Medical Treatment System and Method

• US 20070055090A1
• Filed: 08/10/2006
• Published: 03/08/2007
• Est. Priority Date: 08/12/2004
• Status: Abandoned Application

• Current Assignee: Navotek Medical Ltd.
• Original Assignee: Navotek Medical Ltd.
• Inventors: Kornblau, Giora, NEUSTADTER, David
• Application Number:
  US11/463,659
• Publication Number:
  US 20070055090A1
• Time in Patent Office: Days
• US Class Current: 600/3
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2090/101 for stereotaxic radiosurgery
• CPC Class Codes: A61B 2090/3908 Soft tissue, e.g. breast tissue
• CPC Class Codes: A61B 2090/392 Radioactive markers
• CPC Class Codes: A61B 2090/3987 Applicators for implanting markers
• 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 5/1127 using markers
• 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 5/1069 Target adjustment, e.g. moving the patient support

Abstract

A method of aiming a therapeutic beam at a patient having a source of radioactive emissions implanted at a position having a geometric relationship to a target tissue, the method comprising: (a) providing a patient having a source of radioactive emissions implanted therein; (b) determining at least an indication of a location of said source using at least one radioactivity detecting position sensor; and (c) automatically aiming a therapeutic beam at said target based on said at least an indication of location.

Claims

1. A method of aiming a therapeutic beam, the method comprising:

(a) implanting a source of radioactive emissions in a patient at a position having a geometric relationship to a target tissue;

(b) determining at least an indication of a location of said source using at least one radioactivity detecting position sensor; and

(c) automatically aiming a therapeutic beam at said target based on said at least an indication of location.

2. A method according to claim 1, wherein said geometric relationship is known prior to said implanting.

3. A method according to claim 1, wherein said geometric relationship is determined after said implanting using imaging.

4. A method according to claim 1, wherein automatically aiming comprises maintaining said aim while at least one of said target and said beam move.

5. A method according to claim 1, wherein said determined location is a location relative to said sensor.

6. A method according to claim 1, wherein determining at least an indication of a location comprises determining a direction.

7. A method according to claim 1, wherein said position sensor generates a direction signal.

8. A method according to claim 1, wherein the location is determined in three dimensions.

9. A method according to claim 1, wherein the source is characterized by an activity which does not cause clinically significant cytotoxicity in a period of 7 days.

10. A method according to claim 1, wherein the source is attached to, or integrally formed with, a tissue fixation element adapted to maintain said source in said geometrical relationship.

11. A method according to claim 1, wherein the source includes a biocompatible outer surface.

12. A method according to claim 1, wherein the source location is determined with an error not exceeding 2 mm.

13. A method according to claim 1, wherein the source location is determined with an error not exceeding 1 mm.

14. A method according to claim 1, wherein determining at least an indication of a location comprises determining a series of location indications as affected by a physiological motion cycle.

15. A method according to claim 14, wherein said cycle comprises breathing.

16. A method according to claim 1, wherein determining at least an indication of a location comprises providing a series of temporally defined locations which define a trajectory.

17. A method according to claim 1, comprising registering a first position co-ordinate system employed by said sensor and a second position co-ordinate system employed by a beam aiming mechanism with respect to one another.

18. A method according to claim 1, additionally comprising:

(d) irradiating said target with a therapeutic dose of radiation using said beam.

19. A method according to claim 18, comprising alternating between (c) and (d).

20. A method according to claim 18, comprising positioning at least one of said position sensor and said beam so that an amount of radiation originating from said beam and impinging on said sensor does not significantly affect an ability of said sensor to determine a location of said source.

21. A method according to claim 1, wherein (c) includes moving said target to a desired location.

22. A method according to claim 1, wherein (c) includes moving said therapeutic beam to a desired position.

23. A method according to claim 1, wherein (c) includes subjecting said therapeutic beam to an angular adjustment.

24. A method according to claim 1, including supporting said patient using a frame mechanically coupled to said at least one radioactivity detecting position sensor.

25. A method according to claim 1, wherein (c) comprises at least one of aiming said beam to miss said sensor and moving said sensor to be out of a path of said beam.

26. A method according to claim 25, comprising predetermining a motion of the at least one position sensor to avoid irradiation by said beam.

27. A method according to claim 26, comprising selecting a location for said at least one sensor, taking into account a desired therapy of said target, said location designed to avoid said beam.

