DE102009017616A1 - Radio frequency ablation device for ablation of regions of tissue volume, has probe provided with coding that comprises dimension and/or condition of probe differing from dimension and/or condition of other probes - Google Patents

Abstract

The device (1) has an ablation probe (3a) provided with a biunique coding that comprises dimension and/or condition of the ablation probe, where the dimension and/or condition of the probe differ from dimension and/or condition of other ablation probes (3b, 3c). The former ablation probe is connected with a separate ablation control (9a), and temperature probes (5a-5d) are provided for acquisition of measuring values represented in an ablation process. The ablation probes are arranged in form of a bundle at a common discharge position (11) of the device. Independent claims are also included for the following: (1) a method for supplying identity information of an ablation probe of an ablation device (2) a method for controlling an ablation device.

Description

The The present invention relates to an ablation device for targeted Ablation of areas of tissue volume with a plurality of Ablation probes. Moreover, it relates to a method for Providing identity information of at least one first ablation probe of an ablation device that has a plurality of ablation probes. In addition, it also relates to an ablation arrangement with such ablation device, a driving method for an ablation device and a computer program product.

ablation within tissue volumes are now additionally through imaging systems, such as computed tomography, magnetic resonance imaging, Ultrasound or similar imaging Method based imaging systems, supported. With Help of the obtained image data ablation devices Navigate a specific target point within a tissue volume become.

There are several ablation techniques, in common with placing an instrument in the target tissue volume to destroy the tissue there:

In so-called cryo-ablation, this is done by icing. This method has the advantage that the icing zone is very clearly recognizable in a computed tomography image. A very new process uses the effect of electroporation. In this case, the cell membranes are changed by applying very high pulsed DC voltage, which leads to the death of the cell. The most commonly used technique is RF (Radio Frequency) ablation, which uses high frequency waves to introduce thermal energy into the target tissue volume, thus "overcooking" the tumor. This method will be discussed in more detail below by way of example.

at RF tumor ablation becomes a needle-shaped applicator an ablation device inserted into a tissue and under control based on the image data of a computer tomograph pushed to the location of a tumor. If the applicator is in the target area, is produced by microwaves thermal energy, the leads to the destruction of tumor tissue.

It There are different types of RF ablation devices, where basically between needle-shaped and umbrella-like Ablation devices can be distinguished. In the latter After positioning several single antennas are extended which are designed both as ablation probes and as measuring sensors can be or combine both functions in itself. Schirmchenartige Ablation devices thus achieve a greater ablation volume as needle-shaped.

While An ablation process is performed by means of the measuring sensors in different Method determined when the end point of an ablation in about is reached: For example, in an impedance measurement against End of the ablation, an increase in impedance, the so-called "roll-off", be determined. This arises when the corresponding tissue ablated and the conductivity decreases. Usually will go through about two roll-offs before the ablation ends becomes. Analogously, it is also possible to proceed with a temperature measurement which is an exceedance of a temperature threshold the end of the ablation means.

The Expansion of the ablated area depends on the type of Ablation device among other things on the ablation performance used and on the duration of use. The corresponding parameters will be in advance by a user on the ablation device in dependence set by various basic information. As basic information will be for example, the size and extent of each tissue to be ablated, the type of tissue nearby lying vessels that dissipate the heat could, as well as particularly sensitive zones such as nerves, which should not be affected.

The Product information of the manufacturers of ablation devices often contain tables that indicate the thermal spread depending on the device setting. These tables were and can be determined on dead tissue do not respond to the individual ablation situation. you are therefore not exactly accurate.

The current method for setting the parameters is therefore currently that a user works based on his own experience. Naturally, this still results in high uncertainty in tissue ablation, which also depends crucially on the experience of the respective user. This is especially true if the tissue volume to be ablated exceeds a diameter of 5 cm. It can then be expected that, for example, not all tumor cells of an affected tissue are detected by the ablation. Currently, tumors are therefore generally ablated only to a diameter of at most 5 cm. Another danger is that such ablation can also affect sensitive structures in the vicinity of the ablation area, such as nerves. In addition, ablation is particularly difficult when near the ablation A blood vessel is present, which removes heat and thus changes the thermal ablation volume. All these problems mean that ablation processes can only be controlled imprecisely until today.

at Shield-shaped ablation equipment consists additional problem for the operator in that he uses the ablation probes of the device simultaneously can reach relatively large tissue area.

What an advantage in itself, then carries risks if the ablation in sensitive tissue areas, in which, for example, nerves or blood vessels are located. A more precise, controlled entry of ablation energy becomes especially by preventing a user, for example, in the CT image can not detect which ablation probe is currently in which tissue area is located. So he hits with any of the ablation probes on a critical tissue, he must match the ablation performance generally reduce or reposition the ablation device, which is time consuming and also additional injuries in the (healthy) tissue causes.

task It is therefore an object of the present invention to provide an improved, i.e. H. to provide a more precise ablation device, as well as a way of detecting individual ablation probes of such an ablation device, in particular supported by Imaging procedures.

These Task is by an ablation device according to claim 1 and by a provisioning method according to claim 11 solved.

Accordingly, includes an ablation device according to the invention for targeted ablation of areas of tissue volume a plurality of ablation probes, wherein at least a first ablation probe has a coding that different from other ablation probes of the Ablation device, preferably from all other ablation probes, makes distinguishable in an imaging process. The coding includes while a dimension diverging from these other ablation probes and / or nature of the first ablation probe.

