Method and device for effecting thermal therapy of a tissue
Inventors
Tyc, Richard • Qureshi, Salman • Grant, Mark Andrew • Fernandes, Luis Filipe Silva • Carreira, Daniel Prazeres • Schellhorn, John
Assignees
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Publication Number
US-10548678-B2
Publication Date
2020-02-04
Expiration Date
Abstract
Image-guided therapy of a tissue can utilize magnetic resonance imaging (MRI) or another medical imaging device to guide an instrument within the tissue. A workstation can actuate movement of the instrument, and can actuate energy emission and/or cooling of the instrument to effect treatment to the tissue. The workstation and/or an operator of the workstation can be located outside a vicinity of an MRI device or other medical imaging device, and drive means for positioning the instrument can be located within the vicinity of the MRI device or the other medical imaging device. The instrument can be an MRI compatible laser probe that provides thermal therapy to, e.g., a tissue in a brain of a patient.
Core Innovation
The disclosed invention provides an MRI-compatible image-guided thermal therapy system and method for effecting interstitial thermal therapy to brain tissue using an in vivo probe in a patient. The system includes an external or remote workstation and a controller that drives an MRI-safe, motorless probe driver through an interface platform and associated electronics rack and umbilicals. It uses stereotactic miniframe head fixation and an MRI compatible head coil and stabilization system to support guided probe insertion and positioning.
A treatment workflow identifies a three-dimensional region of interest and calculates a plurality of target positions as a sequence of positions and alignments of the probe based on a symmetric or asymmetric output pattern of the probe. The workflow includes identifying a treatment profile that includes a selected sequence corresponding to one or more positions of the probe and a minimum treatment time based on an expected output of the probe. Therapeutic energy is applied at a first target position, the probe is actuated to adjust at least one of a linear position and a rotational position to move to a next target position, and therapeutic energy is applied at the next target position according to the treatment profile.
The system supports real-time MRI thermometry and thermographic analysis with continuous temperature and thermal-dose monitoring for completion of thermal therapy at each target position, including monitoring at a point within or adjacent to the region of interest and also monitoring at an external point outside the region of interest. It includes noise masking and reference-point correction for MR phase drift to improve thermometry robustness during monitoring. In response to monitoring feedback, a cooling functionality of the probe can be activated to minimize tissue damage near the probe.
The disclosed probes include an MR-compatible laser side-fire probe and a diffuse-tip probe with cooling, including Joule-Thomson cooling. The probe output patterns include symmetric or asymmetric output patterns and allow shaped ablation patterns. A guide sheath supports delivery of multiple probes or modalities and can enable off-axis delivery through a guide sheath delivery hole, including shaped ablation while minimizing interruptions.
Claims Coverage
The partial content provides two independent claims (clm-00001 and clm-00009). Across these independent claims, the main inventive features center on: (i) generating a treatment profile from a symmetric or asymmetric probe output pattern with a sequence of positions/alignments and a minimum treatment time, (ii) applying therapeutic energy at successive target positions while actuating linear and/or rotational probe motion, and (iii) determining completion using temperature and/or imaging feedback with MR-based thermometry/thermometry imaging, including thermal-dose considerations.
Treatment profile based on symmetric or asymmetric output pattern with minimum treatment time
The method/process identifies a three-dimensional region of interest and calculates a plurality of target positions as a sequence of positions and alignments of the probe based on a symmetric or asymmetric output pattern, where each target position is associated with power level, energy level, emission pattern, time period, and geometry; it then identifies a treatment profile including a selected sequence and a minimum treatment time based on an expected output of the probe.
Successive therapeutic energy at target positions with linear and rotational probe actuation
The method applies thermal therapy by activating delivery of therapeutic energy at a first target position and then causing actuation of the probe to adjust at least one of a linear position and a rotational position to a next target position, followed by activating delivery of therapeutic energy at the next target position according to the treatment profile.
Completion determination using temperature and/or imaging feedback from MR thermometry systems
The non-transitory computer readable medium causes monitoring feedback related to a target area, where the feedback comprises at least one of temperature feedback and imaging feedback provided by at least one of an MR imaging system and a thermometry imaging system, and it determines completion of thermal therapy at a position based at least in part on the feedback.
Overall, the claim set in the partial content covers a thermal therapy control approach that derives probe position/alignment sequences from a symmetric or asymmetric probe output pattern and an expected output to set a treatment profile with minimum treatment time, delivers therapeutic energy across successive target positions with linear and/or rotational probe motion, and uses MR-based temperature and/or imaging feedback to determine completion of therapy at each position.
Stated Advantages
Not explicitly described in patent.
Documented Applications
Not explicitly described in patent.
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