Method and system for fiducials contained in removable device for radiation therapy

• US 9,943,704 B1
• Filed: 09/18/2009
• Issued: 04/17/2018
• Est. Priority Date: 01/21/2009
• Status: Expired due to Fees

• Current Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Original Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Inventors: Mate, Timothy P., Zeller, Tricia V., Dimmer, Steven C., Quigley, Fergus
• Primary Examiner(s): Smith, Ruth S
• Application Number:
  US12/563,084
• Time in Patent Office: 3,133 Days
• Field of Search: 600420, 600424, 600426, 600431, 600432, 600458
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/101 for stereotaxic radiosurgery
• CPC Class Codes: A61B 2090/3908 Soft tissue, e.g. breast tissue
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2090/3975 active
• CPC Class Codes: A61B 2090/3987 Applicators for implanting 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 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61N 2005/1051 using an active marker
• CPC Class Codes: A61N 5/1014 Intracavitary radiation therapy
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam

Abstract

Method and system fiducials contained in removable a device for use in guided radiation therapy treatment. One embodiment includes an active marker configured to be pre-loaded into a catheter for removeably implanting in the tissue of a patient. Another embodiment of the implantable device includes a stability element coupled to the marker and further coupled to an explant line. In some embodiments, the stability element is configured to hold the marker at a fixed location within the catheter (e.g., known location) with respect to a target in the tissue. In other embodiments, the explant line has a first portion coupled to the marker and/or the stability element and a second portion configured to be at least proximate to the dermis of the patient.

Claims

1. An implantable device for guided radiation therapy, comprising:

a removable implantable device having a first portion configured to be implanted in tissue of a patient and opposing end portions configured to remain external to the patient on two sides of a resection cavity, wherein the first portion includes a predefined cavity extending from one of the opposing end portions to another of the opposing end portions;

an active marker contained within the predefined cavity of the first portion, the marker having a circuit configured to transmit a wirelessly transmitted location signal from within the patient, wherein the marker is configured to be received in the predefined cavity via one of the opposing end portions;

a first fastener coupled to one of the opposing end portions of the removable implantable device and having a portion configured to be external to the patient at least proximate to a dermis of the patient; and

a second fastener coupled to another of the opposing end portions of the removable implantable device and having a portion configured to be external to the patient at least proximate to a dermis of the patient, wherein the first and second fasteners are configured to place the removable implantable device under tension between the opposing end portions to adjust for shrinkage or expansion of the resection cavity, and wherein the removable device, the active marker, and the first and second fasteners are configured to remain implanted in the patient during external beam radiation therapy.

2. The device of claim 1 wherein the active marker is one of a plurality of active markers.

3. The device of claim 1 wherein the active marker comprises a wired marker having a casing and a core within the casing, and wherein the circuit comprises a coil within the casing around the core.

4. The device of claim 1 wherein the active marker comprises a leadless marker having a casing and a core within the casing, and wherein the circuit comprises a coil within the casing around the core.

5. The device of claim 1, further comprising a stability element coupled to the active marker and configured to fix the active marker at a fixed location within the predefined cavity of the removable implantable device.

6. The device of claim 1, further comprising a tether extending into the predefined cavity and coupled to the active marker and at least one of the first and the second fasteners, wherein the at least one first and second fasteners is configured to hold the tether in a stable position within the tissue.

7. The device of claim 6 wherein the tether is a filament.

8. The device of claim 1 wherein the removable implantable device is a sheath.

9. The device of claim 1 wherein the removable implantable device is a catheter.

10. The device of claim 1 wherein the removable implantable device is a capsule.

11. The device of claim 1 wherein the removable implantable device is a plurality of capsules.

12. The device of claim 1 wherein the removable implantable device is a plurality of interconnected capsules.

13. A method for tracking a target site in a patient after a procedure that leaves a resection cavity within the patient, the method comprising:

inserting a portion of an implantable device into the resection cavity, wherein the implantable device has opposing end portions and is configured to remain implanted in the patient during external beam radiation therapy,

wherein inserting the portion of the implantable device into the resection cavity comprises passing the implantable device through the resection cavity such that the opposing end portions of the implantable device are positioned external to the patient on two sides of the resection cavity, and wherein the implantable device is under tension between the opposing end portions to adjust for shrinkage or expansion of the resection cavity,

inserting an active marker affixed to a first portion of an explant line into a lumen of the implantable device after the implantable device has been implanted in the patient such that the active marker is positioned at least proximate to the resection cavity, wherein the explant line has a second portion configured to extend outside the patient after the active marker and the first portion of the explant line are implanted; and

localizing the active marker positioned within the patient relative to the implantable device by transmitting a non-ionizing location signal from the active marker and calculating a position of the active marker in an external coordinate system based on the location signal.

14. A method for tracking a target site in a patient after a procedure that leaves a resection cavity within the patient, the method comprising:

passing an implantable device through the resection cavity such that opposing end portions of the implantable device are positioned external to the patient on two sides of the resection cavity and a portion of the implantable device is in the resection cavity, wherein the implantable device is under tension between the opposing ends to adjust for shrinkage or expansion of the resection cavity, and wherein the implantable device is configured to remain implanted in the patient during external beam radiation therapy;

inserting an active marker into a lumen of the implantable device after the implantable device has been implanted in the patient such that the active marker is positioned at least proximate to the resection cavity; and

localizing the active marker positioned within the patient relative to the implantable device by transmitting a non-ionizing location signal from the active marker and calculating a position of the active marker in an external coordinate system based on the location signal.

15. The method of claim 14, further comprising adjusting cinching buttons on the opposing ends of the implantable device to place the implantable device under tension as the resection cavity shrinks or expands.