The Invention is thus based essentially on a coding at least an ablation probe in a set of probes. In addition to the first Ablation probe can also use even more probes Coding, but preferred is a single coding, d. H. a one-unambiguous coding, particularly preferably such that every single ablation probe has its own, that of the other Ablation probes has different coding.

With Encoding assistance is possible in the image, for example in the CT image, at least the first ablation probe unambiguously from other probes or Sensing wires of the ablation device to distinguish. This gives a user a clear indication of how his ablation device is aligned and how he possibly with minimal tissue damage and reduced time must reposition to a desired exact location in the Reach tissue.

For example, an asymmetric, in particular rotationally asymmetric arrangement of ablation probes could also be understood as a type of coding. A rotationally asymmetric arrangement is already out of the US 5,672,173 known. However, since detection of the individual probes on the basis of such an arrangement is relatively difficult and above all dependent on the positioning of the ablation device, it has proven to be significantly easier to realize the coding in a different way, namely by (at least partially) divergent dimensions and / or properties of the ablation probes with each other. In this case, the texture preferably relates to the choice of material of the ablation probes, but also includes probes of the same material but with different physical properties, in particular those different physical properties which lead to different image characteristics of the individual ablation probes in imaging methods, ie for example the material density. As far as the diverging dimension of the first ablation probe is concerned, it preferably refers to the length and / or thickness of this probe. In both cases, especially with a suitable combination of a variation in length and thickness of the ablation probe (s), it is relatively easy to make a distinction between differently dimensioned ablation probes within medical imaging.

In addition to an ablation device according to the invention, the invention also encompasses an ablation arrangement with a drive system for controlling an ablation device, an imaging system and a visualization unit for visualizing image data generated by the imaging system. Such an arrangement constellation thus consists of elements which have hitherto already been used in ablation methods supported by imaging systems, further developed by the ablation device according to the invention. For example, the imaging system may be a computed tomography device connected to a visualization unit in the form of a monitor and / or printer with appropriate control, and the drive system may be in the ablation device integrated, ie integrated directly into it or realized as an upstream, processor-based processing unit.

With Such an ablation arrangement is an improved interaction the individual components of the system insofar as possible based on the improved differentiability between the ablation probes the ablation device in the imaging additional Findings can be obtained by a user help to perform a more accurate ablation. It is particularly advantageous if the coding of the first Ablation probe depending on the type of imaging system is selected. For example, certain materials Compared to other materials in the computed tomogram while other materials are discriminated in the MRI can be.

One Inventive method for providing Identity information of the type mentioned is characterized by the fact that the first ablation probe with a Coding and the coding of the first ablation probe a recognition logic is read from the image data and from it Identity information for an identifying Visualization of the first ablation probe derived in the image data and provided.

The Coding of the first ablation probe is thus used in the method automatic detection, based on the identity the first ablation probe also clarifies in the image processing, d. H. is made visible by a mark of any kind is. Thereby is also the spatial location of all other ablation probes determined.

Especially is preferred in the context of the invention Method an ablation device according to the invention or a corresponding ablation arrangement used. The procedure However, this goes beyond that in principle also allows to recognize a coding based purely on asymmetric positioning of ablation probes works, as already mentioned above.

The inventive delivery method is suitable In particular, indirectly, location information in the context of a Control method for an ablation device to provide, from the according to the invention determined identity information be derived. In such a driving method is a Ablation device driven by a plurality of ablation probes, wherein at least one first ablation probe is independent of other ablation probes depending on the thus derived Location information of the first ablation probe is driven. This is the first ablation probe particularly preferably with a separate Ablations control connected, with such a separate control only with this one probe or with the first ablation probe can be linked to a comprehensive group.

This means that an ablation device with a separate control linked for at least the first ablation probe is and that this independent control depending on the position the first ablation probe is varied. So it can be, for example be detected in a dead tissue by an imaging system, where there is this ablation probe in the tissue. Depending on, whether the area around this Ablati onsonde should be removed or not or to what extent, then corresponding control commands passed only to this particular ablation probe. Similar applications are, for example, also in industrial material post-processing possible, for example, in the targeted ablation of Inclusions within plastic products.

The Ablation arrangement is thus arranged and their individual components so coordinated that they are in an inventive Provisioning procedures in mutual relation stand; The recognition logic in the process is thus on the nature of Coding of the first ablation probe set. Includes the ablation assembly preferably employs a recognition logic unit which in operation, the coding of the first ablation probe in the image data detected. In the context of this, it is advantageous if the image data include the first ablation probe, as a result of their detection based on their image data can. Theoretically, it is possible to use the first ablation probe even then assign indirectly if the probe is not in the image data is included. The detection logic in the detection logic unit can be adapted to encoding the first ablation probe seeks and if not finding the other ablation probe (s) identified, characterized by the fact that they are the coding just do not wear the first ablation probe. Indirectly it is through possible under certain circumstances, conclusions on the place and thus the identity of the first ablation probe to draw.

There in particular realized the recognition logic (unit) computer-based can - and possibly other components of the Ablation arrangement - in whole or in part in the form of software modules be realized on a processor.

The invention therefore also includes a computer program product directly in a process Sor a programmable Ablati onsgeräts and / or a programmable drive system loadable with program code means to perform all the steps of a delivery method according to the invention and / or a corresponding driving method when the program product is executed on the ablation device and / or the drive system.

