System and method of guided treatment within malignant prostate tissue

• US 20070230757A1
• Filed: 03/16/2007
• Published: 10/04/2007
• Est. Priority Date: 04/04/2006
• Status: Active Grant

• Current Assignee: Brian Campbell Wilson, John Trachtenberg, Masoom A. Haider
• Original Assignee: Brian Campbell Wilson, John Trachtenberg, Masoom A. Haider
• Inventors: Wilson, Brian Campbell, Trachtenberg, John, Haider, Masoom A.
• Granted Patent: US 8,548,562 B2
• Time in Patent Office: Days
• US Class Current: 382/128
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2018/00636 Sensing and controlling the application of energy
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

An imaging and diagnostic system and method are used for differentiating between malignant and non-malignant tissue of a prostate and surrounding region. The imaging device of the system acquires imaging data from the prostate and surrounding proximal region, processes the data to differentiate areas of tissue malignancy from non-malignant tissue. A sectioning device or ablative device is provided. The ablative device is operable by automation for receiving the imaging output coordinates and defining the trajectory and quantity of energy or power to be delivered into the malignant tissue of the prostate region. A control system determines calculated energy or power to be deposited into the malignant tissue during ablation, to minimize destruction of the non-malignant tissue within the prostate and surrounding tissue. The system operates on generated ablative device output data. In a second embodiment of the invention, the energy device output data guides the position or orientation of the delivery device or guides the delivery of energy or power from the ablative device into the malignant prostate tissue under active surveillance of the imaging device of the system. Destruction of the target tumor is thus monitored and controlled by active imaging.

Claims

1. An imaging system for differentiating between malignant and non-malignant tissues within the prostate region and for guided delivery of tissue removal instrumentation to and within the malignant tissues of the prostate, and away from the non-malignant tissues, the imaging system comprising:

a) at least one imaging device for providing imaging data;

b) a processor receiving the imaging data and executing software to evaluate the image data according to at least one algorithm,

c) the algorithm processing the imaging data and outputting information relating to size, location and orientation of the malignant tissue;

d) an energy source;

e) an ablative device for deposition of energy into the malignant prostate tissue; and

f) a control system for quantifying the energy delivered from the ablative device into the tissue; and

the processor providing a plan in memory for the energy to be focally delivered by the ablative device to the malignant tissue under image surveillance so as to substantially avoid destruction of the non-malignant tissue of the prostate based upon the output information relating to size, location and orientation of the malignant tissue.

2. The system of claim 1 wherein the imaging device comprises an MRI device.

3. The system of claim 1 in which the first imaging device is a system providing two distinct imaging capabilities consisting of an MRI device and further comprising at least a second imaging device other than an MRI device.

4. The system of claim 3 wherein the second imaging device is selected from the group consisting of an ultrasound imaging device, x-ray imaging device, and fluoroscopy.

5. The system of claim 1 in which the processor for quantifying energy deposition from the ablative device uses a plan constructed by application of an algorithm to the imaging data in a computer program.

6. The system of claim 2 in which the energy deposition is provided by a system selected from the group consisting of a laser, an ultrasound emitter, a radio-frequency emitter is present to provide the energy deposition and a microwave energy source.

7. The system of claim 2 in which a delivery system supplying a pharmaceutical agent is present.

8. The system of claim 2 further comprising a minimally invasive monitoring device for monitoring delivery of the energy deposition to the malignant tissue sector.

9. The system of claim 8 wherein the minimally invasive monitoring device also verifies non-destruction of the non-malignant tissue sector.

