The present disclosure relates to systems and methods for real time detection of biological substances and distinguishing between bodily tissues.
Efforts to improve surgical outcomes and cost structure, particularly with spinal surgery, have led to increased use of minimally invasive procedures. These procedures often use image-guided modalities such as fluoroscopy, CT, nerve stimulators, and, more recently, Doppler ultrasound. While often involving less risk than surgery, minimally invasive spinal procedures, pain management procedures, nerve blocks, ultrasound guided interventions, biopsy, and percutaneous placement or open intra-operative placement continue to carry risks of ineffective outcome and iatrogenic injuries, such as infection, stroke, paralysis and death due to penetration of various structures including, but not limited to, organs, soft tissues, vascular structures, and neural tissue such as, catastrophically, the spinal cord. Injuries can occur regardless of practitioner experience because a surgical instrument must proceed through several layers of bodily tissues and fluids to reach the desired space in the spinal canal.
To illustrate, the intrathecal (or subarachnoid) space of the spinal region, where many medications are administered, houses nerve roots and cerebrospinal fluid (CSF) and lays between two of the three membranes that envelope the central nervous system. The outermost membrane of the central nervous system is the dura mater, the second is the arachnoid mater, and the third, and innermost membrane, is the pia mater. The intrathecal space is in between the arachnoid mater and the pia mater. To get to this area, a surgical instrument may need to first get through skin layers, fat layers, the interspinal ligament, the ligamentum flavum, the epidural space, the dura mater, the subdural space, and the intrathecal space. Additionally, in the case of a needle used to administer medication, the entire needle opening must be within the sub-arachnoid space. Because of the complexities involved in inserting a surgical instrument into the intrathecal space, penetration of the spinal cord and neural tissue is a known complication of minimally invasive spine procedures and spine surgery. Additionally, some procedures require the use of larger surgical instruments. For example, spinal cord stimulation, a form of minimally invasive spinal procedure wherein small wire leads can be inserted in the spinal epidural space, may require that a 14-gauge needle be introduced into the epidural space in order to thread the stimulator lead. Needles of this gauge can be technically more difficult to control, posing a higher risk of morbidity. Complications can include dural tear, spinal fluid leak, epidural vein rupture with subsequent hematoma, and direct penetration of the spinal cord or nerves with resultant paralysis. These and other high-risk situations, such as spinal interventions and radiofrequency ablation, can occur when a practitioner is unable to detect placement of the needle or surgical apparatus tip in critical anatomic structures.
At present, detection of such structures is operator dependent, wherein operators utilize tactile feel, contrast agents, anatomical landmark palpation and visualization under image-guided modalities. The safety of patients can rely upon the training and experience of the practitioner in tactile feel and interpretation of the imagery. Even though additional training and experience may help a practitioner, iatrogenic injury can occur independently of practitioner experience and skill because of anatomic variability, which can arise naturally or from repeat procedures in the form of scar tissue. Fellowship training in some procedures, such as radiofrequency ablation, may not be sufficiently rigorous to ensure competence; even with training, outcomes from the procedure can vary considerably. In the case of epidural injections and spinal surgery, variability in the thickness of the ligamentum flavum, width of the epidural space, dural ectasia, epidural lipomatosis, dural septum, and scar tissue all can add challenges to traditional verification methods even for highly experienced operators. Additionally, repeat radiofrequency procedures that are performed when nerves regenerate, often a year or more later, are often less effective and more difficult because the nerves' distribution after regeneration creates additional anatomic variability.
Features and advantages of the invention will be more readily understood from the following detailed description. In one aspect, a biomarker detection system is disclosed that includes a target biomarker in a biological system. The disclosed biomarker detection system includes real-time fluorescent probe. The disclosed probe for real-time sensing of a target biomarker includes a needle having an opening, a fluorescent probe encased within the needle. The fluorescent probe includes a fluorescent coating disposed within and covering the opening of the needle, wherein the fluorescent coating is in contact with biological tissue. In some embodiments, the biological tissue includes blood. The disclosed fluorescent probe also includes an ion-consuming coating within the needle and adjacent to the fluorescent coating and a fiber optic waveguide in contact with the ion-consuming coating.
