Use of A-mode echography for monitoring the position of a patient during ultrasound therapy

• US 5,720,286 A
• Filed: 05/26/1995
• Issued: 02/24/1998
• Est. Priority Date: 05/30/1994
• Status: Expired

• Current Assignee: Institut National De La Sante Et De La Recherche Medicale (Inserm) (Allianz Global Investors GmbH), Technomed Medical Systems
• Original Assignee: Institut National De La Sante Et De La Recherche Medicale (Inserm) (Allianz Global Investors GmbH), Technomed Medical Systems
• Inventors: Chapelon, Jean-Yves, Blanc, Emmanuel
• Primary Examiner(s): Lateef, Marvin M.
• Assistant Examiner(s): FIELDS, DERRICK LAMAR
• Application Number:
  US08/451,914
• Time in Patent Office: 1,005 Days
• Field of Search: 128/660.03, 128/660.02, 128/662.06, 128/660, 128/661.06, 601/4
• US Class Current: 600/439
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• 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 2090/3784 both receiver and transmitter being in the instrument or receiver being also transmitter
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/4272 involving the acoustic interface between the transducer and the tissue
• CPC Class Codes: A61N 7/022 intracavitary

Abstract

An A-mode ultrasound echography method is employed for monitoring the position of a patient during hyperthermia treatment. A therapy apparatus includes a therapy device having at least one ultrasound therapy transducer and at least one monitoring ultrasound transducer, where the ultrasound monitoring transducer is linked to an electronic circuit for processing A-mode signals and is part of an A-mode echography device. The therapy apparatus further includes a device for causing the ultrasound transducer operating in A-mode to transmit a brief signal and to receive the echo of the brief signal. A comparing device compares the echo received with a reference echo, and transmits the result of the comparison to a control device.

Claims

1. A method of monitoring a position of a patient during a therapy session, the method comprising the steps of:

providing an A-mode echography device having an A-mode echography transducer;

activating the A-mode echography transducer to determine a distance between the A-mode transducer and a target structure of the patient to be monitored, the target structure having a predetermined relationship to an organ of the patient to be treated;

providing a therapy transducer, the therapy transducer operatively coupled to the A-mode echography transducer; and

determining whether the therapy transducer is within a predetermined distance relative to the organ of the patient by monitoring the distance between the A-mode transducer and the target structure.

2. The method according to claim 1, wherein the distance between the therapy transducer and the organ of the patient is modified as a function of movements detected between the A-mode echography transducer and the organ of the patient.

3. The method according to claim 1, wherein said A-mode echography device interrupts operation of the therapy transducer if it is detected that movements of the patient relative to the A-mode echography transducer are greater than a predefined amount.

4. The method according to claim 1, wherein said A-mode echography device carries out real time control of the position of the therapy transducer, with respect to a predetermined reflecting contour.

5. A method for monitoring and treating an organ of a patient during a therapy session, the treatment of the organ provided by a therapy device having a therapy transducer, the method comprising the steps of:

a) providing an ultrasound monitoring transducer operating in A-mode, the monitoring transducer acoustically coupled to a target structure, the target structure having a predetermined relationship to the organ to be monitored;

b) exciting the ultrasound monitoring transducer with a signal in the form of a pulse, the pulse applied during a time interval between the application of therapy by the therapy transducer;

c) receiving echoes of the signal produced by the monitoring transducer;

d) transforming the received echoes into an electrical signal;

e) locating, in the electrical signal corresponding to the received echoes, the position of the target structure to determine a measured distance from the monitoring transducer to the target structure, the target structure defining a highly echogenic interface relative to the organ to be monitored and treated;

f) comparing the distance measured between the monitoring transducer and the target structure with a reference distance, the reference distance corresponding to the distance between the highly echogenic interface in contact with a wall of a balloon means corresponding to the ultrasound therapy transducer; and

g) transmitting a control signal to a control device operative to selectively control the position of the therapy transducer in response to the change in distance between the monitoring transducer and the target structure relative to the reference distance.

6. The method according to claim 5, wherein the control device triggers an alarm when information is transmitted to the control device indicating that a change in the measured distance is greater than a predetermined amount.

7. The method according to claim 5, wherein said control device performs real time closed-loop control of the position of said therapy device as a function of the movements of said patient with respect to a reflecting contour of said patient, said reflecting contours having a known relationship to the organ of the patient.

8. The method according to claim 5 wherein said ultrasound monitoring transducer operating in A-mode is mechanically linked to said therapy transducer.

9. The method according to claim 5 wherein said therapy device comprises at least one ultrasound therapy transducer providing therapy using focused ultrasound.

10. The method according to claim 5 wherein said ultrasound therapy transducer is arranged inside balloon means filled with an acoustic coupling fluid.

11. The method according to claim 5 wherein if said measured distance is smaller than said reference distance, the control device controls said therapy transducer to increase a distance between the therapy transducer and the target structure to be treated while if said measured distance is greater than said reference distance, the control device controls said therapy transducer to decrease a distance between the therapy transducer and the target structure to be treated.

12. The method according to claim 5 wherein said ultrasound therapy transducer is a focused ultrasound therapy transducer integrated into an endocavital probe for providing treatment of the prostate or the thyroid.

