The invention relates to an interventional device with an ultrasound transducer. The interventional device may be used in various interventional procedures in the medical field. In one contemplated application the ultrasound transducer is an ultrasound detector used to track a position of the interventional device respective an ultrasound field of an ultrasound imaging probe.
Interventional procedures in the medical field increasingly use ultrasound to gain more information about, or to treat, a patient's anatomy. In this regard, ultrasound devices may be equipped with an ultrasound transducer, defined herein as an ultrasound detector, or an ultrasound emitter, or a device that is capable of both detecting and emitting ultrasound signals, for use in sensing and actuation applications such as tracking, imaging, or treatment.
In one exemplary application described in more detail in document “A Non-disruptive Technology for Robust 3D Tool Tracking for Ultrasound-Guided Interventions” by Jay Mung, Francois Vignon, and Ameet Jain, in MICCAI 2011, Part I, LNCS 6891, pp. 153-160, 2011, A. Martel, and T. Peters (Eds.), an ultrasound detector is attached to a medical needle and used to track the needle position respective the ultrasound field of a beamforming ultrasound imaging probe based on the timing of ultrasound signals detected by the detector.
Another method for attaching an ultrasound transducer to an interventional device for use in a tracking application is disclosed in document WO2016207041A1. This document describes transfer stack for transferring a portion of a foil within a perimeter that includes a transducer to an article such as a medical device or a medical needle. The transfer stack includes a carrier substrate, a foil having a transducer incorporated therein, and the transducer is laterally surrounded by a perimeter. The foil is separable from the carrier substrate by overcoming a first peel retaining force. An adhesive layer is also attached to the foil. The adhesive layer is configured to provide adhesion between the foil and an article such that when the article is attached to the foil via the adhesive layer the foil is separable from the surface of the article by overcoming a second peel retaining force. The second peel retaining force (PRF2) is greater than the first peel retaining force.
Another document WO2017013224A1 is also relevant to attaching an ultrasound transducer to an interventional device for the purposes of ultrasound-based tracking. This document describes a transducer laminate in which electrical contact is made between electrical conductors and a transducer layer. The transducer laminate includes two adhesive-coated foils, whose adhesive coatings are arranged to face each other. At a first position along the length of the two electrical conductors the two electrical conductors are sandwiched between the adhesive coatings of the two adhesive-coated foils, and the transducer layer is also sandwiched between the two electrical conductors such that electrical contact is made with the electrodes on the transducer layer. At a second position along the length of the two electrical conductors the two electrical conductors are sandwiched between the adhesive coatings of the two adhesive-coated foils and there is no transducer layer sandwiched between the two electrical conductors.
Another document US 2017/172544 A1 relates to a needle with thin film piezoelectric sensors. A sensor device includes a flexible planar strip including a plurality of layers. The strip is configured to at least partially encapsulate a medical device. The strip includes a first dielectric layer, a conductive shield layer disposed on the first dielectric layer, a second dielectric layer formed on the conductive shield layer; and a patterned conductive layer including a sensor electrode, a hub electrode and a trace connecting the sensor electrode and the hub electrode.
Other exemplary applications such as intravascular ultrasound, i.e. IVUS, imaging, also include one or more ultrasound transducers on an interventional device such as a catheter, in order to generate images of the vasculature.
Despite recent progress in this field there remains room to improve the attachment of ultrasound transducers to interventional devices in such application areas.
The present invention seeks to improve the attachment of ultrasound transducers to interventional devices. Some known solutions to this problem may suffer from the ingress of moisture in the vicinity of the ultrasound transducer, which may affect transducer performance. Other known solutions to this problem may suffer from the interventional device having an irregular topology, particularly in the vicinity of the ultrasound transducer. As a result, a medical professional user may experience a variable resistance to insertion when inserting such interventional devices into the body.
