This invention relates to medical devices and methods for use in tissue characterization and treatment.
Techniques for in situ identifying abnormal (e.g. tumorous) cells in a biological tissue are generally known. Such techniques include those utilizing determination of the electrical properties of a tissue, for example, by determination of electrical impedance or dielectric constants. Some kinds of tumors can be identified by determining differences in the measured electrical properties of the tissue. The identified and located region of abnormal tissue can then be treated and/or removed from the body
Various types of tissue characterization sensor and its integration with a tissue treatment/removal tool are described in the following patent publications, all assigned to the assignee of the present application: US2003138378, WO2006103665, WO2007015255, U.S. Pat. No. 6,813,515 and U.S. Pat. No. 7,184,824.
Also, various techniques are known for removing a certain tissue specimen from a tissue mass. These techniques are disclosed for example in U.S. Pat. No. 6,689,145 and U.S. Pat. No. 7,122,011.
There is a need in the art to facilitate precise location and determination of a to volume of a tissue specimen (e.g. abnormal tissues) to be treated (e.g. removed). Also, there is need in the art for a tissue treatment technique capable of adjusting a treatment volume to the determined volume of the abnormal tissue specimen.
The present invention solves the above problems by providing a novel medical device for use in tissue characterization and treatment. The device comprises a tissue characterization probe comprising an elongated carrier for carrying an array of tissue characterization sensors arranged in a predetermined spaced-apart relationship at least along an axis of said carrier. During the progression of the probe through a tissue mass, signals from the tissue characterization sensors are used for locating and determining a dimension of an abnormal tissue specimen inside the tissue mass. This enables consequent treatment of the abnormal tissue specimen by a treatment tool.
In preferred embodiment of the invention, the treatment tool is mounted on the characterization probe carrier. The treatment tool may be configured for carrying out at least one of the following biopsy, cutting, delivering physical treatment, delivering treatment medication, diagnostics.
Preferably, the treatment tool is selectively shiftable between its inoperative position being located substantially entirely inside the carrier and its operative position projecting by its at least one tissue treating portion towards outside the carrier. In preferred embodiments of the invention, the dimension of the tissue treating portion(s) projectable from the carrier, and possibly also location of the tissue treating portion(s) with respect to the carrier can be controllably varied.
In some embodiments of the invention, the probe carrier is formed with a guiding cutting tool, to facilitate insertion of the probe to a targeted location in the tissue. Also, in some embodiments of the invention, a marker may be left in the body, at the location of the treated (removed) tissue.
The invention also provides a novel method for use in tissue characterization and treatment. A tissue mass is scanned with an array of tissue characterization sensors arranged in a predetermined spaced-apart relationship along a scanning axis, and signals from the sensors are detected and analyzed while scanning locate and determine a dimension of an abnormal tissue specimen inside said tissue mass that is to be treated during progression of the array through the tissue mass.
Additionally, the invention provides a system for use in tissue characterization and treatment. The system comprises a medical device and a control unit connectable to the medical device. The latter is configured as described above, namely comprises a tissue characterization probe having a carrier on which an array of tissue characterization sensors is mounted with the sensors being arranged in a spaced-apart relationship at least along an elongated axis of the carrier. The control unit is configured for receiving and analyzing tissue characterizing signals from each of all the sensors and utilizing data indicative of the respective sensors' location, for determining a dimension of an abnormal tissue specimen.
The present invention further provides for a novel convenient presentation of the measurement results. As indicated above, the tissue characterization probe of the invention includes an array (one- or two-dimensional array) of tissue characterization sensors. In the simplest example, this is a one-dimensional array of spaced-apart sensors along the longitudinal axis of the probe. Thus, for a given position of the probe with respect to tissue under measurements, the array of sensors arranged in a predetermined fashion actually presents an array of measurement locations/sites. According to the invention, such an array/matrix of the measurement locations (sensors' positions) is displayed together with corresponding measured data.
According to another aspect of the invention, there is provided a system for use in tissue characterization and treatment, the system comprising the above described medical device and a control unit connectable thereto. The control unit comprises a graphical user interface configured for presenting information related to the signals received from all the sensors, thereby providing an operator with information regarding the tissue type at the locations of the sensors, and facilitating analysis of the location and extent of the tissue to be treated.
According to yet another aspect of the invention, there is provided a control unit for monitoring measurements of tissue properties, the control unit comprising a graphical user interface configured for presenting information related to signals received from an array of sensors arranged in a predetermined spaced-apart relationship along a measurement axis, the presented information being in the form of an array of locations spaced-apart along an axis corresponding to the array of said sensors, and a corresponding array of measured data in association with the array of said locations, said array of measured data being indicative of signals received from the array of the sensors respectively, thereby providing an operator with information regarding a profile of a measured tissue profile along a tissue mass aligned with the array of sensors.
According to yet further aspect of the invention, there is provided a graphical user interface configured for presenting information related to signals received from an array of sensors arranged in a predetermined spaced-apart relationship along a measurement axis, the presented information being in the form of an array of locations spaced-apart along an axis corresponding to the array of said sensors, and a corresponding array of measured data in association with the array of said locations, said array of measured data being indicative of signals received from the array of the sensors respectively, thereby providing an operator with information regarding a profile of measured tissue properties along a tissue mass aligned with the array of sensors.
