Autofluorescent imaging and target ablation

• US 20080058785A1
• Filed: 08/24/2007
• Published: 03/06/2008
• Est. Priority Date: 04/12/2006
• Status: Abandoned Application

• Current Assignee: Searete LLC (Intellectual Ventures LLC)
• Original Assignee: Searete LLC (Intellectual Ventures LLC)
• Inventors: Weaver, Thomas, Boyden, Edward, Leuthardt, Eric, Hyde, Roderick, Rivet, Dennis, Myhrvold, Nathan, Wood, Lowell, Ishikawa, Muriel
• Application Number:
  US11/895,560
• Publication Number:
  US 20080058785A1
• Time in Patent Office: Days
• US Class Current: 606/13
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 18/201 with beam delivery through a hollow tube, e.g. forming an articulated arm through a flexible conduit A61B18/22; Hand-pieces therefor
• CPC Class Codes: A61B 18/203 applying laser energy to the outside of the body
• CPC Class Codes: A61B 2017/00066 intensity
• CPC Class Codes: A61B 2018/00208 actively driven, e.g. by a motor
• CPC Class Codes: A61B 2018/00345 Vascular system
• CPC Class Codes: A61B 2018/00452 Skin
• CPC Class Codes: A61B 2018/00505 Urinary tract
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/0066 without feedback, i.e. open loop control
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00785 Reflected power
• CPC Class Codes: A61B 2018/00904 Automatic detection of target tissue
• CPC Class Codes: A61B 2018/00922 by switching or controlling the treatment energy directly within the hand-piece
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/20361 with redirecting based on sensed condition, e.g. tissue analysis or tissue movement
• CPC Class Codes: A61B 2018/207 mixing two wavelengths
• 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 5/0084 : for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/0086 : using infrared radiation
• CPC Class Codes: A61B 5/0088 : for oral or dental tissue
• CPC Class Codes: A61B 5/0091 : for mammography
• CPC Class Codes: A61B 5/0097 : by applying acoustic waves and detecting light, i.e. acoustooptic measurements
• CPC Class Codes: A61B 5/0507 : using microwaves or terahertz waves
• CPC Class Codes: A61B 5/07 : Endoradiosondes
• CPC Class Codes: A61B 5/412 : Detecting or monitoring sepsis
• CPC Class Codes: A61B 5/4547 : Evaluating teeth
• CPC Class Codes: A61N 2005/0602 : for treatment of blood vessels
• CPC Class Codes: A61N 2005/0606 : Mouth
• CPC Class Codes: A61N 2005/0607 : Nose
• CPC Class Codes: A61N 2005/0609 : Stomach and/or esophagus
• CPC Class Codes: A61N 2005/061 : Bladder and/or urethra
• CPC Class Codes: A61N 2005/0626 : Monitoring, verifying, controlling systems and methods
• CPC Class Codes: A61N 2005/0644 : Handheld applicators
• CPC Class Codes: A61N 2005/0651 : Diodes
• CPC Class Codes: A61N 2005/0654 : Lamps
• CPC Class Codes: A61N 2005/0659 : infrared
• CPC Class Codes: A61N 2005/0661 : ultraviolet
• CPC Class Codes: A61N 2005/0663 : Coloured light
• CPC Class Codes: A61N 2005/1087 : Ions; Protons
• CPC Class Codes: A61N 2005/1089 : Electrons
• CPC Class Codes: A61N 5/01 : Devices for producing movement of radiation source during therapy A61N5/1077 takes precedence
• CPC Class Codes: A61N 5/0603 : for treatment of body cavities
• CPC Class Codes: A61N 5/062 : Photodynamic therapy, i.e. excitation of an agent
• CPC Class Codes: A61N 5/0624 : for eliminating microbes, germs, bacteria on or in the body
• CPC Class Codes: A61N 5/067 : using laser light
• CPC Class Codes: A61N 5/10 : X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy A61N5/01 takes precedence
• CPC Class Codes: A61N 5/1001 : using radiation sources introduced into or applied onto the body; brachytherapy

Abstract

Apparatus, devices, methods, systems, computer programs and computing devices related to autofluorescent imaging and ablation are disclosed.

