IMAGE-GUIDED THERAPY OF A TISSUE

1 . A method for effecting thermal therapy using an in vivo probe, comprising:

positioning the probe in a volume in a patient;

identifying a three-dimensional region of interest at which to apply thermal therapy, wherein the three-dimensional region of interest is irregularly shaped; and

applying, by processing circuitry, thermal therapy to the volume using the probe, wherein applying thermal therapy comprises

a) identifying a first emission level corresponding to thermal therapy of the three-dimensional region of interest at a first rotational angle of the probe, wherein the first emission level is based at least in part upon a depth of a radial portion of the region of interest in the direction of probe emission at the first rotational angle,

b) activating emission of the probe to deliver therapeutic energy at the first emission level to the three-dimensional region of interest at the first rotational angle,

c) causing rotation of the probe to a next rotational angle,

d) identifying a next emission level corresponding to thermal therapy of the three-dimensional region of interest at the next rotational angle of the probe, wherein the next emission level is based at least in part upon a depth of a radial portion of the region of interest in the direction of probe emission at the next rotational angle,

e) activating emission of the probe to deliver therapeutic energy at the next emission level to the three-dimensional region of interest at the next rotational angle, and

f) repeating steps (c) through (e) until therapeutic energy has been delivered to at least a first volume of the three-dimensional region of interest.

2 . The method of claim 1 , further comprising:

i) activating linear adjustment of the probe to move to a next volume of the three-dimensional region of interest;

ii) initiating additional thermal therapy, wherein the additional thermal therapy comprises performing steps (a) through (f); and

iii) repeating steps (i) and (ii) until therapeutic energy has been delivered to the entire volume of the three-dimensional region of interest.

3 . The method of claim 1 , wherein applying thermal therapy comprises continuously monitoring, throughout repetition of steps (c) through (e), respective tissue temperatures at a respective rotational angle corresponding to emission within the first volume of the three-dimensional region of interest.

4 . The method of claim 3 , wherein monitoring the respective tissue temperatures comprises performing thermographic analysis of magnetic resonance (MR) images.

5 . The method of claim 1 , wherein applying thermal therapy further comprises:

while delivering therapeutic energy at the first emission level, monitoring respective temperatures of a plurality of points, wherein each point of the plurality of points is a) within the three-dimensional region of interest or b) adjacent to the three-dimensional region of interest; and

prior to rotating the probe to the next rotational angle, determining, based on at least one of the respective temperatures of the plurality of points and a thermal dose that is based on a temperature history of the plurality of points over a specified time period, to conclude delivery of therapeutic energy at the first rotational angle.

6 . The method of claim 5 , wherein performing thermographic analysis comprises analyzing MR images corresponding to each of a plurality of thermal monitoring planes, wherein a first portion of the plurality of points is within a first thermal monitoring plane of the plurality of thermal monitoring planes, and a second portion of the plurality of points is within a second thermal monitoring plane of the plurality of thermal monitoring planes.

7 . The method of claim 6 , wherein:

each thermal monitoring plane of the plurality of thermal monitoring planes is separated from all adjacent thermal monitoring planes of the plurality of thermal monitoring planes by a respective gap; and

applying thermal therapy comprises, prior to determining to conclude delivery of therapeutic energy at the first rotational angle, interpolating temperature data for regions within the gaps between adjacent thermal monitoring planes.

8 . The method of claim 6 , wherein each thermal monitoring plane of the plurality of thermal monitoring planes intersects the other thermal monitoring planes by a respective angle, wherein the respective angle is determined based at least in part upon one of a) a geometry of the region of interest, and b) a geometry of a region of a skull of the patient.

9 . The method of claim 5 , wherein monitoring the respective temperatures of the plurality of points comprises indicating, based at least in part upon at least one of the respective temperatures of the plurality of points and the thermal dose, cellular death of tissue at the first angle of rotation.