In order to address one or more of the aforementioned drawbacks, an interventional device is provided. A related ultrasound-based position determination system that incorporates the interventional device, and a related method of manufacturing the interventional device are also provided. The interventional device includes an elongate shaft having a longitudinal axis, an ultrasound transducer, an adhesive layer, and a protective tube formed from a heat-shrink material. The ultrasound transducer is disposed on the elongate shaft such that the ultrasound transducer has an axial extent along the longitudinal axis. Moreover, at least along the axial extent of the ultrasound transducer the protective tube surrounds the ultrasound transducer and the adhesive layer is disposed between the ultrasound transducer and the protective tube.
The protective tube may reduce the ingress of moisture into the ultrasound transducer. The protective tube may also provide a smoother topology over the ultrasound transducer and thereby provide for a smoother introduction of the interventional device into the body. By forming the protective tube from a heat shrink material a reliable manufacturing method is provided. Moreover, the inventors have discovered that by disposing the adhesive layer between the ultrasound transducer and the protective tube, improved ultrasound transducer performance may be achieved. It has been found that when such a protective tube is disposed over the ultrasound transducer, typically a thin layer of air is trapped between the ultrasound transducer and the protective tube. This layer of air acts as an ultrasound reflector and/or attenuator, and due to its irregular thickness rotationally about the protective tube, may consequently introduce a rotational variation in ultrasound sensitivity and/or radiated ultrasound signal strength. The adhesive layer reduces the tendency for such a layer of air to form, thereby improving the ultrasound transducer's sensitivity and/or radiated ultrasound signal strength, and the rotational variability in these parameters. Moreover, the adhesive layer also reduces the risk of moisture reaching the ultrasound transducer, which acts to maintain the ultrasound transducer's performance over time.
Further aspects are described with reference to the appended claims. Further advantages from the described invention will also be apparent to the skilled person.
In order to illustrate the principles of the present invention an interventional device in the form of a medical needle is described with particular reference to an exemplary position tracking application in which the positon of an ultrasound detector on the needle is determined respective the ultrasound field of a beamforming ultrasound imaging system. It is however to be appreciated that the invention may also be used in other application areas that employ ultrasound transducers such as ultrasound imaging and treatment applications. It is also to be appreciated that whilst reference is made to an ultrasound transducer in the form of an ultrasound detector, the ultrasound transducer may alternatively be an ultrasound emitter, or indeed be capable of both detecting and emitting ultrasound signals, or indeed comprise both an ultrasound emitter and an ultrasound detector. The invention also finds application with other interventional devices than a medical needle, including without limitation a catheter, a guidewire, a biopsy device, a guidewire, a pacemaker lead, an intravenous line or a surgical tool in general. The interventional device may be used in a wide variety or medical procedures, for example from routine needle insertion for regional anesthesia, to biopsies and percutaneous ablation of cancer, and to more advanced interventional procedures.
In a preferred implementation, ultrasound transducer 102 is formed from a piezoelectric material. Various so-called hard or soft piezoelectric materials may be used. The piezoelectric material may for example be a polymer such as Polyvinylidene fluoride, i.e. PVDF, PVDF co-polymer such as polyvinylidene fluoride trifluoroethylene (P(VDF-TrFE)) layer, or PVDF ter-polymer such as P(VDF-TrFE-CTFE). One exemplary supplier of a suitable PVDF polymer is Goodfellow, Cambridge, UK. Alternatively, ultrasound transducer 102 may be a capacitive micromachined ultrasound transducer, i.e. a CMUT device. In a preferred example, ultrasound transducer 102 comprises a single transducer, although the use of an array of two or more such transducers is also contemplated.
Various adhesive materials are contemplated for use as adhesive layer 103 in
Various heat-shrink materials are contemplated for use as protective tube 104. Polyolefins and fluropolymers including PVDF, HDPE, LDPE, EMA are amongst the materials that are contemplated. Suitable materials for protective tube 104 include polyester, PET, materials provided by Nordson Medical, Colorado, USA and product MT5500 supplied by the Raychem Corporation, USA.