In this disclosure, the terms:
“optical receiver” refers to a light detecting device structured and configured to detect light returning along the optical path from the bioluminescent device to the optical detector;
“optical detector” refers to a device that senses and may measure the amount of light in its optical path;
“optical coupler” refers to a device that is structured and configured to couple light between a fluid channel and at least one optical fiber; and
“optical filter” refers to a device that receives light and allows only light with specific properties such as wavelength, polarity, intensity, or other selective properties to pass therethrough.
In view of these considerations, it would be desirable to provide systems and methods that provide real-time feedback to assist in the precise placement of surgical instruments into patients' anatomies.
The following description should be read with reference to the drawings. The drawings, which are not necessarily to scale, depict examples and are not intended to limit the scope of the disclosure. The disclosure may be more completely understood in consideration of the following description with respect to various examples in connection with the accompanying drawings, in which:
The disclosed biomarker detection system and real-time fluorescent probe can improve upon some of the shortcomings in the present art. Its use can improve surgical outcomes and cost structure, particularly with spinal and other minimally invasive surgical procedures. The disclosed biomarker detection device can take the operator dependency out of finding target biomarker materials instead of relying on tactile feel, contrast agents, anatomical landmark palpitation, and visualization under image-guided modalities thereby improving the safety and efficacy of procedures requiring biomarker identification.
The present disclosure relates to systems and methods used to detect biological substances, such as bodily fluids and tissues, including blood, and for distinguishing between bodily media, such as liquid and air. Various embodiments of systems and methods are to be described in detail with reference to the drawings, wherein like reference numerals may represent like parts and assemblies throughout the several views. Reference to various embodiments does not limit the scope of the systems and methods disclosed herein. Additionally, any examples set forth in this specification are not intended to be limiting and merely set forth some of the many possible embodiments for the systems and methods. It is understood that various omissions and substitutions of equivalents are contemplated as circumstances may suggest or render expedient, but these are intended to cover applications or embodiments without departing from the spirit or scope of the disclosure. Also, it is to be understood that the phraseology and terminology used herein are for the purpose of description and should not be regarded as limiting.
The present disclosure provides systems and methods structured, configured, and/or capable of detecting one or more biomarkers via the interaction(s) of the biomarkers with one or more detection materials, and the optical detection of said interaction(s). In some examples, the interaction of a biomarker with a detection material can result in a luminescent emission of light that can be sensed, with said sensing of luminescent light providing evidence of the interaction, and hence, the presence of the biomarker. In some of these examples, emission of light can be an intrinsic chemiluminescent product of the interaction between the biomarker and the detection material. In some others of these examples, illumination by an external light source of the detection material, when in the presence of the biomarker, can result in a fluorescent or phosphorescent emission of light that can be sensed. The present disclosure provides systems and methods that can provide detection of biomarkers via sensing of chemiluminescence, fluorescence, and/or phosphorescence.
While multiple examples of biomarker detection systems illustrated and described in the present disclosure include, or can be used in conjunction with, needles and fluid delivery systems, the applications of the disclosed biomarker detection systems and methods are not limited to fluid delivery applications. In the present disclosure, medicinal fluids can be delivered through the disclosed fluid delivery systems. Fluid delivery systems incorporating detection technologies of the present disclosure can be employed to deliver wires/leads, nanoparticles, and any suitable pharmacological or otherwise therapeutic agents, including regenerative medicines and chemotherapy drugs.
System 100 can include optical coupler 112 that can be structured and configured to couple light between fluid channel 108 and optical fiber 114. Optical coupler 112 and any other optical couplers of the present disclosure can be structured and configured to perform as a wavelength division multiplexer, which can improve signal-to-noise ratio by, for example, filtering the spectrum of light that reaches a detector. Optical fiber 114 can be selected with core material having an index of refraction that is substantially close or essentially equal to an index of refraction of a fluid in fluid channel 108, such that light can readily be coupled between the two while minimizing reflectance losses and other optical issues that can arise from an optical mismatch. Alternatively, or in addition, the index of refraction of the fluid in channel 108 can be adjusted to substantially or essentially exactly match the index of the core of optical fiber 114, for example, by selecting the concentration of various components of the fluid, such as glucose, alcohol, saccharide salts, and/or any other biocompatible fluid(s). Fluid channel 108 can be structured and configured such that it, with fluid present, can serve as an optical waveguide.
