Apparatus and method of use for a photosensitizer enhanced fluorescence based biopsy needle

• US 5,318,023 A
• Filed: 04/03/1991
• Issued: 06/07/1994
• Est. Priority Date: 04/03/1991
• Status: Expired due to Term

• Current Assignee: Cedars-Sinai Medical Center (Cedars Sinai Health System)
• Original Assignee: Cedars-Sinai Medical Center (Cedars Sinai Health System)
• Inventors: Vari, Sandor G., Papazoglou, Theodore, Grundfest, Warren S.
• Primary Examiner(s): Green, Randall L.
• Assistant Examiner(s): ZUTTARELLI, ANTHONY
• Application Number:
  US07/679,766
• Time in Patent Office: 1,161 Days
• Field of Search: 606/2, 606/13-15, 128/633, 128/634, 128/664, 128/665
• US Class Current: 600/317
• CPC Class Codes: A61B 10/0233 Pointed or sharp biopsy instruments
• CPC Class Codes: A61B 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 2017/22087 photodynamic
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 5/0059 using light, e.g. diagnosis by transillumination, diascopy, fluorescence A61B5/0093, A61B5/1455, A61B5/02416 and A61B5/0261 take precedence
• CPC Class Codes: A61B 5/415 the glands, e.g. tonsils, adenoids or thymus
• CPC Class Codes: A61B 5/418 lymph vessels, ducts or nodes

Abstract

A method and apparatus is disclosed for the instant intraoperative detection and biopsy of metastatic cancer using fluorescence spectroscopy. A photosensitizing agent selectively retained by cancerous tissue is administered prior to surgery. A fiberoptic probe integrated with a biopsy device illuminates the examined tissue and causes fluorescence which is recorded by a spectrograph and plotted as a spectral curve. The intensity ratio (S1/S2) for the fluorescence from the photosensitizing agent (S1) and autofluorescence (S2) for the examined tissue is compared with the intensity ratio at the same wavelengths for primary tumor and normal tissue. Tissue that displays an intensity ratio different from that of normal tissue can immediately be analyzed for the depth of tumor involvement and then excised for histological examination using the biopsy device.

Claims

1. A method for the detection and biopsy of metastatic cancer comprising:

a. administering intravenously an effective amount of a photosensitizing agent selectively retained by cancerous tissue and capable of light=induced fluorescence,

b. exciting a tissue to be examined with a beam of light from a light source,

c. examining the tissue of step (b) by contacting it with the beam of light from the light source of step (b) to induce fluorescence,

d. observing the fluorescence emitted from the examined tissue of step (c) and a tissue whose condition is known to be without cancer, each observation made at two difference wavelengths in order to calculate a first fluorescence intensity ratio for the examined tissue and a second fluorescence intensity ratio for the tissue whose condition is known to be without cancer,

e. determining if the tissue is cancerous by observing whether the first fluorescence intensity ratio is different than the second fluorescence intensity ratio,

f. excising for histological examination the cancerous tissue using a hollow biopsy needle integrated with the light source.

2. A method for the detection and biopsy of metastatic cancer comprising:

a. administering intravenously an effective amount of a photosensitizing agent selectively retained by cancerous tissue and capable of light-induced fluorescence,

b. exciting a tissue to be examined with a beam of light from a light source,

c. examining the tissue of step (b) by contacting it with the beam of light from the light source of step (b) to induce fluorescence,

d. observing the fluorescence emitted from the examined tissue of step (c) and a tissue whose condition is known to be without cancer, each observation made at two different wavelengths in order to calculate a first fluorescence intensity ratio for the examined tissue and a second fluorescence intensity ratio for the tissue whose condition is known to be without cancer,

e. determining if the tissue is cancerous by observing whether the first fluorescence intensity ratio is different than the second fluorescence intensity ratio,

f. determining the depth of cancer involvement in the cancerous tissue using a biopsy blade integrated with the light source, and

g. excising for histological examination the cancerous tissue using a hollow biopsy needle.

9. The method of claim 2 wherein the cancerous tissue is diagnosed and excised with an apparatus comprising:

a. a light source capable of inducing fluorescence of photosensitizing agents which agents are selectively retained by cancerous tissue following injection, and

b. a hollow biopsy needle to remove suspected cancerous tissue, the biopsy needle having thereon the light source.

