Embodiments of the present invention relate generally to controlling and delivering electric fields. More particularly, embodiments of the present invention provide systems and methods for controlling and delivering current to a tissue (e.g., prostate tissue) of a patient for the destruction of cancerous and/or hyperplastic cells or tissue.
The prostate gland is a walnut-sized gland located in the pelvic area, just below the outlet of the bladder and in front of the rectum. It encircles the upper part of the urethra, which is the tube that empties urine from the bladder. The prostate is an important part of the male reproductive system, requiring male hormones like testosterone to function properly, and helps to regulate bladder control and normal sexual functioning. The main function of the prostate gland is to store and produce seminal fluid, a milky liquid that provides nourishment to sperm and increases sperm survival and mobility.
Cancer of the prostate is characterized by the formation of malignant (cancerous) cells in the prostate. Prostate cancer is the leading cancer-related cause of death in men in the United States. There are currently over 2 million men in the United States with prostate cancer, and it is expected that there will be approximately 190,000 new cases of prostate cancer diagnosed, with 28,000 men dying from the disease in 2008.
In addition to risks of morbidity due to prostate cancer, most men over 60 years old experience partial or complete urinary obstruction due to enlargement of the prostate. This condition can originate from prostate cancer, or more typically, from benign prostatic hyperplasia (BPH), which is characterized by an increase in prostate size and cell mass near the urethra.
Common active treatment options include surgery and radiation. Surgery often includes the complete surgical removal of the prostate gland (“Radical Prostatectomy”), and in certain instances the regional lymph nodes, in order to remove the diseased tissue from the body. In some instances, a nerve sparing prostatectomy is attempted in an effort to maintain erectile function in the patient after treatment. Side effects associated with radical prostatectomy can include pain, inflammation, infection, incontinence, shorter penis and impotence.
Radiation therapy is another treatment option for prostate cancer and is characterized by the application of ionizing radiation to the diseased area of the prostate. Ionizing radiation has the effect of damaging a cells DNA and limiting its ability to reproduce. For prostate cancer treatment, two methods of radiation therapy include External Beam Radiation Therapy (EBRT) and internal radiation, commonly known as Brachytherapy. EBRT involves the use of high-powered X-rays delivered from outside the body. The procedure is painless and only takes a few minutes per treatment session, but needs to be over extended periods of five days a week, for about seven or eight weeks. During EBRT, the rays pass through and can damage other tissue on the way to the tumor, causing side effects such as short-term bowel or bladder problems, and long-term erectile dysfunction. Radiation therapy can also temporarily decrease energy levels and cause loss of appetite.
Brachytherapy involves the injection of a tiny radioactive isotope containing ‘seeds’ into the prostate. Once positioned in the tissue, the radiation from the seeds extends a few millimeters to deliver a higher radiation dose in a smaller area, causing non-specific damage to the surrounding tissue. The seeds are left in place permanently, and usually lose their radioactivity within a year. Internal radiation also causes side effects such as short-term bowel or bladder problems, and long-term erectile dysfunction. Internal radiation therapy can also temporarily decrease energy levels and cause loss of appetite. It is also common for the implanted seeds to migrate from the prostate into the bladder and then be expelled through the urethra during urination. Most significant, however, is the change in the texture of the prostate tissue over time, making the subsequent removal of the gland, as described above, complicated and difficult as a secondary treatment.
Given the significant side-effects with existing treatments such as radical prostatectomy and radiation therapy, less invasive and less traumatic systems and procedures have been of great interest. One such more minimally invasive system developed in recent years includes so called “Trans-urethral Needle Ablation” or TUNA, which involves passing a radio-frequency (RF) device such as a catheter electrode or scope into the urethra for delivery of high frequency energy to the tissue. The RF instruments include electrode tips that are pushed out from the side of the instrument body along off-axis paths to pierce the urethral wall and pass into the prostatic tissue outside of the urethra. High-frequency energy is then delivered to cause high-temperature ionic agitation and frictional heating to tissues surrounding the electrodes. The high temperature induced in the tissue, e.g., up to 90-100 degrees C. or more, is non-specific to cancerous tissue and destroys both healthy and non-healthy tissue.
Another technique developed in recent years for treating BPH is Trans-urethral Microwave Thermo Therapy (or “TUMT”). This technique involves use of a device having a microwave electrode or antenna located near its distal end and connected to an external generator of microwave power outside the patient's body. The microwave electrode is inserted into the urethra to the point of the prostate for energy delivery and microwave electromagnetic heating. Since the microwave electrode delivers substantial heating that can cause unwanted damage to healthy tissues or to the urethra, devices typically make use of a cooled catheter to reduce heating immediately adjacent to the electrode. The objective is to carefully balance cooling of the urethra to prevent damage to it by the heating process, while at the same time delivering high temperature heating (typically much greater than 50 degrees C.) to the prostatic tissue outside of and at a distance from the urethra. In this procedure, the prostatic tissue immediately around the urethra and the urethra itself are deliberately spared from receiving an ablative level of heating by attempting to keep the temperatures for these structures at less than 50 degrees C. Unfortunately, controlling the tissue heating due to the applied microwave energy is difficult and unintended tissue damage can occur. Further, destruction of tissue beyond the cooled region is indiscriminate, and control of the treatment zone is imprecise and limited in the volume of tissue that can be effectively treated.
Accordingly, there is a continuing interest to develop less invasive devices and methods for the treatment of cancerous or hyperplastic conditions, such as in BPH and prostate cancer, that is more preferential to destruction of hyperplastic/cancerous cells of target tissue and more precisely controllable.
Embodiments of the present invention include a method of controlling electric fields created by a plurality of electrodes. The method includes repetitively applying multiple sets of voltages to at least some of a plurality of electrodes over a treatment period so as to heat a target area (e.g., an area or volume of a target tissue) to a selected or desired temperature or temperature range. At least some electrodes may be treatment electrodes. The multiple sets of voltages may include a first set of voltages that creates an electric potential difference between at least some adjacent pairs of the treatment electrodes; and a second set of voltages that creates an electric potential difference between at least some adjacent pairs of the treatment electrodes for which an electric potential difference was not created while applying the first set of voltages. In one embodiment, the multiple sets of voltages in combination create an electric potential difference between each adjacent pair of treatment electrodes.
Embodiments of the present invention also include a system for selectively generating electric fields. The system includes a plurality of electrodes and a control unit, where the control unit may include a storage medium and a computer processor, the storage medium having executable instructions stored thereon. The computer processor may be operable to execute the instructions so as to cause the control unit to perform operations including switching between different or unique electrode patterns, where each unique electrode pattern includes providing an electrical voltage to at least some of the electrodes, the at least some electrodes being treatment electrodes, and the electrical voltage being provided so as to generate a current flow between adjacent pairs of the treatment electrodes. The operations may further include applying a feedback control loop controlling the electrical voltage provided to the treatment electrodes based at least in part on one or more of: a temperature difference for a treatment electrode based on a temperature of an adjacent treatment electrode, and an estimate of a voltage at a treatment electrode provided by one or more other treatment electrodes.
Embodiments of the present invention further include a control unit for controlling electric fields created by a plurality of electrodes. The control unit may include a storage medium and a computer processor, the storage medium having executable instructions stored thereon. The computer processor may be operable to execute the instructions so as to cause the control unit to perform operations including applying a feedback control loop controlling an electrical voltage provided to at least some of a plurality of electrodes, the at least some electrodes being treatment electrodes. Wherein applying a feedback control loop may include, for each treatment electrode, adjusting a voltage applied to the electrode based at least in part on one or more of: a temperature difference for the electrode based on a temperature of an adjacent electrode, and an estimate of a voltage at the electrode provided by one or more other electrodes.
For a fuller understanding of the nature and advantages of the present invention, reference should be made to the ensuing detailed description and accompanying drawings. Other aspects, objects and advantages of the invention will be apparent from the drawings and detailed description that follows.
All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference.
The novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings of which:
Embodiments of the present invention provide systems, devices, and methods for selectively monitoring and controlling electric fields. For example, voltages applied to electrodes and/or current and heating to the target tissues may be selectively controlled, and temperatures in regions proximate to the electrodes can be selectively monitored. In some embodiments, the electrodes may be introduced into a target tissue region and an electric field applied to the target tissue region for controlled and/or preferential destruction of cancerous and/or hyperplastic cells of the target tissue compared to non-cancerous or non-hyperplastic cells in the treatment region.
In some embodiments, tissue heating may be performed using a plurality of electrodes disposed in a treatment area. Voltages may be applied to the electrodes in a plurality of voltage patterns, where voltages applied to the electrodes may be changed so as to switch between the voltage patterns. By applying voltages to the electrodes using a number of voltage patterns, current densities and thus electrode temperatures may be averaged out over all of the electrodes, thereby reducing the number and/or effect of localized hot spots.
In other embodiments, the voltage to be applied to each electrode may be determined using a customized feedback control loop. The customized feedback control loop may determine a temperature difference for a controlled electrode based on a temperature of an adjacent electrode. By using a temperature of an adjacent electrode, the voltage of the controlled electrode may be controlled so as to prevent an overheating of the adjacent electrode. In some cases, the customized feedback control loop may estimate an average voltage provided at the controlled electrode from other electrodes, and use this average voltage in determining the voltage to apply to the controlled electrode. By using an average voltage provided at the controlled electrode from other electrodes, such as adjacent electrodes, a current flow to or from the controlled electrode may be more accurately controlled. These and other embodiments are further described herein.
System for Applying Electric Fields
Some general features and functionality of certain system 100 aspects or components may be described in U.S. patent application Ser. Nos. 12/251,242, 12/283,847, 12/761,915, which are commonly assigned and incorporated herein by reference in their entirety.
System 100 in certain embodiments is a system for selectively applying electric fields to target tissues including various components such as an electrode 102, a system control unit 108, a electrode guide 110, and an imaging device/system 112. However, it will be appreciated by those of ordinary skill in the art that such a system could operate equally well in a system having fewer or a greater number of components than are illustrated in
System Control Unit
Computing device 120 may include, e.g., a computer or a wide variety of proprietary or commercially available computers or systems having one or more processing structures, a personal computer, and the like, with such systems often comprising data processing hardware and/or software configured to implement any one (or combination of) the processing operations described herein. Any software will typically include machine readable code of programming instructions embodied in a non-transitory tangible media such as an electronic memory, a digital or optical recovering media, or the like, and one or more of these structures may also be used to transmit data and information between components of the system in any wide variety of distributed or centralized signal processing architectures. According to one embodiment, computing device 120 includes a single core or multi-core processor 122 and a tangible non-transitory computer-readable storage device 124, where processor 122 may execute computer-readable code stored in storage device 124.
Display device 130 may be any type of suitable device for displaying information to an operator of system control unit 108. For example, display device 130 may incorporate cathode ray tubes, liquid crystals, light emitting diodes, electrically charged ionized gases (i.e., a plasma display), and the like. In some embodiments, system control unit 108 may further include one or more input devices (not shown), such as a mouse, keyboard, keypad, trackball, light pen, and the like. Such input devices may be electrically coupled to computing device 120 to enable the operator of system control unit 108 to provide inputs to computing device 120. In other embodiments, display device 130 may additionally or alternatively enable the operator of system control unit 108 to provide inputs to computing device 120. For example, display device 130 may comprise a touchscreen display.
Display device 130 is in communication with computing device 120 to enable data to be transferred between the two devices. For example, display device 130 may be electrically coupled to computing device 120 via a connecting cable. For another example, display device 130 and computing device 120 may communicate data to one another wirelessly over any suitable wireless communication protocol, such as Bluetooth™, IEEE 802.11, etc.
