Patent Application
20050065426
The present invention relates to a medical system, method and device and, more particularly, to a medical system, method and apparatus particularly useful for tissue characterization. The present invention also relates to an endoscopic device which is useful for tissue characterization.
Medical technologies for examining the internal structure of tissues are of immense diagnostic importance. Internal body tissues are often examined to determine the structural details thereof and/or the flow of fluid therethrough in order to detect abnormalities, including pathologies, such as, but not limited to, cysts, tumors (benign and malignant), abscesses, mineral deposits, obstructions and anatomical defects.
One internal structural abnormally is atherosclerosis, which is an arterial disease in which fatty substances accumulate in the intima or inner media, the innermost membranes encompassing the lumen of the arteries. The resulting lesions are referred to as atherosclerotic plaques.
Clinical symptoms finally occur because the growing mass of the atherosclerotic plaque gradually constricts the inflicted artery and reduces blood flow therethrough, thereby compromising the function of a tissue or organ positioned downstream thereto.
Atherosclerosis and its complications, such as myocardial infarction, stroke and a variety of peripheral vascular diseases, such as gangrene of body extremes, remain major causes of morbidity and mortality in the modern world.
The plaques typically accumulate on the arterial wall in the form of pockets having a hard and flexible fibrous cover which does not easily crumble. This type of plaque is generally termed an “occlusive plaque”, and as long as it is stable and not overly constrictive, the inflicted subject is symptomatically undisturbed.
However, when the plaque pocket is covered with a soft, fatty wall, the wall tends to shed flakes downstream due to the fierce blood stream or due to flow associated cavitations. A flake migrating into the brain can cause CerebroVascular Accident (CVA). A flake migrating into the heart coronary system (CVD: CardioVascular Disease) can cause a stroke. A flake migrating into a leg via the femoral artery can, in the extreme case, cause gangrene. This type of plaque is therefore termed a “vulnerable plaque”. Statistics show that almost 80% of CVA and CVD deaths are due to vulnerable plaques rather than occlusive plaques, and therefore means with which to identify and cure vulnerable plaque are of a higher priority.
Left undetected, the formation of a plaque can result in the complete occlusion of the inflicted artery and lead to severe clinical consequences. For example, when complicated, the lesion becomes a calcified fibrous plaque, characterized by various degrees of necrosis, thrombosis and ulceration. With increasing necrosis and accumulation of cell debris, the arterial wall progressively weakens, and rupture of the intima can occur, causing aneurysm and hemorrhage. Arterial emboli can form when fragments of a plaque dislodge into the arterial lumen. Stenosis and impaired organ function result from gradual occlusion as plaques thicken and thrombi form.
Over the years, immersive attempts have been made both to detect and to identify internal structural abnormalities, with or without physically invading the body.
One such method is non-invasive ultrasound imaging. Ultrasonic images are formed by producing very short pulses of ultrasound using an electro-acoustic transducer, sending the pulses through the body, and measuring the properties (e.g., amplitude and phase) of the echoes from tissues within the body. Focused ultrasound pulses, referred to as “ultrasound beams”, are targeted to specific tissue regions-of-interest in the body. Typically, an ultrasound beam is focused at small lateral sections differing by predetermined depth intervals within the body to improve spatial resolution. Echoes are received by the ultrasound transducer and are processed to generate an image of the tissue or object in a region-of-interest. Ultrasonic imaging technology is presently used worldwide for examination of various internal structural abnormalities.
Another detection and classification method is the intravascular ultrasound (IVUS). Unlike in non-invasive ultrasound, in an IVUS system, an ultrasonic transducer is attached to an end of a catheter that is maneuvered through a patient's body to a point-of-interest such as within a blood vessel. The transducer is a single-element crystal or probe which is mechanically scanned or rotated back and forth to cover a sector over a selected angular range. Acoustic signals are transmitted during the scanning and echoes of these acoustic signals are received to provide data representative of the density of tissue over the sector. As the probe is swept through the sector, many acoustic lines are processed, building up a sector-shaped image of the patient. Once the data is collected, images of the blood vessel are reconstructed. A typical analysis includes determining the size of the lumen and amount and distribution of plaque in the analyzed vessel. The image data may show the extent of stenosis, reveal progression of disease, assist in determining whether procedures such as angioplasty or atherectomy are indicated or whether more invasive procedures may be advantageously warranted.
To date, many different types of IVUS measurements have been practiced. For example, imaging by IVUS “soft echo” using a compression ergonometer to determine the stiffness of a tissue was demonstrated in Hiro, T. et aL, Am. Heart, J. 133(1) 1-7 (1997). Another work [de Corte et al., Circ. 8, 102(6) 617-23 (2000)] elaborated on IVUS sonoelasticity that yields a stiffness image of the arterial wall as the catheter moves forward. However, as these methods are mostly qualitative, the number of medical applications in which they can be used is limited. Moreover, the IVUS method is minimally invasive.
Another internal structural abnormality is a tumor, which may be malignant, and as such its eradication is promoted by early detection and treatment. One example of a malignant tumor is breast carcinoma, known as breast cancer.
The standard breast examination employed today in the detection of breast cancer is mammography, in which the breast is compressed between a source of x-rays and an x-ray sensitive film or plate, and x-rays are transmitted through the compressed breast tissue to expose the x-ray sensitive film or plate. The rays that pass through healthy tissue are moderately absorbed by the moderate density of the tissue, which causes healthy tissue to leave a gray shadow image on the x-ray sensitive film or plate. X-rays which pass through dense particles, such as calcifications characteristic of malignancy, undergo significant absorption, and the consequent deposit of relatively few photons on the x-ray film or plate leaves a bright spot thereon. X-rays which pass through very soft structures, such as cysts are only slightly absorbed, and leave a relatively dark spot on the x-ray sensitive film or plate.
Breast cancer can also be detected by ultrasound imaging in conjunction with mammography and/or hand-examination. Standard two dimensional ultrasound imaging has proven capable of detecting those calcified lesions which are also detectable by mammography. An example of the use of ultrasound imaging for detecting early calcification in breast is found in, for example, U.S. Pat. No. 5,997,477.
Once an abnormal tissue has been detected, it needs to be further diagnosed.
Although tissue biopsy is an extremely important diagnostic procedure for characterizing a tumor and for determining the most appropriate treatment for its eradication, the biopsy procedure can be preceded by non-invasive diagnostic techniques.
It is recognized herein that the desired diagnosis lies within the realm of the mechanical frequency response spectrum of the vibrating body tissue rather than in its shape, as yielded, e.g., by ultrasonic imaging. The reason for this recognition is that the mechanical characteristics of an examined tissue may be used to differentiate both between abnormal and normal tissues and between different types of abnormal tissues (e.g., benign or malignant tumors, different types of atherosclerotic plaques, etc.).
For Example, as is described hereinabove, blood vessel plaques are generally categorized into three major groups: (i) blood clots; (ii) occlusive plaques; and (iii) vulnerable plaques. These groups differ by the nature of their formation, their mechanical properties and the appropriate therapeutic treatment required once identified.
Thus, blood clots are soft and may present in many locations inside a blood vessel. Blood clots tend to sink on the arterial wall close to a bifurcation. The treatment for blood clots is by dissolving using specified enzymes.
Occlusive or fibrous plaque pocket wall may contain calcifications; hence it is heavier than normal intima tissue and sufficiently flexible to stay adhered to the arterial wall regardless of the blood flow. Nevertheless, the mechanical stiffness of fibrous plaque is higher than that of a normal blood wall.
Vulnerable or fatty plaque pocket wall is only slightly flexible and of a lower density than the normal arterial wall. Generally, a vulnerable plaque, which is considered to be the most dangerous plaque, does not follow the movement of the arterial wall and therefore may easily detach from the wall and migrate downstream with the blood flow.
Similarly, cysts, benign and malignant tumors have different mechanical properties, associated with their way of formation and constituents. Skin cancer of the Melanoma type appears as black, amorphous nevi. In their stage I and II development the nevi may not differ visually from other nevi or moles. Mechanically, nevertheless, malignant nevi are generally softer and lighter than healthy ones. In the case of breast cancer the cysts are not visually detectable, developing deep within the breast. These cists, or lesions, are usually harder and heavier than neighboring healthy tissue.
Hence, the mechanical properties of healthy and pathological tissues can be used as discriminators between different types of tissues and different types of pathologies, such as discriminating between an arterial wall and a plaque, discriminating between different types of plaques, discriminating between different types of tumors and healthy tissue, and the like.
Prior art teachings of the measurement of elastic moduli of tissues present in the body is based on ultrasound imaging of the mechanical properties of tissue, ultrasonic sonography, tactile sensor technology and other methods grouped under the definition of “sonoelasticity”.
The science of testing the elastic properties of living tissues is relatively young. Nevertheless, obtaining knowledge of the elastic and viscoelastic moduli of normal and abnormal (pathological) tissues is essential for the purpose of characterization and subsequent decision on the appropriate treatment.
A review of prior art attempts for tissue characterization is provided herein.
Early ex vivo experiments on canine aortic tissue [Yin FC, Circ. Res., 53(4) 464-72 (1983)] shed light on the measurement of the elastic modulus of fish via resonance. Parker K. J. et al. [Tissue Response to Mechanical Vibrations for “Sonoelasticity Imaging”, Ultrasound in Med. & Biol., vol. 16, No. 3, 1990, pp. 241-246] and Herrington [U.S. Pat. No. 6,264,609] used transverse excitation to measure the shear modulus in tissues. Measurement of tissue deformation under static pressure and comparison with simulations were carried out by Sarvazyan et al. [U.S. Pat. No. 5,524,636]. Recently, speed measurements of excited tissue were carried out by Sarvazyan et al. [U.S. Pat. No. 5,810,731].
Speed measurements, using a combined ultrasound—audio loudspeaker device operating in low frequency (10-1000 Hz) were performed by Lin et al. [U.S. Pat. Nos. 6,068,597 and 5,919,139] to obtain the elastic modulus of the tissue under excitation. The two acoustic effects were used simultaneously, transmission at one point and reception at another. However, the uneven attenuation of the ultrasonic signal was not compensated for in the low frequency resonance shape. A similar method was contemplated by Trahey et al. [U.S. Pat. No. 5,487,387] under the name ARFI (Acoustic Radiation Force Imaging). Another combination of sound and ultrasound was suggested by Fatemi et al. [Proc. Nat. Acad. Sci. 96, 6603-6608 (1999)]. The method practiced was to measure the reflections of bursts of ultrasound modulated by low frequency varying AM modulation.
Stiffness measurements of tissue were also made using the tactile sensors. P. M. Plinkert et. al. (Bi-annual report 1 Jan. 1995-31 Dec. 1996, University of Tubingen, Germany) measured the dynamic force at the resonance of an impedance of freshly resected tissues. The research was motivated for providing tactile feedback during endoscopy by invasively touching an internal limb. The measurements showed difference in the resonance between internal benign and cancerous tissue. However, the modeling of this behavior is only partial, omitting dynamic parameters such force frequency response, or the resonance width.
