Automatic Patient-Specific Microwave Ablation Planning Accelerated by a Physics-Guided Deep Learning Model

Microwave ablation (MWA) is a promising minimally invasive treatment for liver tumors, but its therapeutic outcome strongly depends on patient-specific planning of antenna insertion trajectory, power, and treatment duration. Accurate numerical simulation can provide physically reliable ablation predictions; however, its high computational cost limits its use in optimization-based planning, where repeated forward evaluations are required. To address this issue, we propose a digital twin-based automatic planning framework that combines a neural ablation prediction model with a genetic algorithm. The model was trained on multiphysics simulation data generated from patient-specific tumor and vessel structures, antenna configurations, and treatment conditions, and was used as a fast forward model during planning. The prediction model achieved a Dice score of 95.1%, enabling accurate deep learning-based optimization. In 13 unseen planning cases, the proposed method improved ablation efficiency by 54.3% and reduced organ damage by 55.0% compared with clinician-defined planning, while slightly shortening the insertion path length by 3.3%. Most generated plans were also judged clinically applicable by MWA specialists. Furthermore, the framework enabled approximately 420-fold faster planning than numerical-simulation-based planning, demonstrating its potential as a fast digital twin for quantitative and personalized MWA treatment planning. The code is available at: https://github.com/SeonAengCho/MWA-Planning.git

tFUSOperator: Operator Learning for Transcranial Focused Ultrasound Digital Twins

Transcranial focused ultrasound (tFUS) requires accurate estimation of the intracranial acoustic field, which is distorted by skull-induced aberrations. Numerical solvers are accurate but computationally expensive for digital twins, where the field must be re-estimated repeatedly as treatment conditions change. Existing deep-learning surrogates are fast but typically use voxel-to-voxel regression on a fixed grid, with no mechanism reflecting how acoustic energy propagates through the skull. We instead cast tFUS simulation as an operator learning problem and propose tFUSOperator, a coordinate-aware neural operator that maps the free-field pressure, skull anatomy, and treatment parameters to the intracranial field within a shared physical coordinate frame. To our knowledge, this is the first operator-based formulation of tFUS field prediction. On both seen and unseen skulls, the model localizes the acoustic focus accurately-reaching about 90% and 72% Dice, respectively-and it performs nearly as well from magnetic resonance (MR) as from computed tomography (CT) input while running $5.6 \times 10^4$ times faster than numerical simulation. These results suggest a fast, radiation-free route to safe and practical digital twins for patient-specific tFUS treatment. The code is available at: https://github.com/CMME-Lab/tFUSOperator.git.

Few-shot Deep Learning for Phase-Amplitude Aberration Correction in Transcranial Focused Ultrasound

Transcranial focused ultrasound (tFUS) is a non-invasive technique that delivers focused acoustic energy through the skull for neuromodulation and therapeutic applications. However, the heterogeneous structure of the skull induces complex, patient-specific phase and amplitude aberrations that distort the acoustic focus and deviate it from the intended target, compromising therapeutic efficacy and safety. Conventional time-reversal (TR) simulations can correct these aberrations but rely on computationally expensive full-wave solvers, making them impractical for real-time use and iterative treatment planning. We propose a few-shot deep surrogate framework that predicts per-element phase and amplitude corrections for a 96-element 3D phased-array transducer from patient CT images. A geometry-aware encoder extracts skull-path features shared across dedicated phase classification and amplitude regression branches, where phase periodicity is handled via circular expectation decoding. The framework is pretrained on diverse skull geometries and fine-tuned with only ten target points, enabling rapid adaptation to unseen patients without full patient-specific simulation. Evaluated via leave-one-out cross-validation across 12 skulls, it achieves a mean phase CMAE of 0.155 rad and amplitude rMAE of 9.089%, a focal centroid error of 0.467 mm, Dice score of 94.422%, and peak pressure ratio of 92.332%, with an approximately 2,535 times speedup over TR simulation. The code is available at https://github.com/Minju-Seol/fewshot-tfus-correction.

PhysRFANet: Physics-Guided Neural Network for Real-Time Prediction of Thermal Effect During Radiofrequency Ablation Treatment

Radiofrequency ablation (RFA) is a widely used minimally invasive technique for ablating solid tumors. Achieving precise personalized treatment necessitates feedback information on in situ thermal effects induced by the RFA procedure. While computer simulation facilitates the prediction of electrical and thermal phenomena associated with RFA, its practical implementation in clinical settings is hindered by high computational demands. In this paper, we propose a physics-guided neural network model, named PhysRFANet, to enable real-time prediction of thermal effect during RFA treatment. The networks, designed for predicting temperature distribution and the corresponding ablation lesion, were trained using biophysical computational models that integrated electrostatics, bio-heat transfer, and cell necrosis, alongside magnetic resonance (MR) images of breast cancer patients. Validation of the computational model was performed through experiments on ex vivo bovine liver tissue. Our model demonstrated a 96% Dice score in predicting the lesion volume and an RMSE of 0.4854 for temperature distribution when tested with foreseen tumor images. Notably, even with unforeseen images, it achieved a 93% Dice score for the ablation lesion and an RMSE of 0.6783 for temperature distribution. All networks were capable of inferring results within 10 ms. The presented technique, applied to optimize the placement of the electrode for a specific target region, holds significant promise in enhancing the safety and efficacy of RFA treatments.