DEVICES AND METHODS FOR MINIMALLY INVASIVE REDUCTION OF PARATHYROID ADENOMAS

• US 20140236145A1
• Filed: 02/11/2014
• Published: 08/21/2014
• Est. Priority Date: 02/19/2013
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Robertson, David W.
• Granted Patent: US 9,592,018 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 2017/00079 Radioactivity
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 6/4057 by using radiation sources located in the interior of the body A61B6/037 takes precedence
• CPC Class Codes: A61B 6/425 using detectors specially adapted to be used in the interior of the body
• CPC Class Codes: A61B 6/4258 for detecting non x-ray radiation, e.g. gamma radiation A61B6/037 takes precedence

Abstract

Apparatus and methods for performing glandular reduction are described. In an example embodiment, an apparatus includes a needle-like probe containing a scintillation detector for converting gamma and x-rays emitted from a radio-labeled gland into photons that are then carried from the probe through a fiberoptic cable to a photodetector, and a therapy element for causing selective tissue destruction by directing energy toward the radio-labeled gland.

Claims

1. A method of glandular reduction in a patient, comprising:

radio-labeling a gland as a target tissue;

inserting a probe into the patient toward the target tissue;

measuring radiation emitted by the target tissue using a scintillation detector within the probe;

positioning the probe in proximity to the target tissue based upon the measured radiation;

guiding the probe to the target tissue by rotating and longitudinally translating a radiation shield surrounding the scintillation detector within the probe, wherein the radiation shield has an aperture for allowing radiation to reach the scintillation detector; and

,

delivering energy from a therapy element of the probe to the target tissue.

2. The method of claim 1 further comprising conveying photons from the scintillation detector to a photodetector via a fiber optic cable

3. The method of claim 1 further comprising delivering energy from the therapy element in a manner to cause necrosis of the target tissue.

4. The method of claim 1 further comprising:

(a) rotating the aperture until the radiation measured is at a maximum;

(b) adjusting an insertion angle of the probe toward the direction that the aperture faces; and

,

(c) rotating the aperture while the radiation is measured and repeating steps (a) and (b) until no change in the measured radiation is detected.

5. The method of claim 4 further comprising, after the insertion angle of the probe is adjusted so that the probe points toward the target tissue:

(a) increasing the insertion depth of the aperture by moving the aperture longitudinally within the probe toward the target tissue;

(b) measuring radiation from the target tissue and, if an increase in measured radiation is detected after increasing the insertion depth of the aperture, increasing the insertion depth of the probe; and

,

(c) repeating steps (a) and (b) until no increase in measured radiation is detected at step (b) and then initiating delivery of energy from the probe.

6. The method of claim 5 wherein the positioning of the probe is performed by a robotic manipulator.

7. The method of claim 5 wherein the rotation and translation of the radiation shield is performed by a robotic manipulator.

8. The method of claim 1 wherein the target tissue is a parathyroid adenoma.

9. The method of claim 1 wherein the therapy element is a voltage source for delivering radio-frequency electrical energy.

10. The method of claim 1 wherein the therapy element is a voltage source for delivering direct current electrical energy.

11. The method of claim 1 wherein the therapy element is an ultrasonic transducer.

12. An apparatus, comprising:

a probe for inserting into a body tissue containing a radio-labeled target tissue;

a scintillation detector within the probe;

a therapy element incorporated into the probe for delivering energy to the target tissue;

a control unit that includes a therapy element actuator and processing circuitry connected to a photodetector;

wherein the processing circuitry is configured to measure the radiation emitted by the target tissue from signals generated by the photodetector; and

wherein the therapy element actuator is operable to cause delivery of energy by the therapy element to the target tissue.

13. The apparatus of claim 12 further comprising a radiation shield surrounding the scintillation detector within the probe, wherein the radiation shield has an aperture for allowing radiation to reach the scintillation detector and wherein the radiation shield may be rotated and longitudinally translated along the axis of the probe to aid in positioning the probe in proximity to the target tissue.

14. The apparatus of claim 13 further comprising a robotic manipulator operated by the processing circuitry, wherein the processing circuitry is programmed to:

(a) rotate the aperture until the radiation measured is at a maximum;

(b) adjust an insertion angle of the probe toward the direction that the aperture faces; and

,

(c) rotate the aperture while the radiation is measured and repeat steps (a) and (b) until no change in the measured radiation is detected.

15. The apparatus of claim 14 wherein, when the insertion angle of the probe is adjusted so that the probe points toward the target tissue, the processing circuitry is programmed to:

(a) increase the insertion depth of the aperture by moving the aperture longitudinally within the probe toward the target tissue;

(b) measure radiation from the target tissue and, if an increase in measured radiation is detected after increasing the insertion depth of the aperture, increase the insertion depth of the probe; and

,

(c) repeat steps (a) and (b) until no increase in measured radiation is detected at step (b) and then initiate delivery of energy from the probe.

16. The apparatus of claim 12 wherein the therapy element is a voltage source for delivering radio-frequency electrical energy.

17. The apparatus of claim 12 wherein the therapy element is a voltage source for delivering direct current electrical energy.

18. The apparatus of claim 12 wherein the therapy element is an ultrasonic transducer.

19. The apparatus of claim 12 further comprising a user interface connected to the processing circuitry for providing information to an operator relating to radiation measurement.

20. The apparatus of claim 12 further comprising a user interface connected to the processing circuitry for controlling the therapy element actuator.