Omata [U.S. Pat. No. 5,766,137] scanned the shift of a resonance frequency as a function of the mechanical load on the measured subject. In the method disclosed by Omata, a hardness measuring apparatus is first set to oscillate in a resonance state and then the operator initiates a contact between the apparatus and the subject's skin. Due to the impedance of the skin at the contact location, resonance frequency and voltage values are changed and monitored using appropriate measuring circuits. These changes, measured as a function of the load, are then used to determine the hardness of the tissue.
The frequency ranges used by Omata are of the order of 50 kHz, which frequency ranges result in several major drawbacks. First, a frequency of 50 KHz allows measuring resonance frequencies of the hardness measuring apparatus itself, as opposed to measuring the resonance frequencies of the tissues-of-interest. Second, as the typical resonance frequency of the tissues is of the order of few hundreds of Hz, the frequency changes which are to be measured are considerably small (of the order of 1%). Thus, some frequency changes may not be observed by the hardness measuring apparatus. Third, a skilled artisan would appreciate that a variation in the contact quality between the apparatus and the skin result in a variation of the frequency and voltage reads. Given the low percentage the effect such variation may be crucial for determining the type of tissue. Forth, high frequency oscillations are known to allow measurements of tissues which are close to the contact location. Hence, for non-invasive procedures, only tissues which are close to the skin can be analyzed.
Another non-invasive method with which elastographic images are obtainable is Magnetic Resonance Imaging (MRI). Of interests are MRI scans that yield accurate elastographic images that show only qualitatively the nature of the various tissues in these scans [Van Huten E E et al. Magn. Reson. Med., 45(5) 827-37 (2001)]. Also, the price of such a procedure is substantially high The present invention provides solutions to the problems associated with the prior art non-invasive techniques for tissue characterization.
According to one aspect of the present invention there is provided a method of characterizing a tissue present in a predetermined location of a body of a subject, the method comprising: generating mechanical vibrations at a position adjacent to the predetermined location, the mechanical vibrations are at a frequency ranging from 10 Hz to 10 kHz; scanning the frequency of the mechanical vibrations; and measuring a frequency response spectrum from the predetermined location, thereby characterizing the tissue.
According to further features in preferred embodiments of the invention described below, the method further comprises imaging the subject so as to determine a position of the tissue.
According to still further features in the described preferred embodiments the imaging is by a non invasive imaging device.
According to still further features in the described preferred embodiments the imaging is by a minimal invasive imaging device.
According to still further features in the described preferred embodiments the imaging is during an invasive procedure.
According to an additional aspect of the present invention there is provided a method of characterizing a tissue of a subject, the method comprising: (a) endoscopically inserting an endoscopic device into the subject, and using the endoscopic device for (i) imaging the subject so as to determine a position of the tissue; and (ii) generating mechanical vibrations at the position, the mechanical vibrations being at a frequency ranging from 10 Hz to 10 kHz; (b) scanning the frequency of the mechanical vibrations; and (c) measuring a frequency response spectrum from the tissue; thereby characterizing the tissue.
According to further features in preferred embodiments of the invention described below, the method further comprises measuring a phase angle as a function of the frequency.
According to still further features in the described preferred embodiments the method further comprises calculating at least one mechanical property of the tissue from the frequency response spectrum.
According to still further features in the described preferred embodiments the measurement of the frequency response spectrum comprises measuring an amplitude as a function of the frequency.
According to still further features in the described preferred embodiments the step of generating mechanical vibrations is repeated a plurality of times, each time in a different location.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly comprises at least one mechanical linkage device for transferring the mechanical vibrations to the body.
According to another aspect of the present invention there is provided a system for characterizing a tissue present in a predetermined location of a body of a subject, the system comprising: a mechanical vibrations generating assembly for generating mechanical vibrations at a position adjacent to the predetermined location, the mechanical vibrations are at a frequency ranging from 10 Hz to 10 kHz; and a control unit for scanning the frequency of the mechanical vibrations, and for measuring a frequency response spectrum from the predetermined location, thereby to characterize the tissue.
According to further features in preferred embodiments of the invention described below, at least one of a size and a natural frequency of the mechanical linkage device is selected so as to increase dynamical interactions between the tissue and the at least one mechanical linkage device.
According to still further features in the described preferred embodiments the mechanical linkage device is characterized by a plurality of natural frequencies, where at least one frequency of the plurality of natural frequencies is higher than the frequency of the mechanical vibrations.
According to still further features in the described preferred embodiments the mechanical linkage device comprises a variable width beam spring.
According to still further features in the described preferred embodiments the mechanical linkage device comprises a strain gage for measuring displacement of the plurality of mechanical linkage devices.
According to still further features in the described preferred embodiments the mechanical linkage device comprises a proximity sensor for measuring displacement of the plurality of mechanical linkage devices.
According to still further features in the described preferred embodiments the system further comprises at least one additional mechanical vibrations generating assembly having a plurality of mechanical linkage devices being in mutual communication, and operable to generate mechanical vibrations at a position adjacent to the predetermined location
According to yet another aspect of the present invention there is provided an endoscopic device for in vivo characterization of a tissue of a subject, the device comprising: at least one imaging device for imaging the subject so as to determine a position of the tissue; and at least one mechanical vibrations generating assembly for generating mechanical vibrations at the position of the tissue, and for measuring a frequency response spectrum of the tissue, the mechanical vibrations are at a frequency ranging from 10 Hz to 10 kHz.
According to further features in preferred embodiments of the invention described below, the device further comprises a first mechanical linkage device connected to a first end of the tubular transducer and a second mechanical linkage device connected to a second end of the tubular transducer.
According to still further features in the described preferred embodiments the mechanical vibrations generating transducer assembly is selected from the group consisting of a piezoelectric mechanical vibrations generating transducer assembly, an electric mechanical vibrations generating transducer assembly, an electrostrictive mechanical vibrations generating transducer assembly, a magnetic mechanical vibrations generating transducer assembly, a magnetostrictive mechanical vibrations generating transducer assembly, an electromagnetic mechanical vibrations generating transducer assembly, a micro electro mechanical device (MEMS) vibrating generating transducer assembly and an electrostatic mechanical vibrations generating transducer assembly.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly comprises a preamplifier, for at least partially amplifying electrical signals received from the at least one mechanical sensor.
According to still another aspect of the present invention there is provided a system for in vivo characterization of a tissue of a subject, the system comprising: an endoscopic device having at least one imaging device and at least one mechanical vibrations generating assembly, the at least one imaging device being for imaging the subject and the at least one mechanical vibrations generating assembly being for generating mechanical vibrations at a position of the tissue, the mechanical vibrations are at a frequency ranging from 10 Hz to 10 kHz; and a control unit for scanning the frequency of the mechanical vibrations, and for measuring a frequency response spectrum from the tissue, thereby to characterize the tissue.
According to further features in preferred embodiments of the invention described below, the mechanical vibrations generating assembly is operable to generate mechanical vibrations which are perpendicular to the tissue.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly is operable to generate mechanical vibrations which are inclined to the tissue by a predetermined inclination angle.
According to still further features in the described preferred embodiments the at least one mechanical linkage device comprises a first mechanical linkage device and a second mechanical linkage device.
According to still further features in the described preferred embodiments the system further comprises a first mechanical linkage device connected to a first end of the tubular transducer and a second mechanical linkage device connected to a second end of the tubular transducer.
According to still further features in the described preferred embodiments the imaging device is selected from the group consisting of an intra vascular ultra sound device, an intra vascular magnetic resonance device and a camera.
According to still further features in the described preferred embodiments the mechanical vibrations are perpendicular to the tissue.
According to still further features in the described preferred embodiments the mechanical vibrations are inclined to the tissue by a predetermined inclination angle.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly comprises at least one mechanical linkage device for transferring the mechanical vibrations to the tissue.
According to still further features in the described preferred embodiments at least one of a size and a natural frequency of the at least one mechanical linkage device is selected so as to increase dynamical interactions between the tissue and the at least one mechanical linkage device.
According to still further features in the described preferred embodiments the at least one mechanical linkage device comprises a variable width beam spring.
According to still further features in the described preferred embodiments the at least one mechanical linkage device comprises a strain gage for measuring displacement of the at least one mechanical linkage device.
According to still further features in the described preferred embodiments the at least one mechanical linkage device comprises a proximity sensor for measuring displacement of the at least one mechanical linkage device.
According to still further features in the described preferred embodiments the generating the mechanical vibrations is by transmitting mechanical vibration from a first mechanical linkage device to a second mechanical linkage device via at least one mechanical sensor.
According to still further features in the described preferred embodiments the method further comprises converting electrical signals into mechanical motions using a mechanical vibrations generating transducer assembly.
According to still further features in the described preferred embodiments the endoscopic device comprises an imaging device, selected from the group consisting of an intra vascular ultra sound device, an intra vascular magnetic resonance device and a camera.
According to still further features in the described preferred embodiments the method further comprises bulging the at least one contact-tip out of an encapsulation of the mechanical vibrations generating assembly so as to touch the tissue.
According to still further features in the described preferred embodiments the method further comprises at least partially amplifying electrical signals received from the at least one mechanical sensor.
According to still further features in the described preferred embodiments the transmitting the electrical comprises generating a synthesized electrical pulse.
According to still further features in the described preferred embodiments the method further comprises amplifying the synthesized electrical pulse.
According to still further features in the described preferred embodiments the method further comprises amplifying electrical signal transmitted from the mechanical vibrations generating assembly.
According to still further features in the described preferred embodiments the method further comprises displaying the electrical signal transmitted from the mechanical vibrations generating assembly.
According to still further features in the described preferred embodiments the method further comprises classifying the frequency response spectrum.
According to still further features in the described preferred embodiments the classifying the frequency response spectrum comprises: (a) identifying resonance peak maxima of the frequency response spectrum; (b) from the resonance peak maxima, determining a first type of maximum being indicative of a first type of tissue, and a second type of maximum being indicative of a second type of tissue; and (c) using the first type of maximum and the second type of maximum to classify the first and the types of tissue.
According to still further features in the described preferred embodiments the step (c) comprises calculating a ratio between the first type of maximum and the second type of maximum.
According to still further features in the described preferred embodiments the method further comprises averaging the resonance peak maxima.
According to still further features in the described preferred embodiments the first and the second types of maxima are determined by absolute values of the resonance peak maxima.
According to still further features in the described preferred embodiments the first and the second types of maxima are determined by shapes of the resonance peak maxima.
According to still further features in the described preferred embodiments the first and the second types of maxima are determined by frequency shifts of the resonance peak maxima.
According to still further features in the described preferred embodiments the classifying comprises: (a) constructing a physical model of a plurality of harmonic oscillators, the physical model comprises a set of parameters and being characterized by a plurality of equations of motion; (b) simultaneously solving the plurality of equations of motion so as to provide at least one frequency response; and (c) comparing the at least one frequency response with the frequency response spectrum; thereby classifying the frequency response spectrum.