Amplifier board 140 may be any suitable amplifier for driving one or more electrodes in a needle electrode assembly 170 and/or receiving and communicating temperature measurements from needle electrode assembly 170. In some embodiments, amplifier board 140 is operable to individually control at least one of a voltage and current amplitude and phase applied to each of the electrodes of electrode assembly 170. Amplifier board 140 may be operable to sample at least one of a voltage, current, and temperature of each of the electrodes. Amplifier board 140 may also be operable to electrically disconnect one or more of the electrodes, connect one or more of the electrodes to ground, or connect one or more of the electrodes to a driving signal. For example, amplifier board 140 may include, for each electrode, a relay for controlling a state of the electrode. In one embodiment, amplifier board 140 performs signal conditioning on at least one of voltage, current, and temperature measurements sampled from electrode assembly 170.
Amplifier board 140 may be electrically coupled to needle electrode assembly 170 via, for example, a cable assembly 145. Cable assembly 145 may enable communication between amplifier board 140 and needle electrode assembly 170, and may enable amplifier board 140 to provide power to electrodes of needle electrode assembly 170. According to one embodiment, electrode assembly 170 includes thermistor circuitry for calculating temperatures of the electrodes. In such a case, amplifier board 140 may route signals from the thermistor circuitry to computing device 120 and supply power to the thermistor circuitry. According to other embodiments, other devices may be capable of calculating temperatures of the electrodes. For example, computing device 120 may perform such calculations based on measurements received from electrodes in electrode assembly 170.
Computing device 120 may also include a data acquisition card 126. Data acquisition card 126 may be electrically or wirelessly coupled to amplifier board 140 and may receive various measurement data read by amplifier board 140. For example, data acquisition card 126 may receive voltage, current, and temperature measurements of each of the electrodes. In some embodiments, data acquisition card 126 may receive such measurements after amplifier board 140 has performed signal conditioning.
According to some embodiments, data acquisition card 126 may further be configured to control amplifier board 140. For example, data acquisition card 126 may provide a digital bit stream to amplifier board 140 instruct amplifier board 140 to drive one or more of the electrodes and acquire various measurements. In some embodiments, the digital bit stream may be clocked into memory of amplifier board 140 and, as a result, field programmable gate arrays (FPGAs) of amplifier board 140 may configure various subcomponents of amplifier board 140 to output and measure the desired signals. This may be done many times per second, allowing for smooth, closed-loop control of the system.
Isolation transformer 150 may be any suitable transformer for transferring alternating current (AC) power from an AC power source to one or more other elements of the system, such as computing device 120, display device 130, and direct current (DC) power supply 160, while isolating such elements from the earth ground.
DC power supply 160 may be any suitable power supply for converting AC power to DC power. In some embodiments, DC power supply 160 converts AC power received from isolation transformer 150 to DC power and provides the DC power to amplifier board 140. In other embodiments, amplifier board 140 includes an AC/DC converter and receives AC power directly or uses battery power, thus obviating the need for DC power supply 160.
Needle electrode assembly 170 may be electrically coupled to amplifier board 140 as previously discussed. Needle electrode assembly 170 includes a plurality of needle or elongated electrodes. The electrodes may each generate an electric field based on a voltage and current provided by amplifier board 140. In some embodiments, one or more electrodes may include or be replaced by a thermistor for measuring a temperature of the electrodes or within a vicinity of the electrodes. In some cases, one or more electrodes are used for measuring temperature, but not for generating an electric field. For example, some electrodes may be used to monitor temperature and provide a reference temperature (e.g., a body temperature).
According to one embodiment, the electrodes may be individually advanced and positioned within a target tissue (e.g., a prostate tissue). Once the electrodes are positioned, a voltage can be applied to one or more of the electrodes, thereby causing electrical fields, magnetic fields, and currents to be generated in portions of the target tissue. Such fields may be used, for example, for tissue ablation to destroy cancerous and/or hyperplastic cells.
System control unit 108 in certain embodiments is a system for controlling a needle electrode assembly including various components such as a computing device 120, a display device 130, an amplifier board 140, an isolation transformer 150, and a DC power supply 160. However, it will be appreciated by those of ordinary skill in the art that the system control unit could operate equally well by having fewer or a greater number of components than are illustrated in
Electrode Assembly
A system will typically include a plurality or array of electrodes that operatively couple to one or more components of a system (e.g., power source, etc) and can be positioned in the tissue for delivery of current field as described herein. Some of all of the electrodes may be used for delivery of a current field. For example, a plurality of electrodes may be positioned in the tissue, but only some of those electrodes used for delivery of a current field. Various different electrode configurations and assemblies can be utilized and may be suitable for current field delivery as described herein.
In one embodiment, elongated electrodes 210 are substantially cylindrical in shape. A distal end of elongated electrodes 210, for example, an end for penetrating tissue of a patient, is narrowed to a tip. Such narrowing may advantageously reduce penetration resistance when inserting the electrode into an object such as tissue of a patient. A proximal end of elongated electrodes 210 may be mechanically and electrically coupled to an end of a corresponding conductive wire 220. Accordingly, current, voltage, and/or temperature measurements may be communicated to and from electrodes 210 via the conductive wires 220. In other embodiments, elongated electrodes 210 may have other shapes, such as being elongated with a square, rectangular, or oval cross-section. In some embodiments, elongated electrodes 210 have a variety or a combination of shapes. Electrodes 210 are further discussed with reference to
Each of the plurality of wires 220 includes a first end and a second end, where the first end is mechanically coupled to one of electrodes 210 and the second end is mechanically coupled to an interface of housing 230. Each wire 220 may comprise one or more cores that may be made of any suitable conductive material, such as copper, aluminum, metal alloys, coated metals, etc. In case each wire comprises only a single core, the single core may be insulated with a non-conductive sheath made of any suitable insulating material, such as plastic, silk, etc. In case each wire comprises a plurality of conductive cores, each core may be insulated, and the plurality of insulated cores may then be bundled with, e.g., a further sheath. In some embodiments, the further sheath may also be made of non-conductive material.
In one embodiment, one or more of wires 220 includes a shielding element. The shielding element is operable to prevent EMI leakage and noise on measured signals. The shielding element may be made of any suitable material and may include, for example, a braided or foil-type shielding.
Each core may be operable to communicate any suitable signal or signals to and/or from electrodes 210. For example, each core may communicate electrical voltage, resistance, and/or current, and/or differences in voltage, resistance, and/or current, etc. This may include treatment signals, which may be any suitable signal for excising tissue, and may include temperature measurement signals, which may be any suitable signal for measuring a temperature in, on, or around electrodes 210.
The first end of each wire 220 may include an enlarged portion 222. The enlarged portion may be of any suitable shape. In one embodiment, enlarged portion 222 has a cross-section having a shape that is the same shape as at least a portion of electrode 210. In another embodiment, enlarged portion 222 has a cross-section having a shape this is the same shape as wire 220. For example, enlarged portion 222 may have a cross-section in the shape of a circle, oval, rectangle, etc. Enlarged portion 222 may be enlarged such that a diameter of enlarged portion 222 is larger than a diameter of other portions of wire 222. The diameter of enlarged portion 222 may be stay the same along a length of enlarged portion 222, or may vary along the length of enlarged portion 222. In one embodiment, the diameter of enlarged portion 222 at an end proximate to electrode 210 is larger than the diameter of enlarged portion 222 at an end proximate to other portions of wire 210. In another embodiment, enlarged portion 222 may include a surface proximate to electrode 210 that is planar and perpendicular to a direction in which electrode 210 extends. In some embodiments, enlarged portion 222 may be part of electrode 210 rather than wire 220.
Enlarged portion 222 may serve one or more functions. In one embodiment, enlarged portion 222 may provide a location that is easy to grasp by a clinician. In a further embodiment, enlarged portion may protect and insulate connections between conductive cores of a wire 220 and portions of an electrode 210. In another embodiment, enlarged portion 222 may provide a depth stop for electrodes 210. For example, where a electrode guide 110 includes a plurality of apertures to allow electrodes 210 to pass through, the enlarged portions 222 may be sized so that they abut the electrode guide 110 and prevent electrodes 210 from passing entirely through the electrode guide 110. In one embodiment, enlarged portions 222 may have a diameter larger than a diameter of receiving apertures of electrode guide 110. In another embodiment, enlarged portion 222 may have a cross section having a shape that is different than a shape of a receiving aperture of electrode guide 110.
Housing 230 selectively receives the plurality of electrodes 210 and includes an interface for providing an electrical coupling to electrodes 210. Housing 230 may further include apertures for receiving the plurality of electrodes 210, and electronics for calculating thermal measurements, passing voltages and currents to electrodes 210, and the like. The interface may include a first interface portion mechanically coupled to wires 220, and a second interface portion for receiving a cable assembly from amplifier board 140 such as cable assembly 145.
Housing 230 may be any suitable shape. For example, as illustrated in
As previously mentioned, housing 230 may include electronics for calculating thermal measurements, passing voltages and currents to electrodes 210, and the like. For example, housing 230 may surround or embody a printed circuit board (PCB) having circuitry and/or software for calculating thermal measurements from electrodes 210. The PCB may be partially or fully disposed, mechanically and electrically, between interface portion 236(a) and interface portion 236(b). Housing 230 may also include electronics for storing data. Stored data may include identification data such as a serial number, mode number, expiration data, authentication code, etc. In some embodiments, such stored data may be read by various computing devices, such as computing device 120.
According to one embodiment, housing 230 may receive electrodes 210 via apertures 238. Housing 230 may use any suitable mechanism for maintaining electrodes 210 within apertures 238 so as to advantageously reduce the likelihood of electrodes 210 unexpectedly disengaging from apertures 238. For example, electrodes 210 may have a friction fit with apertures 238. Upon engaging electrodes 210 with apertures 238, enlarged portions 222 of wires 220 may extend from a side surface of housing. In one embodiment, apertures 238 and enlarged portions 222 may be sized to create a friction fit between enlarged portions 222 and apertures 238.
Electrode assembly 200 in certain embodiments is an assembly of electrodes for generating electric fields so as to create current patterns in a delivery medium, and may include various components such as elongated electrodes 210, flexible conductive wires 220, and a housing 230. However, it will be appreciated by those of ordinary skill in the art that the electrode assembly could operate equally well by having fewer or a greater number of components than are illustrated in
For example, in some embodiments, electrode assembly 200 may consist only of elongated electrodes 210. In such cases, electrodes 210 may be controlled by electrode guide 110, and/or information may be communicated to and from the electrodes via electrode guide 110. For example, receiving apertures of electrode guide 110 may each include electrical contacts for electrically contacting a received electrode. The electrical contacts may then operate to communicate current to and/or from received electrodes. The electrical contacts may be powered and/or in wired or wireless communication with other parts of system 100, such as system control unit 108, so as to facilitate power transfer and/or information communication between electrodes 210 and system control unit 108. In some embodiments, electrodes 210 may include circuitry such as a wireless communication interface and/or a power supply, so that electrodes 210 may be in wireless communication with parts of system 100 such as system control unit 108 and/or may communicate current to and/or from a target area regardless of whether electrode guide 110 includes elements for controlling and/or powering electrodes 210.
Exposed portion 320 may have any suitable length. For example, exposed portion 320 may have a length equal to 1 cm, 2 cm, 3 cm, or in a range between 1 cm and 3 cm, or less than 1 cm, or greater than 3 cm. The distance from the sharpened tip of electrode 300 may be indicated on an exterior surface of electrode 300. For example, distances of 1 cm, 2 cm, 3 cm, etc. may be marked on the surface of electrode 300. The indications may be made using any suitable method, such as chemical marking, laser marking, a printing process, etc.
Electrode 300 may have any suitable shape, size, and/or diameter, and electrode design or configuration may be selected based on the particular use of the system or aspects of a particular treatment to be performed. For example, electrode 300 may have a diameter of approximately 18 gauge, or a diameter in the range of 16 gauge to 20 gauge, or lower than 16 gauge or higher than 20 gauge. Electrode 300 may have any suitable length. For example, electrode 300 may have a length of approximately 20 cm, or a length in the range of 15 cm to 25 cm, or less than 15 cm or greater than 25 cm. According to one embodiment, electrode 300 is in the shape of a brachytherapy-style needle. According to other embodiments, electrode 300 is in a shape other than a needle, such as a catheter.
