System and method using fluorescence to examine within a patient's anatomy

• US 8,626,271 B2
• Filed: 04/13/2007
• Issued: 01/07/2014
• Est. Priority Date: 04/13/2007
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Dunki-Jacobs, Robert J., Yazdi, Youseph, Weir, Michael P., Ritchie, Paul G., Youmans, David C., Gill, Robert P.
• Primary Examiner(s): Le, Long V.
• Assistant Examiner(s): Negarestan, Farshad
• Application Number:
  US11/735,123
• Publication Number:
  US 20080255458A1
• Time in Patent Office: 2,461 Days
• Field of Search: 600/103, 600/117, 600/424
• US Class Current: 600/476
• CPC Class Codes: A61B 5/0071 by measuring fluorescence emission
• CPC Class Codes: A61B 5/0075 by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy A61B5/0071 takes precedence
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/0086 using infrared radiation
• 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 system for examining an area of a patient'"'"'s anatomy that comprises a probe capable of fluorescing, and a scanning beam assembly that scans the probe with a beam of excitation radiation and detects the probe'"'"'s fluorescence. The scanning beam assembly including a radiation source capable of emitting one or more wavelengths of radiation that are capable of exciting the probe and causing the probe to fluoresce, a scanning device that directs the radiation onto a field-of-view to create a scan of the field-of-view, a detector to detect radiation returned from the field-of-view, and a controller to convert the detected radiation into a displayable fluorescence image.

Claims

1. A system for examining an area of a patient'"'"'s anatomy comprising:

a) a probe capable of fluorescing, the probe configured to be deliverable within the anatomy; and

b) a medical instrument including at least part of a scanning beam assembly and having an outer surface that includes, at least in part, a fluorophore, wherein the scanning beam assembly scans the probe with a beam comprising imaging radiation and excitation radiation and detects the probe'"'"'s fluorescence while simultaneously detecting imaging radiation returned from a field-of-view, the scanning beam assembly comprising;

a radiation source configured for simultaneously emitting one or more wavelengths of imaging radiation and excitation radiation, the excitation radiation being configured for exciting the probe and the fluorophore and causing the probe and the fluorophore to fluoresce;

a scanning device that includes an oscillating reflector that directs the imaging and excitation radiation onto the field-of-view to create a scan of the field-of-view;

a separator that separates radiation returned from the field-of-view into imaging radiation and fluorescence radiation;

a first detector configured to detect the imaging radiation and a second detector configured to detect the fluorescence radiation; and

a controller configured to convert the detected imaging radiation into a displayable image of the field-of-view and the detected fluorescence radiation into a displayable fluorescence image of both the probe and the fluorophore;

wherein the fluorophore while fluorescing enables the visualization of the movement of the outer surface of the instrument.

2. The system of claim 1 further comprising a display system for displaying the image of the field-of-view and the fluorescence image.

3. The system of claim 2 wherein the fluorescence image of the probe is anatomically registered with the image of the field-of-view.

4. The system of claim 2 wherein the controller converts the fluorescence radiation into a fluorescence designated color that is within a color scheme of the display system such that the fluorescence stands out on the image of the field-of-view.

5. The system of claim 1 wherein the probe is selected from the group consisting of a nanoparticles, antibody, colloid, dye, mixture, substance or combinations thereof that are capable of fluorescing.

6. The system of claim 5 wherein the probe is configured to be delivered within the patient'"'"'s anatomy to a tumor, a cancer site, a lumen, an organ, or blood stream.

7. The system of claim 5 wherein the probe is an injectable solution delivered to the blood stream to be cleared by the kidneys so the probe is distributed within at least one of the kidneys, ureters, bladder, and urethra.

8. The system of claim 5 wherein the nanoparticles is a semiconductor nanoparticles, a silica-based nanoparticle, or mixtures thereof.

9. The system of claim 5 wherein the antibody is a fluorescent tagged monoclonal antibody.

10. The system of claim 1 wherein the second detector is a spectrometer or a filter.

11. The system of claim 10 wherein the second detector is a tunable spectrometer that is tunable to various wavelengths including at least one fluorescence wavelength of the probe.

12. The system of claim 1 wherein the fluorophore is a nanoparticle, colloid, dye, substance, mixture, or combination thereof that are capable of fluorescing.

13. The system of claim 1 wherein the fluorophore is a part of a housing covering the instrument, a coating on the instrument, or a part of the instrument itself.