28. A method according to claim 26, comprising using an angle of a patient couch adapted for receiving said patient and an angle of said beam to determine an expected interaction between said beam and said at least one sensor.

29. A therapy system, the system comprising:

(a) a position sensing module capable of determining at least an indication of a location of an implantable radioactive source based upon radioactive emissions of said source and providing a position output signal, responsive to the determination;

(b) control circuitry configured to receive the position output signal, calculate an alignment correction based on said signal and provide said correction to a beam-target alignment mechanism;

(c) a beam source; and

(d) a beam-target alignment mechanism configured to align said beam source and said target according to said correction.

30. A system according to claim 29, wherein the target location is defined in three dimensions.

31. A system according to claim 29, wherein said alignment mechanism is configured to align based on a desired therapeutic effect.

32. A system according to claim 29, wherein said alignment mechanism is configured to align based on a desired safety effect.

33. A system according to claim 29, wherein said alignment mechanism is configured to align based on a desired lack of interaction between said module and said beam.

34. A system according to claim 29, wherein the sensing module is capable of determining a location indication in less than 1 second and an accuracy of better than 5 mm, for a source characterized by an activity which does not cause clinically significant cytotoxicity in a period of 7 days.

35. A therapy system according to claim 34, wherein the activity is in the range of 1 μ

Ci to 300 μ

Ci.

36. A therapy system according to claim 35, wherein the activity is in the range of 1 μ

Ci to 100 μ

Ci.

37. A therapy system according to claim 29, wherein the position sensing module employs at least one position sensor which employs at least one radiation shield.

38. A therapy system according to claim 37, wherein the position sensor employs a collimator.

39. A therapy system according to claim 29, wherein the position sensor employs a differential radiation detector.

40. A therapy system according to claim 29, wherein the position sensor employs a rotating radiation sensor with angular sensitivity.

41. A therapy system according to claim 29, wherein the target location is calculated with an error not exceeding 2 mm.

42. A therapy system according to claim 29, wherein the target location is calculated with an error not exceeding 1 mm.

43. A therapy system according to claim 29, wherein said control circuitry is configured for registering a first position co-ordinate system employed by said sensor module and a second position co-ordinate system employed by a beam aiming mechanism with respect to one another.

44. A therapy system according to claim 29, configured to alternate between position sensing and patient irradiation.

45. A therapy system according to claim 29, configured to ignore a position output signal generated while said beam is in operation.

46. A therapy system according to claim 29, configured to inactivate said position sensing module while said beam is in operation.

47. A therapy system according to claim 29, wherein said position sensing module is positioned so that an amount of radiation originating from said beam and impinging on said sensing module does not significantly affect an ability of said sensing module to determine a position of said source.

48. A therapy system according to claim 29, wherein said beam-target alignment mechanism is configured to move said target to a desired position in response to said target co-ordinates.

49. A therapy system according to claim 29, wherein said beam-target alignment mechanism is configured to move said therapeutic beam to a desired position.

50. A therapy system according to claim 29, wherein said beam-target alignment mechanism is configured to subject said therapeutic beam to an angular adjustment.

51. A therapy system according to claim 29, wherein the control circuitry is adapted to provide the correction as a series of temporally defined sets of co-ordinates which define a trajectory.

52. A therapy system according to claim 29, wherein a position sensor of the position sensing module is provided within a patient support adapted to hold a patient during therapy.

53. A therapy system according to claim 29, including at least one radiation shield adapted to be shield said sensor from radiation, by movement of at least one of said sensor and said shield.

54. A system according to claim 52, wherein said patient support is rotatable.

55. A system according to claim 52, wherein said sensing module is adapted to move within said support.

56. A therapy system according to claim 29, including a sensor displacement mechanism adapted to position at least one sensor of the position sensing module outside of a beam path when the beam source is operative.

57. A method of aiming a therapeutic beam, the method comprising:

(a) implanting a source of radioactive emissions in a patient at a position having a geometric relationship to a target tissue;

(b) detecting said source using at least one radioactivity detecting position sensor; and

(c) automatically aiming a therapeutic beam at said target based on detecting.

58. A therapy control system, the system comprising:

(a) a position sensing module configured to determine at least an indication of a location of an implantable radioactive source based upon radioactive emissions of said source and providing a position output signal, responsive to the determination; and

(b) control circuitry configured to receive the position output signal and calculate and output at least one of target coordinates and tool aiming instructions to an output channel, based upon the position output signal.