Apparatus for controlling thermal dosing in a thermal treatment system

Abstract

A thermal treatment system including a heat applying element for generating thermal doses for ablating a target mass in a patient, a controller for controlling thermal dose properties of the heat applying element, an imager for providing preliminary images of the target mass and thermal images during the treatment, and a planner for automatically constructing a treatment plan, comprising a series of treatment sites that are each represented by a set of thermal dose properties. The planner automatically constructs the treatment plan based on input information including one or more of a volume of the target mass, a distance from a skin surface of the patient to the target mass, a set of default thermal dose prediction properties, a set of user specified thermal dose prediction properties, physical properties of the heat applying elements, and images provided by the imager. The default thermal dose prediction properties are preferably based on a type of clinical application and include at least one of thermal dose threshold, thermal dose prediction algorithm, maximum allowed energy for each thermal dose, thermal dose duration for each treatment site, cooling time between thermal doses, and electrical properties for the heat applying element. The user specified thermal dose prediction properties preferably include at least one or more of overrides for any default thermal dose prediction properties, treatment site grid density; and thermal dose prediction properties not specified as default thermal dose prediction properties from the group comprised of thermal dose threshold, thermal dose prediction algorithm, maximum allowed energy for each thermal dose, thermal dose duration for each treatment site cooling time between thermal doses, and electrical properties for the heat applying element.

1. A thermal treatment system, comprising:
 a heat applying element for generating a delivering thermal dose doses used to ablate a target mass in a patient; 
 a controller for controlling thermal dose properties of the heat applying element; 
 an imager for providing preliminary images of the target mass; and  
 a planner for automatically constructing a treatment plan, the treatment plan comprising a series of treatment sites that are each represented by a set of thermal dose properties; 
 wherein the planner automatically constructs the treatment plan based on input information including one or more of: 
 a volume of the target mass, 
 a distance from a skin surface of the patient to the target mass, 
 a set of default thermal dose prediction properties, 
 a set of user specified thermal dose prediction properties, 
 physical properties of the heat applying elements, and 
 images provided by the imager. 
 
     
     
       2. The treatment system of  claim 1 , wherein the thermal dose properties translate, at least in part, to electrical and mechanical properties of the heat applying element. 
     
     
       3. The treatment system of  claim 1 , wherein the default thermal dose prediction properties are based on a type of clinical application and include at least one of:
 thermal dose threshold, 
 thermal dose prediction algorithm, 
 maximum allowed energy for each thermal dose, 
 thermal dose duration for each treatment site, 
 cooling time between thermal doses, and 
 electrical properties for the heat applying element. 
 
     
     
       4. The treatment system of  claim 1 , wherein the user specified thermal close dose prediction properties include at least one of: 
 overrides for any default thermal dose prediction properties, 
 treatment site grid density, and 
 thermal dose prediction properties not specified as default thermal dose prediction properties selected from the group comprised consisting of thermal dose threshold, thermal dose prediction algorithm, maximum allowed energy for each thermal dose, thermal dose duration for each treatment site cooling time between thermal doses, and electrical properties for the heat applying element. 
 
     
     
       5. The treatment system of  claim 1 , wherein the treatment plan ensures that the entire target mass is covered by a series of thermal doses so as to obtain a composite thermal dose sufficient to ablate the entire target mass. 
     
     
       6. The treatment system of  claim 1 , wherein the thermal dose properties are automatically optimized using physiological properties as the optimization criterion. 
     
     
       7. The treatment system of  claim 1 , wherein the planner limits the thermal dose at each treatment site in order to prevent carbonization or evaporation. 
     
     
       8. The treatment system of  claim 1 , wherein the planner constructs a predicted thermal dose distribution illustrating the predicted thermal dose contours of each treatment site in the treatment plan. 
     
     
       9. The treatment system of  claim 1 , further comprising a User Interface (UI) for entering user specified thermal dose prediction properties and for editing the treatment plan once the treatment plan is constructed. 
     
     
       10. The treatment system of  claim 1 , wherein the treatment plan is constructed in three dimensions. 
     
     
       11. The treatment system of  claim 1 , further comprising a feedback imager for providing thermal images illustrating the an actual thermal dose distribution resulting from a respective thermal dose delivery at each treatment site. 
     
     
       12. The treatment system of  claim 11 , wherein the imager acts as the feedback imager. 
     
     
       13. The treatment system of  claim 1 , wherein the heat applying element applies one of the following: 
 ultrasound energy, 
 laser light energy, 
 RF energy, 
 microwave energy, and 
 electrical energy. 
 
