EXPANDABLE BRACHYTHERAPY APPARATUS AND METHODS FOR USING THEM

• US 20080091055A1
• Filed: 10/06/2007
• Published: 04/17/2008
• Est. Priority Date: 10/08/2006
• Status: Active Grant

• Current Assignee: Cianna Medical Inc. (Merit Medical Systems, Inc.)
• Original Assignee: Cianna Medical Inc. (Merit Medical Systems, Inc.)
• Inventors: Urquidi, Luis, Nguyen, Tommy, Nguyen, Than, Sutton, Doug, Hermann, George
• Granted Patent: US 7,862,498 B2
• Time in Patent Office: Days
• US Class Current: 600/7
• CPC Class Codes: A61N 2005/1018 with multiple channels for guiding radioactive sources
• CPC Class Codes: A61N 5/1014 Intracavitary radiation therapy
• CPC Class Codes: A61N 5/1015 Treatment of resected cavities created by surgery, e.g. lumpectomy

Abstract

Apparatus for delivering brachytherapy to a target tissue region includes an elongate body including a proximal end, a distal end sized for introduction into a tissue tract and carrying a plurality of elongate members including pathways for receiving a source of radiation. The elongate members are movable between collapsed and expanded configurations. During use, a tract is created through tissue, and the elongate body carrying the elongate members is advanced through the tract into a target location with the elongate members in the collapsed configuration. The elongate members are directed to the expanded configuration at the target location, and radiation is delivered to treat tissue at the target location, e.g., by introducing one or more radiation sources along the pathways. The apparatus may include features to prevent overexpansion of the elongate members and/or to facilitate rapid collapse of the elongate members.

Claims

1. A brachytherapy treatment apparatus, comprising:

an elongate core member comprising a proximal end and a distal end configured for introduction into a tract through tissue, the proximal and distal ends defining a longitudinal axis;

a distal hub coupled to the distal end of the core member;

a proximal hub on the proximal end of the core member and movable axially relative to the distal hub; and

a plurality of elongate members coupled to the proximal and distal hubs and extending between the proximal and distal ends of the core member, the elongate members movable from a collapsed configuration extending substantially parallel to the longitudinal axis for introduction through a tissue tract to a target location, and an expanded configuration when the proximal hub is directed distally relative to the distal hub, the elongate members comprising pathways for receiving a source of radiation therealong.

2. The apparatus of claim 1, wherein the core member comprises first and second telescoping tubes, the first tube coupled to the proximal hub and the second tube coupled to the distal hub such that rotation of the first tube relative to the second tube causes the proximal hub to move distally to direct the elongate members towards the expanded configuration.

3. The apparatus of claim 2, wherein the first and second tubes are telescopingly coupled by mating threads, and wherein the threads are disengaged when the first tube is rotated sufficiently to direct the elongate members to the expanded configuration, thereby limiting further distal movement of the proximal hub.

4. The apparatus of claim 3, wherein at least one of the first and second tubes comprises a stop to prevent further distal movement of the first tube relative to the second tube when the elongate members are directed to the expanded configuration, thereby preventing overexpansion of the elongate members.

5. The apparatus of claim 3, wherein the proximal hub and the first tube include mating features that couple rotation of the first tube to axial movement of the proximal hub.

6. The apparatus of claim 2, further comprising a release mechanism on at least one of the first tube and the proximal hub for disengaging the proximal hub from the first tube to allow rapid collapse of the elongate members from the expanded configuration.

7. The apparatus of claim 6, wherein the release mechanism comprises a retaining ring disposed around the first tube to prevent proximal movement of the proximal hub relative to the first tube unless a predetermined axial force is applied to at least one of the proximal hub and the first tube.

8. The apparatus of claim 1, wherein the distal hub is substantially radiolucent.

9. The apparatus of claim 1, further comprising a release mechanism on at least one of the core member and the proximal hub for disengaging the proximal hub to allow rapid collapse of the elongate members from the expanded configuration.