According to still further features in the described preferred embodiments the method further comprises repeating the steps (a)-(c) at least once, each time using different set of parameters.
According to yet an additional aspect of the present invention there is provided a system for characterizing a tissue present in a predetermined location of a body of a subject, the system comprising: at least one mechanical vibrations generating assembly each having a plurality of mechanical linkage devices being in mutual communication, and operable to generate mechanical vibrations at a position adjacent to the predetermined location, the mechanical vibrations being at a frequency ranging from 10 Hz to 10 kHz; and a control unit for scanning the frequency of the mechanical vibrations, and for measuring a frequency response spectrum from the tissue, thereby to characterize the tissue.
According to further features in preferred embodiments of the invention described below, at least one of a size and a natural frequency of the plurality of mechanical linkage devices is selected so as to increase dynamical interactions between the tissue and the at least one mechanical linkage device.
According to still further features in the described preferred embodiments the at least one mechanical linkage device is characterized by a plurality of natural frequencies, and further wherein at least one frequency of the plurality of natural frequencies is higher than the frequency of the mechanical vibrations.
According to still further features in the described preferred embodiments the plurality of mechanical linkage devices comprises a variable width beam spring.
According to still further features in the described preferred embodiments the plurality of mechanical linkage devices comprises a strain gage for measuring displacement of the plurality of mechanical linkage devices.
According to still further features in the described preferred embodiments the plurality of mechanical linkage devices comprises a proximity sensor for measuring displacement of the plurality of mechanical linkage devices.
According to still further features in the described preferred embodiments the control unit is operable to measure an amplitude as a function of the frequency.
According to still further features in the described preferred embodiments the control unit is operable to measure a phase angle as a function of the frequency.
According to still further features in the described preferred embodiments the control unit is operable to calculate at least one mechanical property of the tissue from the frequency response spectrum.
According to still further features in the described preferred embodiments the mechanical property is an elastic constant.
According to still further features in the described preferred embodiments the mechanical property is selected from the group consisting of an elastic modulus, a Poisson's ratio, a shear modulus, a bulk modulus and a first Lamé coefficient.
According to still further features in the described preferred embodiments the position is on a skin of the body.
According to still further features in the described preferred embodiments the position is close to a blood vessel-of-interest.
According to still further features in the described preferred embodiments the blood vessel-of-interest is selected from the group consisting of a carotid, a femoral vessel and an abdominal aorta.
According to still further features in the described preferred embodiments the position is close to a lesion selected from the group consisting of a dermal lesion, a sub-dermal lesion and an internal lesion.
According to still further features in the described preferred embodiments the position is close to a bone.
According to still further features in the described preferred embodiments the position is close to a thorax.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly is operable to generate mechanical vibrations which are perpendicular to the body.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly is operable to generate mechanical vibrations which are inclined to the body by a predetermined inclination angle.
According to still further features in the described preferred embodiments the plurality of mechanical linkage devices comprises a first mechanical linkage device and a second mechanical linkage device.
According to still further features in the described preferred embodiments the first and the second mechanical linkage devices are connected by at least one mechanical sensor, capable of receiving mechanical vibration therebetween.
According to still further features in the described preferred embodiments the first and the second mechanical linkage devices are connected by at least one connection rod.
According to still further features in the described preferred embodiments the mechanical vibrations generating transducer assembly comprises a tubular transducer.
According to still further features in the described preferred embodiments the plurality of mechanical linkage devices comprises a first mechanical linkage device connected to a first end of the tubular transducer and a second mechanical linkage device connected to a second end of the tubular transducer.
According to still further features in the described preferred embodiments the mechanical vibrations generating transducer assembly is selected from the group consisting of a piezoelectric mechanical vibrations generating transducer assembly, an electric mechanical vibrations generating transducer assembly, an electrostrictive mechanical vibrations generating transducer assembly, a magnetic mechanical vibrations generating transducer assembly, a magnetostrictive mechanical vibrations generating transducer assembly, an electromagnetic mechanical vibrations generating transducer assembly, a micro electro mechanical system (MEMS) vibrating generating transducer assembly and an electrostatic mechanical vibrations generating transducer assembly.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly is sizewise compatible with an anatomical system selected from the group consisting of the vascular system, the cardiovascular system and the urinary system.
According to still further features in the described preferred embodiments the system further comprises an imaging device for imaging the tissue.
According to still further features in the described preferred embodiments the imaging device is selected from the group consisting of an intra vascular ultra sound device, an intra vascular magnetic resonance device, a camera, a computer tomography device, and a magnetic resonance device.
According to still further features in the described preferred embodiments the imaging device is in communication with the control unit.
According to still further features in the described preferred embodiments the communication is selected from the group consisting of optical communication, electrical communication and acoustical communication.
According to still further features in the described preferred embodiments the imaging device is connected to the mechanical vibrations generating assembly.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly comprises a posing mechanism for bulging the at least one contact-tip out of an encapsulation of the mechanical vibrations generating assembly so as to touch the tissue.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly comprises a preamplifier, for at least partially amplifying electrical signals received from the at least one mechanical sensor.
According to still further features in the described preferred embodiments the control unit comprises a transmission unit for transmitting an electrical signal to the mechanical vibrations generating assembly.
According to still further features in the described preferred embodiments the transmission unit comprises a computerized synthesizer for generating a synthesized electrical pulse.
According to still further features in the described preferred embodiments the transmission unit further comprises a power amplifier for amplifying the synthesized electrical pulse.
According to still further features in the described preferred embodiments the control unit comprises a receiver for receiving an electrical signal from the mechanical vibrations generating assembly.
According to still further features in the described preferred embodiments the receiver comprises a preamplifier and a line amplifier, the preamplifier and the line amplifier configured and designed to amplify the electrical signal transmitted from the mechanical vibrations generating assembly.
According to still further features in the described preferred embodiments the receiver further comprises a display for displaying the electrical signal transmitted from the mechanical vibrations generating assembly.
According to still an additional aspect of the present invention there is provided a mechanical vibrations generating assembly for generating mechanical vibrations at a position of a body of a subject, comprising a transducer assembly, a first mechanical linkage device, connected to a first end of the transducer assembly, and a second mechanical linkage device, connected to a second end of the transducer assembly; wherein the transducer assembly, the first mechanical linkage device and the second mechanical linkage device are constructed and designed so that when electrical signals are inputted to the transducer assembly, the electrical signals are converted into mechanical motions, and the first and the second mechanical linkage devices generates the mechanical vibrations.
According to further features in preferred embodiments of the invention described below, the mechanical vibrations generating assembly further comprises at least one additional mechanical linkage device, mechanically communicating with the transducer assembly.
According to still further features in the described preferred embodiments the first and the second mechanical linkage devices are each independently membranes.
According to still further features in the described preferred embodiments the membranes are made of a material selected from the group consisting of a plastic and a metal.
According to still further features in the described preferred embodiments the membranes are piezo-polymeric membranes.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly further comprises at least one contact-tip, connected to at least one of the mechanical linkage devices.
According to still further features in the described preferred embodiments at least one of a size and a natural frequency of the mechanical linkage devices is selected so as to increase dynamical interactions between the a portion of the body and the mechanical linkage devices.
According to still further features in the described preferred embodiments the mechanical linkage devices are characterized by a plurality of natural frequencies, where at least one frequency of the plurality of natural frequencies is higher than a frequency of the mechanical vibrations.
According to still further features in the described preferred embodiments the plurality of mechanical linkage devices comprises a strain gage for measuring displacement of the mechanical linkage devices.
According to still further features in the described preferred embodiments the mechanical linkage devices comprises a proximity sensor for measuring displacement of the mechanical linkage devices.
According to still further features in the described preferred embodiments the transducer assembly comprises a tubular transducer.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly further comprises at least one mechanical sensor.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly further comprises at least one mechanical sensor connecting the first mechanical linkage device and the mechanical linkage device, the at least one mechanical sensor being capable of receiving mechanical vibration therethrough.
According to a further aspect of the present invention there is provided a method of classifying a frequency response spectrum of a structural material, the method is executable by a data processor and comprising; (a) constructing a physical model of a plurality of harmonic oscillators, the physical model comprises a set of parameters and being characterized by a plurality of equations of motion; (b) simultaneously solving the plurality of equations of motion so as to provide at least one frequency response; and (c) comparing the at least one frequency response with the frequency response spectrum of the structural material, thereby classifying the frequency response spectrum of the structural material.
According to further features in preferred embodiments of the invention described below, the method further comprises repeating the steps (a)-(c) at least once, each time using a different set of parameters.
According to yet a further aspect of the present invention there is provided an apparatus for classifying a frequency response spectrum of a structural material, the apparatus comprising; (a) a constructor for constructing a physical model of a plurality of harmonic oscillators, the physical model comprises a set of parameters and being characterized by a plurality of equations of motion; (b) a solver for simultaneously solving the plurality of equations of motion so as to provide at least one frequency response; and (c) a comparing unit for comparing the at least one frequency response with the frequency response spectrum of the structural material, thereby to classify the frequency response spectrum of the structural material.
According to further features in preferred embodiments of the invention described below, the physical model is an N degree-of-freedom physical model, the N is a positive integer.
According to still further features in the described preferred embodiments the plurality of harmonic oscillators are coupled harmonic oscillators.
According to still further features in the described preferred embodiments at least a portion of the plurality of harmonic oscillators are damped harmonic oscillators.
According to still further features in the described preferred embodiments at least a portion of the plurality of harmonic oscillators are forced harmonic oscillators.
According to still further features in the described preferred embodiments the set of parameters comprises at least one constant of inertia and at least one elastic constant.
According to still further features in the described preferred embodiments the constant of inertia is mass and the elastic constant is a spring constant.
According to still further features in the described preferred embodiments the constant of inertia is inductance and the elastic constant is a reciprocal of capacitance.
According to still further features in the described preferred embodiments the set of parameters represent dynamic stiffness and density of the structural material.
According to still a further aspect of the present invention there is provided a method of constructing a frequency resonance spectra library the frequency resonance spectra characterizing a plurality of tissues of a plurality of subjects, the method comprising, for each subject: (a) selecting a tissue of the subject and generating mechanical vibrations at a position adjacent to the tissue, the mechanical vibrations are at a frequency ranging from 10 Hz to 10 kHz ; (b) scanning the frequency of the mechanical vibrations; (c) measuring a frequency response spectrum from of the tissue; and (d) recording the frequency response spectrum; thereby providing a frequency response spectrum entry of the library, the frequency response spectrum entry characterizing the tissue, thereby constructing the frequency resonance spectra library.
According to further features in preferred embodiments of the invention described below, the mechanical vibrations are perpendicular to the body.
According to still further features in the described preferred embodiments the generating the mechanical vibrations is performed such that the mechanical vibrations are inclined to the body, by a predetermined inclination angle.
According to still further features in the described preferred embodiments the predetermined inclination angle is selected so as to enhance data acquisition.
According to still further features in the described preferred embodiments the step of generating mechanical vibrations is repeated a plurality of times, each time with a different inclination angle.