     
     
       14. A focused ultrasound system, comprising:
 a transducer for generating delivering successive delivered thermal doses of ultrasound energy that results in thermal doses to ablate for ablating a target mass in a patient; 
 a controller for controlling thermal dose properties of the transducer;  
 an imager for providing preliminary images of the target mass, and for providing thermal images illustrating an actual thermal dose distribution in the patient resulting from a delivered thermal dose of ultrasound energy to the target mass; and 
 a planner configured for automatically constructing a treatment plan using the preliminary images, the treatment plan comprising a series of predicted thermal doses to treatment sites represented by a set of thermal dose properties used by a controller to control the transducer of the target mass; 
 wherein the planner further constructs a predicted thermal dose distribution illustrating the predicted thermal dose contours of each treatment site in the treatment plan; 
 wherein after a thermal dose is delivered to each treatment site in the treatment plan, the actual thermal dose distribution is compared to the predicted thermal dose distribution to determine remaining untreated locations within the target mass. 
 
     
     
       15. The focused ultrasound system of  claim 14 , wherein after a thermal dose is delivered to a treatment site in the treatment plan, the comparison of the actual thermal dose distribution is compared to the predicted thermal dose distribution is used to determine changes to the dosing parameters in neighboring sonication sites treatment plan for treating the remaining untreated locations. 
     
     
       16. The focused ultrasound system of  claim 14 , wherein the planner automatically evaluates the treatment plan based on the remaining untreated locations and updates, in order to ensure complete ablation of the target mass, either changes the treatment plan to ensure complete ablation of the target mass is achieved by one or more of adding treatment sites, removing treatment sites, modifying existing treatment sites, or leaving leaves the treatment plan unchanged, based on the comparison of the actual thermal dose distribution to the predicted thermal dose distribution. 
     
     
       17. The focused ultrasound system of  claim 14 , wherein a user can manually adjust the treatment plan based on the remaining untreated locations. 
     
     
       18. The focused ultrasound system of  claim 14 , wherein the preliminary images and the thermal images represent three-dimensional data. 
     
     
       19. The focused ultrasound system of  claim 14 , wherein the predicted thermal dose distribution and actual thermal dose distribution represent three-dimensional data. 
     
     
       20. The focused ultrasonic system of  claim 14 , wherein the imager further provides outlines of sensitive regions within the patient where ultrasonic waves are not allowed to pass that are sensitive to ultrasound. 
     
     
       21. The focused ultrasonic system of  claim 20 , wherein the processor planner uses the outlines in constructing the treatment plan so as to avoid exposing the sensitive regions to ultrasound. 
     
     
       22. The focused ultrasound system of claim  20  21, wherein the sensitive regions comprise bones, gas, and other sensitive tissues. 
     
     
       23. The focused ultrasound system of claim 14, wherein based on the comparison of the actual thermal dose distribution to the predicted thermal dose distribution for a given treatment site, the planner adjusts the treatment plan to include delivery of an additional thermal dose to the same or substantially the same treatment site. 
     
     
       24. A thermal treatment system, comprising:
 a heat applying element for delivering thermal doses to ablate a target mass in a patient;   a controller for controlling thermal dose properties of the heat applying element;   an imager for providing preliminary images of the target mass; and   a planner for automatically constructing a treatment plan, the treatment plan comprising a series of treatment sites that are each represented by a set of thermal dose properties,   wherein the planner automatically constructs the treatment plan based on input information including thermal dose prediction properties comprising at least one of   a set of default thermal dose prediction properties, or   a set of user specified thermal dose prediction properties.   
     
     
       25. The treatment system of claim 24, wherein the thermal dose properties translate, at least in part, to electrical and mechanical properties of the heat applying element. 
     
     
       26. The treatment system of claim 24, wherein the default thermal dose prediction properties are based on a type of clinical application and include at least one of:
 thermal dose threshold,   thermal dose prediction algorithm,   maximum allowed energy for each thermal dose,   thermal dose duration for each treatment site,   cooling time between thermal doses, and   electrical properties for the heat applying element.   
     
     
       27. The treatment system of claim 24, wherein the user specified thermal dose prediction properties include at least one of:
 overrides for any default thermal dose prediction properties,   treatment site grid density, and   thermal dose prediction properties not specified as default thermal dose prediction properties and selected from the group consisting of thermal dose threshold, thermal dose prediction algorithm, maximum allowed energy for each thermal dose, thermal dose duration for each treatment site cooling time between thermal doses, and electrical properties for the heat applying element.   
     
     
       28. The treatment system of claim 24, wherein the treatment plan ensures that the entire target mass is covered by a series of thermal doses so as to obtain a composite thermal dose sufficient to ablate the entire target mass. 
     
