OVERALL ABLATION WORKFLOW SYSTEM
A technology is provided for supporting cardiac stereotactic ablative radiotherapy (SABR) procedure. The technology collects an arrhythmia electrocardiogram (ECG) from the patient and a CT scan. The technology employs a mapping system to generate a demarcated generic three-dimensional (3D) mesh based on the ECG. The demarcated generic 3D mesh has a target for an ablation demarcated. The technology employs a 3D machine learning (ML) model to generate a patient-specific 3D mesh based on the CT scan. The technology employs a demarcation ML model to generate a demarcated patient-specific 3D mesh based on the patient-specific 3D mesh and the demarcated generic 3D mesh. The demarcated patient-specific 3D mesh has the target for the ablation demarcated to account for difference between cardiac geometry of the patient-specific 3D mesh and the demarcated generic 3D mesh.
1 . A method performed by one or more computing systems for planning a cardiac stereotactic ablative radiotherapy procedure for a patient, the method comprising:
accessing an arrhythmia electrocardiogram (ECG) of a patient, a 3D image of a thorax collected from the patient, and patient characteristics;
applying a mapping system to the arrhythmia ECG and patient characteristics to generate a demarcated generic three-dimensional (3D) mesh of heart with a region of interest (ROI) demarcated;
applying a 3D machine learning (ML) model to the 3D image to generate a patient-specific 3D mesh and a labeling of thoracic segments;
applying a demarcation ML model to the patient-specific 3D mesh and the demarcated generic 3D mesh to generate a demarcated patient-specific 3D mesh; and
generating a delivery plan for the patient by:
identifying thoracic segments that represent avoidance structures; and
applying a planning ML model to the demarcated patient-specific 3D mesh, avoidance structures, and radiation dosage information to generate a delivery plan for the stereotactic ablative radiotherapy procedure.
2 . The method of claim 1 wherein the delivery plan includes movements of a delivery arm of a stereotactic ablative radiotherapy device, doses of radiation for orientations of the delivery arm, and shapes of a delivery beam for the doses.
3 . The method of claim 2 further comprising sending the delivery plan to the stereotactic ablative radiotherapy device and directing the performing of the cardiac stereotactic ablative radiotherapy procedure according to the delivery plan.
4 . The method of claim 1 wherein a first ROI is a source location and a second ROI is scar tissue.
5 . The method of claim 1 wherein the mapping system includes a mapping ML model that inputs the arrhythmia ECG and patient characteristics and outputs the demarcated generic 3D mesh.
6 . The method of claim 1 wherein the avoidance structures are demarcated by a specification of a volume and location within the thorax of the patient.
7 . The method of claim 1 wherein the ROI is specified by a volume at a location within the demarcated patient-specific 3D mesh of a target of the stereotactic ablative radiotherapy procedure.
8 . The method of claim 1 wherein the 3D image is a computed tomography scan.
9 . The method of claim 1 wherein the 3D image is a magnetic resonance image scan.
10 . A method for planning a procedure on an organ of a patient, the method comprising:
applying a mapping system that inputs a patient electrogram representing electrical activity of the patient's organ and patient characteristics of the patient and outputs a demarcated generic three-dimensional (3D) mesh representing the organ based on a generic organ geometry and having one or more regions of interest (ROIs) within the demarcated generic 3D mesh demarcated, the one or more ROIs including a target region for the procedure;
collecting a 3D image of at least a portion of the thorax of the patient that includes the patient's organ;
generating a patient-specific 3D mesh representing the patient's organ based on the 3D image, the patient-specific 3D mesh representing patient organ geometry of the patient's organ;
identifying segments within the 3D image and generating labels for the segments that indicate segment type; and
applying a demarcation machine learning (ML) model to the patient-specific 3D mesh and the demarcated generic 3D mesh to generate a demarcated patient-specific 3D mesh with the one or more ROIs demarcated accounting for differences between the generic organ geometry and the patient organ geometry.
11 . The method of claim 10 further comprising generating a delivery plan for the patient based on the demarcated patient-specific 3D mesh, labels for the segments, and a radiation dosage information.
12 . The method of claim 10 wherein the mapping system applies a mapping ML model that inputs the patient electrogram and the patient characteristics and outputs the demarcated generic 3D mesh.
13 . The method of claim 10 wherein the mapping system identifies, from a library of associations between library electrograms and library demarcated generic 3D meshes, a library electrogram that matches the patient electrogram based on a matching criterion and outputs the library demarcated generic 3D mesh associated with the matching library electrogram.
14 . The method of claim 10 wherein the mapping system generates the demarcated generic 3D mesh based on a simulated organ geometry used in a simulation of electrical activity of the organ based on simulated organ characteristics that include the simulated organ geometry.
15 . The method of claim 10 further comprising applying a 3D ML model to the 3D image to generate the patient-specific 3D mesh, identify the segments, and generate the labels.
16 . The method of claim 10 wherein the organ is selected from the group consisting of a brain, a gastrointestinal organ, a heart, and a lung.
17 . A method performed by one or more computing systems for generating a three-dimensional (3D) machine learning (ML) model, the method comprising:
accessing training data that includes training sets that each includes features based on a 3D image that includes an organ with an organ geometry and based on characteristics associated with the organ and that each includes labels indicating a labeling of segments of the 3D image and indicating a 3D mesh that is based on that organ geometry; and
training the 3D ML model based on the training sets, the 3D ML model for inputting features derived from a patient 3D image of the organ of the patient and characteristics associated with the patient's organ and outputting a labeling of the segments with the 3D image and a patient-specific 3D mesh representing the organ geometry of the patient.