10. The method of claim 2 wherein the cancerous tissue is diagnosed and excised with an apparatus comprising:

a. a light source capable of emitting substantially monochromatic light or incoherent light filtered to a specific wavelength to induce fluorescence of photosensitizing agents, which agents are selectively retained by cancerous tissue following injection, and

b. a hollow biopsy needle to remove suspected cancerous tissue, the biopsy needle having thereon the light source.

11. The method of claim 10 and wherein the light source comprises multiple or single fiber arrays with a core diameter from about 400 microns.

12. The method claim 10 and wherein the needle is calibrated to measure the depth of cancer involvement in the cancerous tissue.

3. A method for the detection and biopsy of metastatic cancer comprising:

a. administering intravenously an effective amount of a photosensitizing agent selectively retained by cancerous tissue and capable of light-induced fluorescence,

b. exciting a tissue to be examined with a beam of light that is at least substantially monochromatic or incoherent light filtered to a specific wavelength,

c. examining the tissue of step (b) by contacting it with the beam of light from the light source of step (b) to induce fluorescence,

d. observing the fluorescence emitted from the examined tissue of step (c) and a tissue whose condition is known to be without cancer, each observation made at two different wavelengths in order to calculate a first fluorescence intensity ratio for the examined tissue and a second fluorescence intensity ratio for the tissue whose condition is known to be without cancer.

e. determining if the tissue is cancerous by observing whether the first fluorescence intensity ratio is different than the second fluorescence intensity ratio,

f. excising for histological examination the cancerous tissue using a hollow biopsy needle integrated with the light source.

4. A method for the detection and biopsy of metastatic cancer comprising:

a. adminsistering intravenously an effective amount of a photosensitizing agent selectively retained by cancerous tissue and capable of light-induced fluorescence,

b. exciting a tissue to be examined with a beam of light that is at least substantially monochromatic or incoherent light filtered to a specific wavelength,

c. examining the tissue of step (b) by contacting it with the beam of light from the light source of step (b) to induce fluorescence,

d. observing the fluorescence emitted from the examined tissue of step (c) and a tissue whose condition is known to be without cancer, each observation made at two different wavelengths in order to calculate a first fluorescence intensity ratio for the examined tissue and a second fluorescence intensity ratio for the tissue whose condition is known to be without cancer.

e. determining if the tissue is cancerous by observing whether the first fluorescence intensity ratio is different than the second fluorescence intensity ratio,

f. determining the depth of cancer involvement in the cancerous tissue using a hollow biopsy needle integrated with the light source, and

g. excising for histological examination the cancerous tissue using the biopsy needle.

5. The method of claim 4 and wherein determining if cancerous tissue is present includes producing a signal corresponding to the ratio between the intensities at two different wavelengths and then displaying the signal.

6. A method for the detection and biopsy of metastatic cancer comprising:

a. administering intravenously an effective amount of a photosensitizing agent selectively retained by cancerous tissue and capable of light-induced fluorescence,

b. exciting a tissue to be examined with a beam of monochromatic light or incoherent light filtered to a specific wavelength from a light source,

c. examining the tissue of step (b) by contacting it with the beam of light from the light source of step (b) to induce fluorescence,

d. generating a fluorescence spectrum of light emitted by the examined tissue,

e. determining the ratio of intensities at two different wavelengths for the examined tissue and then comparing the ratio of intensities at the same wavelengths for primary tumor and normal tissue,

f. determining that the tissue is cancerous if the intensity ratio for examined tissue is different than the ratio of intensity at the same wavelengths for normal tissue,

g. determining the depth of cancer involvement in the cancerous tissue using a hollow biopsy needle integrated with the light source, and

h. excising for histological examination tissue that displays a fluorescence pattern different from that of normal tissue using the biopsy needle.

7. The method of claim 6 and wherein the two different wavelengths from which fluorescence is observed are 630 nm and 540 nm.

8. The method of claim 6 and wherein determining the depth of cancer involvement of the affected tissue comprises using a calibrated biopsy needle.