In the exemplary interventional device 100 illustrated in
In the exemplary interventional device 100 illustrated in
In one exemplary fabrication process, interventional device 100 in
In an alternative exemplary fabrication process, a pressure sensitive adhesive may be used for adhesive layer 102. A layer of PSA may for example be deposited on the outer surface of ultrasound transducer 102 after its attachment to elongate shaft 102. Alternatively ultrasound transducer 102 may be attached to a portion of PSA-coated foil having PSA on both surfaces prior to its attachment to elongate shaft 101. Upon application of heat to protective tube 104, the inner surface of protective tube 104 becomes attached to the outermost PSA layer as the protective tube contracts.
Another contemplated method of attaching ultrasound transducer 102 to interventional device is to provide ultrasound transducer 102 as a transducer strip and to wrap this in the form of a spiral around elongate shaft 101 of interventional device 200. Thereto,
With reference to
Optionally, width dimension W in
In order for consecutive turns of the spiral to abut, i.e. just touch, one another, the following equation should be satisfied:
W=π·D·Sin(α) Equation 1
Wherein α is the acute angle defined by transducer direction 114 with respect to length direction 113, and D is the diameter of elongate shaft 101. By arranging that W exceeds the above value, consecutive turns of the spiral overlap one another. Likewise by arranging that W is less than this value a small gap may be provided between consecutive turns of the spiral.
The spiral wrapping arrangement of
Thus, together,
As illustrated in the exploded views of
In an alternative wrapped implementation an interventional device includes an elongate shaft having a longitudinal axis, an ultrasound transducer, an adhesive layer, and a protective tube formed from a heat-shrink material. The ultrasound transducer is disposed on the elongate shaft such that the ultrasound transducer has an axial extent along the longitudinal axis. At least along the axial extent of the ultrasound transducer the protective tube surrounds the ultrasound transducer and the adhesive layer is disposed between the ultrasound transducer and the protective tube such that the adhesive layer adheres to an inner surface of the protective tube. Moreover, in this implementation the ultrasound transducer and the adhesive layer are provided by a transducer strip. The transducer strip comprises the ultrasound transducer, the adhesive layer, a first edge and an opposing second edge, the first edge and the second edge being separated by a width dimension, and the first edge and the second edge each extending along a length direction of the transducer strip. The ultrasound transducer is disposed on the transducer strip and extends along a transducer direction that is perpendicular with respect to the length direction of the transducer strip. The adhesive layer covers the ultrasound transducer. Moreover, the transducer strip is wrapped around the elongate shaft of the interventional device such that the first edge is parallel with the longitudinal axis of the elongate shaft and such that the ultrasound transducer forms a band around the elongate shaft. By arranging the first edge parallel to the longitudinal axis of the elongate shaft the attachment of the transducer strip to the elongate shaft of the interventional device may be simplified. Optionally the width dimension may be defined in this implementation such that the first edge and the second edge abut or overlap one another. The abutting or overlapping adjacent turns act to avoid the exposure of material underlying the wrapped transducer strip. In this implementation the interventional device may also be rolled across the transducer strip in order to attach it to the interventional device. The terms “parallel” and “perpendicular” as used in this alternative wrapped implementation are to be interpreted as including arrangements within three degrees of exactly parallel or exactly perpendicular.
As mentioned above, the interventional devices described herein may for example be used in an ultrasound-based tracking application. In this, the ultrasound transducer may detect, or emit, or both detect and emit, ultrasound signals, and the position of the ultrasound transducer may thus be determined based on ultrasound signals transmitted between ultrasound detector 102 and a beamforming ultrasound imaging system.
Thereto,
In-use the above-described conventional ultrasound imaging system is operated in the following way. An operator may plan an ultrasound procedure via imaging system interface 735. Once an operating procedure is selected, imaging system interface 735 triggers imaging system processor 736 to execute application-specific programs that generate and interpret the signals transmitted to and detected by beamforming ultrasound imaging probe 730. A memory, not shown, may be used to store such programs. The memory may for example store ultrasound beam control software that is configured to control the sequence of ultrasound signals transmitted by and/or received by beamforming ultrasound imaging probe 730. The function of image reconstruction unit 732 may alternatively be carried out by imaging system processor 736. Image reconstruction unit 732 provides a reconstructed ultrasound image corresponding to ultrasound field 731 of beamforming ultrasound imaging probe 730. Image reconstruction unit 732 thus provides an image corresponding to the image plane defined by ultrasound field 731 and which intercepts region of interest ROI. The image is subsequently displayed on display 734. The reconstructed image may for example be an ultrasound Brightness-mode “B-mode” image, otherwise known as a “2D mode” image, a “C-mode” image or a Doppler mode image, or indeed any ultrasound image.