     
       29. The treatment system of claim 24, wherein the thermal dose properties are automatically optimized using physiological properties as the optimization criterion. 
     
     
       30. The treatment system of claim 24, wherein the planner limits the thermal dose at each treatment site in order to prevent carbonization or evaporation. 
     
     
       31. The treatment system of claim 24, wherein the planner constructs a predicted thermal dose distribution illustrating the predicted thermal dose contours of each treatment site in the treatment plan. 
     
     
       32. The treatment system of claim 24, further comprising a user interface for entering user specified thermal dose prediction properties and for editing the treatment plan once the treatment plan is constructed. 
     
     
       33. The treatment system of claim 24, wherein the treatment plan is constructed in three dimensions. 
     
     
       34. The treatment system of claim 24, wherein the imager provides thermal images illustrating an actual thermal dose distribution resulting from a respective thermal dose delivery at each treatment site. 
     
     
       35. The treatment system of claim 24, wherein the heat applying element applies one of the following:
 ultrasound energy,   laser light energy,   RF energy,   microwave energy, and   electrical energy.   
     
     
       36. The treatment system of claim 24, wherein the input information further includes a volume of the target tissue mass. 
     
     
       37. A method of treating a target tissue mass in a patient using a focused ultrasound system, the system comprising a transducer for delivering thermal doses of ultrasound energy to the target tissue mass, an imager for providing images of the target mass, a controller for controlling the transducer, and a planner for constructing a treatment plan, the method comprising
 obtaining preliminary images of the target tissue mass; and   based on the preliminary images, constructing a treatment plan for ablating the target mass, the treatment plan comprising a series of treatment sites in the target mass that are to each receive a thermal dose of ultrasound energy from the transducer, each treatment site represented by a set of thermal dose properties to be used by the controller to control the delivery of ultrasound energy by the transducer.   
     
     
       38. The method of claim 37, further comprising constructing a predicted thermal dose distribution illustrating the predicted thermal dose contours of each treatment site in the treatment plan. 
     
     
       39. The method of claim 37, further comprising delivering thermal doses of ultrasound energy to one or more of the treatment sites. 
     
     
       40. The method of claim 37, wherein the imager provides thermal images illustrating an actual thermal dose distribution in the target tissue mass resulting from a thermal dose of ultrasound energy to a treatment site, the method further comprising
 constructing a predicted thermal dose distribution illustrating the predicted thermal dose contours of each treatment site in the treatment plan,   delivering thermal doses of ultrasound energy to the treatment sites according to the treatment plan, and   after a thermal dose is delivered to a treatment site in the treatment plan, comparing the actual thermal dose distribution to the predicted thermal dose distribution for the treatment site.   
     
     
       41. The method of claim 40, further comprising, based on the comparison of the actual thermal dose distribution to the predicted thermal dose distribution, selectively changing the treatment plan by one or more of adding treatment sites, removing treatment sites, and modifying treatment sites, to ensure complete ablation of the target mass. 
     
     
       42. The method of claim 40, further comprising, based on the comparison of the actual thermal dose distribution to the predicted thermal dose distribution, delivering an additional thermal dose of ultrasound energy to the same or substantially the same treatment site. 
     
     
       43. The method of claim 37, further comprising manually adjusting the treatment plan. 
     
     
       44. The method of claim 37, further comprising:
 identifying in images used to construct the treatment plan outlines of regions within the patient that are sensitive to the application of ultrasound, and   constructing the treatment plan so as to avoid exposure of the sensitive regions to ultrasound energy delivered by the transducer.   
     
     
       45. The method of claim 37, wherein the thermal dose properties translate, at least in part, to electrical and mechanical properties of the transducer. 
     
     
       46. The method of claim 37, wherein the treatment plan ensures that the entire target mass is covered by a series of thermal doses of ultrasound energy so as to obtain a composite thermal dose sufficient to ablate the entire target mass. 
     
     
       47. The method of claim 37, further comprising optimizing the thermal dose properties based on physiological properties as optimization criterion. 
     
     
       48. A method for treating a target tissue mass in a patient using a thermal energy treatment system, the system comprising a heat applying element for delivering thermal doses used to ablate the target mass, a controller for controlling thermal dose properties of the heat applying element, an imager for providing images of the target mass, and a planner for constructing a treatment plan, the method comprising:
 receiving input information including preliminary images of the target mass; and   based on the input information, automatically constructing a treatment plan for ablating the target mass, the treatment plan comprising a series of treatment sites in the target mass that are to each receive a thermal dose from the heat applying element, each treatment site represented by a set of thermal dose properties to be used by the controller to control the delivery of the thermal doses.   
     