Further particularly advantageous embodiments and developments of the invention also result from the dependent claims as well as the following description. In this case, the inventive Ablation device and the ablation assembly equipped with it also according to the present claims to the provision method or be further developed for the driving method and each also vice versa.

A particularly preferred embodiment of the invention Ablation device is that the first ablation probe is formed variable in their dimensions.

These Variation possibility refers in particular, however not exclusively, to the length of the first Ablation probe, d. H. this can continue in operation, for example be retracted or retracted than others. It can also be the aspect ratio the ablation probes are mutually changed. Prefers is therefore a plurality of ablation probes, more preferred All ablation probes are designed to be variable in their dimensions. Due to such a configuration, not only a static Coding done but even a movement can be realized which is recognizable, for example, in the CT image.

According to one advantageous development is an inventive Ablation device with measuring sensors for acquisition of an ablation process equipped with representative measured values, wherein at least a measuring sensor of the first ablation probe assigned metrologically is. A metrological assignment means that measured values as the temperature or the impedance by means of the associated measuring sensor whoever was born on the first ablation probe Refer to effects. So one of the first ablation probe would be metrological associated measuring sensor locally in their vicinity be arranged (at least in the tissue to be ablated) and / or Record readings from the activity of the first ablation probe originate. Such measurements thus represent for example, generated by means of the first ablation probe temperature differences and / or currents or electromagnetic waves generated by come from the first ablation probe. With the help of this measuring sensor and it's possible to assign it, not just identity information but also get information about from the identified first ablation probe generated effects or pulses. In order to This development of the invention is still a clear step pure identification, because it makes it possible to make a local reference to the probe as well a reference to the specifically generated or expected by her Effects in the tissue to be ablated.

Corresponding It has proved to be particularly advantageous if the first Ablation probe associated measuring sensor individually or in conjunction with the first ablation probe is designed to be spatially variable. The associated measuring sensor and the ablation probe thus form either an allocation unit not only in the metrological sense, but also locally, or the measuring sensor can be placed so that he is optimally positioned with respect to the first ablation probe is. Both facilitate the metrological detection of the effect the first ablation probe clearly.

in principle may be an ablation device according to the invention in any known or novel geometric arrangement form be realized by ablation probes. A particularly preferred embodiment is that the ablation probes in the form of a bundle at a common exit point of the ablation device are arranged.

In This constellation, the invention unfolds first effect especially good, as they are the only option in this case represents a recognizable coding of individual ablation probes. Secondly but this arrangement also has clear advantages over such, at the ablation probes from different exit sites stand out: The ablation probes may be in a bundle-like manner Arrangement at an exit point namely so extended be or be very even Cover specific tissue volume. In such a uniform Now cover a coding (and a corresponding recognition of the Coding) thus means the benefits of uniformity Reach coverage and still have identity information to be able to provide.

In an ablation arrangement according to the invention with a recognition logic unit which detects the coding of the first ablation probe in the image data during operation, this recognition logic unit preferably derives from the detected coding identity information for an identifying visualization of the first ablation probe by the visualization unit in the image data and get them ready. The visualization unit becomes the identity information of the first ablation probe and with their help they are visualized. Such a visualization is realized, for example, with the aid of brightness and / or color markings, markings, inscriptions or the like of the first ablation probe or its surroundings. In this case, the visualization unit can also include an activation (for example the driver) of a display (eg a monitor) which automatically or partially automatically processes the identity information such that the identifying visualization results therefrom on the display.

In an ablation arrangement according to the invention Furthermore, it is preferable to provide a measured value display unit which in operation, information about readings of the first ablation probe are assigned displays. The measured value display unit is preferably in turn linked to the visualization unit, d. H. either connected or integrated into it, so that the Display of measured values assigned to the first ablation probe with help the visualization unit can be performed. For example may indicate temperature next to or above the first ablation probe displayed, which reflects the temperature value in closer Environment of this ablation probe. A user can get out of it directly deduce whether the emitted by the first ablation probe Energy is sufficient, for example, to ablate tissue in their environment and if so, to what degree.

• – Eine Eingangsschnittstelle für Bilddaten des Gewebevolumens,
• – eine Identifizierungseinheit zur Identifizierung eines Zielgewebes aus den Bilddaten,
• – eine Modell-Gewinnungseinheit zur Gewinnung von Initial-Prozess-Modellen und/oder Fein-Prozess-Modellen von zu erwartenden Ablationsentwicklungen, die mit einer Wert-Ableitungseinheit zur Ableitung von Modell-Messwerten aus dem Initial-Prozess-Modell und/oder einer Wert-Ermittlungseinheit zur Ermittlung von den Ablationsverlauf repräsentierenden Messwerten verknüpft ist,
• – eine Befehl-Ableitungseinheit zur Ableitung von Steuerbefehlen auf Basis der Initial-Prozess-Modelle und/oder zur Ableitung von verfeinerten Steuerbefehlen auf Basis von Fein-Prozess-Modellen,
• – eine Vergleichseinheit zum Vergleich von Messwerten und
• – eine Geräteschnittstelle zur Weiterleitung von Steuerbefehlen und/oder von verfeinerten Steuerbefehlen an das Ablationsgerät.