A light source 116 such as a diode laser or other suitable light source can be optically coupled to optical fiber 114 such that light from the light source can be delivered to tip 106 of needle 102 via the optical fiber and the optical wave guide provided by fluid channel 108, and more specifically, to biomarker luminescent material 110 at said tip. Light that is emitted or otherwise scatters from biomarker luminescent material 110 can be returned by the optical path provided by fluid channel 108 and optical fiber 114 to an optical receiver 118, which can be a photo detector or any other suitable light detecting device structured and configured to detect light returning along the optical path from tip 106 of needle 102. Optical coupler 112 can be structured, configured, and tuned such that it can effectively couple light between fluid channel 108 and optical fiber 114 for any relevant optical frequencies, including one or more emission frequencies of light source 116 and the frequency(ies) of luminescence of biomarker luminescent material 110.
Via various mechanisms, light from light source 116 can undesirably reach optical receiver 118, such as via back-reflections from tissue and other back-scattering avenues, adding to the noise read by receiver 118 as it measures the signal of luminescent emission from biomarker luminescent material 110. This source of measurement noise can be countered in multiple ways. As aforementioned, optical coupler 112 can be structured and configured to perform as a wavelength division multiplexer, which can selectively filter the frequencies of light incident upon optical receiver 118 to the frequency(ies) emitted from biomarker luminescent material 110. Alternatively or in addition, optical receiver 118 can include a filter to selectively prevent frequencies other than the frequency(ies) of luminescence of biomarker luminescent material 110 from reaching the optical receiver, such as illumination light from light source 116, and other light that may exist in the environment, such as ambient room lighting. Other measures to improve signal-to-noise can be taken, such as filtering room lighting to attenuate emission at the frequencies of sensitivity of optical receiver 118. Such wavelength and frequency filtration/sensitivity considerations may apply to any relevant systems of the present disclosure.
Another technique that can be employed to improve signal-to-noise for detection at optical receiver 118 of light emitted from biomarker luminescent material 110 is time division multiplexing. By temporally separating the illumination of biomarker luminescent material 110 by light source 116 from the detection of luminescent emission from the material, this source of noise can be circumvented. In an illustrative example, light source 116 can be driven with a fully-on, fully-off square wave. With a light source 116 that can be switched-off sufficiently quickly (that is, fast compared to the decay time constant for luminescent emission from biomarker luminescent material 110), data collection from optical receiver 118 can be gated to be performed only when light source 116 is off, such that no back-reflected/scattered light originating from light source 116 is recorded at optical receiver 118. Potentially, other sources of light (as might be employed in a surgical suite, for example) that might undesirably reach optical receiver 118 could also be driven with the same waveform as light source 116, to prevent their detection. With a sufficiently high frequency, such pulsing could be imperceptible to the human eye. These time division multiplexing methods may be advantageously employed with any compatible systems and methods of the present disclosure.
In an example method of use of system 100, needle 102 can be advanced into a patient by a clinician, with light source 116 activated to provide illumination of biomarker luminescent material 110. A fluid having an optically suitable index of refraction can be present in fluid channel 108 (including lumen 103). Needle 102 can be advanced until tip 106 of the needle encounters a target biomaterial (for example, blood, although other target biomaterials are possible), upon which interaction of the target biomaterial (e.g., blood) with biomarker luminescent material 110, in combination with illumination light from light source 116, can result in emission of light from the biomarker luminescent material, which can be detected by optical receiver 118. A notification system (not illustrated) operatively coupled to optical receiver 118 can inform the clinician that the target biomarker has been detected. The clinician can then position tip 106 of needle 102 in accordance with the detection of the target biomaterial and knowledge of the patient's anatomy (for example, further advancing, stopping advancing, or retracting the needle). With tip 106 of needle 102 appropriately placed, delivery of a therapeutic fluid from the fluid delivery system through fluid channel 108 can be performed.
