# Cryo-RL: automating prostate cancer cryoablation planning with reinforcement learning

arXiv: https://arxiv.org/abs/2509.04886 · HTML: https://mlsanity.com/paper/2509.04886/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in RL for clinical treatment and surgery, one of 15 directions in Deep reinforcement learning methods.
- Builds on 5 of its 21 references that are in the map.
- First posted on arXiv 5 Sep 2025.

## Placed in

- Deep reinforcement learning methods / [RL for clinical treatment and surgery](https://mlsanity.com/deeprl/rl-for-clinical-treatment-and-surgery/)

## Builds on (most cited first, 5 of 5)

- [Proximal Policy Optimization Algorithms](https://mlsanity.com/paper/1707.06347/) (2017)
- [Prototypical few-shot segmentation for cross-institution male pelvic structures with spatial registration](https://mlsanity.com/paper/2209.05160/) (2022)
- [Weakly supervised localisation of prostate cancer using reinforcement learning for bi-parametric MR images](https://mlsanity.com/paper/2402.13778/) (2024)
- [Promptable cancer segmentation using minimal expert-curated data](https://mlsanity.com/paper/2505.17915/) (2025)
- [SPARS: Self-Play Adversarial Reinforcement Learning for Segmentation of Liver Tumours](https://mlsanity.com/paper/2505.18989/) (2025)

## Abstract (arXiv)

Cryoablation is a minimally invasive localised treatment for prostate cancer that destroys malignant tissue during de-freezing, while sparing surrounding healthy structures. Its success depends on accurate preoperative planning of cryoprobe placements to fully cover the tumour and avoid critical anatomy. This planning is currently manual, expertise-dependent, and time-consuming, leading to variability in treatment quality and limited scalability. In this work, we introduce Cryo-RL, a reinforcement learning framework that models cryoablation planning as a Markov decision process and learns an optimal policy for cryoprobe placement. Within a simulated environment that models clinical constraints and stochastic intraoperative variability, an agent sequentially selects cryoprobe positions and ice sphere diameters. Guided by a reward function based on tumour coverage, this agent learns a cryoablation strategy that leads to optimal cryoprobe placements without the need for any manually-designed plans. Evaluated on 583 retrospective prostate cancer cases, Cryo-RL achieved over 8 percentage-point Dice improvements compared with the best automated baselines, based on geometric optimisation, and matched human expert performance while requiring substantially less planning time. These results highlight the potential of reinforcement learning to deliver clinically viable, reproducible, and efficient cryoablation plans.