18 . The method of claim 17 wherein the 3D ML model includes a segmentation ML sub-model that inputs the 3D image and outputs a segmentation of the 3D image, a labeling ML sub-model that inputs the segmentation of the 3D image and outputs a labeling of segments, and a 3D ML sub-model inputs the labeling of segments and outputs the patient-specific 3D mesh.
19 . The method of claim 17 wherein the organ is a heart.
20 . The method of claim 17 wherein at least some of the 3D images are collected using a scanning device and have a labeling of segments of the 3D image.
21 . The method of claim 17 wherein at least some of the 3D images are simulated 3D images, each simulated 3D image representing a different combination of segment geometries and segment positions of segments within a body.
22 . The method of claim 17 further comprising accessing a patient 3D image of the organ of a patient and patient characteristics and applying the 3D ML model to the patient 3D image and the patient characteristics to generate a patient-specific 3D mesh of the patient's organ and a labeling of segments within the patient 3D image.
23 . A method performed by one or more computing systems for generating a planning machine learning (ML) model, the method comprising:
accessing training data that includes training sets, each training set including features derived from a demarcated three-dimensional (3D) mesh representing an organ with a target region for a medical procedure demarcated and from other structures within a body, the features labeled with a delivery plan for the medical procedure; and
training the planning ML model based on the training sets, the planning ML model for inputting features derived from a demarcated patient-specific 3D mesh representing the organ of a patient with a target region demarcated and from other structures within the patient's body and outputting a delivery plan for the medical procedure to treat the target region of the patient's organ.
24 . The method of claim 23 wherein the target region is demarcated using metadata associated with the demarcated 3D mesh.
25 . The method of claim 24 wherein a feature derived from the demarcated 3D mesh is a 3D image that includes the organ.
26 . The method of claim 23 wherein a feature is based on dosage information.
27 . The method of claim 24 wherein the organ is a heart and further comprising collecting a 3D image of a portion of the body of a patient that includes the heart and non-cardiac structures, generating features based on a demarcated patient-specific 3D mesh derived from the collected 3D image demarcated with a target region and a labeling of segments within the collected 3D image and applying the planning ML model to the features to generate a delivery plan for treating the patient.
28 . A method performed by one or more computing systems for treating a patient by performing a cardiac stereotactic ablative radiotherapy procedure on the heart of the patient, the method comprising:
collecting an arrhythmia electrocardiogram (ECG) and patient characteristics of the patient;
receiving a demarcated generic three-dimensional (3D) mesh representing a generic cardiac geometry by inputting the arrhythmia ECG and patient characteristics into a mapping system that outputs the demarcated generic 3D mesh with a region of interest (ROI) demarcated;
collecting a 3D image of the heart of the patient;
generating based on the 3D image a patient-specific 3D mesh representing the patient's heart; and
generating a demarcated patient-specific 3D mesh based on the patient-specific 3D mesh and the demarcated generic 3D mesh, the demarcated patient-specific 3D mesh with the ROI demarcated to reflect differences in the patient's cardiac geometry and the generic cardiac geometry.
29 . The method of claim 28 further comprising submitting the demarcated patient-specific 3D mesh to a stereotactic ablative radiotherapy device.
30 . The method of claim 28 further comprising generating a 3D image corresponding to the demarcated patient-specific 3D mesh and submitting the 3D image to a stereotactic ablative radiotherapy device.
31 . The method of claim 28 further comprising generating a labeling of segments within the 3D image and generating a delivery plan based on demarcated patient-specific 3D mesh, the labeled segments, and a target dose.
32 . The method of claim 31 wherein the delivery plan is generated using a planning machine learning model.
33 . One or more computing systems for supporting treatment of a patient with an arrythmia, the one or more computing systems comprising:
one or more computer-readable storage mediums that store:
an arrhythmia cardiogram collected from the patient;
a 3D image of the heart of the patient; and
computer-executable instructions for controlling the one or more computing systems to:
generate a demarcated generic three-dimensional (3D) mesh representing a generic cardiac geometry by inputting the arrhythmia cardiogram into a mapping system that outputs the demarcated generic 3D mesh with a region of interest (ROI) demarcated;
generate based on the 3D image a patient-specific 3D mesh representing the patient's heart; and
generate a demarcated patient-specific 3D mesh based on the patient-specific 3D mesh and the demarcated generic 3D mesh, the demarcated patient-specific 3D mesh with the ROI demarcated based on differences in the patient's cardiac geometry and the generic cardiac geometry; and
one or more processors for controlling the one or more computing systems to execute one or more of the computer-executable instructions.
34 . The one or more computing systems of claim 33 wherein the instructions that generate the patient-specific 3D mesh apply a 3D machine learning (ML) model that includes a segmentation ML sub-model, a labeling ML sub-model, and a 3D ML sub-model.
35 . The one or more computing systems of claim 33 wherein the computer-executable instructions include instructions to generate a delivery plan based on the demarcated patient-specific 3D mesh, a labeling of segments within the patient's thorax, and dosage information.
36 . The one or more computing systems of claim 33 wherein the computer-executable instructions include instructions to display a 3D graphic of a heart based on the patient-specific 3D mesh.
37 . The one or more computing systems of claim 33 wherein the computer-executable instructions include instructions to generate a demarcated patient-specific 3D image based on the demarcated patient-specific 3D mesh.
38 . The one or more computing systems of claim 33 wherein the computer-executable instructions include instructions to generate a demarcated patient-specific 3D image based on the demarcated patient-specific 3D mesh and the 3D image.