This application claims the benefit of priority to Japanese Patent Application No. 2017-135616 filed 11 Jul. 2017, the disclosures of all of which are hereby incorporated by reference in their entireties.
The present invention relates to a technique of a photoacoustic catheter system using a photoacoustic catheter, and a control method of the same.
Imaging a blood vessel broadly by X-ray fluoroscopy is provided in order to identify a lesion for treating vascular stenosis or the like. However, there is a problem that such imaging undesirably causes radiation exposure. Intravascular catheter imaging with light or ultrasound is utilized as a method to solve this problem. Intravascular catheter imaging allows for reducing burden on patients and taking local images. In addition, catheter treatment for vascular stenosis gives fewer burden on patients than open chest surgery, and therefore tends to be increasingly utilized.
As a technique of such intravascular catheter imaging, International Patent Application Publication No. 2016/063406 discloses an optical imaging prove that “includes: an optical fiber that transmits light between a front end and a rear end of the probe, and has a condenser lens on the leading end side thereof; a piezoelectric element or an electrostrictive element that causes the optical fiber near the condenser lens to make an angle with respect to its axis line; and an optical path changer that is collinearly arranged in front of the condenser lens, wherein the optical path changer changes an radiation angle of a light beam radiated through the condenser lens to cause the light beam to be radiated stereoscopically, achieving three-dimensional scanning.”
Surgery in an extremely small area such as catheter treatment requires both (1) visibility and (2) operability. Particularly, in cases such as chronic total occlusion (CTO), it is required to capture an image of the lesion in real time and then to accurately provide device treatment to the area specified by the operator (physician).
Here, a description will be given of visibility and operability required for catheter treatment.
(1) Visibility: For vascular stenosis such as CTO, visual recognition in front of the catheter is important.
(2) Operability: CTO treatment using a catheter usually involves piercing a guide wire into the lesion under X-ray fluoroscopy. However, under X-ray fluoroscopy, it is difficult to determine the actual lesion. Alternatively, there is treatment using a laser, but laser beam treatment needs to have the lesion identified. In addition, even when the lesion is identified, extremely precise positional accuracy is required to irradiate the lesion with laser beams.
As described above under (1) visibility, for a CTO case, a field of view in front of the catheter needs to be made visible to identify the occlusive lesion for treating the identified lesion. However, no catheter has been put into practical use that makes a field of view in front thereof visible. Particularly, no catheter has been put into practical use that makes a field of view in front thereof visible and is used for laser beam treatment. Further, with regard to (2) operability, no technique of laser beam treatment using a catheter has been disclosed so far.
The present invention has been made in view of such a background, and the present invention is intended to facilitate treatment with an acoustic catheter.
In order to solve the above-mentioned problems, the present invention provides a photoacoustic catheter system including: an imaging laser beam generator that generates an imaging laser beam used for imaging; a treatment laser beam generator that generates a treatment laser beam used for treatment; an emitter that emits the imaging laser beam and the treatment laser beam so as to be directionally aligned with each other; a driver that drives the emitter so as to emit the imaging laser beam and the treatment laser beam toward a predetermined direction with respect to an advancing direction of a catheter; an acoustic detector that receives an acoustic wave generated due to irradiation of the imaging laser beam; and a controller that causes the emitter to synchronously emit the imaging laser beam and the treatment laser beam. Other solutions will be described as appropriate in respective embodiments.
The present invention facilitates treatment with an acoustic catheter.
Next, a description will be given in detail of embodiments of the present invention, with reference to the drawings as appropriate.
A hollow 12 is formed inside the acoustic element 11 arranged in a ring shape, and the laser beam R emitted from the optical fiber 13 passes through the hollow 12. Once the laser beam R emitted from the optical fiber 13 in the catheter 1 passes through the hollow 12 to cause an observation object of a living body to be irradiated with the laser beam R, the observation object produces heat to expand itself in volume. This volume expansion causes an acoustic wave to be generated, and this acoustic wave is detected by the acoustic element 11. That is, the acoustic element 11 receives the acoustic wave generated by the irradiated laser beam R.