10. The system of claim 9 in which the minimally invasive monitoring device comprises a monitor.

11. A method of removing malignant tissue from a prostate using ablative energy comprising the steps of:

a) taking imaging data by non-invasive imaging;

b) executing a software program using the imaging data to provide an indication of differentiation between malignant and non-malignant tissues of a prostate;

c) determining the size, location and orientation of the malignant and non-malignant tissue of the prostate represented on the image display;

d) providing an energy source through or from an ablative device to deliver focal ablation to the malignant tissue of the prostate in accordance with the determined size, location and orientation of at least the malignant tissue;

e) operating a monitoring system quantifying an amount of energy deposited by the ablative device; and

f) delivering tissue removing focal therapeutic treatment to the malignant tissue of the prostate, in an amount responsive to the output data of the monitoring system.

12. The method of claim 11 wherein quantifying the amount of energy is representative of physiological changes to be caused by ablation.

13. The method of claim 12 wherein the quantified amount of energy generates output data to an ablative device.

14. The method of claim 11 wherein determination indicates size, location and orientation of the malignant tissue by application of an algorithm to the imaging data that characterizes likelihood of grades of data with respect to likelihood of malignancy versus benignity.

15. The method of claim 14 wherein the imaging device provides an image display during or after the determination.

16. A method of removing malignant tissue from a prostate using resection by non-ablative tools comprising the steps of:

a) taking imaging data by non-invasive imaging;

b) executing a software program using the imaging data to provide an indication of differentiation between malignant and non-malignant tissues of a prostate,

c) determining the size, location and orientation of the malignant and non-malignant tissue of the prostate represented on the image display;

d) providing a resectioning medical tool to deliver focal therapy of excision of tissue to the malignant tissue of the prostate in accordance with the determined size, location and orientation of at least the malignant tissue;

e) monitoring the amount and location of tissue removed and comparing the tissue removing focal therapeutic treatment to determined size, location and orientation of the malignant tissue.

17. The method of claim 16 further comprising of operating a monitoring system in real time to display remaining prostate tissue during or after surgical removal of the malignant tissue to ensure complete removal of the malignant tissue.

18. A computer implemented method used in conjunction with the method of claim 16 for identifying and localizing malignant tissues of a prostate, using T2 weighted imaging, dynamic contrast enhanced imaging and diffusion-weighted imaging, comprising the steps of:

a) generating a series of axial images through the prostate;

b) inputting variable “

a”

to represent the presence of malignant tissue and variable “

b”

to represent the absence of malignant tissue in accordance with T2 weighted, diffusion weighted and dynamic contrast enhanced images, acquired spanning the prostate tissue;

c) using a T1 weighted pulse sequence to obtain at least one dynamic contrast enhanced image;

d) generating an apparent diffusion coefficient map (ADC) on an MRI scanner using standard software;

e) administering an intravenous contrast agent;

f) generating a permeability map using a modified Brix pharmacokinetic model; and

g) automatically generating a value, by weighting pre-determined regions of the permeability map,

to determine the size, location, and orientation of the malignant and non-malignant tissue of the prostate represented on the image display.

19. A method for developing a plan for the removal of malignant tissue from a prostate using ablative energy in a removal step comprising the steps of taking imaging data by non-invasive imaging;

a) executing a software program in a processor using the imaging data to provide an indication of differentiation between malignant and non-malignant tissues of a prostate,

b) determining size, location and orientation of the malignant and non-malignant tissue of the prostate from image data represented on the image display;

c) determining quantities and location for provision of ablative energy through or from an ablative device that would deliver focal ablation to the malignant tissue of the prostate in accordance with the determined size, location and orientation of at least the malignant tissue; and

d) establishing a planned delivery procedure for delivering the determined quantities and location to the malignant tissue by operating a monitoring system quantifying an amount of energy to be deposited by the ablative device according to distribution of determined malignant tissue.

20. The method of claim 19 wherein the processor quantifies energy deposition from the ablative device using a plan constructed by application of an algorithm to the imaging data in a computer program.

21. The method of claim 19 wherein determining indicates size, location and orientation of the malignant tissue by application of an algorithm to the imaging data that characterizes likelihood of scholastic or percentage grades of data with respect to likelihood of malignancy versus benignity.