially resolved manner, in the directionally resolved manner, or in the spatially resolved manner and in the directionally resolved manner based on the modified three-dimensional tissue model; and generating a further therapeutic plan for the therapeutic ultrasound treatment depending on the load variable determined again in the spatially resolved manner, in the directionally resolved manner, or in the spatially resolved manner and in the directionally resolved manner.

8. The computer-implemented method of claim 7, further comprising comparing the load variable determined again in the spatially resolved manner, in the directionally resolved manner, or in the spatially resolved manner and in the directionally resolved manner with a prespecified load limit, wherein: the further therapeutic plan is generated depending on a result of the comparison of the load variable determined again with the prespecified load limit and depending on the treatment region; or a further part of the tissue region is determined as a further treatment region depending on a result of the comparison, and the further therapeutic plan is generated depending on the further treatment region.

9. The computer-implemented method of claim 1, wherein the at least one material parameter includes a modulus of elasticity, a shear modulus, a bulk modulus, or any combination thereof.

10. The computer-implemented method of claim 1, wherein the therapeutic plan is created, such that the at least one characterization parameter characterizes an anisotropic distribution of the plurality of lesions.

11. The computer-implemented method of claim 1, wherein the therapeutic plan is generated such that the at least one characterization parameter is generated in the form of a binary map for the treatment region, and wherein the binary map stores a first value for positions at which one lesion of the plurality of lesions is provided and stores a second value that is different than the first value for positions at which no lesions of the plurality of lesions is provided.

12. The computer-implemented method of claim 1, further comprising providing image data that depicts the tissue region of a patient to be examined, wherein the tissue model is generated based on the image data.

13. In a non-transitory computer-readable storage medium that stores instructions executable by one or more processors to plan therapeutic ultrasound treatment of a three-dimensional tissue region, the instructions comprising: providing a three-dimensional tissue model of the three-dimensional tissue region containing at least one material parameter relating to deformability, elasticity, or deformability and elasticity of a corresponding material of the three-dimensional tissue region in spatially resolved, directionally resolved, or spatially and directionally resolved form; determining, based on the three-dimensional tissue model, part of the tissue region as a treatment region; and depending on the three-dimensional tissue model and the treatment region, generating a therapeutic plan for the therapeutic ultrasound treatment, such that the at least one material parameter is changed in a predefined manner, wherein the therapeutic plan includes: at least one characterization parameter that characterizes a plurality of lesions that are generatable by a therapeutic ultrasound apparatus in the treatment region with respect to spatial arrangement, respective pose, respective shape, or any combination thereof; at least one configuration parameter for the therapeutic ultrasound apparatus for generating the plurality of lesions; or a combination thereof.

14. The non-transitory computer-readable storage medium of claim 13, wherein the instructions further comprise: determining, based on the three-dimensional tissue model, a load variable relating to a mechanical force acting on one or more parts of the tissue region, relating to a mechanical stress present in the tissue region, or relating to a combination thereof in a spatially resolved manner, in a directionally resolved manner, or in a spatially resolved and directionally resolved manner; and determining the treatment region depending on the load variable determined in the spatially resolved manner, in the directionally resolved manner, or in the spatially resolved and the directionally resolved manner.

15. The non-transitory computer-readable storage medium of claim 14, wherein the load variable is determined in the spatially resolved manner, in the directionally resolved manner, or in the spatially resolved manner and in the directionally resolved manner based on the three-dimensional tissue model and a predefined movement of the tissue region.

16. The non-transitory computer-readable storage medium of claim 14, wherein the instructions further comprise comparing the load variable determined in the spatially resolved manner, in the directionally resolved manner, or in the spatially resolved manner and the directionally resolved manner with a prespecified load limit, and wherein the treatment region is determined as part of the tissue region within which the load variable is determined in the spatially resolved manner, in the directionally resolved manner, or in the spatially resolved manner and in the directionally resolved manner is greater than the prespecified load limit.

