System and method of guided treatment within malignant prostate tissue

• US 8,548,562 B2
• Filed: 03/16/2007
• Issued: 10/01/2013
• Est. Priority Date: 04/04/2006
• Status: Active Grant

• Current Assignee: Brian Campbell Wilson, John Trachtenberg, Masoom A. Haider
• Original Assignee: Brian Campbell Wilson, John Trachtenberg, Masoom A. Haider
• Inventors: Trachtenberg, John, Haider, Masoom A., Wilson, Brian Campbell
• Primary Examiner(s): Jung, Unsu
• Assistant Examiner(s): Santos Rodriguez, Joseph M
• Application Number:
  US11/724,750
• Publication Number:
  US 20070230757A1
• Time in Patent Office: 2,391 Days
• Field of Search: 600/407, 600/411, 600/420, 600/427, 600/439, 600/471, 601/2, 601/3, 606/11, 606/12, 606/27, 607/61, 607/62, 607/96, 607/100, 604/19, 604/20
• US Class Current: 600/411
• CPC Class Codes: A61B 18/20 using laser
• 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 2018/00636 Sensing and controlling the application of energy
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

An imaging and diagnostic system and method to differentiate between malignant and non-malignant tissue of a prostate and surrounding region. The system acquires imaging data from the prostate and surrounding proximal region, and processes the data to differentiate areas of tissue malignancy from non-malignant tissue. A sectioning device or ablative device is provided. The ablative device is operable by automation for receiving the imaging output coordinates and defining the trajectory and quantity of energy or power to be delivered into the malignant tissue. A control system determines calculated energy or power to be deposited into the malignant tissue during ablation, to minimize destruction of the non-malignant tissue within the prostate and surrounding tissue. The system operates on generated ablative device output data.

Claims

1. An imaging system in combination with a laser ablation device for differentiating between malignant and non-malignant tissues within the prostate region and for guided delivery of energy from an interstitially positioned laser ablation device acting as tissue removal instrumentation to and within the malignant tissues of the prostate, the imaging and ablation device comprising:

a) an MRI device for providing real-time, non-invasive imaging data by generating a series of axial MR images through the prostate that differentiates between malignant tissues within the prostate region and for guided delivery of the laser ablation device and guiding delivery of energy;

b) a processor receiving the generated MR image data and executing a software program on the received generated MR image data to provide an indication of differentiation between malignant and non-malignant tissues of prostate by steps comprising;

i) inputting variable “

a”

to represent the presence of malignant tissue and variable “

b”

to represent the absence of malignant tissue in accordance with T2 weighted, diffusion weighted and dynamic contrast enhanced images further acquired by the MRI device spanning the prostate tissue; and

ii) using a T1 weighted pulse sequence to obtain at least one additional dynamic contrast enhanced image;

c) generating an apparent diffusion coefficient map (ADC) on the MRI device;

d) administering an intravenous contrast agent;

e) generating a permeability map sing a modified Brix pharmacokinetic model; and

f) automatically generating a value, by weighting pre-determined regions of the permeability map, to determine the size, location and orientation of the malignant and non-malignant tissue of the prostate represented on an image display;

g) an energy source for the laser ablation device;

h) the laser ablation device for interstitial deposition of ablative energy into the malignant prostate tissue being connected to the energy source for the ablation device;

i) a control system for quantifying the ablation energy interstitially delivered from the laser ablation device into the tissue; and

the processor is further configured to provide a real-time plan in memory for the energy to be focally delivered interstitially by the laser ablation device to the malignant tissue of the prostate based upon the output information relating to size, location and orientation of the malignant tissue.

2. The system of claim 1 wherein the real-time plan contains variations in laser ablation power and energy applied based upon parameters of tissue density, power and energy levels available from the laser ablation device, direction of energy delivery by the laser ablation device, available positions or orientations of the laser ablation device to provide a trajectory of the laser energy during delivery, and the location of especially sensitive organs or tissue near regions where ablation is to be performed.

3. The system of claim 2 in which a delivery system supplying a pharmaceutical agent is present.

4. The system of claim 2 further comprising a minimally invasive monitoring device for monitoring delivery of the laser energy deposition to a sector about the malignant tissue in real-time.

5. The system of claim 4 wherein the minimally invasive monitoring device also verifies non-destruction of the non-malignant tissue sector in real-time.

