Systems and methods for locating and defining a target location within a human body

• US 8,452,375 B2
• Filed: 12/23/2003
• Issued: 05/28/2013
• Est. Priority Date: 05/14/1998
• Status: Expired due to Fees

• Current Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Original Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Inventors: Meier, Eric, Dimmer, Steve, Durbin, Duane, Moody, Trevor, Silverstein, Fred, Harry, Rosemary, Frecksa, Richard, Kinsella, Amy, Gilbert, Jon, Krag, David
• Primary Examiner(s): ROZANSKI, MICHAEL T
• Application Number:
  US10/745,104
• Publication Number:
  US 20040138555A1
• Time in Patent Office: 3,444 Days
• Field of Search: 600/421, 600/422, 600/426, 600/302, 128/899, 378/65, 324/260
• US Class Current: 600/424
• CPC Class Codes: A61B 17/3201 Scissors for biopsy A61B10/02
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 17/3211 Surgical scalpels, knives; Accessories therefor
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/3413 guided by ultrasound
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2090/3908 Soft tissue, e.g. breast tissue
• CPC Class Codes: A61B 2090/392 Radioactive markers
• CPC Class Codes: A61B 2090/3925 ultrasonic
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3933 Liquid markers
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/3941 Photoluminescent markers
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2090/3958 : emitting a signal
• CPC Class Codes: A61B 2090/3975 : active
• CPC Class Codes: A61B 2090/3983 : Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 2090/3995 : Multi-modality markers
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/25 : User interfaces for surgical systems
• CPC Class Codes: A61B 34/74 : Manipulators with manual electric input means
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61B 90/90 : Identification means for patients or instruments, e.g. tags
• CPC Class Codes: A61B 90/92 : coded with colour
• CPC Class Codes: A61B 90/98 : using electromagnetic means, e.g. transponders

Abstract

Systems and methods for locating and defining a target location within a human body. The system can include at least one marker, a probe, and a detector for use in locating the markers by providing information to a surgeon that is representative of changes in proximity between the probe and the marker. The marker can have various detection characteristics, e.g., gamma radiation, that are detectable by an associated probe and detector. The tissue volume is removed by manipulating a cutting tool based on the proximity information provided by the detector, which can be used by the surgeon to define the boundary of the tissue volume. The systems and methods of the invention are particularly useful in locating and then removing a tissue volume or other target location from amorphous, pliable tissue (e.g., breast tissue) or other body parts.

Claims

1. A wireless marker for use in localizing a target of a patient, comprising:

a magnetic signal element including a core and a coil around the core, wherein the signal element produces a wireless resonating signal at a predetermined resonant frequency in response to a wireless excitation energy wherein the resonating signal response is used to localize the signal element;

a biocompatible casing housing the signal element and being configured to be implanted in the patient relative to the target, wherein the casing includes a cylindrical section with a diameter of 1-2 mm; and

an external fastener configured to hold the marker at a reference location relative to the target.

2. The marker of claim 1 wherein the signal element further comprises a capacitor electrically coupled to the coil.

3. The marker of claim 1 wherein the fastener comprises a protrusion integral with the casing.

4. The marker of claim 1 wherein the fastener comprises a biasing member that expands from a stored position to a deployed position.

5. The marker of claim 1 wherein the fastener comprises a biasing member that contracts from a stored position to a deployed position.

6. The marker of claim 1 wherein the fastener comprises a spring that forms a loop configured to grasp tissue in a deployed position.

7. The marker of claim 1, further comprising an identifier on and/or in the casing that can be observed by an imaging system to distinguish the casing from other items in the patient.

8. The marker of claim 7 wherein the identifier comprises metal bands.

9. A wireless marker for use in localizing a target of a patient, comprising:

a signal element including a core and a coil configured to produce a wireless resonating signal at a predetermined resonant frequency in response to a wireless excitation energy wherein the resonating signal response is used to localize the signal element; and

a biocompatible casing housing the signal element and being configured to be implanted in the patient relative to the target, the casing providing a fastener to hold the marker at a reference location relative to the target, wherein the casing includes a cylindrical section with a diameter of 1-2 mm.

10. The wireless marker of claim 9 wherein the signal element comprises a magnetic resonator.

11. The wireless marker of claim 10 wherein the magnetic resonator comprises a core, a coil around the core, and a capacitor electrically coupled to the coil.

12. The marker of claim 9 wherein the fastener comprises a protrusion integral with the casing.

13. The marker of claim 9 wherein the fastener comprises a biasing member that expands from a stored position to a deployed position.

14. The marker of claim 9 wherein the fastener comprises a biasing member that contracts from a stored position to a deployed position.

15. The marker of claim 9 wherein the fastener comprises a spring that forms a loop configured to grasp tissue in a deployed position.

16. The marker of claim 9, further comprising an identifier on and/or in the casing that can be observed by an imaging system to distinguish the casing from other items in the patient.

17. The marker of claim 16 wherein the identifier comprises metal bands.

18. A plurality of wireless markers for use in localizing a target of a patient, each of the plurality of wireless markers comprising:

a magnetic signal element including a core and a coil around the core, wherein the signal element produces a wireless resonating signal in response to a wireless excitation energy wherein the resonating signal response is used to localize the signal element, and wherein a first marker of the plurality of wireless markers produces a wireless resonating signal at a first predetermined frequency and a second marker of the plurality of wireless markers produces a wireless resonating signal at a second predetermined frequency, wherein the first frequency is different from the second frequency; and

a biocompatible casing housing the signal element and being configured to be implanted in the patient relative to the target the casing providing a fastener to hold the marker at a reference location relative to the target, wherein the casing includes a cylindrical section with a diameter of 1-2 mm.

19. A wireless marker for use in localizing a target of a patient, comprising:

a magnetic signal element including a core and a coil around the core, wherein the signal element produces a wireless resonating signal in response to a wireless excitation energy wherein the resonating signal response is a known resonant frequency and used to localize the signal element; and

a biocompatible casing housing the signal element and being configured to be implanted in the patient relative to the target the casing including a fastener—

configured to hold the marker at a reference location relative to the target, wherein the casing includes a cylindrical section with a diameter of 1-2 mm.