Also shown in
In-use, the position of ultrasound transducer 102 is computed respective ultrasound field 731 by position determination unit 733 based on ultrasound signals transmitted between beamforming ultrasound imaging probe 730 and ultrasound transducer 102.
In one configuration ultrasound transducer 102 is a detector that receives ultrasound signals corresponding to beams B1 . . . k. Position determination unit 733 identifies the position of ultrasound transducer 102 by comparing the ultrasound signals detected by piezoelectric transducer 102. Position determination unit 733 subsequently provides an icon in the reconstructed ultrasound image based on the computed position of ultrasound transducer 102. More specifically the comparison determines the best fit position of ultrasound transducer 102 respective ultrasound field 731 based on i) the amplitudes of the ultrasound signals corresponding to each beam B1 . . . k that are detected by ultrasound transducer 102, and based on ii) the time delay, i.e. time of flight, between emission of each beam B1 . . . k and its detection by ultrasound transducer 102. This may be illustrated as follows. When ultrasound transducer 102 is in the vicinity of ultrasound field 731, ultrasound signals from the nearest of beams B1 . . . k to the transducer will be detected with a relatively larger amplitude whereas more distant beams will be detected with relatively smaller amplitudes. Typically the beam that is detected with the largest amplitude is identified as the one that is closest to ultrasound transducer 102. This beam defines the in-plane angle θIPA between beamforming ultrasound imaging probe 730 and ultrasound transducer 102. The corresponding range depends upon the time delay, i.e. the time of flight, between the emission of the largest-amplitude beam B1 . . k and its subsequent detection. The range may be determined by multiplying the time delay by the speed of ultrasound propagation. Thus, the range and corresponding in-plane angle θIPA of the beam detected with the largest amplitude may be used to identify the best-fit position of ultrasound transducer 102 respective ultrasound field 731.
In the above example, ultrasound beams B1 . . k are imaging beams. In another configuration ultrasound beams B1 . . . k may be dedicated tracking beams that are emitted in tracking frames between consecutive imaging frames in predetermined directions by beamforming ultrasound imaging probe 730.
In yet another configuration ultrasound transducer 102 may be an emitter that emits one or more ultrasound pulses. Such pulses may for example be emitted during tracking frames that are interleaved between consecutive imaging frames of the conventional ultrasound imaging system. In such a tracking frame, beamforming ultrasound imaging probe 730 may operate in a receive-only mode in which it listens for ultrasound signals originating from the vicinity of ultrasound field 731. Beamforming ultrasound imaging probe 730 is thus configured as a one-way receive-only beamformer during such tracking frames. Position determination unit 733 identifies from which beam of virtual beams B1 . . . k the pulse(s) originated by applying delays to the receiver elements of beamforming ultrasound imaging probe 730. The delays correspond to each of virtual beams B1 . . . k. As in the ultrasound detector configuration above, position determination unit 733 may use a comparison procedure that, based on the maximum amplitude and time of flight, identifies the closest beam B1 . . k to the position at which the ultrasound signal was emitted. Position determination unit 733 subsequently provides an icon in the reconstructed ultrasound image based on the identified position of ultrasound transducer 102.
In another configuration ultrasound transducer 102 may be configured to act as both a receiver and an emitter. In this configuration ultrasound transducer 102 may be triggered to emit one or more ultrasound pulses upon receipt of an ultrasound signal from beamforming ultrasound imaging probe 730. In this way the pulse(s) emitted by ultrasound transducer 102 during an imaging mode are received by beamforming ultrasound imaging probe 730 appear as an echo in the reconstructed ultrasound at an in-plane angular position, i.e. in an image line, that corresponds to the relevant beam B1 . . k . Ultrasound transducer 102 thus appears as a bright spot in the reconstructed image. Position determination unit 733 may subsequently identify this bright spot in the reconstructed image and thus compute a position of ultrasound transducer 102 respective ultrasound field 731.