Temperature sensor 330 is operable to measure a temperature of or proximate to electrode 300. Temperature sensor 330 may be any suitable element for measuring temperature. For example, temperature sensor 330 may be a thermistor, thermocouple, resistive thermal device (RTD), etc. Temperature sensor 330 may be made of any suitable material. For example, sensor 330 may be made of platinum, platinum-covered ceramic, wire, glass-covered wire, one or more alloys, metals, etc. In this embodiment, temperature sensor 330 is arranged beside exposed portion 310. In one embodiment, electrode 300 includes a plurality of temperature sensors 330, either of the same or different type.
Electrode 300 includes one or more sensor leads 340 for communicating signals from sensor 330. Sensor lead 340 may be mechanically and electrically coupled to one or more cores of a wire 220. Sensor lead 340 may communicate any suitable signal from sensor 330. For example, sensor lead 340 may communicate electrical voltage, resistance, and/or current, and/or differences in voltage, resistance, and/or current, etc. Electrode 300 also includes one or more electrode leads 350 for communicating a treatment signal to exposed portion 310. Electrode lead 350 may be mechanically and electrically coupled to one or more cores of a wire 220 and, in some embodiments, to cores in the same wire 220 in which sensor lead 340 is coupled to. The treatment signal may be any suitable signal for excising tissue; for example, it may be a voltage, a current, etc.
Temperature sensor 330 and its lead(s) may be included in one, some, all, or none of plurality of elongated electrodes 210. Similarly, exposed portion 310 may be included in one, some, all, or none of elongated electrodes 210. In some embodiments, exposed portion 310 may function as a temperature sensor 330. In such a case, the electrode 210 may or may not include elements for delivering a treatment signal, and in such a case exposed portion 310 may or may not be sharpened to a point.
In one embodiment, electrode 300 includes multiple exposed areas. For example, insulated portion 320 may include one or more apertures for exposing portions of electrode 300. In one case, a portion of temperature sensor 330 may be exposed. In another case, a portion of one or more other element (e.g., a conductive material such as a metal, alloy, etc.) for delivering a treatment signal may be exposed. In such a case, electrode 300 may include multiple exposed portions for delivering multiple treatment signals either dependent or independent of one another. In yet another case, multiple exposed portions 310 may extend from one or more insulated portions 320, where each exposed portion 310 may or may not be sharpened to a point. In such a case, electrode 300 may also deliver multiple treatment signals, and may include none, one, or more temperature sensors 330.
In another embodiment, electrode 300 may be flexible or include one or more flexible elements. For example, electrode 300 may be a catheter, where leads are coupled to the catheter needle so as to communicate a treatment signal to the needle. The catheter may or may not include one or more temperature sensors.
In some embodiments, electrode 300 may be solid or include solid elements, such as a solid exposed portion 310 and temperature sensor 320. In other embodiments, electrode 300 may include hollow portions. For example, exposed portion 310 may include a hollow chamber. Other elements of electrode 300 may also include a hollow chamber. For example, a hollow chamber may extend the length of electrode 300. The hollow chamber may be operable to communicate fluid or the like. For example, blood, water, or other fluids may pass in either direction through the hollow chamber.
Electrode 300 in certain embodiments may include various components such as an exposed portion 310, an insulated portion 320, a temperature sensor 330, a temperature sensor lead 340, and electrode leads 350. However, it will be appreciated by those of ordinary skill in the art that the electrode could operate equally well by having fewer or a greater number of components than are illustrated in
For example, in some embodiments electrode 300 may include a light source (not shown) such as a light emitting diode (LED). The light source may be operable to selectively output light such that a medical practitioner can visibly see the light. This may be useful for a practitioner to identify a particular, selected electrode. The light source may be provided in any suitable location, such as on an exterior surface of insulated portion 320 or beneath a transparent surface of insulated portion 320, or at an end of electrode 300 such as the end connected to flexible conductive wire 220. In one embodiment, computing device 120 provides an option via display device 130 for a user to locate or otherwise identify one or more electrodes. In response to receiving a user input selecting a particular electrode to locate, computing device 120 communicates an instruction to needle electrode assembly 170 and, in particular, to the electrode corresponding to the selected electrode. The instruction instructs the selected electrode to generate light such as via a light source provided in the electrode. Accordingly, in such embodiments, electrode 300 may include circuitry or other components operable to receive and interpret the received instruction and cause the light source to output light in response to receiving such an instruction.
Electrode Guide
A system will typically include an electrode guide or positioning device or apparatus. An electrode guide will typically be configured to engage electrodes of the system for assistance or facilitation of electrode positioning in the tissue of the patient. A guide may optionally include electrical connects that electrically couple with or in some manner facilitate, monitor, or affect energy delivery, monitoring, or control of current delivery. Various different designs or configurations of an electrode guide may be included in a system of the present invention.
Electrode guide 400 may include any suitable number of templates. In one embodiment, electrode guide 400 includes a first electrode template 420 and a second electrode template 430. The electrode templates may be any suitable template operable to receive electrodes and, in some embodiments, allow the electrodes to pass therethrough. The electrode templates may be any suitable shape. For example, they may have a cross section that is square, rectangular, circular, oval, or any other suitable shape.
First electrode template 420 may include one or more apertures 440 formed partially or entirely through a depth of the template. Apertures 440 may have any suitable shape, such as circular, square, rectangular, oval, etc., and may be of any suitable size. For example, apertures 440 may be sized to receive an electrode such as elongated electrode 210 discussed with reference to
In one embodiment, at least one of first electrode template 420 and second electrode template 430 includes an electronic circuit (not shown). For example, an electrode template may include a printed circuit board. The electronic circuit may include hardware and/or software for performing a variety of functions. For example, the electronic circuit may include conductive components for electrically coupling with an electrode disposed in an aperture of the electrode template. In such a fashion, a presence or absence of an electrode may be detected by the electronic circuit. The electronic circuit may then be communicatively coupled to other elements for communicating indications of the presence or absence of electrodes in one or more of the electrode templates. For example, the electronic circuit may be communicatively coupled to computing device 120.
In some embodiments, first electrode template 420 includes at least one securing element (not shown) extending from a surface of the template. For example, the at least one securing element may be a pin (not shown) extending from a bottom surface of the template. The securing element may be operable to mechanically couple first electrode template 420 to adjustable template securing apparatus 450. One embodiment of the at least one securing element is further discussed with reference to
Adjustable template securing apparatus 450 is operable to secure the plurality of electrode templates with respect to one another and adjust a distance between the plurality of electrode templates. In one embodiment, adjustable template securing apparatus 450 is operable to secure first electrode template 420 with respect to second electrode template 430 and adjust a distance between first electrode template 420 and second electrode template 430.
According to an embodiment, adjustable template securing apparatus 450 includes a first template mount 460, a second template mount 470, and a distance adjustment element 480. First template mount 460 may be operable to support first electrode template 420. For example, first template mount 460 may be mechanically couplable to distance adjustment element 480 and secure a position of first electrode template 420 relative to first template mount 460. First template mount 460 may be mechanically couplable to first electrode template 420 using any suitable mechanical coupling. For example, first electrode template 420 may be bonded to first template mount 460. For another example, first electrode template 420 may engage a cutout or aperture of first template mount 460. For yet another example, first template mount 460 may include one or more cutouts 462 each for receiving one or more securing elements (not shown) of first electrode template 420. In one embodiment, first template mount 460 includes two cutouts 462 arranged at opposite sides of first electrode template 420. In some embodiments, adjustable template securing apparatus 450 may also include at least one tightening element 492 for adjusting the strength of a mechanical coupling between first electrode template 420 and first template mount 460. For example, tightening element 492 may be a screw or other rotatable element operable to increase and/or decrease a size of cutout 462, where decreasing the size of cutout 462 results in an increased pressure on the securing element of first electrode template 420 by first template mount 460. In one embodiment, adjustable template securing apparatus 450 includes one tightening element 492 for each cutout 462.
Second template mount 470 may include some or all of the features discussed above for first template mount 460. For example, second template mount 470 may include a cutout 472 similar to cutout 462. Further, in some embodiments, adjustable template securing apparatus 450 may include one or more tightening elements 494 similar to the at least one tightening element 492, where the tightening elements 494 are operable to adjust the strength of a mechanical coupling between second electrode template 430 and second template mount 470.
In some embodiments, second template mount 470 is removably secured to distance adjustment element 480. Second template mount 470 may be removably secured to distance adjustment element 480 using any suitable mechanical coupling mechanism. For example, second template mount 470 may include a clasp, strap, or the like (not shown) for mechanically coupling to distance adjustment element 480. For another example, second template mount 470 may include one or more apertures 474 extending through a depth of second template mount 470. Aperture 474 may be any suitable shape and size to receive distance adjustment element 480 and allow distance adjustment element 480 to pass therethrough. In one embodiment, second template mount 470 includes two apertures 474 arranged on opposite sides of second electrode template 430. In some embodiments, template securing apparatus 450 may also include one or more tightening elements 496, similar to tightening element 492, for adjusting the strength of a mechanical coupling between distance adjustment element 480 and second template mount 470. For example, template securing apparatus 450 may include one tightening element 496 for each aperture 474.
Distance adjustment element 480 may be any suitable device operable to adjustably secure first electrode template 420 to second electrode template 430. In one embodiment, distance adjustment element 480 includes one or more cylindrically-shaped rods, although it may have any suitable cross-section shape, such as square, rectangular, oval, and the like. Distance adjustment element 480 may be removably secured to one or more of the plurality of electrode templates. In some embodiments, distance adjustment element 480 may be bonded to one or more of the plurality of electrode templates. For example, distance adjustment element 480 may be mechanically bonded to first template mount 460. In one embodiment, distance adjustment element 480 includes a pair of rods. Distance adjustment element 480 may include distance markers 482 that may be evenly spaced visual indicators indicating a distance along a length of distance adjustment element 480. For example, distance markers 482 may illustrate numerical values increasing in value from first template mount 460 so that a distance from first template mount 460 to second template mount 470 may be easily identified. Distance adjustment element 480 may be made of any suitable solid material, including metal, metal alloys, ceramic, polymers, etc.
Securing element 432 may be any suitable element extending from a surface of second electrode template 430 to removably secure second electrode template 430 to second template mount 470. For example, securing element 432 may be a pin-shaped extension extending from a bottom surface 434 of second electrode template 430, where a distal end of securing element 432 is sized larger than a proximal end of securing element 432 mechanically coupled to or formed with bottom surface 434. Securing element 432 may be sized to engage cutout 472. Further, tightening element 494 may be operable to increase or decrease a size of cutout 472 so as to increase or decrease a mechanical coupling between second electrode template 430 and second template mount 470.
In one embodiment, first electrode template 420 and second electrode template 430 are each arranged such that corresponding apertures in the templates are provided at identical distances from distance adjustment element 480 along a Y-axis. For example, first electrode template 420 and second electrode template 430 may be arranged in parallel along a Z-axis and be oriented to extend along the Y-axis. Apertures 440 provided in first electrode template 420 may be aligned along the Y-axis with apertures 440 provided in second electrode template 430. For example, an aperture provided at location E-5 in first electrode template 420 may be provided at a same height (H) relative to distance adjustment element 480 as an aperture provided at location E-5 in second electrode template 430.
In one embodiment, first electrode template 420 and second electrode template 430 are each arranged such that corresponding apertures in the templates are provided at identical distances from a distance adjustment element 480 along an X-axis. For example, first electrode template 420 and second electrode template 430 may be arranged in parallel along a Z-axis and be oriented to extend along the X-axis. Apertures 440 provided in first electrode template 420 may be aligned along the X-axis with apertures 440 provided in second electrode template 430. For example, an aperture provided at location E-5 in first electrode template 420 may be provided at a same distance (D) from a distance adjustment element 480 as an aperture provided at location E-5 in second electrode template 430.
By providing apertures 440 in first electrode template 420 in horizontal and vertical alignment with apertures 440 in second electrode template 430, the stability of an electrode passing through the templates may advantageously be increased as well as an accuracy of disposing the electrode into a target area.
