Methods and systems for intra-operatively providing anatomical guidance in surgery

• US 10,258,275 B2
• Filed: 12/27/2016
• Issued: 04/16/2019
• Est. Priority Date: 07/30/2008
• Status: Active Grant

• Current Assignee: Vanderbilt University
• Original Assignee: Vanderbilt University
• Inventors: Mahadevan-Jansen, Anita, White, Lisa, Phay, John, Paras, Constantine A., Bartz, Elizabeth Kanter, Keller, Matthew D., Mathews, Nicole, Amundson, Jennifer Whisenant, Pence, Isaac J.
• Primary Examiner(s): Santos Rodriguez, Joseph M
• Application Number:
  US15/391,046
• Publication Number:
  US 20170105623A1
• Time in Patent Office: 840 Days
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2505/05 Surgical care
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/0071 by measuring fluorescence emission
• CPC Class Codes: A61B 5/0075 by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy A61B5/0071 takes precedence
• CPC Class Codes: A61B 5/0086 using infrared radiation
• CPC Class Codes: A61B 5/415 the glands, e.g. tonsils, adenoids or thymus
• CPC Class Codes: A61B 5/418 lymph vessels, ducts or nodes
• CPC Class Codes: A61B 5/4227 endocrine glands, i.e. thyroid, adrenals, hypothalamic, pituitary
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: G01N 2021/6439 with indicators, stains, dyes, tags, labels, marks
• CPC Class Codes: G01N 21/6456 Spatial resolved fluorescence measurements; Imaging
• CPC Class Codes: G01N 21/65 Raman scattering
• CPC Class Codes: G01N 2201/0221 Portable; cableless; compact; hand-held

Abstract

In one aspect, the present invention relates to a process for intra-operatively providing anatomical guidance in endocrine surgery. In one embodiment, the process includes the steps of illuminating tissues in the neck area of a living subject with a beam of light having a predetermined wavelength, obtaining Raman data from light scattered from the illuminated tissues, finding Raman signatures corresponding to thyroid or parathyroid tissues from the obtained Raman data, and identifying the thyroid or parathyroid tissues from the corresponding Raman signatures.

Claims

1. A process for intra-operatively providing anatomical guidance in endocrine surgery, comprising the steps of:

(a) illuminating tissues in the neck area of a living subject with a beam of light having a predetermined wavelength;

(b) obtaining auto-fluorescence data from light emitted from the tissues in the neck area in response to the illumination, wherein the predetermined wavelength is adapted such that the auto-fluorescence data emitted from the illuminated tissues in the neck area are in a wavelength range of 800-1000 nm; and

(c) displaying the obtained auto-fluorescence data on a display and identifying parathyroid glands of the living subject from the displayed auto-fluorescence data in real time for providing anatomical guidance to a medical professional performing the endocrine surgery, wherein intensity of the auto-fluorescence data emitted from tissues of the parathyroid glands is higher than that emitted from tissues surrounding the parathyroid glands in the wavelength range of 800-1000 nm.

2. The process of claim 1, wherein the predetermined wavelength is in the near-infrared range.

3. The process of claim 1, wherein the auto-fluorescence data comprises near-infrared auto-fluorescence data.

4. A system for intra-operatively providing anatomical guidance in endocrine surgery, comprising:

(a) a light source configured to emit a beam of light having a predetermined wavelength for illuminating tissues in the neck area of a living subject;

(b) means for obtaining optical signals emitted from the illuminated tissues in response to the illumination, wherein the predetermined wavelength is adapted such that the optical signals emitted from the illuminated tissues in the neck area are in a wavelength range of 800-1000 nm; and

(c) a display in communication with the means for obtaining optical signals and configured to display the obtained optical signals for identifying parathyroid glands of the living subject from the displayed optical signals in real time for providing anatomical guidance in an endocrine surgery, wherein intensity of the optical signals emitted from tissues of the parathyroid glands is higher than that emitted from tissues surrounding the parathyroid glands in the wavelength range of 800-1000 nm,

wherein the optical signals comprise auto-fluorescence data.

5. The system of claim 4, wherein the light source comprises a laser or an LED configured to emit light having a wavelength in the near-infrared range.

6. The system of claim 4, wherein the means for obtaining optical signals comprises:

a light delivery device optically coupled with the light source and configured to deliver the beam of light from the light source to the tissues in the neck area of the living subject; and

a detector optically coupled with the light delivery device and configured to detect and record the optical signals emitted from the illuminated tissues.

7. The system of claim 6, wherein the means for obtaining optical signals further comprises:

a lens positioned between the tissues and the detector in an optical path along which the optical signals emitted from the illuminated tissues travel and utilized to receive the optical signals emitted from the tissues and focus them on a desired spot on the detector.

8. The system of claim 7, wherein the means for obtaining optical signals further comprises:

a filter positioned between the tissues and the lens in the optical path and utilized to block unwanted wavelengths, ambient light and/or reflected light from the illuminated tissues to ensure the optical signals to be detected.

9. The system of claim 6, wherein the light delivery device comprises one or more light guides, or one or more optical fibers.

10. The system of claim 6, wherein the detector comprises at least one camera.

11. The system of claim 10, wherein the detector further comprises a filter coupled with the at least one camera to block unwanted wavelengths, ambient light and/or reflected light from the illuminated tissues to ensure the optical signals to be detected.

12. The system of claim 6, wherein the display is in communication at least with the detector, and adapted with a controller and software to control signal acquisition, process data and display images corresponding to the optical signals emitted from the illuminated tissues.

13. The system of claim 4, further comprising a viewer being connectable to the display, configured for the medical professional to view the optical signals emitted from the illuminated tissues on site so as to identify the parathyroid glands that need to be acted on.

14. A system for intra-operatively providing anatomical guidance in endocrine surgery, comprising:

(a) a light source configured to emit a beam of light having a predetermined wavelength;

(b) an optical probe optically connected to the light source and configured to deliver the emitted beam of light to tissues in the neck area of a living subject to illuminate the tissues, and to collect light of auto-fluorescence data emitted from the tissues in the neck area in response to the illumination, wherein the predetermined wavelength is adapted such that the auto-fluorescence data emitted from the illuminated tissues in the neck area are in a wavelength range of 800-1000 nm;

(c) a detector optically coupled with the optical probe and configured to obtain the collected auto-fluorescence data; and

(d) a computer in communication with the detector and programmed to process the obtained auto-fluorescence data and display the processed auto-fluorescence data on a display for identifying parathyroid glands of the living subject from the displayed auto-fluorescence data in real time for providing anatomical guidance to a medical professional performing the endocrine surgery, wherein intensity of the auto-fluorescence data emitted from tissues of the parathyroid glands is higher than that emitted from tissues surrounding the parathyroid glands in the wavelength range of 800-1000 nm.

15. The system of claim 14, wherein the predetermined wavelength is in the near-infrared range.

16. The system of claim 14, wherein the optical probe comprise a head portion for collecting auto-fluorescence data emitted from the illuminated tissues, a noise filter and a band pass positioned in the head portion blocking unwanted wavelengths and/or ambient light to ensure the auto-fluorescence data to be collected.