System 200 can include light source 218, such as a diode laser or other suitable light source, that can be optically coupled to optical fiber 212 such that light from the light source can be delivered to the distal tip of the optical fiber, and more specifically, to biomarker luminescent material 214 at said tip. Light that is emitted or otherwise scatters from biomarker luminescent material 214 can be returned by optical fiber 212 to optical receiver 220, which can be a photo detector or any other suitable light detecting device structured and configured to detect light returned by optical fiber 212 from the distal tip of the fiber.
System 200 can include optical coupler 222 that can be structured and configured to pass light from light source 218 to biomarker luminescent material 214 at the distal tip of optical fiber 212, and to transmit light emitted from biomarker luminescent material 214 to optical receiver 220. Optical coupler 222 can be tuned, for example as a wavelength division multiplexer, to selectively maximize transmission of light emitted from biomarker luminescent material 214 to optical receiver 220, and to minimize the transmission of such emitted light back toward light source 218. Second optical receiver 224, which can be a photo detector or any other suitable light-detecting device, can be coupled to the optical system of system 200 via fiber optic splitter 222. Second optical receiver 224 can be used to sense the drive signal level of emission from light source 218, which can be used to create a differential signal for purposes of compensating for variations in intensity of light source 218 (for example, drifts due to temperature variations), when interpreting signals at optical receiver 220. This arrangement might also be used, in some cases, to implement phase sensitive detection of the signal received at optical receiver 220 from biomarker luminescent material 214.
System 200 can be used similarly in many aspects as described for system 100. In operation, needle 202 of system 200 can be advanced into a patient with optical fiber 212 positioned in lumen 210 such that biomarker luminescent material 214 at the distal tip of the fiber is disposed at or near tip 206 of needle 202. Once biomarker luminescent material 214 contacts the target biomaterial (e.g., blood), light resulting from such contact can be transmitted up the fiber to optical receiver 220 and detection indicated to a user of the system. Once the needle is properly positioned (e.g., in a bloodstream), optical fiber 212 can be retracted (for example, to 216), opening lumen 210 for the flow of fluid from syringe 204 to delivery at tip 206 of needle 202.
Coupling optics 312, when appropriately positioned and aligned with respect to optical fiber 310, can couple or focus illumination light emitting from the optical fiber into lumen 320 of needle 302. Interior walls 322 surrounding lumen 320 of needle 302 can be polished or otherwise smoothed, such as by an electrochemical or other suitable process, such that they can serve as a waveguide for the illumination light so coupled. In some examples, interior walls 322 surrounding lumen 320 of needle 302 can be coated or lined with a thin layer of a dielectric material such as a glass or a polymer having an index of refraction lower than the index of the fluid within the lumen, such that a total internal reflection waveguide similar to an optical fiber results, with a higher-index fluid in the lumen serving as the “core” and the lower-index thin dielectric layer coating the walls of the lumen serving as the “cladding.” (This waveguide configuration can potentially be employed in any system of the present disclosure in which light propagates through a fluid channel, including in needles 102, 402, 502, and 602 of systems 100, 400, 500, and 600, respectively). Illumination light, provided by any suitable light source (not illustrated) such as a diode laser, can be delivered via propagation down lumen 320 of needle 302 to its tip 324, where biomarker luminescent material 326 can be located, such as via a coating process. Light that is emitted or otherwise scatters from biomarker luminescent material 326 can be returned by a reverse optical path (the waveguide of needle lumen 320, then coupled by optics 312 to optical fiber 310) to an optical receiver (not illustrated), which can be a photo detector or any other suitable light detecting device structured and configured to detect light returning by optical fiber 310 from tip 324 of needle 302.
Coupler 308 can include one or more fluid channels 328 that can fluidically communicate between fluid channel 304 of fluid line 306 and lumen 320 of needle 302. Optical mount 314 can define or provide void 330 that can be fluidically sealed from the fluidic path (304, 328, 320) of the fluid delivery system, and in which a vacuum or gas atmosphere of stable refractive index can be maintained, such that effects of index-of-refraction variations on optical coupling can be reduced or eliminated. For the same reason, the fluid-facing side of lens 312 can be a planar surface.