In the above-described ultrasound-based position determination system 730 the dependence of the sensitivity profile, or emission profile, of piezoelectric transducer 102, or more specifically its magnitude and/or dependence on rotational angle of the interventional device, may impact its positioning respective ultrasound field 731. Thereto, the use of the above-described interventional device has the benefits of improved reliability and sensitivity.
It is to be appreciated that the exemplified beamforming ultrasound imaging probe 730 is only one example of a beamforming ultrasound imaging system in which interventional device 100 may be used. Interventional device 100 also finds application in ultrasound-based position determination systems that include other types of 2D or 3D beamforming ultrasound imaging systems. These may include for example a “TRUS” transrectal ultrasonography probe, an “IVUS” intravascular ultrasound probe, a “TEE” transesophageal probe, a “TTE” transthoracic probe, a “TNE” transnasal probe, an “ICE” intracardiac probe. Moreover, it is to be appreciated that the interventional device 100 also finds application in other sensing and actuation applications in the medical field beyond position tracking.
Thereto, with reference to
providing an ultrasound transducer transfer stack 840 that includes:
Electrical shield layer 105, the first foil strip 121, the ultrasound transducer 102 and second foil strip 122 are arranged layerwise on substrate 841 such that at first position D-D′ along transducer transfer stack 840, electrical shield layer 105 is disposed between substrate 841 and second foil strip 122 and first foil strip 121 is arranged on second foil strip 122 with one of the PSA layers 123 of first foil strip 121 facing outwards with respect to substrate 841, and such that at second position E-E′ along transducer transfer stack 840, adhesive layer 103 is disposed between substrate 841 and electrical shield layer 105 and second foil strip 122 is arranged on electrical shield layer 105 and ultrasound transducer 102 is arranged on second foil strip 122 and first foil strip 121 is arranged on ultrasound transducer 102 with one of the PSA layers 123 of first foil strip 121 facing outwards with respect to substrate 841.
The method also includes rolling 842 elongate shaft 101 of interventional device 100, 200, 300 across outwards-facing PSA layer 123 of first foil strip 121 such that outwards-facing PSA layer of first foil strip 123 adheres to elongate shaft 101 and such that first foil strip 121 and the ultrasound transducer 102 and the adhesive layer 103 and the second foil strip 122 and the electrical shield layer 105 become attached to the elongate shaft 101 with adhesive layer 103 facing outwards with respect to the elongate shaft 101.
The method also includes arranging a protective tube 104 comprising a heat-shrink material over a portion of the elongate shaft 101 to cover at least the ultrasound transducer 102, and applying heat to the protective tube 104 such that the protective tube 104 contracts radially with respect to the longitudinal axis A-A′ of elongate shaft 101 and such that adhesive layer 103 adheres to an inner surface of the protective tube 104.
Whilst not illustrated in
In summary, an interventional device has been provided. The interventional device 100, 200, 300 includes an elongate shaft 101 having a longitudinal axis A-A′, an ultrasound transducer 102, an adhesive layer 103, and a protective tube 104 formed from a heat-shrink material. The ultrasound transducer 102 is disposed on the elongate shaft 101 such that the ultrasound transducer 102 has an axial extent L along the longitudinal axis A-A′. At least along the axial extent L of the ultrasound transducer 102 the protective tube 104 surrounds the ultrasound transducer 102 and the adhesive layer 103 is disposed between the ultrasound transducer 102 and the protective tube 104.
Various embodiments and options have been described in relation to the interventional device, and it is noted that the various embodiments may be combined to achieve further advantageous effects. Any reference signs in the claims should not be construed as limiting the scope of the invention.
Number | Date | Country | Kind |
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18198820.5 | Oct 2018 | EP | regional |
Filing Document | Filing Date | Country | Kind |
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PCT/EP2019/071159 | 8/7/2019 | WO | 00 |
Number | Date | Country | |
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62716144 | Aug 2018 | US |