According to still further features in the described preferred embodiments the step of generating mechanical vibrations is repeated a plurality of times, each time for a different tissue.
According to still further features in the described preferred embodiments the frequency of the mechanical vibrations is selected from the group consisting of a single frequency, a superposition of a plurality of frequencies, a continuous frequency scan (chirp), and a band-limited white noise frequency.
According to still further features in the described preferred embodiments the generating the mechanical vibrations is by a mechanical vibrations generating assembly.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly is constructed and designed so as to minimize effects of environmental noise.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly comprises a mechanical linkage device for transferring the mechanical vibrations to the body.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly comprises at least one contact-tip.
According to still further features in the described preferred embodiments the at least one contact-tip comprises a plurality of contact-tips arranged in a matrix-like arrangement.
According to still further features in the described preferred embodiments the at least one contact-tip is sterilizable.
According to still further features in the described preferred embodiments the at least one contact-tip comprises at least one sterilizable cover.
According to still further features in the described preferred embodiments the at least one contact-tip is disposable.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly comprises a mechanical vibrations generating transducer assembly, the mechanical vibrations generating transducer assembly is operable to convert electrical signals into mechanical motions.
According to still further features in the described preferred embodiments the mechanical vibrations generating transducer assembly is selected from the group consisting of a piezoelectric mechanical vibrations generating transducer assembly, an electric mechanical vibrations generating transducer assembly, an electrostrictive mechanical vibrations generating transducer assembly, a magnetic mechanical vibrations generating transducer assembly, a magnetostrictive mechanical vibrations generating transducer assembly, an electromagnetic mechanical vibrations generating transducer assembly, a micro electro mechanical system (MEMS) vibrating generating transducer assembly, and an electrostatic mechanical vibrations generating transducer assembly.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly comprises at least one mechanical sensor.
According to still further features in the described preferred embodiments the at least one mechanical sensor is selected from the group consisting of a contact sensor and a remote sensor.
According to still further features in the described preferred embodiments the at least one mechanical sensor is selected from the group consisting of an acceleration sensor, a force sensor, a pressure sensor and a displacement sensor.
According to still further features in the described preferred embodiments the mechanical vibrations generating assembly comprises a mechanism for isolating the mechanical vibrations generating assembly from environmental vibrations.
According to still further features in the described preferred embodiments the mechanism is operable to independently move in three orthogonal directions.
According to still further features in the described preferred embodiments the mechanism is operable to independently rotate in at least two orthogonal directions.
According to still further features in the described preferred embodiments the method further comprises transmitting an electrical signal to the mechanical vibrations generating assembly.
According to still further features in the described preferred embodiments the measuring is by receiving an electrical signal transmitted from the mechanical vibrations generating assembly.
According to still further features in the described preferred embodiments the method further comprises displaying the electrical signal transmitted from the mechanical vibrations generating assembly on a display.
According to still further features in the described preferred embodiments the display is selected from the group consisting of an oscilloscope, a spectrum analyzer, a processor display and a printer.
According to still a further aspect of the present invention there is provided a resonance spectra library produced by at least one of the methods of the present invention, the resonance spectra of the library are stored, in a retrievable and/or displayable format, on a memory media.
According to still a further aspect of the present invention there is provided a memory media, storing in a retrievable and/or displayable format the resonance spectra of the resonance spectra library.
According to further features in preferred embodiments of the invention described below, the tissue forms a part of, or is associated with, the urinary system of the subject.
According to still further features in the described preferred embodiments the tissue forms a part of an organ.
According to still further features in the described preferred embodiments the tissue forms a part of an internal organ.
According to still further features in the described preferred embodiments the tissue forms a portion of a tumor.
According to still further features in the described preferred embodiments the tissue forms a portion of an internal tumor.
According to still further features in the described preferred embodiments the tissue is a pathological tissue.
According to still further features in the described preferred embodiments the tissue forms a part of, or is associated with, a blood vessel tissue.
According to still further features in the described preferred embodiments the blood vessel tissue is selected from the group consisting of a blood clot, an occlusive plaque and a vulnerable plaque.
According to still further features in the described preferred embodiments the blood vessel is selected from the group consisting of a carotid, a femoral, and an abdominal aorta.
According to still further features in the described preferred embodiments the tissue forms a portion of a bone.
According to still further features in the described preferred embodiments the tissue is a stenotic tissue.
According to still further features in the described preferred embodiments the tissue is a lesion.
According to still further features in the described preferred embodiments the lesion is selected from the group consisting of a dermal lesion, a sub-dermal lesion and an internal lesion.
According to still further features in the described preferred embodiments the position is close to an internal lesion.
According to still further features in the described preferred embodiments the adjacent to the tissue is on a skin of the body.
The present invention successfully addresses the shortcomings of the presently known configurations by providing a method, system and device for characterizing a tissue present in a body of a subject.
Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, suitable methods and materials are described below. All publications, patent applications, patents, and other references mentioned herein are incorporated by reference in their entirety. In case of conflict, the patent specification, including definitions, will control. In addition, the materials, methods, and examples are illustrative only and not intended to be limiting.
Implementation of the method and system of the present invention involves performing or completing selected tasks or steps manually, automatically, or a combination thereof. Moreover, according to actual instrumentation and equipment of preferred embodiments of the method and system of the present invention, several selected steps could be implemented by hardware or by software on any operating system of any firmware or a combination thereof. For example, as hardware, selected steps of the invention could be implemented as a chip or a circuit. As software, selected steps of the invention could be implemented as a plurality of software instructions being executed by a processor using any suitable operating system. In any case, selected steps of the method and system of the invention could be described as being performed by a data processor, such as a computing platform for executing a plurality of instructions.
The invention is herein described, by way of example only, with reference to the accompanying drawings. With specific reference now to the drawings in detail, it is stressed that the particulars shown are by way of example and for purposes of illustrative discussion of the preferred embodiments of the present invention only, and are presented in the cause of providing what is believed to be the most useful and readily understood description of the principles and conceptual aspects of the invention. In this regard, no attempt is made to show structural details of the invention in more detail than is necessary for a fundamental understanding of the invention, the description taken with the drawings making apparent to those skilled in the art how the several forms of the invention may be embodied in practice.
In the drawings:
a illustrates a typical configuration of the mechanical vibrations generating assembly, according to the present invention;
b illustrates a cross sectional view of the mechanical vibrations generating assembly, in the embodiment in which more than one mechanical linkage device is used, according to the present invention;
c illustrates an endoscopic device for in vivo characterization of a tissue, according to the present invention;
a illustrates a two dimensional model which consists of a plurality of particles, according to the present invention;
b illustrates coupling of a certain particle of the two dimensional model with its eight neighbours, according to the present invention;
c illustrates forces, spring, and viscous damper between two neighboring particles of the two dimensional model, according to the present invention;
d shows a square region of particles of the two dimensional model, which simulates an artery, according to the present invention;
a-c schematically exemplify a mechanical linkage device, according to a preferred embodiment of the present invention;
a is an image of a common carotid of a subject having hard plaque, whereby extremely hard plaque is shown as dark areas;
b-c show the frequency of the lower (
d-e show the amplitude at the lower (
The present invention is of a method, system and device for characterizing a tissue present in a predetermined location of a body of a subject, which can be used for non-invasive and minimal-invasive (e.g., catheter based) medical diagnostics. More particularly, the method, system and device of the present invention can be used for classifying the frequency response spectrum of tissue structures within the body, to thereby provide for non-invasive or minimal invasive medical diagnostics. Specifically, the present invention can be used to characterize and identify a variety of tissues and pathologies in the body, such as, but not limited to, plaques, lesions, tumors, cysts and the like.
The principles and operation of a method, apparatus and system for characterizing a tissue according to the teachings of the present invention may be better understood with reference to the drawings and accompanying descriptions.
Before explaining at least one embodiment of the invention in detail, it is to be understood that the invention is not limited in its application to the details of construction and the arrangement of the components set forth in the following description or illustrated in the drawings. The invention is capable of other embodiments or of being practiced or carried out in various ways. Also, it is to be understood that the phraseology and terminology employed herein is for the purpose of description and should not be regarded as limiting.
The present invention exploits the dynamics of harmonic oscillators for tissue characterization. For the purpose of providing a complete and self contained description of the invention, an introductory explanation of the principles of harmonic oscillators precedes the detailed description of the invention in context of the drawings describing its preferred embodiments.
Many systems in nature which vibrate or oscillate may be approximated by a well known physical model, called harmonic oscillator. A simple harmonic oscillator is a physical system in which a generalized coordinate representing the system is proportional to its second derivative, where the constant of proportionality is negative. The generalized coordinate of the system may be realized as, for example, a displacement, an angle, an electric charge or any other degree-of-freedom in the system.
Mathematically, a harmonic oscillator is represented by one or more differential equations, called the equations of motion. The number of equations of motion depends on the number of generalized coordinates, and the solutions of these equations describe the functional dependence of the generalized coordinates on time. The solution of a simple harmonic oscillator is a periodic function characterized by a frequency, called the natural frequency. The natural frequency depends on the parameters of the system, which parameters are referred to as the constant of inertia (or the inertia) and the elastic constant (or the elasticity).
The most illustrative example of a harmonic oscillator is a mass connected to some elastic object of negligible mass (e.g., a spring) that is fixed at the other end and constrained so that it can only move in one dimension. In this example, the generalized coordinate may be the position of the mass, the constant of inertia is the mass and the elastic constant is the spring constant measured in units of force per mass unit. Another typical example of harmonic oscillator is an electric circuit which comprises a capacitor and an inductor. In this example the generalized coordinate is the electric charge on the capacitor, the constant of inertia is the inductance and the elastic constant is related to the capacitance. Other examples include a pendulum on a long wire, a molecule, motion of a charged particle within a quadratic potential (e.g., inside a spherically symmetrical charged distribution), acoustic waves and the like. Irrespective of the physical realization of the system, all the mathematical solutions of harmonic oscillations are equivalent.
For each harmonic oscillator, there is one particular point in which, under certain initial conditions, no oscillations occur. This point is referred to as the point of equilibrium. For example, for a mass connected to a horizontal spring, the point of equilibrium is the point where the spring is loose. When the system is displaced from its equilibrium position, the elasticity provides a restoring force which is directed to the equilibrium position, and the inertia property causes the system to overshoot equilibrium. A continued interplay between the elastic and inertia properties of the system results in an oscillatory motion. In a simple harmonic oscillator, the motion is characterized by a natural frequency which is related to the elastic constant and constant of inertia.
In reality, dissipative forces prevent from the simple harmonic oscillator from its perpetual motion, and, unless other driving forces exist, the oscillations of the system decrease with time. Such a physical model is called a damped harmonic oscillator, and the decreasing rate of the oscillations depends on other parameters of the system. In terms of energy, a damped harmonic oscillator releases energy to the environment, typically by heating the medium in which the system oscillates. Once all the energy of the system is released, the system is loose again. An approximation to the dissipative force resulting from friction between the harmonic oscillator and the medium in which it oscillate, is a force which is proportional to the velocity of the system where the constant of proportionality, called the damping factor, is negative. In this case, the amplitude of the oscillations decreases exponentially with time.