Next, a description will be given of the laser-beam emission mechanism in the catheter 1 used in the first embodiment. In the catheter 1, the laser beam R is transmitted from an imaging laser beam generator 2 or a treatment laser beam generator 3 (see
The laser beam R emitted from the front end of the optical fiber 13 diverges at an angle specific to the optical fiber 13. Therefore, as shown in
In addition, as shown in
Note that although not shown in
The imaging laser beam generator 2 generates the imaging laser beam R1 which is a low power pulse laser beam for imaging. The treatment laser beam generator 3 generates the treatment laser beam R2 which is a high power pulse laser beam for treatment. Both the imaging laser beam R1 and the treatment laser beam R2 travel inside the optical fiber 13. Note that in
The catheter 1 has an optical element 17, a driver 19, and an acoustic element (acoustic detector) 18. The optical element 17 includes the front end of the optical fiber 13 and the lens 16, and emits the imaging laser beam R1 and the treatment laser beam R2. The driver 19 is the driver 14 in
The address management device 4 manages a timing, at which the imaging laser beam R1 has been emitted, as an address. The address indicates a position (emission position) at which the imaging laser beam beam R1 has been emitted, and is represented such as by coordinates. The address management device 4 includes a timing latcher 41, an address manager 42, a driving waveform setter 43, a driving controller 44, and a corrector 45. The timing latcher 41 records an emission timing of the imaging laser beam R1 based on information from the imaging laser beam generator 2.
The address manager 42 calculates the address at which the imaging laser beam R1 has been emitted, based on the emission timing recorded by the timing latcher 41 and the driving voltage waveform set by the driving waveform setter 43. The driving waveform setter 43 sets the driving voltage waveform. The driving controller 44 applies driving voltage to the driver 19 according to the driving voltage waveform set by the driving waveform setter 43. The corrector 45 corrects the address calculated by the address manager 42, based on calibration information (distortion information) 8 inputted in advance such as by manual input, and the like. As a result, the corrector 45 generates a corrected address. Processing by the corrector 45 will be described later.
The imaging processor 5 reconstructs the catheter-captured image, based on a signal transmitted from the acoustic element 18, the corrected address, and the like. The imaging processor 5 includes a signal receiver 51, an information storage 52, and an image constructor 53. The signal receiver 51 receives the signal transmitted from the acoustic element 18. The information storage 52 stores the signal received by the signal receiver 51, the address of the emission timing of the imaging laser beam sent from the address manager 42, the corrected address calculated by the corrector 45, and the like. The image constructor 53 reconstructs the catheter-captured image, based on the information stored in the information storage 52, and the like. Note that in the present embodiment, the signal received by the signal receiver 51, the address of the emission timing of the imaging laser beam sent from the address manager 42, the corrected address, and the like are once stored in the information storage 52, and then retrieved by the image constructor 53. However, the signal received by the signal receiver 51, the address of the emission timing of the imaging laser beam sent from the address manager 42, the corrected address, and the like may directly be inputted to the image constructor 53 without being stored in the information storage 52. Additionally, the image constructor 53 stores the reconstructed catheter-captured image in the information storage 52.
The interface device 6 provides input and output. The interface device 6 has a display unit 61 and a target specifying unit 62. The display unit 61 displays the catheter-captured image reconstructed by the image constructor 53. The target specifying unit 62 is composed of a pointing device or the like. The operator (such as a nurse) specifies a lesion to be treated in the catheter-captured image, which is displayed on the display unit 61, with the target specifying unit 62.
The treatment laser beam controller 7 controls emitting the treatment laser beam R2. The treatment laser beam controller 7 has an address converter 71, a comparator 72, and a pulse generator 73. The address converter 71 converts a target on the catheter-captured image specified by the target specifying unit 62 into an address (target address), based on the catheter-captured image, the address, and the like which are stored in the information storage 52. The comparator 72 compares the address (current address) at which imaging is currently being made (the imaging laser beam R1 is being emitted) with the target address sent from the address converter 71. A corrected address may be used as the current address. Note that imaging continues even during treatment. When the comparator 72 determines that the current address matches the target address, the pulse generator 73 sends a pulse for emitting the treatment laser beam R2 to the treatment laser beam generator 3. This causes the treatment laser beam generator 3 to emit the treatment laser beam R2 at the timing when the pulse generator 73 has generated a pulse.