10 . A system for effecting in vivo thermal therapy comprising:

a probe;

a probe driver connected to the probe and operable to manipulate at least an angle of rotation of the probe;

a processor; and

a memory having instructions stored thereon, wherein the instructions, when executed by the processor, cause the processor to, while the probe is positioned within in a volume in a patient:

a) identify a first emission level at which to deliver therapeutic energy to a three-dimensional region of interest at a first rotational angle of the probe,

b) activate delivery of therapeutic energy at the first emission level to the three-dimensional region of interest at the first rotational angle,

c) identify, based at least in part upon monitoring respective temperatures of a first plurality of points, completion of thermal therapy at the first rotational angle, wherein each point of the first plurality of points is within the three-dimensional region of interest or adjacent to the three-dimensional region of interest,

d) direct the probe driver to rotate the probe to a next rotational angle,

e) identify a next emission level at which to deliver therapeutic energy to the three-dimensional region of interest at the next rotational angle of the probe,

f) activate delivery of therapeutic energy at the next emission level to the three-dimensional region of interest at the next rotational angle,

g) identify, based at least in part upon monitoring temperatures of a next plurality of points, completion of treatment at the next rotational angle, wherein each point of the second plurality of points is within the three-dimensional region of interest or adjacent to the three-dimensional region of interest, and

h) repeat steps (d) through (g) until therapeutic energy has been delivered to at least a first volume of the three-dimensional region of interest.

11 . The system of claim 10 , wherein

the therapeutic energy is ultrasonic energy; and

the probe is a high intensity focused ultrasound (HIFU) probe operable to effect cellular damage within the three-dimensional region of interest at a depth of at least one centimeter.

12 . The system of claim 11 , wherein the HIFU probe comprises at least one ultrasound producing element mounted in a side-firing position within a rigid external shaft.

13 . The system of claim 11 , wherein the cellular damage comprises reversible cellular damage.

14 . The system of claim 10 , wherein:

the therapeutic energy is laser energy; and

the probe is a side-firing probe.

15 . The system of claim 10 , wherein the second plurality of points comprises at least a portion of the first plurality of points.

16 . The system of claim 10 , further comprising a workstation located in a control room separate from a room containing the probe and probe driver, wherein the workstation comprises the processor.

17 . The system of claim 16 , wherein:

thermal therapy is initiated via user input to the workstation; and

the instructions further cause the processor to present, upon a display device, at least one thermal monitoring view pane illustrating the region of interest.

18 . A non-transitory computer readable medium having instructions stored thereon, wherein the instructions, when executed by a processor, cause the processor to effect thermal therapy to a three-dimensional region of interest within a volume of a patient, the thermal therapy comprising:

a) identifying a first dose profile for effecting thermal therapy, wherein the first dose profile includes one or more of a time period, and a geometry of a first target area of the three-dimensional region of interest;

b) identifying, based at least in part on the first dose profile, a first emission level at which to deliver therapeutic energy to the three-dimensional region of interest at a first rotational angle of a probe;

c) activating delivery of therapeutic energy by the probe at the first emission level to the three-dimensional region of interest at the first rotational angle;

d) monitoring feedback related to the first target area, wherein the feedback comprises at least one of temperature feedback and imaging feedback;

e) determining, based at least in part on the feedback, completion of thermal therapy at the first rotation angle;

f) activating rotation of the probe to a next rotational angle;

g) identifying, based at least in part on a next dose profile, a next emission level at which to deliver therapeutic energy to the three-dimensional region of interest at the next rotational angle of the probe;

h) activating delivery of therapeutic energy by the probe at the next emission level to the three-dimensional region of interest at the next rotational angle;

i) monitoring feedback related to the next target area to determine completion of thermal therapy at the next rotation angle; and

j) repeating steps (f) through (i) until therapeutic energy has been delivered to at least a first volume of the three-dimensional region of interest.

19 . The computer readable medium of claim 18 , wherein the first emission level comprises a first power level corresponding to a depth of the three-dimensional region of interest at the first rotational angle, wherein the depth is identified by the geometry of the first target area.

20 . The computer readable medium of claim 18 , wherein rotating the probe comprises rotating the probe while continuing to deliver therapeutic energy, such that therapeutic energy is constantly delivered during thermal therapy of the three-dimensional region of interest.

21 . The computer readable medium of claim 18 , wherein the instructions, when executed, further cause the processor to, after delivering therapeutic energy to the first volume of the three-dimensional region of interest:

activate linear adjustment of the probe; and

initiate a second thermal therapy.

22 . The computer readable medium of claim 21 , wherein the instructions, when executed, further cause the processor to, prior to initiating the second thermal therapy, verify a current placement of the probe.

23 . The computer readable medium of claim 22 , wherein verifying the current placement of the probe comprises:

identifying, within imaging data, a plurality of fiducial markers; and

calculating a probe position based at least in part upon identification of the plurality of fiducial markers.