A particularly advantageous development of the ablation arrangement consists in that the actuation system has at least:

• An input interface for image data of the tissue volume,
• An identification unit for identifying a target tissue from the image data,
• A model extraction unit for obtaining initial process models and / or fine-process models of expected ablation developments, which are provided with a value derivation unit for deriving model measurement values from the initial process model and / or a value Determining unit is linked to the determination of measured values representing the course of the ablation,
• A command derivation unit for deriving control commands on the basis of the initial process models and / or for deriving refined control commands on the basis of fine-process models,
• A comparison unit for comparing measured values and
• A device interface for forwarding control commands and / or refined control commands to the ablation device.

• a) Identifizierung eines Zielgewebes aus mit einem bildgebenden System akquirierten Bilddaten des Gewebevolumens,
• b) Generierung eines Initial-Prozess-Modells einer zu erwartenden Ablationsentwicklung in Abhängigkeit von definierten Prozess-Parametern auf Basis von hinterlegten Ablations-Modelldaten,
• c) Ableitung von zu erwartenden Initial-Modell-Messwerten aus den Initial-Prozess-Modell,
• d) Generierung von Initial-Steuerbefehlen auf Basis des Initial-Prozess-Modells,
• e) Ansteuerung des Ablationsgeräts mit den Initial-Steuerbefehlen,
• f) Ermittlung von den Ablationsverlauf repräsentierenden Messwerten,
• g) Vergleich der Messwerte mit den Initial-Modell-Messwerten,
• h) Generierung eines Fein-Prozess-Modells auf Basis des Vergleichs und Planung des weiteren Ablationsverlaufs auf Basis des Fein-Prozess-Modells und
• i) Ableitung verfeinerter Steuerbefehle auf Basis des Fein-Prozess-Modells, die in der Folge zur erneuten Ansteuerung des Ablationsgeräts dienen können.

An actuation method which can be carried out in this way has at least the following steps:

• a) identification of a target tissue from tissue volume image data acquired with an imaging system,
• b) generation of an initial process model of an expected ablation development as a function of defined process parameters on the basis of stored ablation model data,
• c) derivation of expected initial model measured values from the initial process model,
• d) generation of initial control commands on the basis of the initial process model,
• e) activation of the ablation device with the initial control commands,
• f) determination of measured values representing the course of ablation,
• g) comparison of the measured values with the initial model measured values,
• h) Generation of a fine-process model based on the comparison and planning of the further course of the ablation on the basis of the fine-process model and
• i) derivation of refined control commands based on the fine-process model, which can subsequently be used to re-activate the ablation device.

In such a control method or with such an ablation arrangement, therefore, the generation of an initial-process model of an expected ablation development on the basis of stored ablation model data initially takes place. This can be, for example, from examinations ex situ or in situ gained experience ablation data or a computer simulation of the physical processes in the coupling of the high-frequency energy and the thermal propagation or the progress of the icing. On the basis of the inital process model, a planning of the ablation process is now carried out in which expected initial model measured values are generated. They serve as the basis for inital control commands, with the help of which the ablation device is initially controlled. In the following, a feedback of measured values from the ablation device to the control system then takes place. These measured values are compared with the initial model measured values from the initial process model. An iteration is made from which an increasingly accurate modeling process results in the course of the driving process. On the basis of the refined control commands obtained by the iteration, further activation of the ablation device is undertaken. The potential for refinement of the activation process thus achieved automatically entails that a controlled ablation process becomes safer and faster, since one does not have to pay attention to the highest possible accuracy of sequence simulation data at the beginning of the process. Especially in combination with an ablation with the operation of imaging systems such as Computed tomography thereby creates a high time and thus cost savings potential, especially when, as preferred, a fully automatic control using the control system takes place. In the context of such a fully automatic control, for example, it may also be provided that the ablation device itself is automatically movable, for example with the aid of robotic systems.

Either this advantageous embodiment of the ablation arrangement as well as the corresponding control method are essential characterized in that a feedback of measurement data from the Ablation process in the control is enabled. Corresponding it is particularly advantageous if in the driving method iterative repetitions of the steps c) to i) take place, wherein the last generated fine-process model in the iterative iterations used as a new initial process model, d. H. is redefined. In this way, a gradual refinement of the driving method, thus at the end of the ablation process very precisely on the tuned to Ablatierende tissue volume.

It is therefore not absolutely necessary, as input data very precise Ablation model data, but it is sufficient in principle the currently known model data, for example to be used ex situ from preliminary examinations. In the course of the driving process anyway, the control system receives sufficient feedback about the actual ablation history, giving the ablation model data only act as initial values, which then constantly in the course of the proceedings is verified. The control system is thus self-learning - off The ablation history obtained measurement data can even for refined models are used, so for later ablation processes already refined ablation model data can be stored.

A Such an iterative approach also has the advantage that a closed control loop is created. In case of failure components of the ablation assembly or the ablation device this circuit is broken, making such errors quite simple are detectable.

• – Ablationsvolumen,
• – Nicht-Ablationsvolumen,
• – Risikovolumen,
• – Gefäßvolumen.

The corresponding activation system of the ablation arrangement preferably has a distinguishing unit which is designed such that it makes a distinction in the image data between at least two of the following tissue volumes:

• - ablation volume,
• - non-ablation volume,
• - risk volume,
• - Vessel volume.