17. A data processing apparatus comprising: at least one processor configured to plan therapeutic ultrasound treatment of a three-dimensional tissue region, the plan of the therapeutic ultrasound treatment comprising: provision of a three-dimensional tissue model of the three-dimensional tissue region containing at least one material parameter relating to deformability, elasticity, or deformability and elasticity of a corresponding material of the three-dimensional tissue region in spatially resolved, directionally resolved, or spatially and directionally resolved form; determination, based on the three-dimensional tissue model, of part of the tissue region as a treatment region; and depending on the three-dimensional tissue model and the treatment region, generation of a therapeutic plan for the therapeutic ultrasound treatment, such that the at least one material parameter is changed in a predefined manner, wherein the therapeutic plan includes: at least one characterization parameter that characterizes a plurality of lesions that are generatable by a therapeutic ultrasound apparatus in the treatment region with respect to spatial arrangement, respective pose, respective shape, or any combination thereof; at least one configuration parameter for the therapeutic ultrasound apparatus for generating the plurality of lesions; or a combination thereof.

18. A therapeutic ultrasound apparatus comprising: a data processing apparatus comprising: at least one processor configured to plan therapeutic ultrasound treatment of a three-dimensional tissue region, the plan of the therapeutic ultrasound treatment comprising: provision of a three-dimensional tissue model of the three-dimensional tissue region containing at least one material parameter relating to deformability, elasticity, or deformability and elasticity of a corresponding material of the three-dimensional tissue region in spatially resolved, directionally resolved, or spatially and directionally resolved form; determination, based on the three-dimensional tissue model, of part of the tissue region as a treatment region; and depending on the three-dimensional tissue model and the treatment region, generation of a therapeutic plan for the therapeutic ultrasound treatment, such that the at least one material parameter is changed in a predefined manner, wherein the therapeutic plan includes at least one characterization parameter that characterizes a plurality of lesions that are generatable by a therapeutic ultrasound apparatus in the treatment region with respect to spatial arrangement, respective pose, respective shape, or any combination thereof, at least one configuration parameter for the therapeutic ultrasound apparatus for generating the plurality of lesions, or a combination thereof; an ultrasonic transducer configured to emit ultrasonic waves; and a control unit configured to control the ultrasonic transducer according to the therapeutic plan, such that the plurality of lesions are generated.

Description

BRIEF DESCRIPTION OF THE DRAWING

[0078] FIG. 1 is a schematic representation of an embodiment of a therapeutic ultrasound apparatus.

DETAILED DESCRIPTION

[0079] FIG. 1 is a schematic representation of an exemplary embodiment of a therapeutic ultrasound that is, for example, configured as a histotripsy apparatus 1. The histotripsy apparatus 1 includes a data processing apparatus 2 that may execute a computer-implemented method according to the present embodiments for planning histotripsy therapy of a three-dimensional tissue region 7 of a patient 6. As a result of the computer-implemented method, the data processing apparatus 2 generates a therapeutic plan for the histotripsy therapy in order to change at least one material parameter relating to the deformability and/or elasticity of the corresponding material of the tissue region 7 in a predefined manner.

[0080] The histotripsy apparatus 1 also includes a control unit 4 and a histotripsy transducer 3 for emitting ultrasonic waves. The control unit 4 is set up to control the histotripsy transducer 3 according to the therapeutic plan obtained from the data processing apparatus 2 in order to generate a plurality of lesions in a treatment region 8 within the tissue region 7 by means of histotripsy.

[0081] Optionally, the histotripsy apparatus 1 may also include an ultrasound probe 5 for imaging, which may, for example, also be actuated by the control unit to enable the tissue region 7 or the treatment region 8 to be visually monitored during the histotripsy procedure.

[0082] In the context of the computer-implemented method for planning histotripsy therapy, initially, a three-dimensional tissue model of the tissue region 7 containing the at least one material parameter is provided in spatially resolved and/or directionally resolved form.

[0083] In some embodiments, the tissue model may include a deformable three-dimensional model of the tissue region that may be deformed in any spatial direction according to the tissue properties (e.g., according to the at least one material parameter, elasticity, deformability, stress, presence of calcification, etc.). The tissue model may also contain information relating to a load limit for forces or stresses acting on the tissue.

[0084] In some embodiments, the tissue model may be determined based on image data of the patient 6 acquired prior to the performance of the method from an elasticity measurement. The tissue model may also contain information on positions or regions of existing or previous inflammation, fractures, tears, or other healed or chronic pathological conditions.