     
       49. The method of claim 48, further comprising automatically constructing a predicted thermal dose distribution illustrating the predicted thermal dose contours of each treatment site in the treatment plan. 
     
     
       50. The method of claim 48, further comprising delivering thermal doses from the heat applying element to one or more of the treatment sites. 
     
     
       51. The method of claim 48, wherein the imager provides thermal images illustrating an actual thermal dose distribution in the target tissue mass resulting from a thermal dose delivered to a treatment site, the method further comprising
 constructing a predicted thermal dose distribution illustrating the predicted thermal dose contours of each treatment site in the treatment plan,   delivering thermal doses to the treatment sites according to the treatment plan, and   after a thermal dose is delivered to a treatment site in the treatment plan, comparing the actual thermal dose distribution to the predicted thermal dose distribution for the treatment site.   
     
     
       52. The method of claim 51, further comprising, based on the comparison of the actual thermal dose distribution to the predicted thermal dose distribution, changing the treatment plan by one or more of adding treatment sites, removing treatment sites, and modifying treatment sites, to ensure complete ablation of the target mass. 
     
     
       53. The method of claim 51, further comprising, based on the comparison of the actual thermal dose distribution to the predicted thermal dose distribution, leaving the treatment plan unchanged in order to ensure complete ablation of the target mass. 
     
     
       54. The method of claim 51, further comprising, based on the comparison of the actual thermal dose distribution to the predicted thermal dose distribution, delivering an additional thermal dose to the same or substantially the same treatment site. 
     
     
       55. The method of claim 48, further comprising manually adjusting the treatment plan. 
     
     
       56. The method of claim 48, wherein the thermal dose properties translate, at least in part, to electrical and mechanical properties of the heat applying element. 
     
     
       57. The method of claim 48, wherein the treatment plan ensures that the entire target mass is covered by a series of thermal doses so as to obtain a composite thermal dose sufficient to ablate the entire target mass. 
     
     
       58. The method of claim 48, further comprising optimizing the thermal dose properties based on physiological properties as optimization criterion. 
     
     
       59. The method of claim 48, wherein the input information further includes one or more of the group consisting of:
 a volume of the target mass,   default thermal dose prediction properties, and   user specified thermal dose prediction properties.   
     
     
       60. The method of claim 53, wherein the heat applying element applies one of the following:
 ultrasound energy,   laser light energy,   RF energy,   microwave energy, and   electrical energy.   
     
     
       61. A method of treating a target tissue mass in a patient using a focused ultrasound system, the system comprising a transducer for delivering thermal doses of ultrasound energy to the target tissue mass, an imager for providing images of the target mass, a controller for controlling the transducer, and a planner for constructing a treatment plan, the method comprising
 obtaining preliminary images of the target tissue mass;   based on the preliminary images, automatically constructing, with the planner, a treatment plan for ablating the target mass, the treatment plan comprising a series of treatment sites in the target mass that are to each receive a thermal dose of ultrasound energy from the transducer, each treatment site represented by a set of thermal dose properties to be used by the controller to control the delivery of ultrasound energy by the transducer;   constructing a predicted thermal dose distribution illustrating the predicted thermal dose contours of the treatment sites in the treatment plan; and   delivering thermal doses of ultrasound energy to the treatment sites according to the treatment plan,   wherein the imager provides thermal images illustrating an actual thermal dose distribution in the target tissue mass resulting from a thermal dose delivered to a treatment site, and   wherein after a thermal dose is delivered to each treatment site, the actual thermal dose distribution is compared to the predicted thermal dose distribution to determine remaining untreated locations within the target mass.   
     
     
       62. The method of claim 61, wherein the comparison of the actual thermal dose distribution to the predicted thermal dose distribution is used to determine changes to the treatment plan for treating the remaining untreated locations. 
     
     
       63. The method of claim 61, wherein the planner automatically evaluates the treatment plan based on the remaining untreated locations and, in order to ensure complete ablation of the target mass, either changes the treatment plan by one or more of adding treatment sites, removing treatment sites, and modifying existing treatment sites, or leaves the treatment plan unchanged. 
     
     
       64. The method of claim 61, further comprising manually adjusting the treatment plan based on the remaining untreated locations. 
     
     
       65. The method of claim 61, wherein the preliminary images and the thermal images represent three-dimensional data. 
     
     
       66. The method of claim 61, wherein the predicted thermal dose distribution and actual thermal dose distribution represent three-dimensional data. 
     
     
       67. The method of claim 61, wherein the imager further provides outlines of regions within the patient that are sensitive to ultrasound, and wherein the planner uses the outlines in constructing the treatment plan so as to avoid exposing the sensitive regions to ultrasound.