Then, the acoustic element 18 detects the acoustic wave from the object (S4). Upon receiving the acoustic wave, the acoustic element 18 generates a voltage having a magnitude depending on the detected acoustic wave. The generated voltage is converted into a digital signal having a predetermined magnitude by the signal receiver 51 equipped with an amplifier and an ADC (Analogue-Digital Converter), which are not shown. The converted digital signal is stored in the information storage 52. Note that the acoustic element 18 may be arrayed using a plurality of channels and data may be stored for each channel.
Upon receiving the acoustic wave, the acoustic element 18 transmits an electric signal with a voltage depending on the magnitude of the acoustic wave. The transmitted electric signal is received by the imaging processor 5. Next, the address management device 4 executes address correction processing (S5). Details of the address correction processing will be described later. Then, the imaging processor 5 uses the result of the address correction processing (corrected address) to execute image processing (S6). Details of the image processing will be described later. Then, the catheter-captured image, which is outputted as a result of the image processing, is displayed on the display unit 61 (S7).
Next, the user (physician or the like) determines whether or not the lesion has been identified (S11). If the lesion has not been identified as a result of step S11 (No in S11), the user (physician or the like) determines whether or not a lesion will be identified (S12). If a lesion will be identified, the user (nurse or the like), for example, selectively inputs an “identify lesion” button displayed on the display unit 61.
If a lesion will not be identified as a result of step S12 (No in S12), the photoacoustic catheter system C returns processing to step S2. If a lesion will be identified as a result of step S12 (Yes in S12), lesion identification processing is executed via the interface device 6 (S13). Details of the lesion identification processing will be described later. Next, the photoacoustic catheter system C advances processing to step S14.
Alternatively, if the lesion has already been identified as a result of step S11 (Yes in S11), the treatment laser beam controller 7 and the treatment laser beam generator 3 execute a treatment laser beam emission processing (S14). Details of the treatment laser beam emission processing will be described later. Next, the photoacoustic catheter system C returns processing to step S2. That is, the photoacoustic catheter system C executes a treatment while capturing images. In other words, the imaging laser beam R1 and the treatment laser beam R2 are emitted from the same optical fiber 13 (coaxially, that is, directionally aligned, or toward the same direction).
Note that being coaxial is preferable for positional accuracy, but cores (not shown) for introducing the treatment laser beam R2 and the imaging laser beam R1 into the optical fiber 13 can separately be arranged from each other. In other words, a core dedicated to the treatment laser beam R2 and a core dedicated to the imaging laser beam R1 can be arranged inside the optical fiber 13. Note that when the cores propagating the treatment laser beam R2 and the imaging laser beam R1 are separately arranged in the optical fiber 13, the imaging laser beam R1 and the treatment laser beam R2 will irradiate different areas. However, the difference is very small and therefore the treatment laser beam R2 is simply required to irradiate a target area (lesion), as will be described later.
The resolution of the catheter-captured image depends on “(the optical magnification of the lens 16)×(the core diameter for the imaging laser beam R1)” and therefore the core of the optical fiber 13 used for the imaging laser beam R1 is preferably thin. On another front, the treatment laser beam R2 generally has higher power than the imaging laser beam R1. This may cause the core (optical fiber 13) to be damaged, if the core diameter of the optical fiber 13 is fixed to fit for the imaging laser beam R1 when the imaging laser beam R1 and the treatment laser beam R2 are emitted coaxially (from the common core). Separately arranging the cores for the imaging laser beam R1 and the treatment laser beam R2 can avoid the risk of the core (optical fiber 13) being damaged, without lowering the resolution.
This allows the operator (physician) to provide treatment while viewing the image in real time. For example, the operator (physician) can proceed with the treatment while confirming whether the coagulated blood or the like is suitably removed by the treatment laser beam R2.