[0085] In some embodiments, the tissue model may be determined based on a time series of image data of the patient 6 acquired prior to the performance of the method, where the time series depicts the tissue region 7 during a predefined movement of the patient 6. Herein, the at least one material parameter (e.g., the elasticity) or the load limit may be determined based on deformation of the tissue depicted by the time series and the information about the predefined movement of the patient 6.

[0086] Based on the tissue model, a part of the tissue region 7 is then determined as a treatment region 8 within which the lesions are to be generated. The treatment region 8 may be determined manually, semi-automatically, or automatically. The treatment region 8 may, for example, have different values of the at least one material parameter compared to a reference tissue (e.g., a tissue or vessel surrounding the treatment region 8). Alternatively or additionally, the treatment region 8 may be characterized by the presence or occurrence therein of mechanical forces or stresses that are above the load limit. The treatment region 8 may also contain a plurality of partial treatment regions that may be spatially separated from one another or may touch and/or overlap.

[0087] The therapeutic plan is then generated based on the tissue model and the treatment region 8 so that the at least one material parameter may be changed by the planned lesions in a predefined way.

[0088] Herein, the therapeutic plan contains, for example, at least one characterization parameter that characterizes a plurality of lesions that may be generated by the histotripsy apparatus 1 in the treatment region 8 with respect to spatial arrangement of the plurality of lesions and/or respective pose of the plurality of lesions and/or respective shape of the plurality of lesions. Alternatively or additionally, the therapeutic plan contains at least one configuration parameter for the histotripsy apparatus 1 for generating the plurality of lesions.

[0089] The therapeutic plan may, for example, specify an anisotropic spatial arrangement or an anisotropic spatial pattern consisting of the lesions in order in this way to change the elasticity and/or deformability of the tissue and/or the forces and/or stresses in the tissue region 7 to one or more target values or target specifications.

[0090] In various embodiments, the tissue model may be created based on information about critical regions, such as, for example, fibrotic structures, pre-existing lesions, vessels, calcification, and so on, within the tissue region 7. This information may be incorporated into the tissue model and thereby taken into account when defining the therapeutic plan. For example, the critical regions may be omitted when arranging the lesions. This may, for example, be formulated as a boundary condition during optimization (e.g., by the corresponding definition of a cost function).

[0091] For example, the at least one material parameter (e.g., the elasticity and/or deformability) may be taken into account anisotropically as a tensor. The objective may be increased or reduced elasticity and/or deformability along a specific direction, while the opposite may be desirable along another direction.

[0092] In one embodiment, the anisotropic spatial arrangement of the lesions may be determined such that, for example, all target values, target distributions, or other target specifications may be met. The lesions may be used in conjunction with pre-existing components of the tissue region 7 (e.g., fibrotic structures, scars, vessels, calcification, etc.) or in conjunction with pre-existing implants, such as, for example, stents, in order to achieve the target specifications.

[0093] Similarly to a foam mattress, the therapeutic plan may specify different zones with spatially arranged lesions of a different number, density, type, or shape. This enables the target specifications to be achieved.

[0094] The shape, density, and spatial arrangement of the lesions may reduce forces or stresses in order to accelerate healing processes or prevent the occurrence of disease or damage in the tissue region 7. The effect of histotripsy therapy may be temporary, for example, to accelerate the healing process, or permanent, for example, to prevent future damage.

[0095] The present embodiments enable planning of non-invasive histotripsy therapy for changing tissue properties (e.g., deformability and/or elasticity) in accordance with defined target specifications. This enables mobility and/or transport of fluids, such as blood, nutrients, or lymphatic fluid to be improved and/or pain to the patient 6 to be reduced.

[0096] The elements and features recited in the appended claims may be combined in different ways to produce new claims that likewise fall within the scope of the present invention. Thus, whereas the dependent claims appended below depend from only a single independent or dependent claim, it is to be understood that these dependent claims may, alternatively, be made to depend in the alternative from any preceding or following claim, whether independent or dependent. Such new combinations are to be understood as forming a part of the present specification.

[0097] While the present invention has been described above by reference to various embodiments, it should be understood that many changes and modifications can be made to the described embodiments. It is therefore intended that the foregoing description be regarded as illustrative rather than limiting, and that it be understood that all equivalents and/or combinations of embodiments are intended to be included in this description.