Ultrasound lithotripsy and histotripsy for using controlled bubble cloud cavitation in fractionating urinary stones

• US 9,901,753 B2
• Filed: 08/26/2010
• Issued: 02/27/2018
• Est. Priority Date: 08/26/2009
• Status: Active Grant

• Current Assignee: HistoSonics, Inc, Board of Regents of the University of Michigan (University of Michigan)
• Original Assignee: HistoSonics, Inc, Board of Regents of the University of Michigan (University of Michigan)
• Inventors: Cain, Charles A., Hall, Timothy L., Roberts, William W., Xu, Zhen, Fowlkes, J. Brian, Davison, Thomas W.
• Primary Examiner(s): Akar, Serkan
• Application Number:
  US12/868,775
• Publication Number:
  US 20110054363A1
• Time in Patent Office: 2,742 Days
• Field of Search: 600427
• CPC Class Codes: A61B 17/225 for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
• CPC Class Codes: A61B 17/2256 with means for locating or checking the concrement, e.g. X-ray apparatus, imaging means A61B17/2255 takes precedence
• CPC Class Codes: A61B 2017/00172 Pulse trains, bursts, intermittent continuous operation
• CPC Class Codes: A61B 2017/22008 used or promoted
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 8/00 Diagnosis using ultrasonic, sonic or infrasonic waves imaging of objects using sonar G01S15/00
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

A medical imaging and therapy device is provided that may include any of a number of features. One feature of the device is that it can deliver Lithotripsy therapy to a patient, so as to fractionate urinary stones. Another feature of the device is that it can deliver Histotripsy therapy to a patient, so as to erode urinary stones. In some embodiments, the medical imaging and therapy device is configured to target and track urinary stones in the patient during therapy. Methods associated with use of the medical imaging and therapy device are also covered.

Claims

1. A method of treating urinary stones, comprising:

applying Histotripsy therapy by transmitting Histotripsy ultrasound pulses having a pulse repetition frequency between 100 Hz and 1,000 Hz to generate a bubble cloud;

positioning the bubble cloud on a urinary stone;

applying Lithotripsy therapy by transmitting a Lithotripsy ultrasound pulse having a pulse repetition frequency less than or equal to 2 Hz to generate a shock wave to fractionate the urinary stone into macroscopic urinary stone particles;

applying the Histotripsy therapy to the macroscopic urinary stone particles to erode the macroscopic urinary stone particles; and

displaying real-time imaging of treatment from the Histotripsy therapy and the Lithotripsy therapy on a display.

2. The method of claim 1 wherein the positioning step further comprises positioning the bubble cloud on the urinary stone under imaging guidance.

3. The method of claim 1 wherein the positioning step further comprises positioning the bubble cloud on the urinary stone under ultrasound imaging guidance.

4. The method of claim 1 wherein the positioning step further comprises positioning the bubble cloud on the urinary stone under fluoroscopic and ultrasound imaging guidance.

5. The method of claim 1 wherein the applying Histotripsy therapy steps comprise applying Histotripsy therapy with a multi-mode transducer.

6. The method of claim 5 wherein the applying Lithotripsy therapy step comprises applying Lithotripsy therapy with the multi-mode transducer.

7. The method of claim 1 wherein the applying Histotripsy therapy steps comprise applying Histotripsy therapy at a first pulse repetition frequency, wherein the applying Lithotripsy therapy step comprises applying Lithotripsy therapy at a second pulse repetition frequency, the method further comprising interleaving Histotripsy therapy and Lithotripsy therapy with virtually no change in the first and second pulse repetition rates.

8. A method of treating a target tissue, comprising:

delivering a first Lithotripsy pulse to the target tissue;

delivering a sequence of Histotripsy pulses having a pulse repetition frequency between 100 Hz and 1,000 Hz to the target tissue after the first Lithotripsy pulse;

delivering a second Lithotripsy pulse to the target tissue after the sequence of Histotripsy pulses, wherein the first and second Lithotripsy pulses are separated in time by a pulse repetition frequency less than or equal to 2 Hz; and

displaying real-time imaging of treatment from the Histotripsy pulses and the first and second Lithotripsy pulses on a display.

9. The method of claim 8 wherein the target tissue is a urinary stone.

10. The method of claim 8 further comprising, prior to delivering the first Lithotripsy pulse to the target tissue, delivering a sequence of Histotripsy pulses to suppress cavitation.

11. The method of claim 10 further comprising, prior to delivering the second Lithotripsy pulse to the target tissue, delivering a sequence of Histotripsy pulses to suppress cavitation.

12. The method of claim 8 further comprising delivering a cavitation suppressing Histotripsy field to allow cavitation to occur within the target tissue while suppressing cavitation outside the target tissue.