Next, the timing latcher 41 records the emission timing of the imaging laser beam R1 (S204). The emission timing is specifically the emission time of the imaging laser beam R1, or the like. A photodetector may be used to store the emission time of the imaging laser beam R1 as the emission timing, or the output time of the synchronization signal may be stored as the emission timing where the signal is outputted at the time of outputting the imaging laser beam R1. The address manager 42 calculates information about the emission timing of the imaging laser beam R1 as an address. Then, the address manager 42 stores the information about the emission timing of the imaging laser beam R1, as an address, in the information storage 52 (S205). Note that the address manager 42 calculates an address based on the driving voltage waveform set by the driving waveform setter 43 and the emission timing.
Next, an address calculation will be described with reference to
Φ1=2π*δtL1/ΔTF (1).
That is, the image constructor 53 determines that the position captured by the imaging laser beam R1 emitted at the emission timing t1 of the imaging laser beam in
Similarly, rays extending from the origin cross the emission trail at emission positions 202 and 203 of the imaging laser beam R1 emitted at the timings t2 and t3 in
Φ2=2π*ΔtL2/ΔTF (2)
Φ3=2π*ΔtL3/ΔTF (3)
In this manner, the image constructer 53 calculates an emission position (address) corresponding to each emission timing of the imaging laser beam shown in the timing chart P1 in
Then, the corrector 45 calculates a corrected emission position (corrected address) of the imaging laser beam, based on the calibration information 8 and the address (S502).
Next, the calibration information 8 will be described with reference to
Equation (12) is modified to equations (13) and (14) below.
The inverse matrix in equation (14) is calibration information 8. Note that calculations at a plurality of points are required in order to specify the calibration information 8. In this manner, the signal delay of the imaging laser beam R1 can be corrected. In addition, if a catheter-captured image is displayed on the display unit 61 simply using the emission position (xm (θ), ym (θ)) (that is, the irradiation position) as shown in
Next, the image constructor 53 calculates the distance and direction from the object to be irradiated with the imaging laser beam R1 to the acoustic element 18 (S602), based on the corrected address and the like calculated by the corrector 45.
Next, the image constructor 53 generates a catheter-captured image (S603), based on the image signal and the corrected emission position (corrected address) of the imaging laser beam R1 stored in the information storage 52. The image may be in 1D (Dimension), 2D, or 3D. The photoacoustic catheter system C generates the catheter-captured image, based on the corrected address, to calibrate the catheter-captured image captured by the imaging laser beam R1, according to the calibration information 8. The image constructor 53 stores the generated catheter-captured image in the information storage 52.
Here, a description will be given of a method of calculating the distance and direction from the object to the acoustic element 18, with reference to
L1=Vs×T1
L2=Vs×T2.
Here, Vs is the speed of sound. T1 is the time since the imaging laser beam beam R1 has been emitted until an acoustic wave is detected by the acoustic element 18. Similarly, T2 is the time since the imaging laser beam R1 has been emitted until an acoustic wave is detected by the acoustic element 18.
As a result of step S1402, if the target address does not match the current address within a certain margin (No in S1402), the treatment laser beam controller 7 returns processing to step S1402. As a result of step S1402, if the target address matches the current address within a certain margin (Yes in S1402), the pulse generator 73 generates a pulse signal (S1403). Next, the treatment laser beam generator 3 generates the treatment laser beam R2 (high power pulse laser beam) according to the pulse signal (S1404). Note that using a photoacoustic multimode fiber as the optical fiber 13 allows the imaging laser beam R1 and the treatment laser beam R2 to come in, and be emitted from, the single optical fiber 13.
According to the first embodiment, the imaging laser beam R1 and the treatment laser beam R2 are coaxially emitted in synchronization to allow for providing imaging and treatment at the same time. In particular, treatment can be provided while checking is made whether or not a target spot is irradiated with the treatment laser beam R2. That is, the operator (physician) can provide treatment while checking whether or not a desired spot is irradiated with the treatment laser beam R2. In addition, in the first embodiment, the target specifying unit 62 specifies a given area (lesion) on the catheter-captured image, and the treatment laser beam R2 is emitted toward the specified area. In this way, the operator can specify an area to be irradiated with the treatment laser beam R2, while viewing the captured image in real time. When the target is treated, the pulse energy (intensity) of the treatment laser beam R2, the number of times of irradiation, duration of the treatment, and the like are set by the operator on the setting window or the like displayed on the display unit 61, to cause the treatment laser beam controller 7 to implement a laser beam irradiation method desired by the operator. This allows for providing the treatment desired by the operator.