The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawings(s) will be provided by the Office upon request and payment of the necessary fee.
In order to understand the invention and to see how it may be carried out in practice, embodiments will now be described, by way of non-limiting example only, with reference to the accompanying drawings, in which:
Referring to
The tissue characterization sensor array may include one or more of optical, radiofrequency (RF), microwave (MW), electrical, magnetic, temperature, elastic, biological, chemical, radioactive-emission, and mechanical sensors of any known type. The construction and operation of the tissue characterization sensor does not form part of the present invention, and therefore need not be specifically described. For example, sensors described in the above indicated patent publications assigned to the assignee of the present application may be used.
The sensors S1-S8 are arranged in a spaced-apart relationship along a longitudinal axis LA of the carrier 14, and may be arranged in one- or two dimensional array. For example, the sensor array may include, in addition to a group of sensors arranged in one-dimensional array, sensors arranged in a spaced-apart manner along a circumferential region of the carrier. The sensor array gives, in real time, indication about the nature of tissue along the carrier 14.
The sensors are spaced along the axis LA from one another a known distance, which may or may not be equal for all the sensors in the array. The known relative locations of the sensors along the carrier 12 allows for identifying corresponding locations in a tissue mass when the probe is progressing through the tissue mass (i.e. scans the tissue) based on signals received from the sensors. In this connection, the medical device 10 is associated with an appropriate control system 19 configured for receiving and analyzing the signals generated by the sensors. It should be understood that connection between the sensors and the control unit is shown in the figure schematically, and in case wired connection is used such wires would extend inside the shaft 14 and exit at the proximal end 14B.
The control system may be an external system connectable (via wires or wireless signal transmission) to the sensors, or may be a constructional part of the probe itself. The control system, based on the analysis of the received signals, operates for determining a location of the margins of an abnormal tissue region inside the examined tissue mass and generating output data indicative of a dimension of the abnormal tissue region. This allows for consequent treatment of the abnormal tissue region by an appropriate treatment tool.
The control system preferably includes a graphical user interface (GUI) 19A, and is configured for presenting information related to the signals received from each of the sensors. This information provides the operator with information regarding the tissue type at the locations of the sensors. For example, this may be presented as values of one or multiple parameters of the tissue at the multiple locations corresponding to the positions of the array of the sensors, at a given position of the probe with respect to the tissue. The tissue parameters may relate to the tissue type, physical tissue properties such as conductivity, permittivity, temperature, and others. The information presented on the GUI may assist the operator in analyzing the location and extent of the tissue to be treated. In the present example, GUI 19A displays the information in the form of a continuous graph/profile of a certain tissue property formed by values measured by all sensors. Other ways of presentation are also possible, and will be exemplified below with reference to
Generally, the treatment tool may be configured for carrying out one or more of the following: biopsy, cutting, delivering physical treatment, delivering treatment medication, diagnostics. More specifically, the present invention is used for removal of an intact tissue specimen (abnormal tissue) and is therefore described below with respect to this specific but not limiting example.
Preferably, the probe 12 also carries a treatment tool, e.g. a cutting tool. This is implemented by configuring the probe such that the treatment tool can be selectively shiftable between its inoperative position, when it is located substantially entirely inside the carrier 14, and its operative positions when its one or more excision elements (constituting one or more tissue treating elements) project(s) from the carrier.
In some examples of the invention, the selective projection of the excision element is achieved by using the treatment tool of a kind known in the art, where the excision element projects from the carrier body through an opening made along the body portion while moving with respect to the carrier along an axis inclines with respect to the axis LA. In some other examples, the excision element projects from the carrier (e.g. from its distal end) while moving with respect to the carrier substantially along the axis LA. Such configurations are also generally known in the art. The treatment tool may be configured with a removed tissue collecting unit, which may or may not be selectively projectable from the probe.
According to the invention, the medical device is configured such that a dimension of the excision element part projecting from the carrier can be controllably adjusted (varied) in accordance with the determined dimension of the abnormal tissue margins, thereby adjusting the excision volume. Preferably, the excision element is configured for both cutting the tissue and collecting the tissue being cut.
The following are some specific but not limiting examples of the configuration of the device of the present invention. The same reference numbers are used for identifying components that are common in all the examples.
The cutting tool 16 has a body portion 22 located inside the carrier 14, and an excision element 20 projectable from the body 22 through an opening 18 made in the carrier 14 In the figure, the excision element 20 is shown in its operative projecting state. The excision element has a cutting edge 21, and may be configured to have a cup-like shape when in the projecting state, thereby enabling collection of tissue while being cut during the rotation of the carrier 14 and thus of the excision element 20.