A time-dependent external force, acting on a damped harmonic oscillator, may compensate the energy lose of the system so that the system continues to oscillate while still subjected to the dissipative force. This case is referred to as a damped and forced harmonic oscillator, or damped and driven harmonic oscillator. When the dissipative force is proportional to the velocity of the system and the driving force oscillates in a sinusoidal manner, the equation of motion of the system has an analytic solution consisting of two parts: a transient part and a steady-state part. The transient part is characterized by an amplitude which depends on the initial conditions of the system and corresponds to a damped harmonic oscillator, i.e., decreases exponentially with time. The steady-state part is characterized by a constant amplitude that depends on the driving force, but does not depend on the initial conditions of the system. The amplitude of the steady-state part depends on the relation of the frequency of the driving force to the natural frequency of the system and on the damping factor.
A particular case in which the driving frequency equals the natural frequency is called a resonance. The maximal value of the steady-state amplitude occurs at a driving frequency smaller than the resonance frequency (for constant driving force amplitude). As the damping factor decreases, the maximal amplitude frequency tends to the resonance frequency value, and the amplitude increases as the reciprocal of the damping factor. A frequency response curve is a graph representing the steady-state amplitude as a function of the driving frequency. Typically, the response curve has a sharp peak near the resonance frequency. Hence, by scanning the driving frequency of a damped and forced harmonic oscillator, one can locate the resonance frequency of the system and gain information on the system in general and on its parameters in particular.
Based on Hooke's law, all materials in nature, including tissues, have some elastic properties and in certain deformation regions may be viewed as harmonic oscillators.
While conceiving the present invention it was hypothesized that the mechanical properties of tissues may be measured by studying the response curve of the tissues-of-interest. It has been further hypothesized that based on the mechanical properties, the nature of a tissues-of-interest may be characterized.
Thus, according to one aspect of the present invention there is provided a system for characterizing a tissue present in a predetermined location of a body of a subject, generally referred to herein as system 10. The tissue may be any tissue which can be characterized according to its mechanical properties, e.g., a tumor (malignant or benign), a blood vessel (e.g., stenotic tissue, wall tissue, plaque), a bone, a pathological tissue or any other a part of an organ (either internal or external). System 10 can be used to characterize a tissue in a location which has already been determined by another medical procedure, e.g., an ultrasonic imaging procedure, MRI and the like and provides another dimension to diagnostic procedures.
Referring now to the drawings,
According to a preferred embodiment of the present invention control unit 300 serves two purposes: (i) scanning the driving frequency of the mechanical vibrations generated by assembly 100; and (ii) measuring a frequency response spectrum from the predetermined location. Thus, control unit 300 communicates with assembly 100 in a manner that signals from control unit 300 are converted into the vibrations of assembly 100, and signals from assembly 100 are converted into readable data by control unit 300. The frequency range in which system 10 operates is preferably 10-10000 Hz, more preferably 15-5000 Hz, still preferably 20-5000 Hz most preferably 20-2500 Hz.
According to a preferred embodiment of the present invention the mechanical vibrations are applied onto the skin, thereby provide mechanical excitations of the skin near the predetermined location which is to be characterized. As is further detailed hereinafter, the data, collected by control unit 300, which reflect excitation of body 400 at the external point of contact is sensitive to the mechanical properties of the tissue deep inside the body. In other words, it will be demonstrated that mechanical properties of internal tissues are characterized by external measurements.
According to this embodiment of the invention, system 10 is non invasive. Nevertheless, the scope of the present invention is not limited to non invasive systems and, as further detailed hereinbelow, it will be appreciated that systems operable similar to system 10, yet can be adapted for use in minimally invasive (e.g., catheter based) and more invasive procedures (e.g., during invasive operation) are also within the scope of the present invention.
Reference is now made to
According to a preferred embodiment of the present invention, assembly 100 includes a Mechanical Linkage Device (MLD) 102, which serves for transferring mechanical vibrations to body 400.
MLD 102 is in contact with body 400 (for example, at position 401 shown in
MLD 102 may be, for example, an elastic rod, a leaf spring, a system of springs and masses or any other device which is capable of applying the driving force to body 400. According to a preferred embodiment of the present invention MLD 102 is made of a soft and light material so as to allow MLD 102 to exert a substantially constant force amplitude, e.g., at position 401. In addition, MLD 102 is characterized by a natural frequency which is preferably higher than the frequency of the driving force, so as to minimize dynamical distortion. A judicious selection of the size and the natural frequency of MLD 102 increases the dynamical interaction between the body and the MLD, thus allows for the distinction between different biological materials.
As stated, contact-tip 101 provides for the physical contact between system 10 and the body. Contact-tip 101 may be of any shape suitable to convey the vibrations generated by assembly 100 into the body. Preferably, contact-tip 101 is sterile. Sterilization can be achieved, for example by providing a sterilizable cover onto contact-tip 101, or by manufacturing it from disposable (sterilizable) material, so that it can be replaced between successive operations of system 10.
Several contact-tips, positioned in more than one position adjacent to the predetermined location, may also be used. Contact-tip 101 may be in position 401 adjacent to the tissue which was detected using a previous medical imaging procedure (e.g., ultrasonic, magnetic resonance or x-ray imaging). However, in some cases, an exact location is not known since the medical imaging apparatus only provides a suspected area 402. In this case, contact-tip 101 may be moved or scanned to other positions 402, so as to optimize the measurement.
The orientation of contact-tip 101 with respect to body 400 is determined by the user in accordance with the desired direction of the applied mechanical vibrations. For example, in one embodiment, the vibrations are perpendicular to the plane of body 400, constraining mechanical excitations of the molecules normal to the skin. In another embodiment, the vibrations are inclined to body 400 by a predetermined inclination angle (e.g., 10-80 degrees), allowing for mechanical excitation vectors being both normal and parallel to body 400.
The procedure may also be repeated a plurality of times, where in each time contact-tip 101 engages a different position and/or inclined by a different inclination angle, and the resulting measurements may be analyzed simultaneously and/or independently.
To facilitate multiple measurements, and according to another embodiment of the present invention, a plurality of contact-tips 101 arranged in a matrix-like arrangement are used for simultaneous detection from a plurality of positions and/or a plurality of inclination angles, obviating or reducing the need for scanning the positions/angles for optimum. An aspect ratio of the matrix is preferably selected so as to allow a substantial efficient scanless measurement of body 400.
According to a preferred embodiment of the present invention, the positioning and/or orienting of contact-tip 101 is carried out either manually or automatically, hence, assembly 100 may be manufactured sufficiently compact to facilitate mobility of system 10, or it may include by a suitable machinery for moving contact-tip 101 from one location to another and/or for varying its inclination angle.
According to another embodiment of the present invention, assembly 100 may also include a mechanism for isolating assembly 100 from environmental vibrations.
This may be for example a stand or any other apparatus having static parts attached to a fixed point (e.g., floor, ceiling or wall) and non static parts which can move freely and independently from the static parts. Preferably, the motion of the non static parts is both translational motion and rotation motion. More preferably, the translational motion is governed by three degrees-of-freedom. Still preferably, rotation motion is governed by at least two rotational degrees-of-freedom.
Referring again to
Preferably, assembly 100 further comprises at least one mechanical sensor. A mechanical sensor is a device for converting mechanical signals (acceleration, force, pressure, displacement, etc.) into electric signals. Two mechanical sensors are shown in
A particular feature of a preferred embodiment of the present invention is that second sensor 202 is coupled to contact tip 101. This feature has the advantage that the number of contact points between system 10 and the subject is minimized (e.g., one contact point). However, it is intended not to limit the scope of the present invention for use of any specific configuration of sensors hence other alternatives may be used. For example, sensor 202 may be attached to the body of the subject substantially near position 401, or, a plurality of sensors 202 may be attached to the body at different positions within area 402. In any case, sensor(s) 202 electrically communicates (e.g., by an appropriate wiring setup), with control unit 300.
According to a preferred embodiment of the present invention assembly 100 may comprise more than one MLD, so as to improve the operation of system 10.
Reference is made to
In this embodiment, transducer 103 has a tubular shape, where first MLD 102a is positioned on one end of transducer 103 and second MLD 102b is positioned on another end of transducer 103. according to a preferred embodiment of the present invention transducer 103 may be any transducer of tubular shape which is capable of transforming electrical signal into a mechanical signal and may operate according to any known principle as further detailed hereinabove, for example, a tubular electromagnetic coil, a toroidal electromagnetic coil, a piezoelectric tube, a piezoelectric annulus, a piezomagnetic tube and the like.
First sensor 201 is preferably elongated (e.g., shaped as rod), and positioned so as to connect first MLD 102a and second MLD 102b. First 102a and second 102b MLDs are preferably identical thin membranes (e.g., from thin plastic or thin metal, provided that transducer 103 and first sensor 201 are electrically insulated from each other). Sensor 201 serves for receiving mechanical input from tip 101 which, in operational mode of assembly 100, is continuously in contact with body 400. Sensor 201 may be any sensor capable of transforming an axial mechanical signal into an electrical signal, such as, but not limited to, a piezoelectric rod, a tubular electromagnetic coil, a piezomagnetic.
In another preferred embodiment, MLDs 102a and 102b may be made of piezoelectric polymeric membranes, so as to serve also as sensors. The advantage of such configuration is that the sensing functionality is intrinsic to MLDs 102a and 102b, so that the part, designated in
Second sensor 202 serves as a monitor of transducer 103. According to a preferred embodiment of the present invention, the shape of second sensor 202 matches the shape of transducer 103 so as to allow sensor 202 to measure the vibrations of transducer 103. For example, for a cylindrical shape of transducer 103 sensor 202 may an annulus. Sensor 202 may be for example, a force sensor, an accelerometer, a displacement sensor and the like.
In operational mode, control unit 300 sends input signals to transducer 103 (e.g., via a lead 114 connected thereto), and monitors transducer 103 output using second sensor 202 that is connected to the control unit 300 by cables 115. Transducer 103 transfers the electrical input signals into mechanical input signals which are transferred from transducer 103 to contact tip 101 via MLD 102b, sensor 201 and MLD 102a. Contact tip 101 vibrates in response to the mechanical input signals and sensor 201 measures these mechanical response vibrations, transforms these vibrations into electrical signals and transmits these signals back to control unit 300 (e.g., via a lead 116 connecting sensor 201 and control unit 300). According to a preferred embodiment of the present invention, first MLD 102a and second MLD 102b substantially prevent first sensor 201 from any motion mode other than axial mechanical vibrations as picked up by tip 101. Undesired motion modes of first sensor 201, which may be prevented by MLDs 102a and 102b include, but are limited to, bending, buckling, twisting and the like.
