Method and device for effecting thermal therapy of a tissue
View Patent ↗Image-guided therapy of a tissue can utilize magnetic resonance imaging (MRI) or another medical imaging device to guide an instrument within the tissue. A workstation can actuate movement of the instrument, and can actuate energy emission and/or cooling of the instrument to effect treatment to the tissue. The workstation and/or an operator of the workstation can be located outside a vicinity of an MRI device or other medical imaging device, and drive means for positioning the instrument can be located within the vicinity of the MRI device or the other medical imaging device. The instrument can be an MRI compatible laser probe that provides thermal therapy to, e.g., a tissue in a brain of a patient.
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 said identifying includes calculating a plurality of target positions as a sequence of positions and alignments of the probe based on a symmetric or asymmetric output pattern of the probe, wherein each target position of the plurality of target positions is associated with one or more of a respective power level, a respective energy level, a respective emission pattern, a respective time period, and a respective geometry of a target area of the three-dimensional region of interest;
identifying, by processing circuitry, a treatment profile for effecting thermal therapy to the three-dimensional region of interest, wherein the treatment profile includes a selected sequence corresponding to one or more positions of the probe and a minimum treatment time for effecting the thermal therapy to the three-dimensional region of interest based on an expected output of the probe; and
applying, by the processing circuitry, thermal therapy to the volume using the probe according to the treatment profile, wherein applying the thermal therapy comprises a) activating delivery of therapeutic energy by the probe to the three-dimensional region of interest at a first target position of the plurality of target positions according to the treatment profile, b) causing actuation of the probe to adjust at least one of a linear position and a rotational position of the probe to a next target position of the plurality of target positions, and c) activating delivery of therapeutic energy to the three-dimensional region of interest at a next target position according to the treatment profile.
2. The method of claim 1 , wherein causing actuation of the probe comprises causing actuation of the probe while continuing to deliver therapeutic energy, such that therapeutic energy is continuously delivered during treatment of the three-dimensional region of interest.
3. The method of claim 1 , wherein applying thermal therapy further comprises: monitoring a temperature of a point while delivering therapeutic energy at a first target position, wherein the point is one of within the three-dimensional region of interest and adjacent to the three-dimensional region of interest; and prior to adjusting the probe to the next target position, determining, based at least in part upon at least one of i) the temperature of the point and ii) a thermal dose that is based on a temperature history of the three-dimensional region of interest over a specified time period, to conclude delivery of therapeutic energy at the first target position, the thermal dose including a thermal dose of the point.
4. The method of claim 3 , wherein monitoring the temperature of the point comprises performing thermographic analysis of magnetic resonance (MR) images.
5. The method of claim 4 , wherein applying thermal therapy further comprises monitoring a temperature of an external point that is external to the three-dimensional region of interest, wherein the thermal dose is calculated based on a temperature history over the specified time period of the respective external point, and the external point is one of i) at a periphery of the region of interest and ii) between the periphery of the region of interest and an emission region of the probe.
6. The method of claim 5 , wherein applying thermal therapy further comprises, responsive to monitoring the temperature of the external point, adjusting delivery of therapeutic energy to minimize damage to tissue near the probe.
7. The method of claim 5 , wherein applying thermal therapy further comprises, responsive to monitoring the temperature of the external point, activating a cooling functionality of the probe to minimize damage to tissue near the probe.
8. The method of claim 3 , wherein monitoring the temperature of the point comprises indicating, based at least in part upon the thermal dose of the point, thermal damage of tissue at the first target position.
9. 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 patient using a probe, wherein effecting thermal therapy comprises:
a) identifying a treatment profile by calculating a first sequence of positions and alignments of the probe based on a symmetric or asymmetric output pattern of the probe, and selecting for the treatment profile a selected sequence corresponding to one or more positions of the probe and a minimum treatment time for effecting the thermal therapy to the three-dimensional region of interest based on an expected output of the probe;
b) identifying a first emission level for treatment of the three-dimensional region of interest at a first position of the 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 position;
d) monitoring feedback related to the first target area, wherein the feedback comprises at least one of temperature feedback and imaging feedback provided by at least one of a magnetic resonance (MR) imaging system and a thermometry imaging system;
e) determining, based at least in part on the feedback, completion of thermal therapy at the first position;
f) activating at least one of rotation and linear displacement of the probe to a next position;
g) identifying a next emission level for treatment of therapeutic energy by the probe at the next emission level to the three-dimensional region of interest at the next position;
h) activating delivery of therapeutic energy by the probe at the next emission level to the three-dimensional region of interest at the next position;
i) monitoring feedback related to the next target area;
j) determining, based at least in part on the feedback, completion of thermal therapy at the next positon.
10. The computer readable medium of claim 9 , wherein activating at least one of rotation and linear displacement of the probe to the next position comprises activating retraction of the probe from a first delivery hole of a guide sheath and activating deployment of the probe from a second delivery hole of the guide sheath.
11. The computer readable medium of claim 10 , wherein the probe projects from the first delivery hole at a first angle of projection different than a second angle of projection out of the second delivery hole.