Claims

1. An apparatus including a tethered device comprising:

a first optical energy source configured to provide electromagnetic energy selected to stimulate an auto-fluorescent response in one or more target cells in an internal location;

a sensor configured to detect the auto-fluorescent response;

control circuitry coupled to the sensor and responsive to identify a target area in real time; and

a second energy source responsive to the control circuitry and configured to emit energy selected to at least partially ablate the target area.

2. The device of claim 1, wherein the tethered device is a stent.

3. The device of claim 1, wherein the tethered device is an endoscope.

5. The apparatus of claim 1, wherein the electromagnetic energy selected to induce the auto-fluorescent response is two photon electromagnetic energy.

10. The apparatus of claim 5, wherein the two photon electromagnetic energy is focused at a depth below a surface of the internal location.

12. The apparatus of claim 1, wherein the electromagnetic energy selected to induce the auto-fluorescent response is provided over multiple wavelengths.

13. The apparatus of claim 1, wherein the electromagnetic energy selected to induce the auto-fluorescent response is extended-spectrum electromagnetic energy.

19. The apparatus of claim 1, wherein the electromagnetic energy selected to induce the auto-fluorescent response is directionally variable.

20. The apparatus of claim 1, further comprising:

a third optical energy source alignable with the first optical energy source and configured to provide targeting electromagnetic energy, wherein the targeting electromagnetic energy provides a visual indication of an orientation of the electromagnetic energy selected to induce the auto-fluorescent response.

27. The apparatus of claim 1, wherein the electromagnetic energy selected to induce the auto-fluorescent response is programmable.

28. The apparatus of claim 1, wherein the electromagnetic energy selected to induce the auto-fluorescent response is feedback-controlled.

30. The apparatus of claim 1, wherein the electromagnetic energy selected to induce the auto-fluorescent response is provided at a depth of approximately 0 to 3 mm below a surface of the internal location.

35. The apparatus of claim 1, wherein the sensor is configured to detect the auto-fluorescent response over extended-spectrum electromagnetic energy.

36. The apparatus of claim 1, wherein the sensor is configured to detect a cumulative auto-fluorescent response over a time interval.

37. The apparatus of claim 1, wherein the sensor is configured to detect a time dependent auto-fluorescent response.

49. The apparatus of claim 1, wherein the control circuitry is responsive to identify the target area by analysis of one or more characteristics of the auto-fluorescent response.

50. The apparatus of claim 1, wherein the control circuitry selects one or more characteristics of the energy emitted by the second energy source responsive to one or more characteristics of the auto-fluorescent response.

53. The apparatus of claim 1, wherein the second energy source emits X-ray energy.

54. The apparatus of claim 1, wherein the second energy source emits optical energy.

55. The apparatus of claim 1, wherein the second energy source emits. charged particles.

59. The apparatus of claim 1, wherein one or more of the second energy source, the sensor, and the first optical energy source are in a single handheld unit.

60. The apparatus of claim 1, wherein the second energy source is manually operable.

61. The apparatus of claim 1, wherein the energy selected to at least partially ablate the target area is spatially limited.

67. The apparatus of claim 1, wherein the energy selected to at least partially ablate the target area is directionally variable.

68. The apparatus of claim 1, further comprising:

a fourth optical energy source alignable with the second energy source and configured to provide targeting electromagnetic energy, wherein the targeting electromagnetic energy provides a visual indication of the energy selected to at least partially ablate the target area.

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72. A method for detecting and ablating one or more target cells comprising:

providing to an internal location a tethered device;

providing from the tethered device electromagnetic energy selected to induce an auto-fluorescent response from the one or more target cells;

detecting the auto-fluorescent response;

identifying a target area at least partially based on an analysis of the detected auto-fluorescent response; and

providing energy to at least partially ablate the identified target area in real time.

73. The method of claim 72, further comprising:

selecting the electromagnetic energy to induce the auto-fluorescent response.