As stated, system 10 may also be adapted for use in minimally invasive and more invasive procedures. According to a preferred embodiment of the present invention assembly 100 may be designed and constructed so as to operate inside a tube where tip(s) 101 touches the inner surface of the tube at one or more points. With such design, assembly 100 may be, or may be mounted on, an endoscopic probe to be inserted into the vascular, cardiovascular or urinary system of a mammal. Additionally, according to a preferred embodiment of the present invention assembly 100 can be used during a more invasive procedure whereby the organ of interest (e.g., a blood vessel) can be easily accessed.
In any event, measurements of the frequency response spectrum are preferably performed by scanning the organ point by point along a predetermined pattern such as, but not limited to, a line, a circle, a curve or any other open or closed path. The desired geometrical resolution of the examination preferably dictates the number and density of points at which the response is to be measured. Once the frequency responses are measured along the predetermined pattern, the characterization of the plaque can be determined by considering, for example, by calculating one or more, global or local, mechanical properties of the tissue, or by searching for shifts in the frequency response of the tissue at each location, relative to an existing database and/or relative to the response measured at a different, say, adjacent location.
A particular advantage of the present invention is the capability to determine the existence of plaque as well as to characterize its vulnerability, thereby to allow the physician to decide whether or not a fully invasive procedure is required to remove the plaque. It is recognized that the vulnerability of the plaque depends on its hardness, where harder plaque are less dangerous. In particular, soft and fatty plaque pockets tend to shed flakes down the blood stream thereby casing CVA, stroke or gangrene. As demonstrated in the Examples section that follows, the frequency response of tissues, employed according to a preferred embodiment of the present invention, substantially correlates with the hardness of the plaque hence with the symptomacy of the subject.
Typically, as prior art techniques fail to determine the vulnerability of the plaque, the level of blood vessel constriction is used for deciding whether or not to recommend a fully invasive plaque removal procedure (for carotid patients, for example, the criterion for fully invasive plaque removal is a constriction of 70% or more). As will be appreciated by one of ordinary skill in the art, the determination of both existence and vulnerability provides an efficient set of criteria for selecting the proper treatment.
According to a preferred embodiment of the present invention one or more assemblies may be combined with additional imaging devices to form an endoscopic device 200, which is schematically illustrated in
Referring to
Assemblies 100a and 100b may be configured in more than one way, provided that mechanical vibrations are transmitted thereby to the respective position of body 400. More specifically, each of assemblies 100a and 100b may independently be manufactured as described hereinabove with reference to
Device 200 comprises at least one imaging device 108, such as, but not limited to, an Intra Vascular Ultra Sound (IVUS) device , Intra Vascular Magnetic Resonance (IVMR) device, a camera or any other imaging device suitable for being integrated into an endoscopic probe. Alternatively, imaging device 108 may be located outside device 200 in a manner that allows imaging device 108 to communicate with device 200, for example, via optical (e.g., infrared, visible, ultraviolet), electrical, or acoustical communication channel. In this embodiment, imaging device 108 may also be a noninvasive imaging device, such as, but not limited to, a computer tomography device or a magnetic resonance device.
Imaging device 108 serves for initial detection of the region to be analyzed by assemblies 100a and 100b (and additional assemblies which, as stated, may be present in device 200).
In operational mode device 200 moves, e.g., within a blood vessel in a manner that tips 101 and MLDs 102 of assemblies 100a and 100b are contracted towards the inner part of device 200. When imaging device 108 detects a region-of-interest (e.g., a region having a suspected plaque or other vascular sediments), device 200 stops as to juxtapose at least one of tips 101 opposite to the region-of-interest. Alternatively, if the region-of-interest is farer from device 200 assembly, a posing mechanism 106 bulges tip(s) 101 (and, if necessary also MLD(s) 102) out of encapsulation 109 so as to touch the tissue of the region-of-interest.
Once a contact has been established between tip 101 and the suspected tissue, transducer 103 sends mechanical signals to, and receives responses of tip 101, via MLD 102. If more than one tip touches the suspected tissue, the mechanical signals are preferably transmitted to each of the operative tips, as further detailed hereinabove. The mechanical responses are then used for the analysis of the suspected tissue (e.g., by control unit 300 as further detailed hereinunder, with reference to
Once a certain region-of-interest is analyzed, mechanism 106 withdraws tip 101 and MLD 102 back into encapsulation 109 so as to facilitate a substantially free motion of device 200 to the next region-of interest.
According to a preferred embodiment of the present invention device 200 further comprises a preamplifier 107 electrically communicating with sensors 201 and 202, (e.g., via leads 105) for partial amplifying of the electrical signals received from sensors 201 and 202. The partial amplification of the electrical signals is particularly useful for improving the efficiency of data analysis. Specifically, as device 200 is essentially far from control unit 300, a partial amplification, prior to the transmission of the signals to control unit 300 increases the signal-to-noise ratio thereby improves the accuracy of the measurement.
Reference is now made to
According to a preferred embodiment of the present invention transmission unit 310 comprises a computerized synthesizer 311 for generating a synthesized electrical pulse, synthesizer 311 communicates with processor 330. Transmission unit 310 further comprises a power amplifier 312 for amplifying the electrical pulses, prior to the transmission of the pulses to transducer assembly 103. Transmission unit 310 communicates with transducer assembly 103.
According to a preferred embodiment of the present invention receiver 320 comprises a preamplifier 321 and a line amplifier 322 which are configured and designed to amplify the electrical pulses received from assembly 100. In addition, receiver 320 comprises a display 323 for displaying the electrical pulses. Display 323 may be an oscilloscope, a spectrum analyzer, a computer display, a printer or any other known suitable device. First sensor 201 and second sensor 202 are operable to send electrical signals to receiver 320 so as to allow measurement of the relation between the amplitude of the driving force and the response amplitude.
The electrical pulses from transmission unit 310 which are controlled by processor 330 determine the frequency of the mechanical vibrations applied to the body by MLD 102.
According to a preferred embodiment of the present invention the electrical pulses are selected so as to enhance the mechanical excitations of the tissue and thereby the quality of the measurement. Hence, the mechanical vibration frequency may be, for example, a single frequency, a superposition of a plurality of frequencies, a continuous frequency scan (chirp) or a band-limited white noise frequency, depending on the examined tissue and/or the sensitivity of the equipment which is used in the various embodiments of the invention as is further detailed hereinabove.
According to another aspect of the present invention there is provided a method of characterizing a tissue present in a body of a subject. The tissue undergoing analysis using the method of the present invention can be any of the tissues, either normal or pathological as is further detailed hereinabove. Prior to the characterization of the tissue, the location of the tissue may be determined by another diagnostic, e.g., imaging device, e.g., an ultrasonic imaging device.
The method of this aspect of the present invention comprises the following method steps, in which in a first step mechanical vibrations adjacent to the predetermined location of the tissue are generated. Preferably, the first step is executed so as to optimize the measurement (i) by minimizing effects of environmental noise occurring while the mechanical vibrations are applied, and (ii) by selecting an appropriate position and/or direction of the mechanical vibrations, as further described hereinabove. In a second step, a frequency of the mechanical vibrations is scanned, and in a third step a frequency response spectrum is measured, so as to obtain at least one mechanical property of the tissue.
Each of the above method steps can be carried out using an appropriate equipment or machinery. For example, the first step may be executed using a vibrator, the second step may be executed by varying the power supply of the vibrator and the third step may be executed by a system of sensors which are controlled by a central data processor. Alternatively, one or more of the above method steps may be executed by system 10, as described above.
The present invention provides a method and a system which successfully characterize a large variety of tissues, present in a predetermined location in the body. The position onto which the vibrations are applied (e.g., the position of contact-tip 101) is determined by the type and location of the tissue-of-interest, as further detailed herein. Thus, in cases where the tissue forms a part of, or is associated with, a blood vessel tissue, e.g., forms a plaque inside a blood vessel, the preferred position of contact-tip 101 is onto the skin which is closest to the blood vessel-of-interest, e.g., closest to the carotid, one of the femoral vessels or the abdominal aorta, and the like. In cases where the tissue is a lesion (either a dermal lesion, a sub-dermal lesion or an internal lesion), the preferred position of contact-tip 101 is onto the skin which is closest to the lesion. Lesions include, for example, melanoma, breast cancer, cancer of the prostate and the like.
It will be recognized that, in order to allow for efficient therapeutic procedures to be practiced, melanoma, for example, must be positively diagnosed malignant in phase I (skin surface) or II (up to 3-4 mm deep), both of which are within the scope of the present invention.
In cases of breast or prostate cancer the lesion is located at a small depth (several centimeters) below the outer surface of the skin. Therefore the preferred position of contact-tip 101 is onto the breast or lower abdomen.
In cases where the tissue is a bone (such as, but not limited to, a tibia or fibula), the preferred position of contact-tip 101 is onto the skin which is closest to the bone (e.g., on the leg of the subject).
In other cases the tissues-of-interest is in the lungs (for example, when the lungs are inflamed, suffer an edema or any other fluid fill or are suspected of lung malignancy) the preferred position for contact-tip 101 is onto the thorax.
As stated, the information gained from the mechanical property of the tissue is sufficient for characterizing and identifying the tissue-of-interest. Nevertheless, tissue characterization, according to the present invention, can be done in more than one way.
In one embodiment, the frequency response spectrum is used for calculating at least one mechanical property of the tissue.
Preferably, the calculated mechanical properties are elastic constants, e.g., an elastic modulus, a Poisson's ratio, a shear modulus, a bulk modulus or a first Lamé coefficient. One ordinarily skilled in the art would appreciate that for isotropic materials, it is sufficient to measure two of the above elastic constants and then to calculate the other using theoretical formulae. Such formulae are available for example in a text book by Timoshenko & Young, entitled “Theory of elasticity”, which is incorporated by reference as if fully set forth herein.
In another embodiment of the invention, the frequency response spectrum is compared to an existing database (e.g., a library having a plurality of resonance spectra for different types of tissues). Such a comparison can be executed on, for example, normalized spectra using, for example, a simple square minimal error (SME) mathematical procedure. Other procedures and manipulations of the data, such as, but not limited to, correlation, transfer functions, coherence and cepstrum are not excluded.
To this end, according to yet another aspect of the present invention there is provided a method of constructing a resonance spectra library, the resonance spectra characterizing a plurality of tissues of a plurality of subjects. The method comprising the following method steps, in which, in a first step a tissue of a subject is selected and mechanical vibrations are generated at a position adjacent to the tissue. As will be explained below, the selected tissue is to be associated with the frequency response spectrum. In a second step of the method, a frequency of the mechanical vibrations is scanned, in a third a frequency response spectrum from of the tissue is measured, and a forth step comprises recording the frequency response spectrum, thereby providing a frequency response spectrum entry of the library, which entry characterizes the selected tissue.
Hence, for each tissue one or more entries are recorded, thereby a resonance spectra library is constructed. Entries (e.g., normalized spectra) from similar tissues can be averaged. According to a preferred embodiment of the present invention each of the steps of this aspect of the invention may be executed by any known equipment or machinery, for example, by system 10. It is to be understood that the steps of this method may be repeated a plurality of times, each time for different tissue of the same subject and/or for different subject, so as to increase the size, representability and/or accuracy of the resonance spectra library.