The excision element 20 extends between its first and second ends 20A and 20B which are attached to respective first and second locations on the treatment tool body 22 and spaced-apart along the axis LA of the carrier 14. The treatment tool is configured to enable a controllable change of the dimensions of the excision element 20. In the present example, this is implemented by making the treatment tool body 22 from two spaced members 22A and 22B, where at least one of them is slidable with respect to the other along the carrier axis LA. As a result, a distance between the first and second locations, and accordingly the first and second ends 20A and 20B of the excision element, changes, thereby enable adjustment of the dimension of the cutting portion 21 projecting through the carrier 14.
By controlling the location of the excision element distal and proximal ends 20A and 20B along the carrier 14, and thus controlling the excision volume, a user can perform optimal removal of a tissue specimen, for example during a breast biopsy procedure. The entire excision element 20 may be movable along the body 22. Thus, the excision volume is controlled by user by changing the location of the excision element 20 along the carrier 14 and changing a distance between the distal and proximal ends of the excision element.
In the above example, the tissue removal procedure is carried while rotating the carrier 14. Such procedure can be performed while keeping the carrier position and rotating the treatment tool. This is exemplified in
It should be understood that in all the above-exemplified embodiments the device may be rotated, manually or mechanically, to assist in complete tissue treatment (e.g. cutting and removal).
As described above, the invention provides convenient (user-friendly) manner of presentation of the measurement results on a GUI. The use of an array/matrix of tissue characterization sensors defines the array/matrix of measurement locations corresponding to a given position of the probe. The present invention further takes an advantage of such configuration of the probe for presenting/displaying the array/matrix of the measurement locations/sensors together with the corresponding measured data.
Turning now to
The two longitudinal border/limit lines M1 and M2 may also present dynamically the maximal/minimal value of measured data during a given measurement session (the probe is scanned/moved within the tissue). The maximal/minimal value of measured data is the global value, i.e. taking into account measured data from all the sensors and taking into account the cumulative measured data during the measurement session. In this case, the values (location on GUI) of limit lines M1 and M2 are updated in real-time as different measurement values are obtained, as the probe is scanned/moved within the tissue. At a given time, the values (location on GUI) of limit lines M1 and M2 present the maximal/minimal value of measured data obtained from the beginning of the measurement session up until the current time. The limit lines values may be reset by the user (or automatically based on pre-specified conditions) during the measurement session, through the control unit 19, for each parameter displayed. In this case, the values of limit lines M1 and M2 present the maximal/minimal value of measured data obtained from the time the values were reset up until the current time.
Thus, a change in the bar geometry or shape or size (height/length) may correspond to a change in the value of the tissue parameter being measured, and the measured value may also be presented numerically on each bar. The values of the parameter, and accordingly the bars lengths (sizes), change in real time whenever the device is moved from point to point inside the tissue (i.e. during scanning). In the present example, all the bars B1-B5 are of the same color. Generally, the same color may be used to indicate that all the measured data pieces correspond to the same tissue parameter and/or to the condition that the measured parameter values are at the same side with respect to the predefined threshold.
In some embodiments, the bars may exist on one side only of the measurement axis 12g. In other cases, the same or different measured parameters may be displayed simultaneously at both sides of the measurement axis 12g.
In order to simplify the illustration and understanding, all the
As described above, the sensors may be configured to measure several tissue parameters, such as conductivity, permittivity, impedance, optical property, mechanical property, temperature and others. The bars B1-B5 and/or values on the display correspond to the strength or intensity of the measured parameter. The values usually correspond to properly normalized parameter and are thus non-dimensional (relative units).
As also described above and will be more specifically exemplified in the figures below, the bars may be presented in different colors to indicate either special (exceptional) values of the same parameter, or different parameters presented simultaneously at different sensor/bar couples. The bar color and/or size together with the border lines may be exploited to indicate a range of values. Further, the GUI 700 may include an indication about the mean value of some or all of the measured parameters by lighting up a specific region on the GUI.
Another similar example, where the bar color and size together with the border lines are used to indicate a range of values is illustrated in
As exemplified in
As exemplified in
Further, the GUI 700 may be used to display more than one parameter at the same time for each sensor as can be seen in the example of
The GUI of the present invention may be configured for displaying different parameters simultaneously at both sides of the measurement axis 12g. This is illustrated in
The GUI of the present invention may be configured for displaying the different measured data in the form of different colors, according to a predetermined color to scheme, without assigning a bar presentation. This is illustrated in
The graphical presentation of the information from the measured data, as presented in the examples related to
Thus, the present invention provides a novel medical device capable of precisely locating a tissue volume to be treated (removed), and also provides for treating to (removing) the tissue by an integral medical device. The invention also provides for displaying the measured data in a manner providing immediate and clear indication of the profile of the tissue parameter(s) being measured.
This is a new U.S. Continuation-in-Part Application of prior pending U.S. application Ser. No. 12/663,923, filed Dec. 10, 2009, which claims priority from PCT Application No. PCT/IL08/00965 filed Jul. 13, 2008 and Provisional U.S. Patent Application No. 60/950,081 filed on Jul. 16, 2007. The disclosure of each of the prior applications is hereby incorporated herein by reference in its entirety.
Number | Date | Country | |
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60950081 | Jul 2007 | US |
Number | Date | Country | |
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Parent | 12663923 | Dec 2009 | US |
Child | 13676993 | US |