Biomarker luminescent material 412 can be located at tip 406 of needle 402, such as via a coating process. The interior walls surrounding lumen 404 of needle 402 can be polished or otherwise smoothed, such as by an electrochemical or other suitable process, such that they can form a waveguide to efficiently transport light emitted from biomarker luminescent material 412 to optical receiver 414, which can be a photo detector or any other suitable light detecting device structured and configured to detect light emitted from the biomarker luminescent material. A wavelength-discriminating optical filter 416 that is tuned for one or more wavelengths of light emitted by biomarker luminescent material 412 can help reject stray light and improve signal-to-noise. Optical receiver 414 can be electrically connected to detection electronics via connection 418
System 400 of
Aside from the omission of illumination of biomarker luminescent material 412 by an external light source, system 400 can be used similarly in many aspects as described for system 100 for biomarker detection and therapeutic delivery.
Mount 510 can house optics and electronics to enable bio detection with biomarker luminescent material 508. At mount 510, system 500 can include light source 514 such as a diode laser or other suitable light source, and optical receiver 516, which can be a photo detector or any other suitable light detecting device. The optical system of mount 510 can include beam splitter 518 and mirror 520. With such an optical arrangement, illumination light from light source 514, represented by broken-outline hollow arrows in
Mount 510 and/or needle 502 can include or define one or more fluid channels 528 that can fluidically communicate between a connector-side fluid channel 530 and lumen 504 of needle 502, providing a fluid bypass around mirror 520.
Light source 514 and optical receiver 516 can be electronically coupled to circuit board 532, which can provide power and control signals to the devices and receive and process signals or other information from the devices. In
Semi-permeable barrier 606 can be at least semi-permeable to target biomaterial 610, such that the target biomaterial can come into contact with, and react with, the biomarker luminescent material fluid present in lumen 604. In some examples, semi-permeable barrier 606 can be structured and configured such that it selectively allows passage of iron ions or iron-containing compounds, as found, for example, as a component of blood. The biomarker luminescent material fluid present in lumen 604 can be a material that is reactive with such iron ions or iron-containing compounds. In some embodiments, the blood stays active indefinitely. Once iron in any form present in blood contacts the biomarker luminescent material and emits radiation, the iron is typically not consumed in the reaction. In some embodiments, the target biomaterial and biomarker luminescent material fluid can react such that photons 612 are generated by said reaction. As illustrated, such photons 612 could be generated in a variety of locations within lumen 604, depending on the penetration of the target biomaterial past barrier 606 and into the volume of the lumen. In some embodiments, semi-permeable barrier 606 can be translucent or at least partially transparent, to allow photons 612 generated by reactions within the barrier to exit the barrier for detection.
Photons 612 produced as a result of contact between target biomaterial 610 and biomarker luminescent material fluid can propagate within lumen 604 of needle 602 to optical receiver 614, which can be a photodetector, or any other suitable light-detecting device structured and configured to detect such light. Interior walls 616 surrounding lumen 604 of needle 602 can be polished or otherwise smoothed, such as by an electrochemical or other suitable process, such that they can serve as a waveguide for light propagating in the needle.
Where in
With reference to
With biomarker luminescent material fluid withdrawn from lumen 604 of needle 602, system 600 can be used for delivery of fluid from a fluid delivery system (not illustrated) via fluid input port 624, which can be in fluidic communication with the lumen of the needle via delivery holes 626. Delivery holes 626 can be formed by any suitable process (conventional machining, laser drilling, etching, and so on). Delivery of a fluid from a fluid delivery system is indicated by arrows 628.
Note that space 630 in the cross-sectional view of
Other needle configurations are possible for biomarker detection via sensing luminescent emissions produced as a result of contact between a biomarker luminescent material and a target biomaterial.