The Distinguishing unit distinguishes between different ones Tissue volumes, preferably the ablation volume of one of these tissue volumes is and the non-ablation volume, the risk volume and the vascular volume can be distinguished in each case from this ablation volume. Under a non-ablation volume is to be understood as the tissue area, which is outside the ablation volume. A risk volume represents the volume that results from accidental ablation can lead to damage to bodily functions. Vessel volumes are primarily volumes of Blood and lymph vessels. As already stated, it is of essential importance that during ablation the ablation volume is distinguished from the three other volumes: the non-ablation volume if possible, should not be ablated, the risk volume as the sub-volume amount of the non-ablation volume should be at none Case be ablated, and carries the vessel volume to a heat dissipation, which the ablation process in the ablation volume. The consideration of this different volumes by means of the discriminating unit therefore represents a special refinement of the driving method represents.

Further the corresponding activation system preferably has a residual area determination unit which is designed to cover a residual area of the target tissue determined after carrying out an ablation based the initial control commands remain. With the help of the residual area determination unit it can be determined which non-ablated area of the target tissue, in particular its percentage, its volume in absolute terms Numbers and their position after performing an ablation remains in the tissue volume based on the initial control commands. It should be noted that during the iteration always defines those control commands as initial control commands are as input control commands in step d) of the driving method be used in the respective iteration cycle. This means, that even in the current process, a refinement of the estimate of the rest area is possible.

The Knowledge of the respective residual area, for example, supports in semi-automatic ablation processes an operator at the Decisions, which ablation device, which ablation method, which ablation time and which ablation he is for his Ablation dials. Likewise, the information about the rest of the target tissue the driving system itself - for example in a fully automatic ablation process - for optimization serve the initial control commands.

In addition, such a drive system preferably has a definition data input interface for receiving tissue volume definition data. Definition data are understood as meaning data which contain information about the type or purpose of the definition of a specific tissue volume, for example the definition that a specific volume of tissue is a volume to be ablated or not to be ablated. By way of example, the input interface can be used to define a specific tissue volume from a database or from an image recognition system or by manual input. The corresponding tissue volume can thus be marked, whereby the definition data can be particularly accurate and fine due to the logic of the image recognition system and / or the criteria of the database.

Especially Preferably, the drive system has a registration unit for registering a plurality of successively determined image data to one another on. Under a registration is understood that image data the same volume range or at least similar volume ranges, best possible be reconciled with each other. While of the driving method may be successively more image data fed from the imaging system in the control system become. With the help of an appropriate registration unit this image data is related to each other so that a user and the driving system itself provides a solid basis for evaluation of the respective ablation situation.

Further For example, the drive system may preferably have a characteristic input interface for characteristics of ablation devices and a Characteristic data processing unit containing the model extraction unit with derived from the characteristics of an ablation device Supplied model ablation parameter values. In this case, the characteristic data processing unit if necessary with a database (inside or outside the control system), from which the characteristics of the respective ablation device can be obtained. about the characteristic data input interface thus obtains characteristic data from different ablation devices, such as the Performance, size, number of ablation probes and much more, in the control system, thus providing a valid basis gets to the respective selection of the right ablation devices. As characteristics but can also be a type designation such as serve an identification number of the ablation device, on the basis of which all other characteristics in turn via a internal or external database. Particularly important characteristics within the scope of the invention are the Characteristics for coding the first or further ablation probes because it is about the feeding of these characteristics in the System is much easier possible, the later To enable recognition of the coding.

A particularly advantageous embodiment of the drive system comprises a visualization output interface for forwarding visualization data to a visualization unit for visualizing the initial process model and / or of the fine-process model together with the target tissue. about This output interface can be sent to an operator using the visualization unit a picture, such as an ablation process in the Target tissue expires or what results he zeitigt. This can be displayed starting from the initial process model will be based as well as later in the ablation process the fine-process models. One receives thereby in the course of the Ablation is an increasingly reliable reflection of what's on Basis of the respective control commands in the ablation process happens. For example, the temperature distribution in the fabric by appropriate Coloring the displayed tissue images are visualized.

After all such a drive system preferably has an interface for the collection and / or transfer of coordinates of one and / or to a navigation system. Such a navigation system can for example, both with the ablation device and with be coupled to the imaging system, so that an operator or the drive system is given an orientation in the ablation process.

In the context of the driving method, the image data are preferably obtained from a tomography scan running in parallel. This is understood to mean a timely or simultaneous acquisition of tomographic raw image data and / or the reconstruction of the image data, which occurs within the time frame of the ablation process. This can thus take place, for example, first before carrying out an ablation and then after performing first ablation steps and finally as completion of the ablation process or at the same time or at equal intervals during the ablation process. In this way, the image data from the tomography scan can each be fed as additional input parameters into the driving method and further refine it. Within the scope of this, the image data from the running tomography scan can, for example, be regarded as a kind of measured values for the mentioned iteration steps of the activation process. It may depend on the method with which the image data is acquired and which ablation method is selected: In magnetic resonance images, for example, a thermal distribution during a heat or cold treatment can be clearly recognized. In computer tomography recordings, for example, the Glacial zone clearly visible during cryo-ablation.

The Invention will be described below with reference to the attached Figures on the basis of embodiments again in more detail explained. Here are the same in the different figures Components provided with identical reference numbers.

It demonstrate

1 a schematic sectional view of an embodiment of an ablation device according to the invention,

2 several CT cross-sectional images of the same tissue in different sectional planes with an embodiment of an ablation device according to the invention,

3 a detailed view 2 with additional display of readings and identity information,

4 a schematic block diagram of an embodiment of an ablation arrangement according to the invention and

5 a schematic block diagram of an embodiment of a drive system according to an embodiment of the invention.

