The present invention relates to a medical analysis device and to methods for fabricating and/or using such a device. It finds particular application in magnetic resonance spectroscopy or imaging, for instance for analysis associated with surgery.
Magnetic resonance imaging (“MRI”) for medical diagnosis is well known. Typically, the entire patient or at least that part of the patient to be studied is placed with the main magnetic field of an MRI scanner's magnet. This very strong, homogeneous and static main magnetic field (e.g. 0.5 T) causes the nuclear spins within the patient to align themselves with and against the magnetic field, thereby creating a net magnetic moment in each volume. A transmit coil, typically surrounding the patient, is then used to transmit an excitation pulse which flips the magnetic moment away from its equilibrium position. As the magnetisation decays back to its equilibrium state the spins gyrate around the equilibrium axis and emit signal at the frequency of gyration. This radio frequency signal may be picked up by a receive coil. The frequency of gyration is given by the local magnetic field strength experienced by each spin. This local magnetic field strength is dynamically altered using the scanner's gradients. These superimposed gradients, one in each of the x, y and z directions, typically work at audio frequencies and provide the frequency and phase encoding needed for image reconstruction.
In minimally-invasive MRI, a separate, small, receiving coil or antenna is used to receive the signal, instead of or in addition to the radio-frequency coils of the MRI apparatus itself. Such a coil may be placed either adjacent to the patient's skin or may be inserted by means of a probe into a patient's body cavity, for example into the colon.
MRI is increasingly used during surgical procedures, particularly where tumours or other soft tissue needs to be removed. The area of interest is imaged by the MRI scanner, as surgery proceeds, with both the tumour and the cutting instrument being visible on screen. It is important to remove tumours and their margins without cutting into the affected tissue. Current practice for tumour removal is to mark the tumour boundaries under image guidance (e.g. x-ray, MRI) using markers such as titanium wires, and then to cut around these markers. The result is a lump of tumour, which should have a margin (shell) of healthy tissue surrounding it. It is critical that no off-shoots are missed. Usually this is confirmed by checking that all the markers have been removed and that the tumour is thus completely resected. Furthermore, the operative site is scanned to identify abnormal tissue left and the removed (resected) tissue is placed into a tumour container or resection jar and sent off to a laboratory for further analysis. At the laboratory, x-rays may be taken and frozen sections made.
There are a number of advantages for using MRI for soft tissue imaging. Firstly, the technique does not use ionising radiation. Secondly, no harmful contrast agents are needed. The technique is truly three-dimensional. However, the main advantage is the unrivalled soft-tissue differentiation. MRI may show tumours and tumour margins indistinguishable from healthy tissue in other imaging modality, the naked eye or even to palpation.
In practice, there are a number of problems however. In particular, x-ray analysis of the tumour is not particularly efficient since x-rays do not provide high quality images of soft tissue. Although it would be possible to provide improved images by placing the tumour into another MRI scanner at the laboratory, that would be expensive and would mean either purchasing another scanner to do the analysis or, alternatively, interrupting the routine of a scanner that would normally be used for scanning patients. Because of the time currently taken to analyse the excised tumour, if any problem is found (for example if only part of the tumour has been excised) the patient typically needs to undergo a further surgical operation. That is clearly undesirable.
In a related use of magnetic resonance, there is also increasing interest in spectroscopy of tumours for tumour classification.
According to a first aspect of the present invention, there is provided a container for containing material to be analysed using magnetic resonance, the container including a receive coil for use in analysing material contained in the container.
Such a container can be placed within the magnetic field of a magnetic resonance scanner for use during surgery and material which has been removed from a patient can be placed in the container for imaging, during or immediately after a surgical operation, and preferably while it is still available to resume surgery on the patient.
Thus, using an embodiment of the present invention, when a tumour is removed it can be placed into the container, within the magnetic field of the MR scanner being used during surgery, allowing the tumour to be imaged there and then, in detail. There are several advantages of such an arrangement. Immediately after the surgical operation has been completed, the surgeon can check whether a tumour has been excised cleanly, with a sufficient margin of healthy material around it. This can be done in the operating theatre, while the patient is still in the scanner and at very little additional cost.
The coil included in the container may also be adapted to act as a transmit coil for use in analysing material contained within the container. In such an arrangement, it may not be necessary that the container be placed in the transmit coil of the MR scanner being used during surgery since the container coil itself, acting in transmit mode might be used to create the necessary excitation pulse. Typically, the container will still be positioned within the main magnetic field and the gradients produced by the MR scanner, since the coil may provide an excitation pulse only without simultaneously being used as a receive coil. However, it would be possible for the coil to be used for both transmit and receive.
Preferably, the container is sealable; it may also have access points (e.g. rubber membranes) for biopsies.
Once the surgeon has finished, the container may be sent to a laboratory or other facility for x-rays and/or other analyses to be carried out in the normal way.
Preferably, the container is provided with a connector for connecting the receive coil, directly or indirectly, to an input of a magnetic resonance scanner. In this way, the container can be manufactured as a throw-away item, including just the container with its receive coil and the connector.