Further, the imaging laser beam R1 is emitted forward of the catheter 1. The front end of the optical fiber 13 draws a voltex (spiral) trail to allow for obtaining an image of an area in the axial direction of the catheter 1 and its surroundings. Furthermore, the photoacoustic catheter system C has the calibration information 8 for calibrating the irradiation position of the imaging laser beam R1. This calibration information 8 is information about distortion of the emission position. Based on this calibration information 8, the address management device 4 calibrates the irradiation position of the imaging laser beam R1. This allows for outputting a catheter-captured image in which distortion of the image due to imperfect swinging of the optical fiber 13, a signal delay of the imaging laser beam R1, and the like have been calibrated.
The photoacoustic catheter system C of the first embodiment emits the treatment laser beam R2 on the condition that an address (current address), at which imaging is currently in execution (the imaging laser beam R1 is emitted), matches an address (target address) specified as a target. In contrast, the photoacoustic catheter system C1 of the second embodiment emits the treatment laser beam R2 based on time management instead of address comparison.
More specifically, in the processing corresponding to step S1401 in
According to the second embodiment, components of the address management device 4a and the treatment laser beam controller 7a can be reduced to achieve cost reduction.
Living tissues have different light absorption rates depending on the kind thereof. Therefore, the kind of the living tissue can be identified by irradiating a living tissue with a multicolor laser beam as shown in
Alternatively, the interface device 6 may be a head mounted display. Then, the physician may proceed with the treatment while viewing the catheter-captured image displayed on the head mounted display.
Modifications
Note that in the above-described embodiments, the catheter 1 emits a laser beam forward, but the present invention is not limited thereto. For example, a mirror in a cone shape may be arranged in the direction toward which a laser beam is emitted from the front end of the optical fiber 13, to allow a catheter to laterally emit the laser beam.
In addition, in the above-described embodiments, the treatment laser beam R2 is emitted while imaging is in operation, but the present invention is not limited thereto. That is, imaging may be separated from treatment to avoid imaging at the stage when the treatment laser beam R2 is emitted.
Note that a power adjuster may be provided in the interface device 6 or the like for varying power of the treatment laser beam R2 depending on the lesion. For example, if the lesion cannot be easily removed, the operator may raise the power of the treatment laser beam R2.
The present invention is not limited to the above-described embodiments, and includes various modifications. For example, the above-described embodiments have been described in detail for the purpose of illustrating the present invention, and are not necessarily limited to those having all the components as described above.
Also, a part of the configuration of an embodiment can be replaced with a configuration of another embodiment, or the configuration of an embodiment can be added with the configuration of another embodiment. Additionally, a part of the configuration of each embodiment may be deleted, or added/replaced with other configuration.
In addition, some or all of the above-described configurations, functions, components 41 to 45, 51, 53, 71 to 73, the information storage 52 and the like may be designed on an integrated circuit, for example, to implement them by hardware. Alternatively, programs for implementing the above-described configurations, functions, and the like may be interpreted and executed by a processor such as a CPU, to implement them by software. Information such as programs for implementing respective functions, tables, and files can be stored in a recording device such as a memory device and an SSD (Solid State Drive), or a recording media such as an IC (Integrated Circuit) card, an SD (Secure Digital) card, and a DVD (Digital Versatile Disc), in addition to storing in an HD (Hard Disk). Further, in each embodiment, the control line and the information line indicate what is/are considered to be necessary for the purpose of illustration, but may not necessarily indicate all the control lines and information lines for the respective products. In fact, it is safe to assume that almost all components are connected with one another.
Number | Date | Country | Kind |
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2017-135616 | Jul 2017 | JP | national |