Method and apparatus for combined diagnostic and therapeutic ultrasound system incorporating noninvasive thermometry, ablation control and automation

• US 20040030227A1
• Filed: 05/16/2003
• Published: 02/12/2004
• Est. Priority Date: 05/16/2002
• Status: Active Grant

• Current Assignee: Delphinus Medical Technologies, Inc.
• Original Assignee: Barbara Ann Karmanos Cancer Institute
• Inventors: Littrup, Peter J., Duric, Nebojsa, Holsapple, Earle III
• Granted Patent: US 8,376,946 B2
• Time in Patent Office: Days
• US Class Current: 600/300
• CPC Class Codes: A61B 8/0825 for diagnosis of the breast, e.g. mammography
• CPC Class Codes: A61B 8/40 Positioning of patients, e.g. means for holding or immobilising parts of the patient's body
• CPC Class Codes: A61B 8/406 using means for diagnosing suspended breasts
• CPC Class Codes: A61B 8/4281 characterised by sound-transmitting media or devices for coupling the transducer to the tissue
• CPC Class Codes: A61B 8/4483 characterised by features of the ultrasound transducer
• CPC Class Codes: A61B 8/483 involving the acquisition of a 3D volume of data
• CPC Class Codes: A61B 8/5223 for extracting a diagnostic or physiological parameter from medical diagnostic data for algorithms to analyse biomedical images G06T7/0012
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

A method for treating a medical pathology includes receiving a first set of acoustic radiation scattered by a volume of tissue containing at least a portion of the medical pathology and thereafter, changing a temperature of the volume of tissue. The method also includes thereafter, receiving a second set of acoustic radiation scattered by the volume of tissue and localizing the portion of the medical pathology from the first and second sets of received acoustic radiation. Localizing the portion of the medical pathology comprises identifying the medical pathology from differences in the first and second sets of received acoustic radiation resulting from the change in temperature. The method also includes insonifying the portion of the medical pathology with sufficient energy to damage the portion of the medical pathology.

Claims

1. A method of treating tissue comprising a medical pathology, the method comprising:

in a first diagnostic session, receiving acoustic signals scattered from the tissue with a plurality of acoustic detectors disposed to at least partially surround at least a portion of the tissue;

in a therapeutic session, delivering therapy to the medical pathology; and

thereafter, in a second diagnostic session, evaluating the effect of the therapy on the medical pathology by receiving acoustic signals scattered from the tissue with the plurality of acoustic detectors;

wherein the first and second diagnostic secessions are comprised by a single diagnostic/therapy session and occur substantially contemporaneously with each other.

2. The method of claim 1, wherein at least one of the diagnostic sessions comprises deriving a temperature-related diagnostic parameter from the received acoustic signals.

3. The method of claim 1, wherein at least one of the diagnostic sessions comprises deriving an attenuation-related diagnostic parameter from the received acoustic signals.

4. The method of claim 1, wherein at least one of the diagnostic sessions comprises deriving an elastography-related diagnostic parameter from the received acoustic signals.

5. The method of claim 2, wherein the tissue is comprised by a patient and the single diagnostic/therapy session comprises substantially no repositioning of the patient.

6. The method of claim 5, wherein the tissue is comprised by a portion of the patient selected from the group consisting of breast, brain, bone, liver, kidney, prostate, muscle, any soft tissue tumor, and blood vessel.

7. The method of claim 1, wherein delivering therapy to the medical pathology comprises directing acoustic radiation to the medical pathology.

8. The method of claim 7, wherein delivering therapy to the medical pathology further comprises focusing the acoustic radiation into the medical pathology in accordance with the information derived from the received acoustic signals.

9. The method of claim 8, wherein focusing the acoustic radiation comprises applying time reversal.

10. The method of claim 8, further comprising determining a focal point with an object proximate the tissue.

11. The method of claim 10, wherein the object is a natural object of a body comprising the tissue.

12. The method of claim 10, further comprising depositing an acoustically reflective seed into the tissue, wherein the object comprises the acoustically reflective seed.