In more detail, receive coils for magnetic resonance may in use comprise an inductive part which is connected to circuitry such as matching and decoupling circuits. Preferably, only the inductive part is provided for the container. The more expensive circuitry can be provided as part of the input to a scanner, or as an adaptor for connecting the receive coil to a scanner. The use of an adaptor may be preferred since it supports the use of a single container design with multiple different scanners and/or field strengths. The adaptor can be scanner-specific while the container is a standard item, without there being any need to manufacture a different container for each model of scanner. Containers may however be manufactured in a variety of shapes and sizes, according to application.
Thus in embodiments of the present invention the design can be flexible. It can use standardised scanner independent parts as throw away items. Expensive and specialised parts can all be multi-use.
Preferably, the receive coil is constructed as a volume coil so that material to be imaged can be placed inside the coil. This can provide improved resolution images. Such an arrangement might be particularly suitable for use with an “open” scanner in which patient scans can be carried out during surgical procedures, the surgeon often standing at least partially within the field of the scanner. Open scanners bring huge advantages in guiding the surgeons but current open MRI scanners have low to medium field strengths.
The receive coil could be provided in different ways in relation to the container, and could indeed provide at least part of the containment. It could be formed as part of the container body, or it may be added after the container itself has been manufactured. For example, the coil could be created by sputtering techniques, spraying, screen printing, painting etc. To avoid interfering with the scanner's magnetic field, the container, the receive coil and the connector for connecting the receive coil may be made entirely of non-ferromagnetic material.
According to a second aspect of the present invention, there is provided a scanner for use in analysis by magnetic resonance, the scanner having detachably connected thereto a container comprising at least in part a receive coil for use in analysing material contained in the container.
The scanner may be an open scanner, provided with at least one transmit coil and at least one receive coil which can be arranged for use in imaging the area of a surgical procedure while it is being carried out. The container may be arranged so that it can be disposed in said area to enable analysis of material in the container by use of said at least one transmit coil, together with the receive coil comprised by the container. Alternatively or additionally, the receive coil of the container may also be adapted to function as a transmit coil for use in analysis of material in the container.
An adaptor may be provided between the scanner and the container for adapting the detachable connection to meet requirements of the scanner and of the receive coil of the container in said use in analysing material contained in the container.
According to a third aspect of the present invention, there is provided a method of analysing material by use of magnetic resonance, the method comprising the steps of:
The receive coil of the container might also be adapted to act as a transmit coil, in which case the excitation pulse used for analysis of the material while still in the body of material may be different from the excitation pulse used for analysis of the material after being removed therefrom. However, alternatively, the same excitation pulse could be used for analysis of the material while still in the body of material and after being removed therefrom. The main magnetic field is preferably provided by the main magnet of an MRI scanner, with gradients being supplied by the scanner's gradient coils.
According to a fourth aspect of the present invention, there is provided a method of analysing a sample material by use of magnetic resonance, the method comprising the steps of:
In this fourth aspect, embodiments of the present invention can provide a method of analysing material by placing the material in a container with a receive coil and putting the container in a magnetic field generated independently and externally (e.g. by a MRI scanner). In such a method, there may be at least two receive coils, a first receive coil for use with the scanner in the normal way, in the absence of the container, and a second receive coil being the receive coil of the container.
In the above, reference is made to “analysis”, “analysing” and the like. These are not intended to have any restricted special meaning and should be taken to encompass any operation that might be carried out using magnetic resonance such as imaging, spectroscopy, or characterisation for example, as well as any other suitable form of analysis such as microscopy or biochemical analysis.
Embodiments of the present invention will now be described, by way of example only, with reference to the accompanying drawings in which:
Referring to
The material of the container 100 is preferably transparent so that the position of a sample in it can be seen. Further, as mentioned above, the container and all its parts should be made entirely of non-ferromagnetic material. For example, the lid and body might be made of perspex or glass. The container may include access points, such as rubber-membrane-covered apertures (not shown) via which biopsies may be taken.
Referring to
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Taking the first option, the connector 300 shown in
Taking the second option, as shown in
Both types of coupling are known per se, inductive and direct.
The circuits of
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A decoupling scheme may need to be added if the coil 200 on the container 100 is to be used as receive only. This may be achieved using a DC bias on the coaxial cable to switch a diode at the input terminals of the matching section, as is shown in FIGS. 7(b) and 7(c).
Referring to
Various design features may be preferred for use of the container 100. For instance, it may be preferred that the base of the container is made anti-slip and a label area might be provided on the outside. The entire container is preferably disposable and intended for single-use only. Alternatively, the container may be made of suitable materials to allow sterilisation and re-use.
In the above, attention is given to imaging of material, particularly to support surgical procedures. However, there may be other applications to which embodiments of the invention would be relevant. An example of one of these is magnetic resonance spectroscopy of tumours for tumour classification.
Number | Date | Country | Kind |
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0212581.3 | May 2002 | GB | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/GB03/02372 | 5/30/2003 | WO | 9/8/2005 |