Electrode guide 400 in certain embodiments is an apparatus for controlling the placement and positioning of electrodes and may include various components such as a plurality of electrode templates and an adjustable template securing apparatus. However, it will be appreciated by those of ordinary skill in the art that such an apparatus could operate equally well with fewer or a greater number of components than are illustrated in
For example, electrode guide 400 need not support electrodes operable to conduct current into a target area. Rather, in some embodiments, electrode guide 400 may be operable to support and/or guide radiation sources for applying radiation to a target area, such as in brachytherapy. In other embodiments, electrode guide 400 may be operable to support and/or guide needles or other devices for removing samples from the target area, such as in biopsies. Accordingly, electrode guide 400 may be operable to support a wide variety of instruments, medical or otherwise, for a variety of purposes.
Template
Electrode guides typically include one or more templates for operable to receive electrodes and, in some embodiments, allow the electrodes to pass therethrough. The templates may include one or more characteristics for resiliently positioning one or more electrodes received therein. By such resilient positioning, once an electrode has been placed in the template, accidental movement of the electrode may advantageously be reduced. As previously discussed, in one embodiment, the template(s) may include apertures suitably sized and shape to form a friction fit with an electrode. In other embodiments, the template(s) may include a friction plate operable to selectively change (e.g., increase or decrease) a friction force applied to one or more electrodes received by the template(s). By being operable to selectively change a friction force applied to electrodes, a position of electrodes may be substantially fixed once their appropriate position determined and, in some cases, re-positioning of the electrodes may easily be performed.
Template 500 includes one or more apertures 510 formed partially or entirely through a depth of the template. Apertures 510 may be similar to apertures 440. Template 500 also includes a friction adjustment mechanism 520 operable to change a friction force applied to one or more electrodes provided in apertures 510. Friction adjustment mechanism 520 may assume any suitable mechanical structure for causing displacement of elements of template 500. In one embodiment and as shown in
Template 500 may also include one or more elements operable to move friction plate 550 in conjunction with friction adjustment mechanism 520. For example, template 500 may include one or more return springs 560 operable to apply a return force to friction plate 550. In one embodiment, return springs 560 may apply a force on friction plate 550 in a direction opposite a force applied to friction plate 550 by friction adjustment mechanism 520. For example, friction adjustment mechanism 520 may include a cam 522 that, when rotated in a first direction, applies a linear force to friction plate 550 along the Y-axis. In response to applying the force to friction plate 550, friction plate 550 is caused to be displaced within cavity 540 along the Y-axis, such that a size of apertures 510 is effectively reduced. Return springs 560 apply a return force along the Y-axis in a direction opposite the direction of the force applied by rotation of cam 522 in the first direction. As a result, the force applied by return springs 560 operates to assist in returning friction plate 550 to its original position when cam 522 is rotated in a second direction opposite the first direction.
According to some embodiments, friction plate 550 may be a multi-layered structure. A first layer 552 may be a support structure that is relatively hard. For example, first layer 552 may be made of metal, ceramic, or one or more other relatively hard materials. A second layer 554 may be supported by first layer 552 and, in some embodiments, may be formed on a surface of first layer 552. Second layer 554 may be made of a relatively soft material (compared to first layer 552). For example, second layer 554 may be made of a polymer such as plastic. In these embodiments, first layer 552 may mechanically interact with cam and return springs 560 and, by its relatively hard physical nature, be resilient to long-term use and the wear resulting therefrom. Second layer 554, on the other hand, may mechanically interact with one or more electrodes 502 passing through friction plate 550 and, by its relatively soft physical nature, be operable to apply a friction force to electrode 502 without damaging electrode 502. To facilitate such an operation, first layer 552 and second layer 554 may each have apertures corresponding to apertures of housing 530, where apertures of second layer 554 may be smaller than apertures of first layer 552. As a result, second layer 554 may include an electrode interference portion 556 operable to engage or otherwise mechanically interfere with electrode 502.
Template 500 in certain embodiments is a device operable to selectively apply a friction force to received electrodes and may include various components such as a movable friction plate, friction adjustment mechanism, and return springs. However, it will be appreciated by those of ordinary skill in the art that such a system could operate equally well with fewer or a greater number of components than are illustrated in
In operation 610, a first electrode template is provided. The first electrode template may be any suitable device for receiving and supporting elongated electrodes. For example, the first electrode template may correspond to first electrode template 420 discussed with reference to
In operation 620, a second electrode template is provided. The second electrode template may be any suitable device for receiving and supporting elongated electrodes. For example, the second electrode template may correspond to second electrode template 430 discussed with reference to
In operation 630, the first electrode template is arranged a first distance from the second electrode template. For example, second electrode template 430 may be arranged to contact first electrode template 420 such that the first distance is 0 mm. For another example, second electrode template 430 may be arranged a distance of 10 mm, 20 mm, or 30 mm from first electrode template 420, or in a range from 10 mm to 30 mm, or less than 10 mm or greater than 30 mm.
The first electrode template may be arranged a first distance from the second electrode template using any suitable movement and securing mechanisms. For example, with reference to
In operation 640, the first electrode template is positioned proximate a treatment object. The treatment object may be any suitable object for which penetration of one or more electrodes is desired. For example, the treatment object may be a patient for which tissue ablation of a prostate (P) such as that discussed with reference to
In operation 650, an electrode is disposed through the first and second templates. For example, an elongated electrode may be disposed through an aperture of second electrode template 430 (e.g., an aperture located at template position E-5) and through a corresponding aperture of first electrode template 420 (e.g., an aperture located at template position E-5). The electrode may be disposed to first enter and pass through the second template and then enter and pass through the second template. Upon passing through the second template, the electrode may penetrate a surface of the treatment object.
In one embodiment, the electrode may penetrate the treatment object to a maximum desired depth. For example, with reference to
In operation 660, the second electrode template is repositioned to be a second distance from the first electrode template, where the second distance is greater than the first distance. For example, tightening elements 496 may be relaxed so as to enable second template mount 470 to move along distance adjustment element 480. Second template mount 470 may then be moved in a direction away from first template mount 460, so as to increase a distance between first electrode template 420 and second electrode template 430. This may be performed while maintaining a fixed distance between first electrode template 420 and the treatment object. In one embodiment, the elongated electrode includes an enlarged portion such as enlarged portion 222 discussed with reference to
By first disposing an electrode to a maximum depth and then arranging the second electrode template to be a distance from the first electrode template based on the maximum depth of the electrode, the maximum penetration depth of one or more additional electrodes may advantageously be determined and fixed.
In operation 670, one or more additional electrodes may be disposed through the first and second electrode templates. For example, one or more additional electrodes may be disposed in apertures surrounding the aperture in which the elongated electrode was disposed, and may be disposed while maintaining a position of first electrode template 420 relative to second electrode template 430. In some embodiments, the one or more additional electrodes may have the same size and shape of the previously disposed electrode, and in some cases, may have a similar enlarged portion such as that discussed with respect to the previously disposed electrode. By having the same enlarged portion and securing the second electrode template at the second distance, the one or more additional electrodes are prevented from exceeding the maximum depth.
In some embodiments, the first distance and/or second distance and thus, in some cases, the maximum depth, may be recorded using, for example, distance markers 482. The measurements may be stored in any suitable storage medium such as storage device 124. In some embodiments, multiple maximum depths can be determined and stored for different electrodes. For example, with reference to
It should be appreciated that the specific operations illustrated in
Electrode Control Software
The system further includes software or computer executable instructions that, when executed, cause the system to perform one or more actions or steps of the energy delivery as described herein. The software may provide a user interface for a user to control operation of the electrodes, and may be operable to control various elements of the system in accordance with the user inputs and/or receive and communicate to the user information from the electrodes such as temperature readings. The user interface may include visual depictions of electrodes that are to be controlled, and may also include any suitable input mechanism for receiving a user selection of control parameters. The control parameters may include, for example, an indication of specific electrodes for which a voltage is to be applied, a duration of time for which the voltage is to be applied to the chosen electrodes, and a desired temperature at which the controlled electrodes are to achieve.
Computing device 120 may have stored therein computer software for rendering user interface 700 based on various inputs, such as inputs from amplifier board 140. The computer software may be further functional to receive user inputs via one or more of the previously discussed input devices, and communicate corresponding control information to, e.g., amplifier board 140, for controlling electrodes 210 so as to heat a target area or volume, such as prostate tissue (P) (
User interface 700 may include one or more elements in one or more frames, windows, stacked tabs, or screens for display on one or more display devices. The elements may display various information pertaining to electrodes controlled by system control unit 108, such as voltages and currents applied to electrodes, temperature readings measured by electrodes, and the like. In some embodiments, the elements may also display various information pertaining to controlling the electrodes, such as control or treatment parameters.
According to one embodiment, user interface 700 includes a treatment parameter element 710, a patient information element 730, an electrode control element 750, and an electrode status element 770. At least some of the elements may be arranged proximate to one another. For example, electrode control element 750 may be arranged adjacent to electrode status element 770, and electrode control element 750 may include electrode activation elements that may be dragged from electrode control element 750 and dropped onto locations of electrode status element 770 to cause electrodes to be selectively activated.
Treatment parameter element 710 may include features in addition or alternatively to the aforementioned treatment parameter values. For example, treatment parameter element 710 may include an elapsed time value 720 that shows an amount of time that has elapsed since a particular treatment had begun (i.e., since electrodes in electrode array 170 were initially activated in a given session). For another example, treatment parameter element 710 may include a start button 722 and a quit button 724, activation of start button 722 causing treatment to begin, and activation of quit button 724 causing user interface 700 to terminate.
Patient information element 730 may include features in addition or alternatively to the aforementioned information. For example, patient information element 730 may include temperature statistics 738 that illustrates various statistics concerning the temperature of one or more electrodes in electrode assembly 170. Such statistics may include a time indicator indicating a time that particular temperature statistics are applicable, a mean temperature of the electrode(s), a standard deviation of the temperature of the electrode(s), a minimum temperature of the electrode(s), and/or a maximum temperature of the electrode(s). Such information may be calculated by, for example, processor 122, based on temperature measurements received from amplifier board 140 and may, advantageously, be reviewed by an operator during a test to ensure that a treatment is trending as expected.
Patient information element 730 may additionally or alternatively include a temperature chart 740, where the temperature chart 740 may also illustrate various temperature statistics. For example, temperature chart 740 may graphically illustrate temperature statistics such as mean temperature, standard deviation, etc., with respect to time. The time duration may be predetermined or user selectable, and may include a time range from the beginning of treatment to a current time, or a subset of such a time range. Such information may be calculated by, for example, processor 122 based on temperature measurements received from amplifier board 140 and may, advantageously, be reviewed by an operator during a test to ensure stability of the treatment.
Electrode control element 750 includes, for each electrode, an electrode polarity selector 752. In this embodiment, electrode control element 750 is operable to control 30 electrodes numbered 1 to 30, although any number of electrodes may be controlled. Electrode polarity selector 752 may include a graphical representation of a particular electrode (e.g., electrode number 3) for a number of different polarities of the electrode. For example, polarity selector 752 may include a graphical representation for applying a positive voltage to the electrode (i.e., 0 degree phase), a graphical representation for grounding the electrode, a graphical representation for applying a negative voltage to the electrode (i.e., 180 degree phase), and a graphical representation for electrically disconnecting the electrode (i.e., high impedance). Each graphical representation may have a unique color. In this embodiment, an operator may ‘drag and drop’ a graphical representation of a particular electrode driven at a particular polarity to a location on electrode status element 770. Doing so may cause amplifier board 140 to generate a voltage of the particular polarity and apply the voltage to an electrode of electrode assembly 170 corresponding to the location on electrode status element 770. In such a fashion, electrode patterns may advantageously be created quickly and easily.