13. The method of claim 8, further comprising placing an interstitial needle in the tissue.

14. The method of claim 13, further comprising emitting acoustic radiation from the interstitial needle.

15. The method of claim 13, further comprising measuring a parameter of the tissue with the interstitial needle.

16. The method of claim 15, wherein measuring a parameter of the tissue with the interstitial needle comprises measuring the temperature of the tissue.

17. The method of claim 13, further comprising delivering therapy to the tissue using the interstitial needle.

18. The method of claim 17, wherein the therapy comprises a selection from the group consisting of cryogenic therapy, heat-based therapy, laser therapy, radio frequency therapy, and microwave therapy.

19. The method of claim 17, wherein the therapy comprises cryogenic therapy in combination with acoustic radiation and the acoustic radiation is used to contour a region of the tissue to which the cryogenic therapy is delivered.

20. The method of claim 8, further comprising receiving information from a practitioner who at least partially defines a target region.

21. The method of claim 8, further comprising using software-based auto-detection to at least partially define a target region.

22. The method of claim 1, wherein delivering therapy comprises sonoporating at least a portion of the tissue.

23. The method of claim 1, further comprising interleaving a sequence of diagnostic sessions with a sequence of therapy sessions to thereby treat a tumor volume, wherein a subsequent therapy session depends, at least in part, on information obtained during a previous diagnostic session.

24. The method of claim 23, wherein a subsequent therapy session comprises a different type of therapy than that applied in an immediately previous therapy session.

25. A method for treating a medical pathology, the method comprising:

receiving a first set of acoustic radiation scattered by a volume of tissue containing at least a portion of the medical pathology;

thereafter, changing a temperature of the volume of tissue;

thereafter, receiving a second set of acoustic radiation scattered by the volume of tissue;

localizing the portion of the medical pathology from the first and second sets of received acoustic radiation, wherein localizing the portion of the medical pathology comprises identifying the medical pathology from differences in the first and second sets of received acoustic radiation resulting from the change in temperature; and

thereafter, insonifying the portion of the medical pathology with sufficient energy to damage the portion of the medical pathology.

26. The method recited in claim 25 wherein insonifying the portion of the medical pathology comprises focusing acoustic radiation onto the portion of the medical pathology.

27. The method recited in claim 26 wherein focusing acoustic radiation comprises:

simulating propagation of a divergent acoustic wave from a source positioned at a location of the portion of the medical pathology;

determining an intensity of the simulated divergent acoustic wave at locations of acoustic sources; and

activating the acoustic sources to produce a corresponding acoustic wave convergent on the location of the portion of the medical pathology.

28. The method recited in claim 26 wherein insonifying the portion of the medical pathology comprises sonoporating the portion of the medical pathology.

29. The method recited in claim 28 further comprising delivering chemotherapy to the portion of the medical pathology substantially contemporaneously with insonifying the portion of the medical pathology.

30. The method recited in claim 29 wherein:

delivering chemotherapy to the portion of the medical pathology comprises delivering microbubbles containing the chemotherapy to the location of the portion of the medical pathology; and

insonifying the portion of the medical pathology damages the microbubbles to release the chemotherapy.

31. The method recited in claim 28 further comprising delivering a genetic agent to the portion of the medical pathology substantially contemporaneously with insonifying the portion of the medical pathology.

32. The method recited in claim 31 wherein:

delivering the genetic agent to the portion of the medical pathology comprises delivering microbubbles containing the genetic agent to the location of the portion of the medical pathology; and

insonifying the portion of the medical pathology damages the microbubbles to release the genetic agent.

33. The method recited in claim 25 wherein localizing the portion of the medical pathology further comprises identifying a three-dimensional boundary for the medical pathology.

34. The method recited in claim 25 wherein localizing the portion of the medical pathology further comprises correlating a known position of an acoustically reflective object proximate the medical pathology with a relative position of the medical pathology to the known position.

35. The method recited in claim 34 wherein the acoustically reflective object comprises an acoustically reflective seed, the method further comprising depositing the acoustically reflective seed into the volume of tissue.

36. The method recited in claim 34 wherein the acoustically reflective object comprises a natural object within a body that comprises the volume of tissue.

37. The method recited in claim 25 wherein changing the temperature of the volume of tissue comprises insonifying the volume of tissue with sufficient energy to effect changing the temperature.

