Image-guided thermotherapy based on selective tissue thermal treatment

• US 8,467,858 B2
• Filed: 04/29/2010
• Issued: 06/18/2013
• Est. Priority Date: 04/29/2009
• Status: Active Grant

• Current Assignee: Tomophase Corporation
• Original Assignee: Tomophase Corporation
• Inventors: Vertikov, Andrei, Norris, Peter E.
• Primary Examiner(s): Chen, Tse
• Assistant Examiner(s): Brutus, Joel F
• Application Number:
  US12/770,713
• Publication Number:
  US 20110029049A1
• Time in Patent Office: 1,146 Days
• Field of Search: 600/478, 600/473, 600/476, 600439-439, 600/427, 356/450, 356/456, 607/101, 607/102, 607/156, 607/93, 607/113
• US Class Current: 600/478
• CPC Class Codes: A61B 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/1861 with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/14558 by polarisation
• CPC Class Codes: A61B 90/30 Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61N 5/00 Radiation therapy ultrasound therapy A61N7/00; devices or apparatus applicable to both therapy and diagnosis A61B6/00

Abstract

Devices and techniques for thermotherapy based on optical imaging.

Claims

1. A device for thermotherapy, comprising:

a catheter including a working channel configured for insertion into a passage of a body to reach a target tissue inside the body;

an optical imaging module comprising

(1) an imaging optic fiber having a portion inserted into the working channel, wherein the imaging optic fiber is structured to support light in a first propagation mode and a second, different propagation mode,

(2) an optical probe head coupled to an end of the imaging optic fiber and located inside the working channel,

(3) a light source to produce probe light, wherein the imaging optic fiber receives and guides the probe light in the first propagation mode, wherein the optical probe head is coupled to the imaging optic fiber to receive the light from the imaging optic fiber and to reflect a first portion of the light back to the imaging optic fiber in the first propagation mode and direct a second portion of the light to a target location of the target tissue, the probe head collecting reflection of the second portion from the target location and exporting to the imaging optic fiber the reflection as a reflected second portion in the second propagation mode,

(4) an optical differential delay unit to produce and control a relative delay between the reflected first portion and the reflected second portion received from the imaging optic fiber in response to a control signal,

(5) a detection module to receive the reflected first portion and the reflected second portion from the imaging optic fiber and to extract information of the target tissue carried by the reflected second portion, and

6) an imaging control unit, which produces the control signal to the optical differential delay unit, to set the relative delay at two different bias values to select a layer of material inside the target tissue to measure an optical absorption of the selected layer;

a thermotherapy module having a power delivery waveguide having a portion inserted into the working channel to deliver thermal energy to the target tissue;

a control unit that controls the optical imaging module to extract the imaging information from the collected reflected light, to obtain a spatial distribution of diseased locations of the target tissue, and to obtain a temperature map of the target tissue for thermotherapy based on the spatial distribution of the diseased locations of the target tissue, the control unit controlling the thermotherapy module to control a location and an amount of thermal energy delivery to each of the diseased locations based on the temperature map to perform thermotherapy.

2. The device as in claim 1, comprising:

a liquid cooling unit coupled to the catheter to direct a cooling liquid that cools a surface of the target tissue.

3. The device as in claim 1, wherein the detection module comprises:

an optical device to direct light in the first propagation mode along a first optical path and light in the second propagation mode along a second, different optical path;

a first optical element in the first optical path to separate light into a first set of different beams at different wavelengths;

a plurality of first light detectors to respectively receive and detect the first set of different beams from the first optical element;

a second optical element in the second optical path to separate light into a second set of different beams at the different wavelengths; and

a plurality of second light detectors to respectively receive and detect the second set of different beams from the second optical element.

4. The device as in claim 3, wherein the first and second optical elements are optical gratings.

5. The device as in claim 1, wherein the detection module comprises a digital signal processor to process information of the target area in the reflected second portion and to generate spectral absorbance data of the target area.

6. The device as in claim 1, wherein the optical differential delay unit comprises:

a mode splitting unit to separate received light into a first beam in the first propagation mode and a second beam in the second propagation mode; and

a variable optical delay element in one of the first and the second beams to adjust an optical delay between the first and the second beams in response to the control signal.

7. The device as in claim 1, wherein the first and second propagation modes are two orthogonal polarization modes supported by the probe optic fiber, and wherein the detection module comprises:

an optical detector; and

an optical polarizer to receive and mix the reflected first and second portions to produce an optical output to the optical detector.