According to some embodiments, polarity selector 752 may only include a graphical representation for applying a connected or disconnected electrode. For example, when control unit 108 is used for treating a patient, the operator may only need to select connected electrodes to be involved in a treatment and a high impedance needle to be used as temperature sensors or for other purposes. According to other embodiments, polarity selector 752 may include all of the aforementioned graphical representations. For example, when control unit 108 is used for system testing and/or research and development.
Electrode control element 750 may also include location and polarity information 754 concerning the electrodes. For example, electrode control element 750 may include, for each electrode, a horizontal position, a vertical position, and a polarization. In one embodiment, computing device 120 may calculate and cause such values to be displayed based on the operator's selection of locations on electrode status element 770. In other embodiment, such elements may be fields in which a user may enter the horizontal position, vertical position, etc., rather than performing the aforementioned drag-and-drop technique.
Electrode control element 750 may include various legends for aiding an operator in understanding the electrode control element 750. For example, electrode control element 750 may include a polarity legend 756 and/or a temperature error legend 758. Polarity legend 756 may include information indicating a correspondence between colors of graphical representations of polarity selector 752 and polarities applied to electrodes. Temperature error legend 758 may include information indicating a correspondence between colors of electrode status element 770 and a difference between a current electrode temperature and a desired electrode temperature.
Electrode control element 750 may also include one or more treatment parameters, in addition or alternative to those previously discussed with reference to
Electrode control element 750 may also include one or more buttons, activation of which may cause computing device 120 to perform select functionality. For example, electrode control element 750 may include: a set temperature button 766, activation of which may cause computing device 120 to record and store the value entered in desired electrode temperature field 760 for a subsequent treatment; a set voltage button 768, activation of which may cause computing device 120 to record and store the value entered in minimum electrode voltage field 762 and maximum electrode voltage field 762 for a subsequent treatment; and a disconnect all button 769, activation of which may cause all of the controlled electrodes to be electrically disconnected.
Electrode status element 770 also includes an electrode representation 774 which is a graphical representation of an electrode in electrode assembly 170. Any number of electrode representations 774 may be provided for a corresponding number of electrodes in electrode assembly 170. The number of electrode representations may be the same or different than the number of electrodes in electrode assembly 170. For example, some electrodes in electrode assembly 170 may not be used or positioned in electrode guide 110, thus obviating the need for a graphical representation or control mechanism. Further, the electrode representations 774, and corresponding electrodes in electrode assembly 170, may be provided in any suitable arrangement. For example, the electrodes and their graphic representations may be provided in square, circular, oval, or other arrangement. In some embodiments, the electrodes and electrode representations are provided in arrangements suitable for confined tissue ablations.
Electrode status element 770 may also include summary statistics information 776 for providing a summary of information illustrated by electrode representations 774. For example, summary statistics information 776 may include one or more of a mean temperature of all electrodes, a standard temperature deviation of all electrodes, a minimum electrode temperature, and a maximum electrode temperature.
User interface 700 in certain embodiments is an interface for monitoring and controlling a plurality of electrodes, and may include various components such as a treatment parameter element 710, a patient information element 730, an electrode control element 750, and an electrode status element 770. However, it will be appreciated by those of ordinary skill in the art that the user interface could operate equally well by having fewer or a greater number of components than are illustrated in
Electrode Control Algorithm
The system may execute an electrode control algorithm in which voltages are applied to the electrodes in accordance with the control algorithm. The electrode control algorithm may be implemented in hardware using any suitable electronic components. For example, the algorithm may be programmed into one or more EPROM's, EEPROM's, SRAM, or other programmable logic. Some or all of the electrode control algorithm may also or alternatively be implemented in software executable by any suitable computer processor. For example, the algorithm may be programmed in Fortran, Pascal, C, C++, Visual Basic, or any other suitable programming language.
Method 800 comprises two operations. In operation 810, computing device 120 (discussed with reference to
Computing device 120 may switch between any suitable number of electric voltage patterns. For example, computing device 120 may switch between two, three, four, or greater than four unique electric voltage patterns. Computing device 120 may switch between electric voltage patterns at any suitable rate, such as once every second, once every two seconds, once every three seconds, or once for every time period in a range between one second and three seconds, or once for every time period greater than three seconds, or once for every time period less than one second. Further, computing device 120 may repetitively switch between sequences of electric voltage patterns for any suitable treatment period, such as 20 minutes, 40 minutes, 60 minutes, or in a range between 20 minutes and 60 minutes, or less than 20 minutes, or greater than 60 minutes.
Numerous advantages may arise out of performing pattern switching. For example, if a first voltage is applied to a number of first electrodes and a second voltage is applied to a greater number of second electrodes in a given pattern, the first electrodes will have a higher current density and thus higher temperature than the second electrodes due to their lower numbers. By switching from the given pattern to a different pattern, a balance of voltages may be altered (e.g., the first voltage may be applied to smaller number of electrodes than the second voltage), and current densities and thus electrode temperatures may be averaged out over all of the electrodes. Averaging the electrode temperatures over all of the electrodes may advantageously reduce the number and/or effect of localized hot spots.
For another example, a single electric voltage pattern cannot evenly address all of the corner or outlying electrodes simultaneously. That is, while one outer electrode may have an electric potential difference with three or four adjacent electrodes, thereby creating a high current density for that outer electrode, another outer electrode may have an electric potential difference with only one adjacent electrode, thereby creating a relatively low current density for that outer electrode. By switching between voltage patterns, the number of electric potential differences between an outer electrode and adjacent electrodes may change, thereby averaging the current density and temperature of the outer electrodes over the treatment period.
In operation 820, computing device 120 applies a customized feedback control loop to control the electrical voltage provided to the electrodes. The feedback control loop may incorporate any suitable feedback control, including one or more of closed-loop feedback and open-loop feedback, and including one or more of proportional control, proportional-integral control, proportional-integral-derivative control, bistable control, and hysteretic control.
The customized feedback control loop may control the electrical voltage provided to the electrodes based on any suitable inputs and/or measured signals. In one embodiment, the electrical voltage of an electrode may be controlled based on a temperature difference which is set based on an adjacent electrode. For example, the temperature difference may be the difference between a temperature of an electrode for which the electrical voltage to be applied is being determined and a temperature of an adjacent electrode. For another example, the temperature difference may be the difference between a temperature of the adjacent electrode and a desired temperature. Using a temperature difference based on a temperature of an adjacent electrode may advantageously prevent and/or reduce the likelihood of overheating the adjacent electrode.
In one embodiment, the electrical voltage of an electrode may be controlled using an estimate of the voltage provided at the electrode. For example, computing device 120 may calculate a feedback control error based on the difference between an electrode temperature and another temperature (such as a desired temperature or a temperature of an adjacent electrode). The electrical voltage of the electrode may then be determined based on the calculated feedback control error. In determining the electrical voltage to be applied to the electrode, instead of using an electrical voltage of the electrode, computing device 120 may use an estimated voltage at the electrode, the estimated voltage being an estimate of voltages provided by other electrodes at the electrode under consideration. The estimated voltage provided by other electrodes may be determined by summing the voltages of each of the other electrodes adjusted by a distance of the other electrodes from the electrode, and averaging the result based on the number of other electrodes. By using an estimated voltage provided at an electrode by other electrodes rather than using the voltage of the electrode itself, a current flow between the electrode and other electrodes may be more accurately controlled, thereby increasing the accuracy of heat generation.
In some embodiments, computing device 120 may perform a proportional, proportional-integral, or proportional-integral-derivative control process, where input mechanisms may be controlled using, for example, a weighted sum of errors, integration errors, and derivative errors. In one embodiment, the input mechanisms may be voltages applied to each of the electrodes, and the errors may be a difference between an actual electrode temperature and a desired electrode temperature. Accordingly, via a proportional-integral control process, computing device 120 may track each electrode temperature and adjust each electrode voltage to deliver as much energy as possible without exceeding a thermal limit.
In one embodiment, the customized feedback control loop includes, for each electrode, measuring a current temperature of the electrode. For example, this may be performed using temperature measurements from a thermistor arranged within or proximate to the electrode. The control process may further include, for each electrode, calculating a difference between a current temperature of the electrode and another temperature (e.g., a desired electrode temperature), resulting in an error value. For example, the desired electrode temperature may be input via an input device into field 760, or may be pre-stored by computing device 120.
It should be appreciated that the specific operations illustrated in
Pattern Switching
Systems and methods and apparatus's as described may perform pattern switching, or differential activation of pairs or groups of electrodes in an array. This is generally done so as to deliver current using two or more different electrode patterns, where the current delivery for each pattern is unique. By changing between unique current patterns, the same or approximately the same amount of current may be applied each electrode over a treatment period, thereby averaging the power throughout a treatment area and thus avoiding or reducing hot spots and cold spots.
In operation 920, a first set of voltages is applied to electrodes in the electrode assembly 170 so as to create an electric potential difference between at least some adjacent pairs of the electrodes. The difference in electric potential may be any suitable difference to generate a desired current flow between the adjacent pairs of electrodes. For example, the difference may be 1V, 5V, 10V, in a range from 1V to 10V, less than 1V, or greater than 10V. The electric potential difference may be generated between any suitable adjacent pairs of electrodes so as to treat a treatment area (e.g., cancerous tissue) of a treatment object (e.g., a human patient). For example, with reference to
In some embodiments, applying the first set of voltages includes creating an absence of an electric potential difference between one or more adjacent pairs of the electrodes. For example, the electric potential difference may be 0V or approximately 0V. With reference to
In operation 930, a second set of voltages is applied to the electrodes in the electrode assembly 170 so as to create an electric potential difference between at least some adjacent pairs of the electrodes for which an electric potential difference was not created while applying the first set of voltages. For example, with reference to
In some embodiments, the second set of voltages may remove an electric potential difference between at least one of the adjacent pairs of the electrodes that was created while applying the first set of voltages. For example, with reference to
In other embodiments, applying the first set of voltages creates an electric potential difference between a first one of the electrodes and one or more first adjacent electrodes, and applying the second set of voltages creates an electrical potential difference between the first one of the electrodes and one or more second adjacent electrodes different than the first adjacent electrodes. For example, with reference to
In one embodiment, switching between unique electrode patterns includes creating an electric potential difference between each adjacent pair of electrodes at least once. For example, in operation 920 and with reference to
In some embodiments, one or more additional sets of voltages may be applied in addition to the first set and the second set. For example, a third set of voltages may be applied. The third set of voltages may have the same or different voltage pattern as the first set and the second set. In one embodiment, the third set of voltages is applied so that, together with application of the first set of voltages and the second set of voltages, an electric potential difference is created between each adjacent pair of electrodes for two of the three sets of voltages. For example, with reference to
For another example, a fourth set of voltages may be applied. The fourth set of voltages may have the same or different voltage pattern as the first set, second set, and third set. In one embodiment, the fourth set of voltages is applied so that, together with application of the first set, second set, and third set of voltages, an electric potential difference is created between each adjacent pair of electrodes for two or three of the sets of voltages. In another embodiment, the fourth set of voltages creates an electric potential difference for which an electric potential difference was not created while applying the first set, second set, or third set of voltages.
In operation 940, computing device 120 determines whether the treatment period is finished. For example, with reference to
In one embodiment, by repetitively applying multiple sets of voltages to the electrodes, an electric potential difference is created between each adjacent pair of the electrodes at least once over the treatment period. For example, with reference to
In some embodiments, multiple sets of voltages may be repetitively applied to different subsets of electrodes. For example, with reference to
It should be appreciated that the specific operations illustrated in
As shown in
Although application of the first set of voltages in accordance with the first electrode pattern establishes numerous current flows through a medium, that are there are some paths between electrodes in which only minimal amounts of current flows. The current flows shown by the arrowed lines are significantly larger, such as by an order of magnitude or more, than those paths which are not shown and for which only minimal amounts of current flows. Generally, there is little current flow in a direction from the top left of the electrode array to the bottom right of the electrode array. For example, since there is effectively an absence of electric potential between electrodes 1 and 4 and between electrodes 3 and 7, only a minimal amount of current flows between those electrode pairs. As a result, the medium located between such electrode pairs is not heated as much as between electrode pairs between which a current flows.