In 1 is schematically an ablation device 1 shown that an applicator 7 and several ablation probes 3a . 3b . 3c and temperature probes 5a . 5b . 5c . 5d having, at a common exit point 11 of the applicator 7 escape. A first ablation probe 3a will hereafter be identifiable to a user, so she has an encoding that she receives from the other ablation probes 3b . 3c different. This encoding is in 1 as a significant difference in the thickness of the first ablation probe 3a compared to the thickness of the other two probes 3b . 3c recognizable. Alternative or complementary types of coding include, for example, a difference in the length and / or the nature of the material of the ablation probes 3a . 3b . 3c , However, it may also be provided, the first ablation probe 3a and / or the other two ablation probes 3b . 3c individually variable in length, so that at least one of the ablation probes 3a . 3b . 3c characterized in that it is longer or shorter than other probes.

In the present example, each of the ablation probes is 3a . 3b . 3c to its own control 9a . 9b . 9c connected, which controls the energy entries or cold entries (depending on the design of the probes) separately. The temperature probes 5a . 5b . 5c . 5d are partially metrologically an ablation probe 3a . 3b . 3c assigned. For example, the first temperature probe measures 5a the ambient temperature of the first ablation probe 3a , Also the second temperature probe 5b may be the ambient temperature of the first ablation probe 3a in a second environmental area, but for the sake of simplicity, it is assumed that only the first temperature probe 5a associated with the first ablation probe.

The first ablation probe 3a may thus be in a CT image or in images from other imaging procedures from the other two ablation probes 3b . 3c be distinguished on the basis of the visible coding. Additionally, it is possible to get the temperature readings of the first temperature probe 5a the first ablation probe 3a attributed to it, and thus back to which ablation effect the first ablation probe 3a zeitigt. Accordingly, depending on the location at which the first ablation probe 3a Ablationsimpulse enters - with the help of their control 9a a correspondingly targeted readjustment of the temperature entries of the ablation probe 3a be performed.

2 shows an ablation device according to the invention in the practical application in situ of a tissue region of a liver in sectional images from different perspectives. In the two illustrations on the left side there are only two ablation probes 3a . 3b to detect, of which the first ablation probe 3a extends from the liver tissue into the adjacent lung tissue, as can be seen in the upper left representation. In the right illustration are next to the two mentioned ablation probes 3a . 3b to see more, unspecified here ablation probes, so that results from a bundle of probes a screen-like arrangement.

3 shows an enlarged view of the image at the top right 2 , It can be seen that the first ablation probe 3a is slightly longer than the other probes. This coding was detected by means of recognition logic and displayed in the imaging. This indication is symbolized by the circle around the temperature indication "65", that of one with the ablation probe 3a corresponding temperature probe (not visible in the picture) was determined. A user may therefore choose the first ablation probe based on two different criteria 3a recognize: First, because of the deviating length and secondly because of the circle marking around the temperature indication. Also a misrecognition of the first ablation probe 3a he could easily capture in a comparison of length and marking and correct if necessary by corrective inputs.

Based on this identity information, the user can then draw conclusions about the Identifying the other ablation probes: Identification of the other probes poses no problem on the basis of the previously known arrangement of the ablation probes and the insertion direction of the ablation device into the tissue.

With The user can also help with temperature information recognize which ablation effect unfolds in a tissue area becomes. This can also be supported, for example, alternatively or additionally be by a corresponding, from the local temperature distribution dependent supportive coloring (not here shown), if necessary in a three-dimensional depth of field. One Users can easily see in which areas the achieved temperature is still too low for a sufficient Ablation or in which areas the risk of overheating is available.

It can be seen in this figure that in the lower area, ie within the liver tissue, a significantly higher temperature is generated by the ablation probes, with the temperature at the ablation probe 3b is highest at 83 ° C. In contrast, the first ablation probe 3a controlled so that the temperature entry at 65 ° C is the lowest so as not to unnecessarily injure the lung tissue. Such a differentiated entry of energy is possible only because of the detection of the individual ablation probes and the assignment of the temperature measured values to them. The invention thus allows a much more precise and targeted ablation than before.

4 shows a schematic representation of an ablation arrangement according to the invention 13 , As principal components it includes an imaging system 17 , a driving system 15 , an ablation device according to the invention 1 and a visualization unit 19 ,

The imaging system 17 consists here - in addition to numerous, for the sake of clarity not specifically mentioned other units and subcomponents - from a recording device 21 in the form of a CT scanner with a patient or more generally an object storage table 22 and a control and evaluation unit 23 in the form of a processor. On the processor are control commands SB ₁ , SB ₂ for controlling the recording device 21 and the object storage table 22 generated and image data BD further processed and passed on. A recognition logic unit 25 is inside the processor 23 arranged. It could also be within other components of the ablation assembly 13 be localized, in particular, for example, within the visualization unit 17 ,

The visualization unit 17 includes besides a visualization medium in the form of a computer monitor 28 a measured value display unit 27 , the measured values MW from measuring sensors of the ablation device 1 prepared for an advertisement. The driving system 15 serves for the controlled activation of the ablation device 1 with the help of ablation control commands SB ₃ .