11. The apparatus of claim 1, further comprising a plurality of supports for supporting respective elongate members when the elongate members are directed to the expanded configuration.

12. The apparatus of claim 11, wherein the supports comprise first ends secured to the proximal hub and second ends disposed adjacent to distal ends of the elongate members.

13. The apparatus of claim 12, wherein the first ends of the supports are received within respective grooves within the proximal hub.

14. The apparatus of claim 12, wherein the first ends of the supports are secured to the proximal hub by a locking ring.

17. The apparatus of claim 1, wherein the core member comprises a pathway for receiving a source of radiation.

10. (canceled)

15-16. -16. (canceled)

18-20. -20. (canceled)

21. A brachytherapy treatment apparatus, comprising:

an elongate body comprising a proximal end and a distal end configured for introduction into a tract through tissue;

a plurality of elongate members on the distal end comprising pathways for receiving a source of radiation therealong, the elongate members being movable from a collapsed configuration for introduction through a tissue tract to a target location, and an expanded configuration; and

a plurality of marker devices removably receivable along the pathways of respective elongate members.

22. The apparatus of claim 21, wherein the marker devices comprise radiopaque material.

23. The apparatus of claim 21, wherein the pathways comprise lumens extending between proximal and distal ends of the elongate members, and wherein the marker devices are receivable within the lumens such that the marker devices extend through the lumens to the distal ends of the elongate members.

24. The apparatus of claim 23, wherein the marker devices end caps for engaging the proximal ends of the elongate members when the marker devices are received within the lumens to substantially seal the lumens.

25. (canceled)

26. A brachytherapy treatment apparatus, comprising:

an elongate core member comprising a proximal end and a distal end configured for introduction into a tract through tissue, the proximal and distal ends defining a longitudinal axis;

a distal hub coupled to the distal end of the core member;

a proximal hub on the proximal end of the core member and movable axially relative to the distal hub; and

a plurality of elongate members coupled to the proximal and distal hubs and extending between the proximal and distal ends of the core member, the elongate members movable from a collapsed configuration extending substantially parallel to the longitudinal axis for introduction through a tissue tract to a target location, and an expanded configuration when the proximal hub is directed distally relative to the distal hub, the elongate members comprising pathways for receiving a source of radiation therealong,

wherein the core member comprises features that limit distal movement of the proximal hub to prevent overexpansion of the elongate members in the expanded configuration.

27. A method for brachytherapy treatment of tissue within a body, comprising:

creating a tract through tissue to a target location adjacent to a cavity;

advancing an elongate body carrying a plurality of elongate members through the tract into the target location with the elongate members in a collapsed configuration;

directing the elongate members to an expanded configuration at the target location to position the elongate members away from a central axis; and

delivering radiation to the target location to treat tissue at the target location.

28. The method of claim 27, wherein directing the elongate members to the expanded configuration comprises rotating an expansion tool in a first direction, and wherein, upon directing the elongate members to the expanded configuration, further rotation of the expansion tool in the first direction no longer expands the elongate members.

29. The method of claim 27, further comprising inserting marker devices into the elongate members.

30. The method of claim 29, wherein the marker devices are inserted into the elongate members before delivering radiation, the method further comprising imaging the apparatus, the marker devices enhancing imaging of the elongate members relative to the target location.

31. The method of claim 30, further comprising developing a dose plan based at least on part on the enhanced imaging of the elongate members.

32-36. -36. (canceled)

37. A method for brachytherapy treatment of tissue within a body, comprising:

creating a tract through tissue to a target location adjacent to a cavity;

advancing an elongate body carrying a plurality of elongate members through the tract into the target location with the elongate members in a collapsed configuration;

directing the elongate members to an expanded configuration at the target location to position the elongate members away from a central axis;

inserting marker devices into the elongate members;

imaging the apparatus, the marker devices enhancing imaging of the elongate members in the expanded configuration relative to the target location;

developing a dose plan based at least on part on the enhanced imaging of the elongate members; and

delivering radiation to the target location to treat tissue at the target location according to the dose plan.