Once constructed, the resonance spectra library can be stored in an appropriate memory media for future use, e.g., by system 10 or by other aspects of the present invention as describe above.
Hence, according to yet an additional aspect of the present invention there is provided a resonance spectra library produced, as detailed hereinabove, by the method. The resonance spectra of the library are preferably stored, in a retrievable and/or displayable format, on a memory media.
According to still an additional aspect of the present invention there is provided a memory media, storing in a retrievable and/or displayable format the resonance spectra of the resonance spectra library.
According to a preferred embodiment of the present invention the memory media can be any memory media known to those skilled in the art, which is capable of storing the resonance spectra library either in a digital form or in an analog form. Preferably, but not exclusively, the memory media is removable so as to allow plugging the memory media into a host (e.g., a processing system), thereby allowing the host to store the resonance spectra library in it or to retrieve the resonance spectra library from it.
Examples for memory media which may be used include, but are not limited to, disk drives (e.g., magnetic, optical or semiconductor), CD-ROMs, floppy disks, flash cards, compact flash cards, miniature cards, solid state floppy disk cards, battery-backed SRAM cards and the like.
According to a preferred embodiment of the present invention, the resonance spectra library is stored in the memory media in a retrievable format so as to provide accessibility to the stored data. Preferably information is retrieved from the resonance spectra library either automatically or manually. That is to say that the resonance spectra library may be searched by an appropriate set of search codes, or alternatively, a user may scan the entire library or a portion of it, so as to find a match for the measured frequency response spectrum. According to a preferred embodiment of the present invention the resonance spectra library is stored in the memory media in more than one form.
Hence, in one embodiment the library includes a plurality of images which may be compared the measured resonance curve. Examples for images which may be stored in the library are given in
In another embodiment, the resonance spectra of the library are stored in a textual format which facilitates searching the library using search codes. For example the library may contain elastic moduli of several tissues or the library may contain normalized amplitudes and/or normalized phase angles as a function of normalized frequencies, as further detailed in the Examples section hereinunder.
It is appreciated that in all the above embodiments, library data is stored in the memory media in an appropriate displayable format, either graphically or textually. Many displayable formats are presently known, for example, TEXT, BITMAP™, DIF™, TIFF™, DIB™, PALETTE™, RIFF™, PDF™, DVI™0 and the like. However it is to be understood that any other format that is presently known or will be developed during the life time of this patent, is within the scope of the present invention.
In addition to the resonance spectra library, to which each measured spectrum can be compared, so as to identify the type of tissue, the characterization of the tissue, or any other structural material, may be done also by simulating one or more harmonic oscillators.
Thus, according to still another aspect of the present invention there is provided a method of classifying a frequency response spectrum of a structural material. The method is executable by a data processor and comprising the following method steps, in which, in a first step, a physical model of a plurality of harmonic oscillators is constructed. The physical model may be of any number of dimensions and independently of any number degrees-of-freedom, it comprises a set of parameters and it is characterized by a plurality of equations of motion. The set of parameters may be, for example, one or more constants of inertia (e.g., mass or inductance) and one or more elastic constants (e.g., spring constant or reciprocal of capacitance). A skilled artisan would appreciate that the set of parameters described herein represent dynamic stiffness and density of the structural material which is to be classified.
According to a preferred embodiment of the present invention at least one of the harmonic oscillators is a damped harmonic oscillator and at least one of the harmonic oscillators is a forced harmonic oscillator; hence, the physical model is characterized by at least one driving frequency.
A second step of this method of the present invention is to simultaneously solve the plurality of equations of motion, so as to provide at least one frequency response, which may be, for example, a frequency dependent amplitude or a frequency dependent phase. Examples of physical models and solutions are given in the Examples section below.
In a third step of the method, a frequency response is compared with the frequency response spectrum of the structural material. The comparison may be done by checking overlaps between curves or by numerical comparison. The first two steps of this aspect are preferably repeated, each time with a different set of parameters, while each time the frequency response is compared with the frequency response spectrum of the structural material. Once an appropriate set of parameters that matches the frequency response spectrum is found, the frequency response spectrum of the structural material is classified based on the particular set of parameters.
Additional objects, advantages and novel features of the present invention will become apparent to one ordinarily skilled in the art upon examination of the following examples, which are not intended to be limiting. Additionally, each of the various embodiments and aspects of the present invention as delineated hereinabove and as claimed in the claims section below finds experimental support in the following examples.
Reference is now made to the following examples which, together with the above descriptions, illustrate the invention in a non limiting fashion.
The body is a continuous mass system with viscoelastic properties. The present example is a one dimensional model of a certain region of the body. The model comprises a system of a plurality of degrees-of-freedom each degree-of-freedom is constrained to a one dimensional motion.
The degrees-of-freedom of the system represent the mass lumped parameters of the body, where the rightmost mass represents an arterial tissue which is to be characterized. As the model is directed for simulating a non invasive procedure, the observable is the particle which is close to the surface of the body, i.e., the mass which is in contact with the MLD. The contact point is designated A in
The equations of motion of the system are:
(m0+m1){umlaut over (x)}1=−k(x1−x2)+k0(X0 sin(ωt)−x1)−c({dot over (x)}1−{dot over (x)}2)
m{umlaut over (x)}2=−k(x2−x1)−k(x2−x3)−c({dot over (x)}2−{dot over (x)}1)−c({dot over (x)}2−{dot over (x)}3)
m{umlaut over (x)}3=−k(x3−x2)−k(x3−x4)−c({dot over (x)}3−{dot over (x)}2)−c({dot over (x)}3−{dot over (x)}4)
m1{umlaut over (x)}4=−k1x4−k(x4−x3)−c1{dot over (x)}4−c({dot over (x)}4−{dot over (x)}3) (EQ. 1)
The natural vibration of the system decays due to the dissipative forces, and the steady-state solution to Equation 1 is obtained by the following substitution:
xi=Ai sin(ωt)+Bi cos(ωt),i=1,2,3,4 (EQ. 2)
The result is a set of 8 linear equations, the solution of which yields the 8 constants Ai, Bi.
For the point of contact (representing response of a particle on the surface of the body), the vibration amplitude is {square root}{square root over (A12+B12)} and the phase angle is φ=tan−1(B1/A1).
The set of parameters of the model are the masses and the spring constants. For normal arterial tissue, m1=m and k1=0.1k, where small spring constant corresponds to a soft arterial tissue compared to a tissue adjacent to the artery. On the other hand for a malignant tissue such as a hard plaque which is added onto the artery, the mass is large (m1=10m). For stiffened artery the spring constant is larger than the spring constant of a normal artery (k1=k).
Reference is now made to
Curves on
Reference is now made to
As can be understood from
The present example is a two dimensional model which simulates a continuous mass system of an artery, a plaque (if exist in the artery) and the adjacent skin. The model comprises a system of a plurality of particles each particle has two degrees-of-freedom. Thus, a system of M particles has N=2M degrees-of-freedom.
Reference is now made to
a-d are an illustration of the two dimensional model which consists of a plurality of particles.
A displacement of the jth particle in a direction normal to the external surface is denoted in
Fj(t)=F0j sin(ωt), (EQ. 5)
where ω is a circular frequency and F0j (constant) force amplitude. In practice, constant force amplitude may be achieved using an MLD having a very soft spring.
Referring again to
m17{umlaut over (x)}17=−k1(x17−x16)−k2(x17−x18)−k5(y17+x17−y1−x1)/2−k6(y17−x17−y33−x33)/2+k7(y17−x17−y3+x3)/2+k8(y17−x17−y31+x31)/2
m17ÿ17=−k(y17−y2)−k4(y17−y32)−k5(y17+x17−y1−x1)2−k6(y17+x17−y33−x33)/2−k7(y17−x17−y3+x3)/2−k8(y17−x17−y31+x31)/2 (EQ. 6)
To find the steady forced vibrations of a particle (say, the jth particle) which is subjected to the driving force of Equation 5, one needs to add the driving force to the right hand side of the corresponding equation. A particular solution to the resulting equation is of the form xl(t)=x0leiω1, where xl, x0l are complex numbers. Substituting the solution to the differential equation one obtains a system of N×N linear equations with constant coefficients, which can be written in the following matrix form:
[aij(ω,par.)]{Q0j}={F0j}, (EQ. 7)
where Q0j, representing the amplitudes x0j or y0j, and par stands for the lumped parameters of the model (elasticity, mass, viscosity). The solution of Equations 7 depends on the frequency of the driving force, ω. As stated, the observable is the particle which is in contact with the MLD, i.e., the particle onto which the driving force is applied.
For a symmetrical system with regards to the center in which the force is applied at the center of the artery (at position A, see
It is expected that a change in the parameters of the system (e.g., different masses and/or different spring constants) would result in different responses. Thus, benign or malignant regions of the artery inside the skin are expressed by different parameters, thereby leading to different responses to a given driving frequency. These differences allow identification of the type of plaque. Specifically, hard and dense plaque, which is less dangerous, is expressed by heavy mass particles and hard springs, while soft and light plaque, which is highly dangerous, is expressed by light mass particles and soft springs.
A representative system comprising 451 particles (a 11×41 matrix) was analyzed and the results of the frequencies responses are described below with references to
Curves on
where Rxi Re al(x0i) and Ixi=Im aginery(x0i).
PHIXi=tan−1(Ixi/Rxi). (EQ. 8)
As can be seen from
where Ryi=Re al(y0i) and Iyi=Im aginery(y0i).
PHIYi=tan−1(Iyi/Ryi). (EQ. 10)
As can be seen from
Comparison between hard plaque and benign clean artery for excitation in x direction are shown in
The position in which the driving force is applied reflects on the frequency response spectrum as well. This may be simulated by selecting a different particle of the system to be excited, e.g., by selecting a particle located at a perpendicular cross section designated “B-B” in of
The present example is of a two dimensional model which simulates a continuous mass system of a dermal or sub-dermal lesion surrounded by benign skin tissues. The model comprises a system of a plurality of particles each particle has two degrees-of-freedom. The interactions between the particles and the applied driving force are as in Example 2 and therefore governed by the same set of equations.
Reference is now made to
The mechanical properties of a dermal or sub-dermal lesion differ significantly from a benign skin tissue: the former is known to be much softer than the latter. In this example the suspected region of a skin was simulated by a system comprising 451 particles (a 11×41 matrix), the parameters of 15 of which (a 3×5 matrix) were selected in accordance with a malignant lesion characteristics (small masses and spring constants), and the parameters of all other particles were selected in accordance with a benign skin tissue characteristics. The ratio between the parameters of the malignant lesion to the parameters of benign skin tissue was 1:2, respectively.
For both amplitude and phase angle a significant difference between the responses of benign and malignant tissues was observed, as shown in
At the preliminary stage of bone's decalcification the density of the bone remains unchanged while the elasticity is known to decrease by about 30%.