The configuration of needle employs non-retracting optical fibers 706, 708 for high-efficiency transport of illumination light and light emitted by the biomarker luminescent material, and simultaneously provides a lumen that is always open for fluid delivery to the tip 702 of the needle. In comparison, in system 200 of
Needle 810 of
In some examples contemplated in the present disclosure, instruments with multiple optical fibers, similar to (but not limited to) the needles illustrated in
Biomarker luminescent materials used for biomarker detection in systems and methods of the present disclosure can exploit various different luminescent phenomena. Some biomarker luminescent materials can rely upon chemiluminescence, a chemical reaction that can occur upon contact between a biomarker luminescent material and target biomarker can, without additional energy input, result in light emission that can be sensed as a signal of detection of the biomarker. Systems 400 and 600, which do not necessarily include a light source, may be particularly suited for use with chemiluminescent biomarker luminescent materials, given that they may be less complex (at least in optical complexity) than systems that do include light sources. However, potentially any of systems 100, 200, 300, 400, 500, and 600, and any of needles 700, 802, 810, 816, and 822, could be used in conjunction with chemiluminescent detection, although the inclusion of light sources in some of said systems may be irrelevant to detection of light produced by chemiluminescence.
Some other biomarker luminescent materials can employ photoluminescence (e.g., fluorescence and/or phosphorescence) that is activated by contact between a biomarker luminescent material and target biomaterial. Illumination light for photoluminescence can be provided by light sources of illustrative example systems 100, 200, 300, and 500, and can be transported by optical fibers (and/or in some cases, other waveguides) of systems 100, 200, 300, 500, and at least some of needles 700, 802, 810, 816, and 822.
Some biomarker luminescent materials may exhibit photoluminescence in the absence of a target biomarker, and upon exposure to the target biomarker, the photoluminescence can cease or reduce.
Physical characteristics of biomarker luminescent material coatings can reflect a balance between competing factors. A thin coating can be translucent enough to allow illumination light to penetrate in, and emissions to escape for detection, while a thicker coating can provide greater biomarker detection material and a stronger emission signal. Coatings can include cross-linked hydrophilic coatings. The cross-linked hydrophilic coatings can include the biomarker luminescent material as a part of the coating or can encapsulate or seal it to the delivery device. Porosity of the biomarker luminescent material may be desirable to facilitate interaction between biomarkers and the material.
Fiber optic air sensor 900 can be structured and configured to distinguish between liquid and air at a detection end 908 based upon whether light from a light source (not shown) propagating within the fiber toward the detection end (i.e., from left to right in
Faces 909 can be structured to retroreflect rays of light propagating within core 902 toward detection end 908. They can, for example, be oriented at 45 degrees with respect to the longitudinal axis of core 902. In some embodiments, they can be arranged in a cube corner configuration. Faces oriented at 45 degrees with respect to the longitudinal axis (which is essentially the light propagation axis) of core 902 can be suitably oriented for discrimination between air and liquid. For a fused silica fiber, the critical angle for total internal reflection relative to an external medium of air is approximately 43 degrees, and the critical angle for total internal reflection relative to an external medium of water is approximately 67 degrees. Therefore, light propagating along the longitudinal axis of core 902 and incident upon a face 909 that is oriented at 45 degrees with respect to the longitudinal axis can be incident upon the face at shallower than the critical angle for air and steeper than the critical angle for water.
In operation, a detection scheme can include an optical receiver (not illustrated) that can be suitably configured to detect light from the light source that has retroreflected from detection end 908. This retroreflection signal generally can be brighter when faces 909 of detection end 908 are exposed to an external medium of air, resulting in total internal reflection, as opposed to when the faces are exposed to liquid (and hence not resulting in total internal reflection). Faces 909 can include coatings to enhance their detection utility. Inner portions 916 of faces 909, including the portions of the faces where light in the core can be incident, can have a hydrophobic coating, to repel residual liquid on the faces when the detection end 908 is in air. Outer portions 918 of faces 909 can include a hydrophilic coating to draw liquid away from the inner portions 916.
Needle systems similar to system 1200 of
In the configuration of
In an example method of use of a needle system having an optical, sonic, or electrical air-detection system, such as one of systems 1000, 1100, 1200, or 1300, the needle can be advanced into a patient by a clinician, with the air-detection system activated to provide feedback to the clinician. Upon advancement of the tip of the needle into a media of interest, a notification system (not illustrated) operatively coupled to the air-detection system can inform the clinician that the target media has been detected. The clinician can then position the tip of the needle in accordance with the detection of the target media and knowledge of the patient's anatomy (for example, further advancing, stopping advancing, or retracting the needle). With the tip of the needle appropriately placed, delivery of a therapeutic fluid from the fluid delivery system (or other therapeutic action) can be performed.
