Stefan Braunewell 1 A European project on patient-specific modeling and simulation of FUS in moving organs Stefan Braunewell Fraunhofer MEVIS - Institute.

Stefan Braunewell 1

A European project on patient-specific modeling and simulation of FUS in moving organs

Stefan BraunewellFraunhofer MEVIS - Institute for Medical Image Computing, Bremen

Jenny Dankelman, Thomas Langø, Jürgen Jenne, Michael Müller, Yoav Levy, Mario Bezzi, Christine Tanner, Calin Tiu, Daniel Outmazguine, Matthias Günther, Andreas Melzer, Tobias Preusser

Stefan Braunewell 2

• Reflection, refraction, absorption, cavitation

• Heat transfer, tissue reaction

• Cooling by blood flow and perfusion

• Breathing motion

• Occlusion by ribcage

Focused Ultrasound in the LiverFocused Ultrasound

Computer simulation required for reliable outcome prediction

Stefan Braunewell 3

Goal of FUSIMO

Develop, implement and validate a multi-level model for FUS simulation in moving abdominal organsFUSIMO software system aids in: Assessing feasibility Optimizing outcome Detecting risks Monitoring progress, tracking deviations Training

Stefan Braunewell 4

Therapy planning, prediction and monitoring

Functional organ modeling

Model for ultrasound propagation

Motion model for abdominal organs

Patient specific data

Stefan Braunewell 5

Intra-operative ultrasound

On-line

Prediction of Respiratory Motion

Generic 4D respiratory motion model

Off-line

4DMRI toobserve organ

motion

Quantify organ motion

for population

Prediction

On-line

Image of patient

Pre-therapy

Stefan Braunewell 6

Incorporation of motion

Heterogeneous mediaDeactivation of elements

US and temperature simulationRib

Target

XD

[mm]

[mm]

[mm]

[mm]

oC

oC

Stefan Braunewell 7

Parameter identification

Temperature along lesion

Temperature across lesion

MR thermometry of sonication in agar gel

Simulated sonication after recalibration

Stefan Braunewell 8

Functional Modeling

• Cooling effects due to vessels

• Prediction of supply and drainage areas for blood flow

• Prediction and monitoring of tissue damage

Stefan Braunewell 9

Simulation results

Pressure

Temperature Damage Risk

Planning Image

Stefan Braunewell 10

Integrated Software System

• Segmentation• Preview of presumed

motion• Interactive Planning• Exploration of Results• Progress monitoring• Assessment, training

Stefan Braunewell 11

Multi-level validation

• Volunteers• Motion tracking• Motion model• MR imaging protocols

• Phantoms• US, temperature simulation• Steered sonications

Stefan Braunewell 12

System validation

• Validate and optimize workflow• Positioning using Innomotion Robot Arm• Thiel cadavers

- Motion model- Perfusion- Steered sonications

Renal artery perfusion in cadaver

Stefan Braunewell 13

Fraunhofer

MEVIS

University of

DundeeTU Delft

MediriIBSm

mInSightec Ltd

General Electrics

Universita LaSapien

za

ETH Zurich

Fundatia MEDIS

Stefan Braunewell 14

FUSIMO Take Home Message

Integrated software system for FUS in moving organs Assessing feasibility Optimizing outcome Detecting risks Monitoring progress, tracking deviations Training