Further, while establishing numerous current flows between various electrodes, some electrodes are involved in more current paths than others. For example, electrode number 5 is involved in three current paths; i.e., current flows between electrode 5 and each of electrodes 4, 8, and 12. However, electrode number 2 is involved in only two current paths; i.e., current flows between electrode 2 and each of electrodes 3 and 9. As a result, the medium located at or close to electrode 5 will tend to heat up more quickly than that located at or close to electrode 2 since more current flows in the vicinity of electrode 5 than electrode 2.
This electrode pattern addresses the first weakness of the first electrode pattern, in general current paths are created between electrodes in which only minimal amounts of current flowed as a result of the first electrode pattern. That is, current flows are established in the direction from the top left of the electrode array to the bottom right of the electrode array. For example, since there is an electric potential established between electrodes 1 and 4 and between electrodes 3 and 7, relatively significant amounts of current flows between those electrode pairs.
Further, the number of current paths which electrodes are involved in is changed. For example, electrode number 5, which was previously involved in three current paths, is now involved in one current path; i.e., current flows between electrode 5 and 8, rather than between electrode 5 and each of electrodes 4, 8, and 12.
While numerous current flows are established between various electrodes, there are again some paths between electrodes in which only minimal amounts of current flows. Generally, there is little current flow in a vertical direction (e.g., between electrodes 1, 7, 15, and 24) and in a horizontal direction (e.g., between electrodes 9, 10, 11, 12). Further, some electrodes are now involved in only one current path (e.g., electrodes 2 and 5), and some electrodes are now involved in the same number of current paths (e.g., electrodes 2 and 5 are now involved in one current path) but were previously involved in a different number of current paths (e.g., electrodes 2 and 5 were previously involved in 2 and 3 current paths, respectively). The inconsistent number of current paths may result in uneven heating.
This electrode pattern addresses the weakness of the first electrode pattern, in general current flows are established in the direction from the top left of the electrode array to the bottom right of the electrode array. This electrode pattern also addresses the weakness of the second electrode pattern, in that current flows are established in the vertical direction and in the horizontal direction. However, this electrode pattern has its own weakness, in that only minimal current flows are established in the direction from the top right of the electrode array to the bottom left of the electrode array. That being so, this weakness is addressed by the first and second electrode patterns. Accordingly, by application of the sequence of electrode patterns, current flows are established between all adjacent pairs of electrodes, thereby advantageously generating substantially equal amounts of heat through all regions of the medium located proximate to the electrodes.
Further, the number of current paths which electrodes are involved in is changed once again. For example, electrode number 5, which was previously involved in three paths and then one path, is now involved in two paths. Further, electrode number 2, which was previously involved in two paths and one path, is now involved in three paths. As a result, it can be seen that over the course of applying multiple voltage patterns, the amount of current communicated to a given electrode is advantageously averaged out. This is particularly apparent and important for electrodes at the edge of the electrode array, as these electrodes tend to be consistently provided with too many or two few active current paths when only a single electrode pattern is applied.
It should be appreciated that the specific sequence of electrode patterns illustrated in
The AC signals include a first signal 1110 and a second signal 1120. First signal 1110 may be a voltage applied to a first electrode, and second signal 1120 may be a voltage applied to a second electrode. The first and second electrodes may be arranged adjacent to one another, so that differences in electric potential created between the first and second electrodes creates a current flow between those electrodes.
First signal 1110 and second signal 1120 are sinusoidal in this embodiment. However, in other embodiments, different types of analog waveforms may be used, such as square waves, triangular waves, sawtooth waves, etc. First and second signals have maximum amplitudes of 10V in this embodiment. However, in other embodiments, first and second signals may have different maximum amplitudes, such as 3V, 5V, 7V, in a range from 3V to 10V, less than 3V or greater than 10V. First and second signals always have opposite polarities except at their points of intersection. That is, they have opposite polarities except at angles of 180 degrees, 360 degrees, etc. However, in other embodiments, they may not always have opposite polarities. For example, the signals may be phase offset from one another. Further, in other embodiments, they may have points of intersection at other angles.
An amount of current flow between the electrodes may be altered using any suitable technique. In one embodiment, the amplitude of one or more of first signal 1110 and second signal 1120 may be increased or decreased. For example, to increase the difference in electric potential so as to increase a current flow between the electrodes, the maximum amplitude of first signal 1110 may be increased from 10V to 12V. For another example, to increase the difference in electric potential, the maximum amplitude of second signal 1120 may be increased, in addition to or alternatively to an increase in the maximum amplitude of first signal 1110.
First signal 1130 and second signal 1140 are sinusoidal in this embodiment. However, in other embodiments, different types of analog waveforms may be used, such as square waves, triangular waves, sawtooth waves, etc. In this embodiment, the first and second signals have different maximum amplitudes. First signal 1130 has a maximum amplitude of 10V, while second signal 1140 has a maximum amplitude of 2V. First signal 1130 and second signal 1140 may have any suitable different maximum amplitudes. For example, first signal 1130 may have a maximum amplitude of 6V, 8V, 10V, 12V, or in a range of 6V to 12V, or less than 6V or greater than 12V. Second signal 1140 may respectively have a maximum amplitude of 1V, 2V, 3V, 5V, or in a range from 1V to 5V, or less than 1V or greater than 5V.
First and second signals always have the same polarity. That is, in this embodiment, they both always have voltages greater than 0. However, in some embodiments, first and second signals may have a different polarity at some points in time. For example, instead of having a minimum voltage of 0V, first signal 1130 may have a minimum voltage of −2V. Further, in this embodiment, first and second signals have points of intersection at angles of 180 degrees, 360 degrees, etc. However, in other embodiments, they may have points of intersection at other angles.
An amount of current flow between the electrodes may be altered using any suitable technique. In one embodiment, the amplitude of one or more of first signal 1130 and second signal 1140 may be increased or decreased. For example, to increase the difference in electric potential so as to increase a current flow between the electrodes, the maximum amplitude of first signal 1130 may be increased from 10V to 12V. For another example, to increase the difference in electric potential, the maximum amplitude of second signal 1140 may be decreased from 2V to 1V.
First signal 1150 and second signal 1160 are square voltage pulses in this embodiment. First and second signals have maximum amplitudes of 10V in this embodiment. However, in other embodiments, first and second signals may have different maximum amplitudes, such as 3V, 5V, 7V, in a range from 3V to 10V, less than 3V or greater than 10V. First and second signals always have the same polarity. That is, in this embodiment, they both always have voltages greater than 0. However, in some embodiments, first and second signals may have a different polarity at some points in time.
In this embodiment, the maximum amplitudes of the first and second signals is the same; e.g., 10V. However, in other embodiment, they may be different from one another. For example, first signal 1150 may have a maximum amplitude of 10V, while second signal 1160 may have a maximum amplitude of 5V. In this case, the first and second signals may overlap each other in time, which would also create a difference in electric potential.
The voltage pulses may have any suitable duty cycle, which may be constant or variable. The duty cycle of first signal 1150 may be the same or different than the duty cycle of second signal 1160. Here, in a first time period T, the duty cycles are different. However, in the second time period between T and 2T, the duty cycles are the same. In other embodiments, the duty cycles may be the same for each time period, or different for each time period.
An amount of current flow between the electrodes may be altered using any suitable technique. In one embodiment, the amplitude of one or more of first signal 1130 and second signal 1140 may be increased or decreased. In another embodiment, the duty cycle of one or more of first signal 1130 and second signal 1140 may be increased or decreased. For example, with reference to the first time period T, the duty cycle of second signal 1140 may be increased to, e.g., half of the time period T, so as to increase the amount of time for which a difference in electric potential exists. In yet another embodiment, where the amplitude of the first and second signals in a given time period is different, the voltage pulses may overlap with one another, thereby creating a difference in electric potential not only where the voltage pulses do not overlap but also where they do overlap.
It should be appreciated that the specific techniques for generating a difference in electric potential illustrated in
Customized Feedback Control Loop
Systems and methods and apparatus's as described may use a customized feedback control loop to determine voltages to apply to electrodes in an array. This is generally done so as improve a user's control of current delivery and thus a user's control over tissue heating. For example, the temperature of electrodes adjacent to a controlled electrode may be used in determining a voltage to apply to the controlled electrode. In so doing, an overheating of the adjacent electrode may be controlled. For another example, the voltages of electrodes other than a controlled electrode may be used in determining a voltage to apply to the controlled electrode. In so doing, an increase or decrease in current delivery to the controlled electrode may be more accurately controlled.
In operation 1210, computing device 120 determines a temperature difference for an electrode based on a temperature of an adjacent electrode. In one embodiment, the temperature difference may be the difference between the electrode temperature and a desired electrode temperature (e.g., a desired temperature input via an input device into field 760, or may be pre-stored by computing device 120). The desired electrode temperature may represent a maximum electrode temperature desired by, for example, a medical practitioner. However, if such a temperature difference is the sole difference used to determine the electrode voltage, a temperature of the electrode may be increased without reference to or concern for the temperature of adjacent electrodes. Where an adjacent electrode has already attained a desired temperature, blindly increasing the voltage and temperature of the electrode may undesirably cause a temperature of the adjacent electrode to exceed the desired temperature.
Accordingly, in some embodiments, the temperature difference used to determine a voltage for an electrode may take into consideration a temperature of an adjacent electrode. By taking the temperature of the adjacent electrode into consideration, a temperature of the electrode may not be blindly increased in an attempt to reach a desired temperature, thereby reducing the likelihood that a temperature of the adjacent electrode exceeds a desired temperature of the adjacent electrode.
In one embodiment, a maximum electrode temperature may be set to be less than the desired electrode temperature. The temperature difference may then be set as the difference between the temperature of the electrode and the set maximum electrode temperature. The maximum electrode temperature may represent a maximum temperature of the electrode as identified by computing device 120 for the purposes of determining a voltage to apply to the electrode. By setting the maximum electrode temperature to be less than the desired electrode temperature, a current flow to one or more adjacent electrodes may be reduced compared to what it otherwise may have been, thereby advantageously preventing an excess amount of heat to be generated proximate to the one or more adjacent electrodes.
The maximum electrode temperature of an electrode may be set to be less than a desired electrode temperature using one or more of a variety of techniques. In one embodiment, a temperature of an adjacent electrode may be determined and used to set the maximum electrode temperature. The difference between the temperature of the electrode and the newly set maximum electrode temperature may then be used to determine a voltage to apply to the electrode. In another embodiment, a temperature of a plurality of adjacent electrodes may be determined. If the temperature of one or more of the adjacent electrodes is greater than a temperature of the electrode, one of the temperatures of the adjacent electrodes may be set as the maximum electrode temperature. In some embodiments, a highest temperature of the one or more adjacent electrodes may be identified and used.
In another embodiment, a temperature of an electrode may be set to be greater than the actual temperature of the electrode. The temperature difference may then be set as the difference between the set electrode temperature and a desired electrode temperature. By setting the electrode temperature to be greater than the actual temperature of the electrode, a current flow to one or more adjacent electrodes may be reduced compared to what it otherwise may have been, thereby advantageously preventing an excess amount of heat to be generated proximate to the one or more adjacent electrodes.
The temperature of an electrode may be set to be greater than the actual temperature of the difference using one or more of a variety of techniques. In one embodiment, a temperature of an adjacent electrode may be determined and used to set the temperature of the electrode. The difference between the newly set temperature of the electrode and the desired temperature may then be used to determine a voltage to apply to the electrode. In another embodiment, a temperature of a plurality of adjacent electrodes may be determined. If the temperature of one or more of the adjacent electrodes is greater than a temperature of the electrode, one of the temperatures of the adjacent electrodes may be set as the electrode temperature. In some embodiments, a highest temperature of the one or more adjacent electrodes may be identified and used.