38. The method recited in claim 25 further comprising inserting an interstitial needle within the volume of tissue.

39. The method recited in claim 38 wherein:

the interstitial needle includes an acoustic emitter; and

localizing the portion of the medical pathology comprises;

activating the acoustic emitter;

identifying a position of the acoustic emitter from at least one of the first and second sets of received acoustic radiation; and

correlating the position of the emitter with a relative position of the medical pathology.

40. The method recited in claim 38 wherein:

the interstitial needle includes a thermocouple; and

changing the temperature of the volume of tissue comprises activating the thermocouple.

41. The method recited in claim 38 wherein the interstitial needle is adapted to ablate tissue, the method further comprising ablating the portion of the medical pathology with the interstitial needle.

42. The method recited in claim 41 wherein the interstitial needle is adapted to ablate tissue cryogenically.

43. The method recited in claim 41 wherein the interstitial needle is adapted to ablate tissue through microwave irradiation of the tissue.

44. The method recited in claim 25 further comprising:

receiving a third set of acoustic radiation scattered by the volume of tissue after insonifying the portion of the medical pathology to localize a remaining portion of the medical pathology; and

thereafter, insonifying the remaining portion of the medical pathology with sufficient energy to damage the remaining portion of the medical pathology.

45. The method recited in claim 44 further comprising changing a temperature of the volume of tissue after insonifying the portion of the medical pathology and prior to receiving the third set of acoustic radiation.

46. A system for treating a medical pathology, comprising:

a sensing system configured to receive acoustic radiation scattered by a volume of tissue containing at least a portion of the medical pathology, wherein the sensing system comprises sensors adapted to be disposed to at least partially surround the tissue;

a transmitting system configured to direct acoustic radiation at the medical pathology, wherein the transmitting system comprises transmitters adapted to be disposed to at least partially surround the tissue; and

a processing system programmed to;

process information representative of the received acoustic radiation and generate an acoustic image of the tissue;

simulate propagation of a divergent acoustic wave from a source positioned at a location of the portion of the medical pathology;

determine an intensity of the simulated divergent acoustic wave at locations of the transmitters; and

activate the transmitters to produce a corresponding acoustic wave convergent on the location of the portion of the medical pathology.

47. The system of claim 46, wherein the processing system is further programmed to localize the portion of the medical pathology from multiple sets of received acoustic radiation, wherein localizing the portion of the medical pathology comprises identifying the medical pathology from differences in at least first and second sets of received acoustic radiation, each of the at least first and second sets of received acoustic radiation being received when the portion of the medical pathology is at a different temperature.

48. The system of claim 46, wherein the processing system is further programmed to localize the portion of the medical pathology by correlating a known position of an acoustically reflective object proximate the medical pathology with a relative position of the medical pathology.

49. The system of claim 48, wherein the acoustically reflective object comprises an acoustically reflective seed.

50. The system of claim 48, wherein the acoustically reflective object comprises a natural object within a body that comprises the volume of tissue

51. The system of claim 46, wherein the sensing system comprises a ring transducer assembly.

52. The system of claim 46, wherein the sensing system comprises a paddle transducer assembly.

53. The system of claim 52, wherein the paddle transducer assembly comprises acoustically-coupling pliable bladders adapted to be disposed to surround the tissue.

54. The system of claim 46, further comprising means for changing the temperature of the tissue.

55. The system of claim 46, wherein changing the temperature of the volume of tissue comprises insonifying the volume of tissue with sufficient energy to effect changing the temperature

56. The system of claim 46, further comprising means for emitting acoustic radiation from within the tissue.

57. The system of claim 56, wherein the means for emitting acoustic radiation from within the tissue comprises an interstitial needle.

58. The system of claim 46, further comprising means for delivering therapy via a probe inserted into the tissue.

59. The system of claim 46, means for delivering pharmacological therapy to at least a portion of the tissue.

60. The system of claim 59, wherein the pharmacological therapy comprises micro-bubbles for containing the pharmacological therapy, and wherein the micro-bubbles are adapted to be fractured by the application of sufficient acoustic radiation from the transmitting system.