The present disclosure further contemplates real-time systems and methods for distinguishing between gas (which may be referred to as “air”) and liquid within patients' anatomies to assist in the precise placement of surgical instruments therein. Such systems can include optical, sonic, and/or electrical detection, and can be based upon differences in optical, sonic, and/or electrical impedance.
The present disclosure also contemplates real-time systems and methods for determining the location of a biomarker detection system that can detect the presence of a target biomarker in real-time. In some embodiments, disclosed biomarker detection system can include a probe that can sense the presence of specific types of bodily tissues. For example, a biomarker detection system according to the present disclosure can include a probe that detects iron and thus the presence of blood when in contact with that type of tissue. The disclosed real-time probe for blood can signal whether or not it is in close proximity to blood—signaling the presence of blood when the probe is in contact with blood and the absence of blood when the probe is no longer in contact with blood. Real-time probes according to this disclosure can be useful, for example, in endoscopic procedures that involve probing inside of the body during surgery or in trying to introduce an anesthetic agent in a tight location such as the spinal cavity as discussed above. Such a probe can operate by detecting a concentration of iron in proximity to the probe.
A simplified, typical fluorescence process is shown in the Jablonski diagram illustrated in
The fluorescein molecule has a strong affinity and selectivity to iron ions, having two unshared electron pairs available for donation to a metal ion. Once the covalent bond occurs, the molecule gains the ability to fluoresce. This selectivity for chelating iron ions is one of the reasons that Fluorescein is an ideal choice for this sensor. This sensor platform relies upon photoinduced electron transfer (PET) between this fluorophore and its metal-specific chelate, Fe2+. Also, in general, the persistence of the fluoresce property is a benefit. In a chemical process where the iron is consumed, such as with luminol, the persistence of the luminescence is limited to the time in which the iron is being consumed, often shorter than a surgical procedure. The intensity of the lamination also decreases over time.
The problem with relatively unlimited florescence time is that when leaving an iron ion rich environment, the sensor remains in the “on” state. If the goal of one embodiment of the sensor is to make a sensor with real-time dynamic response to iron ion concentration, then the key objective is to break these iron ion bonds at a steady rate such that the fluorescence reduces over time as the sensor passes to tissue with lower iron concentration.
The present embodiment designed to measure real-time iron concentration can involve a means to steadily draw the iron ions away from the florescence media coating from the backside of the coating, while the frontside of the florescence media coating is exposed to the sample fluid. The present disclosure introduces a biomarker detection probe that utilizes a second coating underneath the florescence media coating with a stronger affinity for the iron ions. The florescence media coating can be a semi permeable membrane such that the iron ion concentration in this coating creates florescence when the front-side of the coating experiences high iron concentrations and is swept clean of iron ions when the front-side of the coating is exposed to a low iron ion concentration, reducing the intensity of the florescence accordingly. The composition of this second layer can consist of many different materials with the desired properties to clear ions from the detection layer over time.
Coating thicknesses and permeability of the different layers can be adjusted to modify the ion sensing response time. Coating compositions must be substantially transparent to the light wavelength emitted by the florescent coating so that emitted light will enter the fiber optic wave guide or selected optical transmission medium.
Another contemplated embodiment can incorporate nanoparticles in the florescence media coating itself wherein the fluorescent media coating can slowly release chemicals to consume the iron ions over time, but not so fast as to inhibit the florescent coating from illuminating in the presence of the target ion. Again, the release rate can be adjusted to modify the ion sensing response time.
This application claims the benefit of U.S. Provisional Patent Application Ser. No. 62/954,404, currently pending and titled, “REAL TIME FLUORESCENT DETECTION SYSTEMS FOR MEDICAL DEVICES”, which was filed Dec. 27, 2019, and is hereby incorporated by reference in its entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/US2020/063181 | 12/4/2020 | WO |
Number | Date | Country | |
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62954404 | Dec 2019 | US |