One skilled in the art would recognize the numerous variations of the above-described techniques and other possibilities for setting the temperature difference for an electrode, and all such variations are within the scope of the present disclosure. For example, the temperature of the electrode and/or the desired electrode temperature may be set to a fraction of the adjacent electrode temperature (e.g., 50%, 70%, 90%, in the range from 50% to 90%, less than 50% or greater than 90%) or to a multiple of the adjacent electrode temperature (e.g., 110%, 150%, 200%, in the range of 110% to 200%, less than 110% or greater than 200%). For another example, the temperature of the electrode and/or desired electrode temperature may be set to an average temperature of one or more adjacent electrodes, or an average temperature of all other electrodes, or an average temperature of select electrodes (e.g., those electrodes having a temperature exceeding the desired temperature). For yet another example, both the temperature of the electrode and the desired electrode temperature may be set based and/or adjusted based on the adjacent electrode temperature.
In some embodiments, the temperature of an electrode may be determined at least in part based on the temperature of one or more adjacent electrodes only during a portion of a treatment period. For example, the temperature of the adjacent electrodes may be used while the temperature of the electrodes ramps up to their desired temperature. In other embodiments, the temperature of the electrode may be determined at least in part based on the temperature of one or more adjacent electrodes during the entire treatment period.
In operation 1220, computing device 120 calculates an estimate of an electrical voltage at the electrode provided by one or more other electrodes. The estimate may be an estimate of an average voltage at the electrode provided by one or more other electrodes. By using an estimated voltage provided at an electrode by other electrodes, it is possible to predict what electrode voltage would result in a high or low current flow between the electrode and other electrodes, thereby increasing the accuracy of heat generation. Specifically, with pattern switching and individual control over electrical voltage and phase, the voltage potential at each electrode location may always be changing. As a result, decreasing the voltage at an electrode (e.g., decreasing the voltage to zero) may not necessarily decrease current flow to or from the electrode if the surrounding electrodes are in phase and at a higher voltage. Accordingly, using an estimated voltage at the electrode rather than zero may advantageously compensate for such complications.
The estimated voltage provided at the electrode may be determined using one or more of a variety of techniques. In one embodiment, a voltage of a plurality of adjacent electrodes is identified. The voltage of each adjacent electrode may then be adjusted based on a distance of the adjacent electrode from the electrode. For example, the voltage may be multiplied by a factor representative of distance. The adjusted voltages may then be averaged by, for example, summing the voltages and dividing the result by the number of adjacent electrodes. The estimated voltage potential at that electrode location may then be used to determine an electrical signal to be applied to the electrode.
In another embodiment, a voltage of all other electrodes may be identified. For example, the all other electrodes may include all of the electrodes in the electrode array being controlled other than an electrode for which the voltage is being determined. Similar to the embodiment discussed above, the average voltage of all of the other electrodes may be calculated and then used to determine an electrical voltage to be applied to the electrode.
One skilled in the art would recognize the numerous variations of the above-described techniques and other possibilities for calculating and using an average voltage to determine a voltage to be applied to an electrode, and all such variations are within the scope of the present disclosure. For example, the average voltage of adjacent electrodes as well as additional (but not all other) electrodes may be calculated and used.
In operation 1230, computing device 120 sets a voltage to be applied to an electrode based at least in part on one or more of the determined temperature difference and calculated voltage estimate. For example, the voltage to be applied to an electrode may be set using the temperature difference determined in operation 1210. For another example, the voltage to be applied to an electrode may be set using the calculated voltage estimate in operation 1220. In some cases, both the temperature difference and the voltage estimate may be used to set the voltage to be applied to an electrode.
It should be appreciated that the specific operations illustrated in
In operation 1310, a desired electrode temperature (T_desired) is input. In one embodiment, the desired electrode temperature may be input via an input device into field 760 discussed with reference to
In operation 1320, the actual temperature (T_actual) of the electrode is read. For example, the electrode may include temperature sensor 330 discussed with reference to
In operation 1330, a determination is made as to whether the actual temperature (T_actual) is equal to the desired temperature (T_desired). If it is determined that T_actual is equal to T_desired, processing may return to operation 1320. If it is determined that T_actual is not equal to T_desired, for example, T_actual is greater or less than T_desired, then processing may continue with operation 1340.
In operation 1340, the electrode temperature is set for the purposes of calculating feedback control error. Various techniques may be used for setting the electrode temperature for the purposes of calculating feedback control error, some of which were discussed with reference to operation of 1210 of
In operation 1350, a feedback control error is calculated. Feedback control error is indicative of a difference between T_actual and T_desired, where the customized feedback control process 1300 seeks to minimize the feedback control error. The feedback control error may be any value representative of the difference between T_actual and T_desired. For example, the feedback control error may be equal to a difference between an actual temperature of the electrode and a desired temperature of the electrode. For another example, the feedback control error may be equal to a difference between the actual temperature of the electrode and a temperature of an adjacent electrode. For another example, the feedback control error may be equal to a difference between the average temperature of one or more adjacent electrodes and the desired temperature of the electrode, or the difference between the actual electrode temperature and the average temperature of one or more adjacent electrodes.
Feedback control error may also be based on one or more additional indicators of error. For example, a constant may be added or removed to a calculated temperature difference. For another example, a derivative and/or integral of one or more temperature differences over time may be added or removed. For yet another example, multiple differences (either the same or different temperature differences) may be summed, averaged, or the like, with the result either used as the feedback control error, added to other error calculations, or removed from other error calculations. One of ordinary skill in the art would recognize and appreciate many variations, modifications, and alternatives for calculating the feedback control error.
In one embodiment, the feedback control error is calculated as the difference between T_actual and T_desired. T_actual may be set in accordance with operation 1340 and as discussed with reference to
In operation 1360, a voltage of the electrode (V_electrode) is modified based on the feedback control error. Various techniques may be used for modifying the voltage of the electrode, some of which were discussed with reference to operation 1210 of
In operation 1370, a determination is made as to whether a treatment period is finished. In one embodiment, the treatment period may be input via an input device into field 712 discussed with reference to
As discussed throughout this description, adjacent electrodes may be any or all electrodes within a suitable vicinity of a subject electrode (e.g., an electrode for which a voltage to be applied thereto is determined). In one embodiment, the adjacent electrodes may be the nearest electrodes in each direction. For example, with reference to
In operation 1344, it is determined whether the temperature of the adjacent electrode (or electrodes) is not greater than a temperature of the electrode under consideration. If it is determined that the temperature of the adjacent electrode (or electrodes) is not greater than a temperature of the electrode under consideration, then processing for setting the electrode temperature may end and thus processing may return to operation 1350. In such a case, the temperature of the electrode is not adjusted for the purposes of calculating feedback control error, and thus the actual temperature of the electrode is used to calculate the feedback control error. In one embodiment, it is determined that the temperature of the adjacent electrode is not greater than a temperature of the electrode only if a temperature of all of the adjacent electrodes is not greater than a temperature of the electrode.
If it is determined that the temperature of the adjacent electrode (or electrodes) is greater than a temperature of the electrode, then processing may continue with operation 1346. In operation 1346, the temperature of the electrode (T_actual) may be set equal to the temperature of the adjacent electrode. Processing for setting the electrode temperature may then end and return to operation 1350. In such a case, the temperature of the electrode is adjusted for the purposes of calculating feedback control error. That is, instead of using the actual temperature of the electrode to calculate the feedback control error, a temperature of an adjacent electrode may be used in place of the temperature of the electrode to calculate the feedback control error.
If a temperature of one or more adjacent electrodes is greater than a temperature of the electrode, any suitable adjustment may be made to the temperature of the electrode. In one embodiment, the maximum temperature of the adjacent electrodes is determined, and T_actual is replaced with this maximum temperature. In another embodiment, an average temperature of all of the temperatures for adjacent electrodes exceeding the temperature of the electrode is determined, and T_actual is replaced with this average temperature. One skilled in the art would recognize the numerous variations of the above-described techniques and other possibilities for adjusting the temperature of the electrode, and all such variations are within the scope of the present disclosure.
In operation 1364, an estimated voltage (V_estimated) at the electrode is calculated. The estimated voltage at the electrode may be determined using one or more of a variety of techniques. In one embodiment, the identified voltage of the other electrodes may be adjusted based on a distance of the other electrodes from the electrode. For example, the voltage may be multiplied by a factor representative of distance. The adjusted voltages may then be averaged by, for example, summing the voltages and dividing the result by the number of adjacent electrodes. The average of the adjusted voltages may then be used as the estimated voltage at the electrode.
In operation 1366, a determination is made as to whether the actual temperature of the electrode (T_actual) is less than the desired temperature (T_desired). The actual temperature of the electrode may be the actual temperature of the electrode as discussed with reference to operation 1330, or it may be set to a different value as discussed with reference to operation 1340.
If it is determined that T_actual is less than T_desired, then processing continues to operation 1368, where V_electrode is set to be greater than V_estimated. In some embodiments, V_electrode may be set to be lower than V_estimated. As a result of creating a difference in voltage between V_estimated and V_electrode, a current may be caused to flow to the electrode, thereby increasing a temperature of the electrode. The difference in voltage between V_estimated and V_electrode may be determined based on the feedback control error calculated in operation 1350. For example, where the feedback control error indicates a large temperature difference, V_electrode may be set to create a large difference in voltage with respect to V_estimated, so as to create a large current flow to the electrode and thus heating of the electrode. Where the feedback control error indicates a small temperature difference, V_electrode may be set to create a small difference in voltage with respect to V_estimated, so as to create a small current flow to the electrode and thus small or reduced heating of the electrode.
If it is determined that T_actual is not less than T_desired, then processing continues to operation 1369, where V_electrode is set approximately equal to V_estimated or is electrically disconnected. As a result of setting V_electrode approximately equal to V_estimated, a current flow to the electrode may be reduced, thereby maintaining or reducing a temperature of the electrode. Similarly, as a result of electrically disconnecting the electrode, a current flow to the electrode may be reduced, thereby maintaining or reducing a temperature of the electrode. In some embodiments, one or more electrodes adjacent to or in the vicinity of the electrode may also be electrically disconnected. For example, all of the electrodes surrounding an electrode for which T_actual is greater than or equal to T_desired may be electrically disconnected. In some cases, electrically disconnecting adjacent electrodes may be performed simultaneously with disconnecting the electrode. In other cases, the adjacent electrodes may be disconnected only if the electrode continues to overheat for a predetermined time.
It should be appreciated that the specific operations illustrated in
In this embodiment, treatment parameters 1410 include a test time 1412 (i.e., treatment period) of 20 minutes, a desired electrode temperature 1414 of 47 degrees Celcius, a minimum voltage 1416 of 0 V, and a maximum voltage 1418 of 4 V. An elapsed time value 1420 shows an elapsed treatment time of 10 seconds. Patient information element 1430 includes a temperature chart 1440 showing a mean temperature 1442 of the electrodes. Electrode status element 1450 shows various information concerning each electrode, including an electrode identifier 1452, a current temperature 1454, a current electrical current 1456, a current electrical voltage 1360, a polarity indicator 1462, and a relative temperature indicator 1464, similar to those discussed with reference to
As shown in
It should be appreciated that the specific sequence of electrode patterns illustrated in
Mobile Cart
Systems for selectively applying electric fields to target areas include various components such as electrodes, a system control unit, and an imaging device. The various components may be provided in any suitable mechanical apparatus or system. In one embodiment, one or more of the components may be provided as a mobile unit such as a mobile cart. By providing components as a mobile unit, the system may advantageously be moved with relative ease to and/or between subjects or other elements for which it is desired to apply controlled voltages.
Mobile cart 1500 may also include a controller 1540 mechanically mounted to frame 1510 which may include various components for controlling display device 1530 and one or more electrodes. For example, controller 1540 may include a processor, storage element, data acquisition card, amplifier board, etc. In one embodiment, controller 1540 may include computing device 120, amplifier board 140, isolation transformer 150, and/or power supply 160 discussed with reference to
Mobile cart 1500 may also include a cassette rack 1550 mechanically mounted to frame 1510. Cassette rack 1550 may be operable to receive part of a needle electrode assembly 1560. For example, needle electrode assembly 1560 may include a cassette connector 1562, one or more wires 1564, one or more electrodes 1566, and a cassette 1568. Cassette rack 1550 may be operable to receive cassette 1568, and controller 1540 may be operable to receive cassette connector 1562.