6. The system of claim 5 in which the minimally invasive monitoring device comprises a monitor displaying visual information regarding both monitored delivery of the laser energy deposition and verification of non-destruction of the non-malignant tumor tissue in real-time.

7. The system of claim 1 wherein the imagine system is a system providing two distinct imaging capabilities consisting of an MRI device and further comprising at least a second imaging device other than the MRI device.

8. The system of claim 7 wherein the second imaging device is selected from the group consisting of an ultrasound imaging device, x-ray imaging device, and fluoroscopy.

9. The system of claim 1 in which the processor for quantifying energy deposition from the ablative device uses a plan constructed by application of the algorithm to the imaging data in a computer program to provide real-time information of energy deposition to remaining malignant tissue.

10. A method for imaging and ablating malignant tissue from a prostate using resection by non-ablative tools comprising the steps of:

a) taking real-time, non-invasive MRI imaging data;

b) executing a software program on the received generated MR image data to provide an indication of differentiation between malignant and non-malignant tissues of prostate by steps comprising;

i) inputting variable “

a”

to represent the presence of malignant tissue and variable “

b”

to represent the absence of malignant tissue in accordance with T2 weighted, diffusion weighted and dynamic contrast enhanced images further acquired by the MRI device spanning the prostate tissue; and

ii) using a T1 weighted pulse sequence to obtain at least one additional dynamic contrast enhanced image;

c) generating an apparent diffusion coefficient map (ADC) on the MRI device;

d) administering an intravenous contrast agent;

e) generating a permeability map sing a modified Brix pharmacokinetic model; and

f) automatically generating a value, by weighting pre-determined regions of the permeability map, to determine the size, location and orientation of the malignant and non-malignant tissue of the prostate represented on an image display;

g) providing a laser ablative energy source through or from an interstitially positioned ablation device to interstitially deliver focal ablation energy to the malignant tissue of the prostate in accordance with the determined size, location and orientation of the malignant tissue;

h) operating in real-time a monitoring system quantifying an amount of energy deposited by the laser ablation device; and

i) interstitially delivering tissue coagulating or tissue ablating focal therapeutic laser coagulating or laser ablating treatment to the malignant tissue of the prostate, in an amount responsive in real-time to the output data of the monitoring system to deliver laser coagulating or laser ablating energy to only remaining malignant tissue.

11. The method of claim 10 wherein quantifying the amount of energy is representative of physiological changes to be caused by ablation to only remaining malignant tissue.

12. The method of claim 11 wherein determination indicates size, location and orientation of the malignant tissue by application of an algorithm to the imaging data that characterizes in real-time likelihood of grades of data with respect to likelihood of malignancy versus benignity of remaining tissue in a target area.

13. The method of claim 12 wherein the imaging device provides an image display during or after the determination of the size, location and orientation of the malignant tissue and displays the determined size, location and orientation of the malignant tissue.

14. The method of claim 10 wherein the quantified amount of energy generates real-time output data to an ablative device to be used on only remaining malignant tissue.

15. A method for imaging and ablating malignant tissue from a prostate using resection by non-ablative tools comprising the steps of:

a) taking real-time, non-invasive MRI imaging data;

b) executing a software program on the received generated MR image data to provide an indication of differentiation between malignant and non-malignant tissues of prostate by steps comprising;

i) inputting variable “

a”

to represent the presence of malignant tissue and variable “

b”

to represent the absence of malignant tissue in accordance with T2 weighted, diffusion weighted and dynamic contrast enhanced images further acquired by the MRI device spanning the prostate tissue; and

ii) using a T1 weighted pulse sequence to obtain at least one additional dynamic contrast enhanced image;

c) generating an apparent diffusion coefficient map (ADC) on the MRI device;

d) administering an intravenous contrast agent;

e) generating a permeability map sing a modified Brix pharmacokinetic model; and

f) automatically generating a value, by weighting pre-determined regions of the permeability map, to determine the size, location and orientation of the malignant and non-malignant tissue of the prostate represented on an image display;

g) providing a resection medical tool to deliver focal therapy of excision of tissue to the malignant tissue of the prostate in accordance with the determined size, location and orientation of at least the malignant tissue;

h) monitoring in real-time the amount and location of tissue removed and comparing the tissue removing focal therapeutic treatment to determined size, location and orientation of the malignant tissue.

16. The method of claim 15 further comprising operating a monitoring system in real time to display remaining prostate tissue during surgical removal of the malignant tissue to ensure complete removal of the malignant tissue.