Systems and methods for treating a lung of a patient using guided radiation therapy or surgery

• US 10,195,464 B2
• Filed: 06/24/2005
• Issued: 02/05/2019
• Est. Priority Date: 06/24/2004
• Status: Active Grant

• Current Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Original Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Inventors: Vertatschitsch, Edward J., Dimmer, Steven C., Mate, Timothy P., Meier, Eric, Seiler, Keith, Wright, J. Nelson
• Primary Examiner(s): Kish, James
• Application Number:
  US11/165,843
• Publication Number:
  US 20060093089A1
• Time in Patent Office: 4,974 Days
• Field of Search: 600424, 600426, 600431, 600433-436, 3405721
• CPC Class Codes: A61B 2034/301 for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2090/3987 Applicators for implanting markers
• CPC Class Codes: A61B 2090/3991 having specific anchoring means to fixate the marker to the tissue, e.g. hooks
• CPC Class Codes: A61B 2090/3995 Multi-modality markers
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61N 2005/1051 using an active marker
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam
• CPC Class Codes: A61N 5/1067 in real time, i.e. during treatment
• CPC Class Codes: A61N 5/107 in real time, i.e. during treatment

Abstract

Systems and methods for treating a lung of a patient. One embodiment of a method comprises positioning a leadless marker in the lung of the patient relative to the target, and collecting position data of the marker. This method further comprises determining the location of the marker in an external reference frame outside of the patient based on the collected position data, and providing an objective output in the external reference frame that is responsive to movement of the marker. The objective output is provided at a frequency (i.e., periodicity) that results in a clinically acceptable tracking error. In addition, the objective output can also be provided at least substantially contemporaneously with collecting the position data used to determine the location of the marker.

Claims

1. A method of treating a target in a lung of a patient, comprising:

positioning a leadless marker in the lung of the patient relative to the target;

collecting position data of the implanted marker with a localization system using a non-ionizing energy to track the implanted marker while the patient is in a treatment session;

determining the location of the implanted marker in an external reference frame based on the collected position data;

providing an objective output in the external reference frame that is (a) directly responsive to movement of the implanted marker and (b) provided at a periodicity that tracks the location of the target;

wherein the position data is collected at a time t_n, and wherein providing the objective output responsive to the location of the target comprises providing the objective output to at least one of a user interface, a memory device, a computer and a medical device within a latency period, wherein the position data is collected by the localization system; and

wherein the latency period between the movement of the implanted marker and the objective output of the collected position data during application of therapeutic ionizing radiation is not greater than approximately 2 seconds of time t_n and the objective output is provided at a periodicity not greater than approximately 2 seconds during the application of the therapeutic ionizing radiation.

2. The method of claim 1, further comprising:

positioning the target at a desired situs in an external reference frame of a radiation delivery device using the objective output; and

irradiating the patient with a radiation beam of the radiation delivery device.

3. The method of claim 2, further comprising controlling the radiation delivery device to activate the radiation beam when the determined location of the marker indicates that the target is at the desired situs and deactivating the radiation beam when the determined location of the marker indicates that the target is outside of the desired situs.

4. The method of claim 2, further comprising controlling the radiation delivery device by moving a robot based on the determined location of the marker.

5. The method of claim 2, further comprising controlling the radiation device by articulating the position of the beam based on the determined location of the marker.

6. The method of claim 2, further comprising controlling the shape of the beam based on the determined location of the marker.

7. The method of claim 1, further comprising moving a surgical instrument relative to the target while tracking the target using the objective output.

8. The method of claim 7 wherein the surgical instrument comprises a knife and the method further comprises cutting and removing a portion of the lung of the patient.

9. The method of claim 7 wherein the surgical instrument comprises an ablation device and the method further comprises ablating a portion of the lung.

10. The method of claim 7 wherein the surgical instrument comprises a cryogenic device and the method further comprises cryogenically necrosing cells.

11. The method of claim 1 wherein positioning the leadless marker comprises deploying the marker in the lung by inserting a catheter into the lung and releasing the marker from the catheter.

12. The method of claim 11 wherein inserting the catheter comprises guiding the catheter through a lumen of the lung, and wherein releasing the marker comprises anchoring the marker in the lung.

13. The method of claim 11 wherein inserting the catheter comprises piercing a lumen in a respiratory system.

14. The method of claim 1 wherein positioning the marker comprises passing a needle through the thorax of the patient and releasing the marker from the needle into the lung of the patient.

15. The method of claim 1 wherein positioning the marker comprises surgically attaching the marker to the lung.

16. The method of claim 1, further comprising repeating the collecting, determining and providing procedures to monitor the position of the marker within the lung.

17. The method of claim 1 wherein the latency period is not greater than approximately 200 ms of time t_n and at a periodicity not greater than approximately 200 ms.

18. The method of claim 1 wherein the latency period is not greater than approximately 100 ms of time t_n and at a periodicity not greater than approximately 100 ms.

19. The method of claim 1, further comprising deploying the leadless marker by optically guiding a delivery device through the patient and releasing the marker at a desired site.

20. The method of claim 1, further comprising deploying the leadless marker in the patient by fluoroscopically guiding a delivery device through the patient and releasing the marker at a desired site.

21. The method of claim 1, further comprising deploying the leadless marker in the patient by magnetically guiding a delivery device through the patient and releasing the marker at a desired site.