The components of mobile cart 1500 may be provided in any suitable arrangement for allowing a user to interact with display device 1530 and access electrodes 1566 to subsequently position electrodes 1566 near a target area. For example, display device 1530 may be provided at or near the top of frame 1510, cassette rack 1550 may be arranged below display device 1530, and controller 1540 may be arranged below cassette rack 1550.
Various elements of electrode assembly 1560 may be the same as or similar to electrode assembly 200 discussed with reference to
In some embodiments, electrode assembly 1560 may also include cassette 1568, which is operable to hold electrodes 1566. Cassette 1568 may include one or more apertures suitable sized and spaced to receive electrodes 1566. For example, apertures 1568a may be similar to apertures 238 discussed with reference to
Controller 1540 may include one or more of a variety of components other than apertures 1542. For example, controller 1540 may include status indicators 1544 for displaying various status information concerning the operation of controller 1540 and/or connectivity of a cassette connector 1562 to controller 1540, a power switch 1546 for activating and deactivating controller 1540, and an emergency stop button 1548 for disabling controller 1540 and/or causing controller 1540 to stop providing voltage and/or current to electrodes 1566.
As shown in
Mobile cart 1500 in certain embodiments is an apparatus for providing a mobile system via which electric fields may be selectively applied to target areas, and may include various components such as a frame, base, display device, controller, and electrodes. However, it will be appreciated by those of ordinary skill in the art that the mobile cart could operate equally well by having fewer or a greater number of components than are illustrated in
The various systems, mobile carts, and components thereof may be used in one or more of a variety of fashions to apply electromagnetic fields to target areas. In one embodiment, a display device such as display device 130 discussed with reference to
Turning briefly to
Returning to
For example,
In response to a cassette 1568 being loaded into cassette rack 1550, controller 1540 may perform a variety of other processing. For example, controller 1540 may perform a test on the receive cassette or instruct the received cassette to perform a self test, so as to test cassette temperatures, sorts, expiration dates, etc. In the event that the test identifies one or more problems with cassette 1568, one or more prompts may be displayed to the user via display device 1530 indicating such problems.
In operation 1630, a user selection of an electrode to be placed is received. For example, a user may select a digital representation of one of the electrodes of the received cassette. A purpose of such a selection may be to subsequently place the digital representation of the electrode into a particular location on grid array 1714, and/or configure one or more other aspects of the selected electrode, such as desired temperature, maximum voltage, minimum voltage, etc.
With reference to
In operation 1640, a user placement of the selected electrode onto grid array 1714 is received. For example, a user may choose to place the electrode selected from the cassette onto a location of grid array 1714. Grid array 1714 should generally correspond to apertures of a template such as template 500, and placement of the graphical representations of electrodes onto grid array 1714 should correspond with placement of the actual electrodes into corresponding apertures of template 500. By providing such a correspondence, user interface 1710 may subsequently provide a graphical representation of actual electrodes disposed in or around a target area.
Turning briefly to
When it is desired to place a plurality of electrodes, operations 1630, and 1640 may be repeated for each electrode of each loaded cassette, and when it is desired to load multiple cassettes operation 1620 may be repeated. In some embodiments, a plurality of cassettes may be loaded and the electrodes from some or all of the cassettes configured.
In operation 1650, treatment begins. Treatment begins by controller 1540 using any received configuration information, together with any suitable configuration defaults and pre-programmed electrode control algorithms, to cause electrodes 1566 which have been digitally placed via user interface 1710 to generate electromagnetic fields. The pre-programmed electrode control algorithms may include any of those previously discussed, such as any or all of those discussed with reference to
For example,
In operation 1660, treatment ends. Treatment ends when the treatment period expires, controller 1540 receives a user input to stop, pause, or otherwise terminate treatment, and/or controller 1540 detects one or more fault conditions such as an electrode short, significant overheating, a hardware or a software failure in any of the components of the system, etc. Once treatment ends, display device 1530 may prompt the user to perform additional tasks, such as removing needles from the template, place sharp objects in containers, unplug connections, remove templates the electrode guide, power down the system, etc.
In accordance with some embodiments, a treatment may include a number of treatment cycles, where each treatment cycle may be the same or different than a previous treatment cycle. For example, a treatment may include a first treatment cycle in which electrodes are controlled to heat a target area for a set duration, and a second treatment cycle in which the electrodes are controlled to heat the target area for the same or a different duration at the same or a different temperature as configured in the first treatment cycle. Controller 1540 may sequentially execute the treatment cycles which may be preconfigured or configured in sequence at the end of a previous treatment cycle. Multiple preconfigured treatment cycles that are sequentially executed may advantageously be used in situations where it is desired to heat treatment volumes at different depths or at otherwise different locations within the volume. For example, electrodes may be disposed in a treatment volume (e.g., a prostate) a first depth in the treatment volume. Upon execution of the first treatment cycle, the electrodes may apply electromagnetic fields at the first depth in the treatment volume. Once the first treatment cycle is complete, the treatment may be paused, whereby controller 1540 prevents electric fields to be applied via the electrodes or otherwise disables the electrodes. The electrodes may then be relocated to a second depth in the treatment volume. Upon relocation of the electrodes to the second depth, the second treatment cycle may be executed. In such a fashion, a three-dimensional volume may be effectively treated.
It should be appreciated that the specific operations illustrated in
Further, user interfaces 1700 and 1710 in certain embodiments are interfaces for facilitating treatment of a target area, and may include various elements such as a dialogue box 1712, grid array 1714, and cassette representation 1716. However, it will be appreciated by those of ordinary skill in the art that the user interface could operate equally well by having fewer or a greater number of components than are illustrated in
It should be understood that the examples and embodiments described herein are for illustrative purposes only and that various modifications or changes in light thereof will be suggested to persons skilled in the art and are to be included within the spirit and purview of this application and scope of the appended claims. Further, numerous different combinations are possible, and such combinations are considered part of the present invention.
For example, user interface 700 may provide any suitable mechanism for receiving information from an operator. With reference to
For another example, user interface 700 may display information in any suitable arrangement. While user interface 700 is discussed as separate elements for displaying and inputting specific information, such as treatment parameter element 710, patient information element 730, electrode control element 750, and electrode status element 770, these elements may be integrated, or partially integrated, and the information displayed therefrom and input thereto may be displayed and input onto the elements as described or onto different elements. For example, while start button 722 is illustrated as being a part of treatment parameter element, start button 722 may be additionally or alternatively part of a different element, such as electrode status element 770.
For yet another example, instead of generating and controlling current flows between electrodes, current flows could be generated and controlled between electrodes and a return pad. That is, with reference to
In certain embodiments, methods and structures as described herein have been demonstrated as remarkably effective in delivering fields to a target tissue while more precisely controlling the resulting temperature applied to the tissue (e.g., controlled tissue heating). Selectively controlling the electromagnetic fields generated by a plurality of electrodes with a corresponding control of applied temperature or heating as described herein can offer several advantages. In accordance with various embodiments described herein, voltages applied to electrodes, and accordingly the current paths established between electrodes, can be specifically controlled, resulting in an unprecedented temperature control of target volumes in which the electrodes are disposed.
Target tissue heating involving methods and structures described herein is not limited to any particular target temperature or temperature range. Delivery of electromagnetic fields as described herein, for example, may include heating of tissue from no discernable increase in tissue temperature above baseline (e.g., body temperature, such as normal human body temperature of about 37 degrees C.) to temperatures inducing indiscriminate, heat-mediated tissue destruction (e.g., tissue necrosis, protein cross-linking, etc.). For example, target tissue heating temperatures may include increases of target tissue from about 0 to about 5, 10, 20, 30 degrees C. (or higher) above baseline, as well as any temperature increment therebetween.
In some embodiments, current delivery may be selected to elicit mild tissue heating, such that target tissue is heated a few degrees above baseline or body temperature, such as 0.1 to about 10 (or more) degrees Celsius above baseline or body temperature (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, etc. degrees Celsius above baseline). Such mild heating and/or accurate temperature control through a target volume can be particularly advantageous in applications where it is desired to destroy cancerous cells while minimizing damage to nearby healthy cells. For example, mild tissue heating may be selected such that current delivery elicits preferential disruption or destruction to cancerous cells in a target tissue (e.g., target tissue volume) compared to non-cancerous cells in the target tissue.
As described above, methods and structures described herein further allow for more precise control of the temperatures or temperature ranges of the target tissue or heating elicited in the target tissue with delivery of electromagnetic fields. Thus, target temperatures can include a target range or selected/expected deviation from the target temperatures. For example, tissue heating temperatures or ranges can include a modest deviation from a target, and will typically be less than a few degrees Celsius, and in some instances less than about 1 degree Celsius (e.g., 0.001 to about 1 degree Celsius). For example, actual heating may be from +/− about 0.001 to about 10 degrees Celsius, or any increment therebetween.
In some of the embodiments described, desired voltages, maximum voltages, minimum voltages, and/or voltage ranges may be defined. For example, a maximum voltage may be 3V, 4V, 5V, in the range from 3V to 5V, 0V to 5V, −5V to 5V, or less than −5V or greater than 5V. By setting such maximum voltages, the control algorithms operate to achieve the desired temperature by setting the appropriate voltage differentials so as to establish appropriate current flows, all without exceeding the set voltage levels. Such selective voltage control is particularly advantageous in applications where excess voltage levels or differentials may cause undesirable secondary effects. Similarly, by controlling maximum voltage ranges, then maximum current ranges are inherently imposed. In some embodiments, instead of a user providing maximum voltages or voltage ranges, a user may input maximum currents or current ranges, which has similar advantages to controlling the maximum voltage levels.
Throughout this description, reference may be made to selected or desired temperatures. Temperatures can be actually temperatures, predicted or calculated temperatures, or measured temperatures (e.g., directly or indirectly measured tissue temperatures). In some embodiments, such temperatures may correspond to the temperature of an electrode, subset of electrodes, or all electrodes disposed in a target volume. For example, electrode temperature may be acquired via a temperature sensor disposed in an electrode, such as temperature sensor 330 (
While the present invention is described with particular reference to targeting prostate tissue or tissues in or proximate to the prostate of a patient, structures and methods described herein can be utilized for targeting various different tissues other than those of or proximate to a patient's prostate, and are not intended for limitation to any particular tissue or bodily location. For example, structures and methods of the present invention can be utilized for targeting various different tissues including cancerous cells of various tissue types and locations in the body, including without limitation breast, liver, lung, colon, kidney, brain, uterine, ovarian, testicular, stomach, pancreas, etc.
Although the description herein is provided in the context of applying voltages to target tissues, voltages may be applied to target areas of any suitable material. For example, voltages may be applied to metals, polymers, ceramics, or other types of material. The material may be solid, liquid, gaseous, or in any other suitable state.
Accordingly, the scope of the invention should be determined not with reference to the above description, but instead should be determined with reference to the pending claims along with their full scope or equivalents.
While preferred embodiments of the present invention have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the invention. It should be understood that various alternatives to the embodiments of the invention described herein may be employed in practicing the invention. It is intended that the following claims define the scope of the invention and that methods and structures within the scope of these claims and their equivalents be covered thereby.
This application is a Continuation of U.S. application Ser. No. 14/365,450, filed Jun. 13, 2014, which is a U.S. National Phase application under 35 U.S.C. §371 of International Application No. PCT/US12/69430, filed Dec. 13, 2012, which claims the benefit of U.S. Provisional Application No. 61/570,154, filed Dec. 13, 2011, the entirety of each of which is hereby incorporated by reference.
Number | Date | Country | |
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61570154 | Dec 2011 | US |
Number | Date | Country | |
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Parent | 14365450 | Jun 2014 | US |
Child | 15376438 | US |