13. The method for monitoring and treating an organ of a patient during a therapy session, the treatment of the organ provided by a therapy device having a therapy transducer, the method comprising the steps of:

a) providing an ultrasound monitoring transducer operating in A-mode, the monitoring transducer acoustically coupled to a target structure, the target structure having a predetermined relationship to the organ to be monitored;

b) exciting the ultrasound monitoring transducer with a signal in the form of a pulse, the pulse applied during a time interval between application of therapy by the therapy transducer;

c) receiving echos of the signal produced by the monitoring transducer;

d) transforming the receive echoes into an electrical signal;

e) locating, in the electrical signal corresponding to the receive echoes, the position of the target structure to determine a measured distance from the monitoring transducer to the target structure, the target structure defining a highly echogenic interface relative to the organ to be monitored;

f) comparing the distance measured between the monitoring transducer and the target structure, with a reference distance; and

g) transmitting a control signal to a control device operative to selectively control the position of the therapy transducer in response to change in distance between the monitoring transducer and the target structure relative to the reference distance.

14. The method according to claim 13 wherein the control device triggers an alarm when information is transmitted to the control device indicating a change in the measured distance cannot be determined.

15. The method according to claim 13 wherein the control device triggers an alarm when information is transmitted to the control device indicating a change in the measured distance is greater than a predetermined amount.

16. The method according to claim 13 wherein the monitoring transducer received the echos reflected from the target structure, the target structure being at least one of a rectal wall during prostate treatment and a trachea during thyroid treatment.

17. The method according to claim 16 wherein the target structure is a reflecting contour having a predetermined relationship relative to the organ of the patient to be treated.

18. The method according to claim 13 wherein said ultrasound monitoring transducer operating in A-mode is mechanically linked to said therapy transducer.

19. The method according to claim 13 wherein said therapy device comprises at least one ultrasound therapy transducer providing therapy using focused ultrasound.

20. The method according to claim 13 wherein said ultrasound therapy transducer is arranged inside balloon means filled with an acoustic coupling fluid.

21. The method according to claim 13 wherein if the measured distance between the monitoring transducer and the target structure is smaller than the reference distance, the control device increases a distance between the therapy transducer and the organ to be treated, while if the measured distance between the monitoring transducer and the target structure is greater than the referenced distance, the control device controls decreases the distance between the therapy transducer and the organ to be treated.

22. The method according to claim 13 wherein the ultrasound therapy transducer is a focused ultrasound therapy transducer integrated into an endocavital probe for providing treatment of the prostate or the thyroid.

23. A therapy apparatus for treating an organ of a patient, the apparatus comprising:

at least one ultrasound therapy transducer and at least one ultrasound monitoring transducer, the monitoring transducer operating in A-mode;

the ultrasound monitoring transducer operatively coupled to an electronic circuit for processing A-mode signals produced by the ultrasound monitoring transducer;

means for coupling the ultrasound monitoring transducer to transmit a pulse signal, the pulse signal causing an echo to be received by the ultrasound monitoring transducer, the echo caused by a reflection of the pulse signal from a target structure, the target structure defining an echogenic interface having a predetermined relationship relative to the organ to be monitored;

means for comparing the echo received with a reference echo and transmitting the result of the comparison to a control device; and

the control device coupled to the means for comparing and coupled to the ultrasound therapy transducer, the control device receiving the result of the comparison and controlling the ultrasound therapy transducer in response thereto.

24. The apparatus according to claim 23, wherein said control device triggers an alarm in response to the result of the comparison.

25. The apparatus according to claim 23, wherein said control device performs real time closed-loop control of the position of said therapy transducer as a function of the movements of the patient, the control device controlling the position of the therapy transducer in real time with respect to a predetermined reflecting contour of said patient, said reflecting contour having a known relationship to the organ of the patient to be treated.

26. The apparatus according to claim 23 wherein said ultrasound therapy transducer is of the focused type.

27. The apparatus according to claim 26, wherein said focused-type therapy transducer is linked to means for supplying an electronic signal providing variable focusing.

28. The apparatus according to claim 27, wherein said control device provides closed-loop control of the focal length of said therapy transducer as a function of the movements of said patient, during the course of therapy.

29. The apparatus according to claim 23, wherein both said ultrasound therapy transducer and said A-mode monitoring transducer are integrated into an endocavital probe.

30. The apparatus according to claim 23, wherein said therapy apparatus includes means for continuously recording the echoes created by said monitoring transducer operating in A-mode.

31. The apparatus according to claims 23, wherein said ultrasound monitoring transducer is mechanically linked to said therapy device.

32. The apparatus according to claim 23, wherein said therapy device comprises at least one ultrasound therapy transducer providing therapy using focused ultrasound, said ultrasound therapy transducer enclosed within a balloon means filled with an acoustic coupling fluid.

33. The apparatus according to claim 23, wherein said apparatus is operative to treat the prostate or the thyroid.

34. A method for monitoring and treating an organ of a patient during a therapy session, the treatment of the organ provided by a therapy device having a therapy transducer, the method comprising the steps of:

a) providing an ultrasound monitoring transducer operating in A-mode, the monitoring transducer acoustically coupled to a target structure, the target structure having a predetermined relationship to the organ to be monitored;

b) exciting the ultrasound monitoring transducer with a signal in the form of a pulse, the pulse applied during a time interval between the application of therapy by the therapy transducer;

c) receiving echoes of the signal produced by the monitoring transducer;

d) transforming the received echoes into an electrical signal;

e) locating, in the electrical signal corresponding to the received echoes, the position of the target structure to determine a measured distance from the monitoring transducer to the target structure, the target structure defining a highly echogenic interface relative to the organ to be monitored and treated; and

f) comparing the distance measured between the monitoring transducer and the target structure with a reference distance, the reference distance corresponding to the distance between the highly echogenic interface in contact with a wall of a balloon means corresponding to the ultrasound therapy transducer.