In this example a bone is modeled by continuous mass beam at a transverse vibration mode. The natural frequency of the nth mode, ωn, of a beam is well known, and is given by:
ωn=An{square root}{square root over (EI/Aρl4)}, (EQ. 11)
where E is Young's Modulus, I is an area moment of inertia, A is an area of the cross section of the beam, ρ is a density of the beam, l is a length of the beam and An, n=1,2, . . . are constants that depend on the boundary conditions.
As a consequence to bone's decalcification the natural frequency, ωn, decreases by about 16%. Thus, bone's decalcification affects the frequency response, which effect is measurable as exemplified in the previous examples.
As stated hereinabove, in one embodiment the MLD is used at a specific position both to apply the force and to measure the displacement with minimal distortions. The dynamical interaction between the MLD and the tested improves the capability to distinguish between different biological materials inside the body.
Ideally, an optimal MLD would be a very soft and very light spring, positioned between a vibrating table and the body, where the vibration amplitude of the vibrating table is much larger than the vibration amplitude of the point of contact with the body. In addition, the natural frequency of the spring of an ideal MLD is much higher than the forcing frequency so as to prevent dynamical distortion. Practically, however, such MLD is rarely attainable.
This example demonstrates an MLD design which is sufficient to provide the desired functionality of the MLD, namely, the capability to apply the force and to measure the displacement with minimal distortions, and an enhanced capability to distinguish between different biological materials.
In this example, the spring is realized as a continuous mass flexible member having many natural frequencies and vibration modes. One ordinarily skilled in the art would appreciate that, if the measured quantity is the ratio between the motion characteristics of the body to the motion characteristics of the vibrating table, such multiplicity of frequencies of the driving force does not interfere with the objects of the present embodiment.
a-c illustrates the MLD of this example. The MLD comprises a thin variable width beam spring 260 which is connected to contact tip 101 on one end and to a vibrating table 264 on the other end. Contact tip 101 touches the body at a point designated in
For the purpose of measuring the vibration's displacement the MLD comprises a strain gage 262 and/or a proximity sensor 265. The use of strain gage and/or proximity allows the measurement of the displacement without addition of mass to the MLD. Strain gage 262 also measures the preload which is needed to be measured and controlled because of the nonlinearity of the biological materials which affect the response.
Senor 202 is a piezoelectric micro mechanical sensor which is simple and practical. Nevertheless, the mass of sensor 202, despite being small (about 0.5 gr.) decreases the natural frequency of the spring.
The dynamical response of point A was simulated considering a system consisting of the body and the MLD. The simulation results in the following set of linear equations:
|aij|{yj}={fi} (EQ 12)
where aij are the elements of a square matrix, yj is the displacements vector, and fj is the force vector due to the vibrator motion, all of which depend on the input frequency. The required output from Equation 12 is yA, the displacement of the contact point A.
The design of the MLD includes optimization of the input frequency, the overall size and the natural frequency of the MLD. Small size MLD (compared to the local parts of the body) corresponds to higher sensitivity; higher natural frequency corresponds to substantial constant force excitation. Hence, judicious choice of the parameters results in the desired dynamical interaction between the body and the MLD, which increases the sensitivity to the mechanical properties inside the body.
In this example, tissues were modeled by a man made structural model which was used to verify the ability to characterize tissues according to their elasticity.
Method
The complex frequency response of the model at a point of contact, at the center of slab 274 with the body was measured using the devices and methods of the present invention as further detailed hereinabove.
Results
This response may be further analyzed by comparing the responses of various contact points along a scanning path. In medical application, for example, the operator may select a geometrical path to follow (a line, a circle, a curve or any other open or closed path). The desired resolution of the examination dictates the number and density of points at which the response is to be measured. The measured frequency responses of the tissue at the various points are recorded and used for the characterization of the tissue.
In this experiment, two geometrical scans were performed, using two test inserts, along and above axis 278 of tube 276 with a resolution of 1 mm space between two adjacent reading-points. The first insert into the tube was a copper rod, 10 mm in length, and the second insert was a rubber plug, 20 mm in length, both positioned so as to touch the inner wall of the tube.
The results of all the responses acquired are displayed as three dimensional “waterfall” plots in
Data Analysis
Following is a detailed description of a method used to quantify and sort the elastic behavior changes along the trace of a scan based on the above findings.
First, the values of the maxima of the resonance peaks in all the scanned geometrical points were identified. Each two resonance frequencies corresponded to two values: (i) for an undisturbed tube region; and (ii) for a disturbed tube region (with an insert). Averaging taken on the frequencies in these two regions catered for small structural variations.
Second, the absolute value of the frequency response function at each of the averaged frequency maxima was plotted. Thus, plots obtained for the lower frequency resonance and for the upper frequency resonance.
Whenever the shifted frequency is higher than the unshifted frequency, the insert makes the complete setup stiffer. The experimental results show that copper is stiffer than rubber plate at the low resonance frequency and softer at the high resonance frequency.
A similar procedure was used on the phase of the frequency response function.
Third, the values of absolute values on the above plots were averaged, both in and out of the disturbed region. On each of the plots, the ratio between the absolute value of the disturbed and the absolute value of the undisturbed frequency range is indicative to the elasticity and geometry of the system.
The results of the copper insert are given in Table 1, below. In Table 1, f1 and fh are, respectively, the low and high resonances; Δf1 and Δfh are, respectively, the frequency shifts at the disturbed region in these two resonances; R1 and R1′ are, respectively, the ratios of the absolute value of frequency response function in the unshifted and shifted low resonance frequency; and R2 and R2′ are, respectively the equivalent values at the high resonance frequency.
By simple logic, if the insert is stiffer than the rubber plate, then Δf>0, R1,2<1 and R′1,2>1, whereas if the insert is softer than the rubber plate, then Δf<0, R1,2>1 and R′1,2<1. Thus, the values of R1,2, R′1,2, and Δf are characteristics of the stiffness (or softness) of the insert and may be used to define the degree of stiffness of the insert, and later of the plaque.
Table 1 demonstrates that the copper insert in rubber plate is characterized by different Δf at different resonance frequencies. Specifically, the copper is characterized by R1, R1′ at the low frequency peak region and Rh, Rh′ at the high frequency peak region.
Following is a description of an experiment in which the tissue characterization in accordance with preferred embodiments of the present invention was used to distinguish between soft and hard plaque in human carotid plaque.
The experiment was performed under a Helsinki permit no. 1653 issued by the Rambam Medical Center, Haifa, Israel.
Method
The experimental setup was similar to the experimental setup of Example 6 (see
The experiment was performed on the common carotid sample only, one patient at the time.
Human carotid plaque specimens were taken from 17 (10 asymptomatic and 7 symptomatic) subjects. The Human carotid plaque specimens were obtained in saline filled vials and were examined to isolate the common carotid part. One symptomatic sample was damaged and could not be included in the experiment.
Each common carotid sample resembles a plaque-made tube that was generally received cut along its axis. The samples were hand-felt for harder parts and photographed. A thin layer of Apizon L soft vacuum grease was used to smear the external faces of the samples. Each sample, once smeared, was inserted into the central section of the bore, and pushed to stick to the wall using a Percutanous Transluminal Angioplasty (PTA) inflatable balloon, which was deflated and removed once the sample was observed through the transparent RTV as fully adhered to the wall. The remaining bore was filled with saline, vacuum-pumped and cocked on both sides.
The resulting sample was a common carotid ex-vivo model ready for experimentation.
The complex frequency response of the sample was measured using the devices and methods of the present invention as further detailed hereinabove. The measurement was performed by scanning, point by point, the complete sample length and several additional points extending its length from both sides. Referring to
The analysis of the geometrical scan was along the guidelines of Example 6 hereinabove.
Results
Similarly to the man made structural model of Example 6, the ex-vivo samples of the present example exhibited two resonance frequencies in the region of 100-1000 Hz. The upper frequency resonance (observed at about 620±30 Hz) is associated with both samples and MLD, and the lower frequency resonance (observed at about 320±30 Hz) is associated with the samples only.
Data Analysis
The values of the maxima of the resonance peaks in all the scanned geometrical points were identified. Each resonance frequency, upper or lower, corresponded to two values: (i) for an undisturbed tube region; and (ii) for a disturbed tube region (with a sample). Averaging taken on the frequencies in these two regions catered for small structural variations.
a is an image of a particular sample. Dark areas of the images, corresponding to extremely hard plaque, are marked by solid circles.
b-c show, for a particular sample, the resonance frequency disturbance shifts for the lower (
d-e show the amplitude at the lower (
Dotted vertical lines drawn through
Statistical Analysis
The parameters which were analyzed were average and maximal values of the low and high resonances along the scan (four parameters). For each parameter in the symptomatic and a-symptomatic groups, the mean and standard deviation were calculated. The resulting p-values of the student t-test were: 0.0284 for average low resonance, 0.0012 for maximal low resonance, 0.0312 for average high resonance and 0.0299 for maximal high resonance, demonstrating high statistical significance for all four parameters.
The results for the a-symptomatic and symptomatic groups are summarized below in Tables 2 and 3, respectively.
Thus, the present embodiment provides the physician with a valid criterion for symptomatic patients. As higher resonance values are associated with harder plaque regions, the measurements of the above parameters can be used for assessing the symptomacy of the patient. Note that the lowest p-value was obtained for the disturbed lower resonance, reflecting that this contribution of the plaque and model is the most relevant. Additionally, the low standard deviation of this resonance shows that symptomatic patients are rather a more unified group than the a-symptomatic.
The present example demonstrates that the efficiency of the determination of course of treatment using frequency response measurements far exceeds conventional techniques which, as stated, are based solely on constriction levels. For example, using the present embodiment, the physician can reject a 70% constriction subject if he was found a-symptomatic. On the other hand, a 40% constriction complaining subject can be found symptomatic and be advised accordingly.
It is appreciated that certain features of the invention, which are, for clarity, described in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features of the invention, which are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable subcombination.
Although the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art. Accordingly, it is intended to embrace all such alternatives, modifications and variations that fall within the spirit and broad scope of the appended claims. All publications, patents and patent applications mentioned in this specification are herein incorporated in their entirety by reference into the specification, to the same extent as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated herein by reference. In addition, citation or identification of any reference in this application shall not be construed as an admission that such reference is available as prior art to the present invention.
This application claims the benefit of priority from U.S. Provisional Patent Application No. 60/496,707, filed Aug. 21, 2003. This application is also a continuation-in-part of International Patent Application No. PCT/IL03/00412, filed May 20, 2003, which claims the benefit of priority from U.S. patent application Ser. No. 10/435,749, filed May 12, 2003, U.S. Provisional Patent Application No. 60/406,056, filed Aug. 27, 2002, now expired, and U.S. Provisional Patent Application No. 60/381,354, filed May 20, 2002, now expired.
| Number | Date | Country | |
|---|---|---|---|
| 60496707 | Aug 2003 | US | |
| 60406056 | Aug 2002 | US | |
| 60381354 | May 2002 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 10435749 | May 2003 | US |
| Child | PCT/IL03/00412 | May 2003 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | PCT/IL03/00412 | May 2003 | US |
| Child | 10921142 | Aug 2004 | US |