In the context of the method according to the invention for providing identity information, the imaging system makes use of 17 Image data BD of areas of an examination object U, which are on the object table 22 is stored (here a human patient) generated and processed. For the sake of simplicity, the image data BD, which in the course of the method is usually processed in several steps for visualization, is always referred to as image data BD, regardless of whether it is raw image data, processed image data for intermediate storage or visualization image data that is used by the visualization unit 17 are displayed. In the processor 23 Among other things, the image data BD are prepared and sent to the visualization unit 19 as well as to the driving system 15 passed. Additionally, using the recognition logic unit 25 Identity information JJ derived from the image data BD, which refers to the identity and possibly the local position of the first ablation probe (see. 1 ) of the ablation device 1 Respectively. Thus, location information OJ of the first ablation probe can also be derived.

The identity information JJ and possibly the location information OJ reach both into the visualization unit 19 as well as in the control system 15 , The driving system 15 again from several separate controls 9a . 9b . 9c (see. 1 ), the control commands SB ₃ varies depending on the identity information JJ and / or the location information OJ and on measured values that the ablation device 1 at the locations of the ablation probes. As a result, fine control of the ablation is also possible on each individual ablation probe, possibly also as a function of its respective ablation site.

The measured values MW are also included in the measured value display unit 27 the visualization unit 19 fed, so that they can be visualized on a visualization of image data BD via the computer monitor 28 can also be displayed as the identity information JJ.

5 shows a schematic block diagram of an embodiment of a drive system 15 with a recognition logic unit 25 , wherein the drive system is configured according to an advantageous embodiment of the invention. It includes numerous input and output interfaces len, namely an input interface 29 for image data BD, a device interface 31 for forwarding control commands SB ₃ or refined control commands VSB to an ablation device according to the invention 1 , a frame data input interface 35 , a characteristic data input interface 41 , a visualization output interface 45 and a navigation interface 47 ,

Between these interfaces are an identification unit 16 , a model extraction unit associated with a model database MDB 18 , a value derivation unit 24 , a command derivation unit 20 , a value determination unit 26 and a comparison unit 30 arranged, as well as continue a discrimination unit 32 , a residual area determination unit 33 , an ablation device selection unit 37 , a registration unit 39 and a characteristic data processing unit 43 , The driving system 15 and the ablation device 1 stand with a navigation system 49 in radio communication. For this purpose, the ablation device 1 a radio interface 50 - analogous to the navigation interface 47 of the driving system 15 - on.

The components shown in the block diagram within the drive system 15 (with the exception of the navigation interface 47 ) are in the form of software-controlled modules within a processor.

Image data BD from an imaging system arrive via the input interface 29 in the identification unit 16 ,

In addition, the discrimination unit meets 32 in the image data BD a distinction between different tissue volumes, namely an ablation volume, a non-ablation volume, a risk volume and a vessel volume. In the identification unit 16 a target tissue is identified in the image data BD. In addition, definition data DD is transmitted via the frame data input interface 35 in the identification unit 16 fed. The registration unit 39 serves to register image data BD of different provenance, in particular successively determined successive image data to each other. As a result, lie in the identification unit 16 prepared tissue data AGD to the target tissue and possibly the target tissue adjacent tissue volumes, which are necessary as a basis for a targeted ablation of the target tissue.

A second central component of the control system 15 is the model extraction unit 18 , It obtains process models of expected ablation processes of the target tissue, in particular an initial process model PM and at least one refined fine-process model FPM. For this purpose, it is used with data from the model database MDB, a characteristic data processing unit 43 , the ablation device selection unit 37 and a value derivation unit 24 or a value determination unit 26 provided. From the model database MDB selects the model extraction unit 18 appropriate process models depending on the input of the other units associated with it. The value derivation unit derives 24 depending on the selected initial process model PM different initial model measured values MM ab, while the value determination unit 26 real measured values MW in the model extraction unit 18 feeds. In this case, the initial model measured values MM are selected such that they are comparable to the real measured values MW, ie they are based on the same parameters or different but mutually derivable parameters so that they can be reconciled with one another. The characteristic data processing unit 43 refers via the characteristic data input interface 41 Characteristics KD of the ablation device 1 from which it derives model ablation parameter values MAW, as well as input to the model recovery unit 18 serve as selection data SD from the ablation device selection unit 37 which, depending on the image data BD, is an ablation device suitable for the subsequent ablation 1 selects.

The essential input for the model extraction unit 18 Thus, the processed tissue data is AGD, the information is SD, MAW associated with the ablation device 1 and virtual or actual measured values MM, MW, which are dependent on a selected initial process model or which are determined during an ablation process.

Depending on this input data, first an initial process model PM and later in the process fine-process models FPM to the command-derivation unit 20 which derives from the initial process model PM control commands SB ₃ and from the fine-process models FPM refined control commands VSB and via the device interface 31 to the ablation device 1 to control the same passes.

The ablation device 1 performs an ablation based on the control commands SB ₃ and generates measured values MW, which are determined by the value determination unit 26 back into the control system 15 be fed. The value determination unit 26 is in communication with the comparison unit 30 consisting of the measured values MW and the model measured values MM from the value derivation unit 24 Measured value comparison data MWV generated. These measured value comparison data MWV, together with the measured values MW, in turn serve as input for the model extraction unit 18 making it a fine-process model Derives FPM.

This fine-process model FPM becomes turn into the instruction-derivation unit 20 fed on this basis refined control commands VSB for controlling the ablation device 1 in the form described above.