14. A method for observing fluorescence within an area of a patient'"'"'s anatomy comprising:

delivering a probe capable of fluorescing into a patient'"'"'s anatomy;

introducing an instrument into the anatomy to scan the area of the anatomy that includes the probe, wherein the instrument includes at least part of a scanning beam assembly and has an outer surface that includes a fluorophore, the scanning beam assembly comprising;

a radiation source configured for simultaneously emitting one or more wavelengths of imaging radiation and excitation radiation, the excitation radiation being capable of exciting the probe and the fluorophore and causing the probe and the fluorophore to fluoresce;

a scanning device that directs the imaging and excitation radiation onto the area of the anatomy to create a scan of the area;

a separator that separates radiation returned from the area of the anatomy into imaging radiation and fluorescence radiation;

a first detector configured to detect the imaging radiation and a second detector configured to detect the fluorescence radiation; and

a controller configured to convert the detected imaging and fluorescence radiation into a displayable image of the anatomy that includes a fluorescence image;

scanning the area of the anatomy that includes the probe and at least a portion of the medical instrument that includes the fluorophore with imaging radiation and excitation radiation;

detecting the probe'"'"'s fluorescence with the second detector;

converting the probe'"'"'s fluorescence into a displayable fluorescence image;

detecting the fluorescence of the fluorophore with the second detector;

converting the detected fluorescence of the fluorophore into a fluorescence image of the outer surface of the portion of the instrument comprising the fluorophore;

detecting the imaging radiation returned from the anatomy with the first detector;

converting the imaging radiation returned from the anatomy into an image of the anatomy; and

displaying the fluorescence image of the outer surface of the instrument on a display system combined with the fluorescence image of the probe and the image of the anatomy.

15. The method of claim 14 further comprising displaying the fluorescence image of the probe in anatomical registration with the image of the anatomy.

16. The method of claim 15 wherein the controller converts the fluorescence radiation into a fluorescence designated color that is within a color scheme of the display system such that the fluorescence stands out on the image of the anatomy.

17. The method of claim 14 wherein the probe is selected from the group consisting of a nanoparticle, antibody, colloid, dye, mixture, substance or combinations thereof that are capable of fluorescing.

18. The method of claim 17 wherein the nanoparticle is a semiconductor nanoparticle, a silica-based nanoparticle, or mixtures thereof.

19. The method of claim 17 wherein the antibody is a fluorescent tagged monoclonal antibody.

20. The method of claim 17 wherein the probe is delivered within the patient'"'"'s anatomy to a tumor, a cancer site, a lumen, an organ, or blood stream.

21. The method of claim 17 wherein the probe is an injectable solution delivered to the blood stream to be cleared by the kidneys to distribute the probe within at least one of the kidneys, ureters, bladder, and urethra for fluorescence observation during a colorectal or gynecological procedure.

22. The method of claim 17 wherein the probe is injected into a biliary tree for fluorescence observation during a cholecystectomy.

23. The method of claim 14 wherein the second detector is a spectrometer or a filter.

24. The method of claim 23 wherein the second detector is a tunable spectrometer that is tunable to various wavelengths including at least one fluorescence wavelength of the probe.

25. The method of claim 14 wherein the fluorophore is selected from the group consisting of a nanoparticle, antibody, colloid, dye, mixture, substance and combinations thereof that are capable of fluorescing.

26. The method of claim 25 wherein the nanoparticle is a semiconductor nanoparticle, a silica-based nanoparticle, or mixtures thereof.

27. The method of claim 25 wherein the antibody is a fluorescent tagged monoclonal antibody.

28. A method for examining an area of a patient'"'"'s anatomy comprising:

introducing a medical instrument into the anatomy to scan the anatomy, wherein the medical instrument has an outer surface that includes, at least in part, a fluorophore and includes at least part of a scanning beam assembly;

the scanning beam assembly comprising;

a radiation source configured for simultaneously emitting one or more wavelengths of imaging radiation and excitation radiation, the excitation radiation being capable of exciting a naturally occurring autofluorescent cell constituent and the fluorophore;

a scanning device that directs the imaging and excitation radiation onto a field-of-view to create a scan of the field-of-view, the scanning device including a reflector that receives both the imaging and the excitation radiation from the radiation source onto the anatomy, wherein the reflector oscillates in at least two directions to create a scan of the anatomy with both the imaging and excitation radiation;

a separator that separates radiation returned from the field-of-view into imaging radiation and fluorescence radiation;

a first detector configured to detect the imaging radiation and a second detector configured to detect the fluorescence radiation; and

a controller configured to convert the detected imaging and fluorescence radiation into a displayable image of the anatomy that includes a fluorescence image;

scanning the area of the anatomy that includes the autofluorescent cell constituent and at least a portion of the medical instrument that includes the fluorophore with at least the excitation radiation;

detecting the fluorescence of the autofluorescent cell constituent with the second detector; and

converting the fluorescence into a displayable fluorescence image of the autofluorescent cell constituent;

detecting the fluorescence of the fluorophore with the second detector;

converting the detected fluorescence of the fluorophore into a fluorescence image of the outer surface of the portion of the instrument having the fluorophore;

detecting the imaging radiation returned from the anatomy with the first detector;

converting the imaging radiation returned from the anatomy into an image of the anatomy; and

displaying the fluorescence image of the outer surface of the instrument on a display system combined with the fluorescence image of the autofluorescent cell constituent and the image of the anatomy;

wherein the second detector is a tunable spectrometer that is tunable to various wavelengths including at least one fluorescence wavelength of the autofluorescent cell constituent.

29. The method of claim 28 further comprising displaying the fluorescence image of the autofluorescent constituent in anatomical registration with the image of the anatomy.