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.