In addition to the previously described functions of the control system 15 is a transfer of visualization data VD via the visualization output interface 45 to a visualization medium, such as a display monitor provided. As a result, an operator, for example, a target tissue can be displayed visually together with the respectively active process model, whereby the ablation process for him is traceable. In addition, via the navigation interface 47 and the radio interface 50 of the ablation device 1 a communication with a navigation system 49 based on which a location of the ablation device 1 and a comparison with the measured values can take place.

It can be seen that with the help of the various input interfaces, information sources and visualization possibilities with the help of the control system 15 First, an initial process model PM is generated by iteration, that is, by feedback of the measured values MW, from the ablation device 1 is refined again. This process can iteratively run several times, so that the database for the control in the context of the driving method according to the invention is always refined and thus an optimal Ablationsergebnis can be achieved.

It Finally, it is pointed out again that it is in the delivery described above in detail and driving method and in the illustrated ablation device and the ablation arrangement only to embodiments which is modified by the expert in a variety of ways can be without departing from the scope of the invention. Farther does not exclude the use of the indefinite article "a" or "an" from the fact that the characteristics in question can also be present several times.

QUOTES INCLUDE IN THE DESCRIPTION

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Cited patent literature

• US 5672173 [0017]

Claims (14)

Ablation device ( 1 ) for the targeted ablation of regions of a tissue volume with a plurality of ablation probes ( 3a . 3b . 3c ), in which at least one first ablation probe ( 3a ) has a coding that it receives from other ablation probes ( 3b . 3c ) of the ablation device ( 1 ) is distinguishable in an imaging procedure and the coding is one of these other ablation probes ( 3b . 3c ) divergent dimension and / or nature of the first ablation probe ( 3a ). Ablation device according to one of the preceding claims, characterized in that the first ablation probe ( 3a ) Is formed variable in their dimensions. Ablation device according to one of the preceding claims, characterized in that the first ablation probe ( 3a ) with a separate ablation control ( 9a ) connected is. Ablation device according to one of the preceding claims, characterized by measuring sensors ( 5a . 5b . 5c . 5d ) for acquiring measured values representing an ablation process, wherein at least one measuring sensor ( 5a ) of the first ablation probe ( 3a ) is assigned metrologically. Ablation device according to claim 4, characterized in that the first ablation probe ( 3a ) associated measuring sensor ( 5a ) individually or in combination with the first ablation probe ( 3a ) is formed movable. Ablation device according to one of the preceding claims, characterized in that the ablation probes ( 3a . 3b . 3c ) in the form of a bundle at a common exit point ( 11 ) of the ablation device ( 1 ) are arranged. Ablation arrangement with a control system ( 15 ) for controlling an ablation device ( 1 ), with an ablation device ( 1 ) according to one of claims 1 to 6, an imaging system ( 17 ) and a visualization unit ( 19 ) for visualization with the imaging system ( 17 ) generated image data (BD). Ablation arrangement according to claim 7, characterized by a recognition logic unit ( 25 ), which in operation encode the first ablation probe ( 3a ) in the image data (BD) and from this identity information (JJ) for an identifying visualization of the first ablation probe ( 3a ) by the visualization unit ( 19 ) in the image data (BD) and provides. Ablation arrangement according to claim 7 or 8, characterized by a measured value display unit ( 27 ), which in operation provide information on measured values of the first ablation probe ( 3a ) are assigned. Ablation arrangement according to one of claims 7 to 9, characterized in that the driving system ( 15 ) comprises at least: - an input interface for image data (BD) of the tissue volume, - an identification unit for identifying a target tissue from the image data, - a model extraction unit for obtaining initial process models and / or fine process models from expected ones Ablation developments associated with a value derivation unit for deriving model measurements from the initial process model and / or a value determination unit for determining ablation history representative measurements, a command derivation unit for deriving control instructions based on the Initial process models and / or for deriving refined control commands based on fine-process models, - a comparison unit for comparing measured values, and - a device interface for forwarding control commands and / or refined control commands to the ablation device ( 1 ). Method for providing identity information (JJ) of at least one first ablation probe ( 3a ) of an ablation device ( 1 ), which has a plurality of ablation probes ( 3a . 3b . 3c ) in image data (BD) from an imaging system ( 17 ), in which the first ablation probe ( 3a ) is coded and the coding of the first ablation probe ( 3a ) is read out of the image data (BD) by recognition logic and from this identity information (JJ) for an identifying visualization of the first ablation probe ( 3a ) are derived and provided in the image data (BD). Method according to claim 11, characterized by a use of an ablation device ( 1 ) according to one of claims 1 to 6 and / or an ablation arrangement ( 13 ) according to one of claims 7 to 10. Control Method for an Ablation Device ( 1 ) with a plurality of ablation probes ( 3a . 3b . 3c ), wherein at least one first ablation probe ( 3a ) independent of other ablation probes ( 3b . 3c ) as a function of location information (OJ) of the first ablation probe ( 3a ), which location information (OJ) is derived from identity information (JJ) provided in a provisioning method according to claim 11 or 12. Computer program product which directly enters a processor of a programmable ablation device ( 1 ) and / or a programmable drive system ( 15 ) with program code means to carry out all the steps of a delivery method according to one of claims 11 or 12 and / or a method of activation according to claim 13, if the program product on the ablation device ( 1 ) and / or the driving system ( 15 ) is performed.