8. The device as in claim 1, wherein the optical imaging module further comprises:

a plurality of light sources emitting light at different wavelength bands centered at different wavelengths as the probe light into the probe optic fiber, wherein the optical probe head reflects a first portion of the probe light back to the imaging optic fiber in the first propagation mode and directs a second portion of the probe light to the target area, and wherein the probe head collects reflection of the second portion from the target area and exports to the imaging optic fiber the reflection as a reflected second portion in a second propagation mode different from the first propagation mode;

an optical differential delay unit to produce and control a relative delay between the reflected first portion and the reflected second portion received from the single waveguide in response to a control signal;

a detection module to receive the reflected first portion and the reflected second portion and to extract information of the target area carried by the reflected second portion; and

a probe control unit, which produces the control signal to the optical differential delay unit, to set the relative delay at two different bias values to select a layer of material inside the target area to measure an optical absorption of the selected layer at each and every wavelength from the different light sources.

9. The device as in claim 1, wherein the optical imaging module further comprises:

a plurality of tunable laser sources emitting light within different wavelength bands centered at different wavelengths as the probe light to the probe optic fiber, wherein the imaging optic fiber is configured to receive and guide the probe light at the different wavelength bands in a first propagation mode,

wherein the probe head is to reflect a first portion of the probe light back to the imaging optic fiber in the first propagation mode and direct a second portion of the light to the target area, and wherein the probe head collects reflection of the second portion from the target area and exports to the imaging optic fiber the reflection as a reflected second portion in a second propagation mode different from the first propagation mode;

a detection module to receive the reflected first portion and the reflected second portion in the waveguide and to extract information of the target area carried by the reflected second portion; and

a probe control unit to tune each tunable laser in a corresponding laser emitting wavelength band to obtain absorption measurements of the target area at different wavelengths within each corresponding wavelength band.

10. The device as in claim 1, comprising:

a liquid cooling unit coupled to the catheter to direct a cooling liquid that cools a surface of the target tissue, the liquid cooling unit including a balloon that receives the cooling liquid and is located in contact with the surface of the target tissue.

11. The device as in claim 10, wherein the balloon comprises two or more balloons.

12. The device as in claim 10, wherein the cooling liquid comprises a liquid that is transparent to light.

13. The device as in claim 1, further comprising a sheath structured to unify the probe head and the imaging optical fiber.

14. The device as in claim 1, wherein the thermotherapy module comprises at least one of:

a laser thermotherapy module, a radiofrequency thermotherapy module, or a microwave thermotherapy module.

15. The device as in claim 1, wherein a single catheter comprises the optical imaging module and the thermotherapy module.

16. The device as in claim 1, wherein a first catheter comprises the optical imaging module and a second, separate catheter comprises the thermotherapy module.

17. The device as in claim 16, wherein the catheter comprises a narrow tip structured to allow one of the first or the second catheters to extend into the narrow tip while the other of the first or the second catheter is retracted within the catheter.

18. The device of claim 1, wherein a common fiber is structured to direct both the probe light and thermal energy.

19. The device of claim 18, wherein the common fiber comprises a single core.

20. The device of claim 18, wherein the common fiber comprises two collinear fiber cores wherein each core is structured to direct one of the probe light or the thermal energy.

21. The device of claim of claim 18, wherein the common fiber is structured to support one or more modes.

22. The device of claim 1, wherein the thermotherapy module is structured to minimize a response to asthmatic stimulus.

23. The device of claim 1, wherein the target tissue comprises airway smooth muscle.

24. The device of claim 1, wherein the target tissue comprises 10-15% of an airway wall.

25. The device of claim 1, wherein the control unit is structured to control the thermotherapy module to deliver an amount of thermal energy below a threshold for thermotherapy to obtain a pre-treatment temperature map.

26. The device of claim 25, wherein the control unit is structured to control the thermotherapy module to deliver an amount of thermal energy above the threshold for thermotherapy such that the temperature map coincides with the pre-treatment temperature map.

27. The device of claim 26, further comprising a contrast agent structured to preferentially absorb optical energy in the target tissue.

28. A method for thermotherapy, comprising:

directing an imaging optical beam to a target tissue, wherein the optical beam is directed to the target tissue in a first propagation mode;

directing a first portion of the optical beam in the first propagation mode at a location near the target tissue away from the target tissue before the first portion reaches the target tissue while allowing a second portion in the first propagation mode to reach the target tissue;

controlling a reflection of the second portion from the target tissue to be in second propagation mode different from the first propagation mode to produce a reflected second portion;

directing both the first portion in the first propagation mode and the reflected second portion in the second propagation mode through a common waveguide into a detection module to obtain information from the reflected second portion on the target tissue;

producing and controlling a relative delay between the first portion and the reflected second portion in response to a control signal to set the relative delay at two different bias values to select a layer of material inside the target tissue to measure an optical absorption of the selected layer;

processing the obtained image information of the target tissue to obtain a spatial distribution of the diseased locations of the target tissue;

generating a temperature map of the target tissue for thermotherapy based on the spatial distribution of the diseased locations of the target tissue; and

controlling the thermal energy delivery to each of the diseased locations and cooling at the surface of each diseased locations based on the temperature map to perform the thermotherapy.