74. The method of claim 73, wherein the electromagnetic energy to induce the auto-fluorescent response is selected using control circuitry.

75. The method of claim 73, wherein selection of the electromagnetic energy to induce the auto-fluorescent response is programmable.

76. The method of claim 72, wherein the target area includes microbial contamination.

77. The method of claim 72, wherein the target area includes cancer cells.

80. The method of claim 72, wherein the electromagnetic energy selected to induce the auto-fluorescent response is two photon electromagnetic energy.

85. The method of claim 80, wherein the two photon electromagnetic energy is focused at a depth below a surface of the internal location.

88. The method of claim 72, wherein the electromagnetic energy selected to induce the auto-fluorescent response is extended-spectrum electromagnetic energy.

89. The method of claim 72, wherein the electromagnetic energy selected to induce the auto-fluorescent response is spatially limited.

94. The method of claim 72, wherein the electromagnetic energy selected to induce the auto-fluorescent response is directionally variable.

98. The method of claim 72, further comprising:

providing to the internal location targeting electromagnetic energy alignable with the electromagnetic energy selected to induce the auto-fluorescent response, wherein the targeting electromagnetic energy provides a visual indication of an orientation of the electromagnetic energy selected to induce the auto-fluorescent response.

102. The method of claim 72, wherein the electromagnetic energy selected to induce the auto-fluorescent response is programmable.

103. The method of claim 72, wherein the electromagnetic energy selected to induce the auto-fluorescent response is feedback-controlled.

105. The method of claim 72, wherein the electromagnetic energy selected to induce the auto-fluorescent response is provided at a depth of approximately 0 to 3 mm below a surface of the internal location.

110. The method of claim 72, wherein the auto-fluorescent response is detected over an extended-spectrum of electromagnetic energy.

111. The method of claim 72, wherein the auto-fluorescent response is detected over a cumulative time interval.

112. The method of claim 72, wherein the auto-fluorescent response is detected in a time dependent manner.

113. The method of claim 72, wherein the auto-fluorescent response is detected by a sensor.

114. The method of claim 113, wherein one or more of the sensor, the electromagnetic energy selected to induce the auto-fluorescent response, and the energy to at least partially ablate the identified target area are provided by a single handheld unit.

116. The method of claim 72, wherein the target area is identified by determining one or more of a direction, a distance a time, a depth, or coordinates from which the auto-fluorescent response originated.

122. The method of claim 72, wherein the target area is identified by analysis of one or more characteristics of the auto-fluorescent response.

123. The method of claim 72, wherein the target area is identified using control circuitry.

124. The method of claim 72, wherein identification of the target area is at least partially based on one or more of a programmed or an automatic analysis of the detected auto-fluorescent response.

126. The method of claim 72, wherein one or more characteristics of the energy to at least partially ablate the identified target area is selected based on one or more characteristics of the auto-fluorescent response.

129. The method of claim 72, wherein the energy to at least partially ablate the identified target area is X-ray energy.

130. The method of claim 72, wherein the energy to at least partially ablate the identified target area is optical energy.

131. The method of claim 72, wherein the energy to at least partially ablate the identified target area is charged particles.

132. The method of claim 72, wherein microbial contamination or cancer cells in the target area are at least partially ablated.

137. The method of claim 72, wherein the energy to at least partially ablate the identified target area is spatially limited.

143. The method of claim 72, wherein the energy to at least partially ablate the identified target area is directionally variable.

145. The method of claim 72, further comprising:

providing to the internal location targeting electromagnetic energy alignable with the energy to at least partially ablate the identified target area, wherein the targeting electromagnetic energy provides a visual indication of an orientation of the energy to at least partially ablate the identified target area.

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149. A method of treatment comprising:

providing to an internal location a tethered device;

providing from the tethered device electromagnetic energy selected to induce an auto-fluorescent response from one or more target cells;

detecting the auto-fluorescent response;

identifying a target area at least partially based on an analysis of the detected auto-fluorescent response; and

providing energy to at least partially ablate the identified target area in real time.