The invention generally relates to an ultrasound apparatus used to provide ultrasound treatment. More particularly, the invention relates to an ultrasound apparatus having a treatment lens that is designed to achieve high acoustic pressure in a desired treatment zone or zones while limiting pressure outside the desired regions.
Ultrasound is used routinely for wide-ranging therapeutic applications, ranging from warming superficial and deep tissue by delivery of low intensity doses to high intensity focused ultrasound (HIFU) for tissue and tumor ablation or lithotripsy. High intensity ultrasound has recently been used to treat subcutaneous tissue for adipose reduction.
The demands of ultrasound treatment devices are significantly different from imaging devices due to their use of generally higher pressure or higher energy ultrasound. One of the concerns associated with using high pressure ultrasound is delivering sufficient pressure to the treatment zone without causing deleterious effects outside of the treatment zone.
Therapeutic ultrasound transducers can be either unfocused or focused by mechanical or electronic means. Unfocused transducers employ a flat ultrasonic resonator (e.g. piezoelectric ceramic) that is coupled directly to the body or by means of a flat matching/wear layer that provides effective acoustic coupling between the resonator and the tissue. The sound intensity field in the superficial (near field) region of a flat emitter is roughly equal in extent to the size of the aperture, so these transducers are generally used to deliver energy over a large treatment area. Without the benefit of focusing gain, emitted acoustic pressure for a flat transducer is limited by transducer efficiency and drive electronics, but can reach levels higher than diagnostic limits. Importantly, even an unfocused transducer exhibits effective “focusing” in the acoustic field due to diffraction effects, which produce pressures at the near field/far field boundary that can be comparable or higher than those in the near field region. The depth of this “natural” focus of a flat resonating aperture is proportional to the square of the physical extent of the aperture and inversely proportional to sound wavelength. This can place the high pressure zone of the natural focus in an undesirable region of the anatomy.
Focused transducers may be mechanically focused by means of physical curvature (e.g. spherical or cylindrical) of the emitting aperture or by use of a lens with a sound speed different than the propagating medium. Electronic focusing can be achieved by applying electrical excitation to each element in the transducer with a defined delay. Many therapeutic transducers are comprised of a single emitter, and thus focusing is generally achieved by mechanical means. In contrast to the unfocused case, focusing the sound beam amplifies the emitted pressure at the face of the transducer by a factor termed the focal gain. Focal gains of up to 20 or higher can be obtained with spherically focused transducers, resulting in substantial and potentially dangerous pressures in the field. Since focal gain is inversely proportional to beam width, the treatment area also diminishes with increasing focal gain.
Current devices and methods for ultrasound treatment have been primarily concerned with very deep and focused treatment regions. There is a need in the art for a device and method which enables treatment of a wider and shallower (subcutaneous) treatment area. Accordingly, an acoustic lens may be employed with either focused or unfocused ultrasound therapy transducers to achieve one or more of the followings objectives: (a) increase the acoustic intensity in the desired treatment region, (b) increase the size of the treatment area or (c) modify the sound intensity pattern within the treatment region, all while reducing the sound intensity in regions outside the treatment region to acceptable levels.
Disclosed is an ultrasound apparatus including an ultrasound transducer having a geometric focus Ftrans, the transducer producing ultrasound waves. The apparatus further includes an acoustic lens assembly including a focal layer acoustically coupled to the ultrasound transducer such that the ultrasound waves are directed through the focal layer. The focal layer includes at least two minor lenses, each minor lens having a natural geometric focus Fminor with each the minor lens yielding a discrete treatment region such that the focal layer includes plural discrete treatment regions.
According to one aspect of the invention the ultrasound transducer produces ultrasound having a mechanical index below the cavitation threshold of tissue and below the threshold at which tissue will emulsify. Stated in other terms, the transducer produces ultrasound having a mechanical index between 1.9 and 2.5. Each of the minor lens increases the mechanical index within the treatment region to between 2 and 8.
According to another aspect of the invention the apparatus further includes a rotational drive mechanism operably attached to the lens assembly, and the drive mechanism rotationally driving the lens assembly such that the lens assembly rotates relative to the transducer.
According to another aspect of invention, the acoustic lens assembly includes a receptacle for receiving tissue to be treated, the receptacle bounded on top and encircled by downwardly depending sidewalls, the transducer directing ultrasound into the receptacle. The focal layer may form the top wall of the receptacle, or the downwardly depending sidewalls of the receptacle.
The apparatus may further include an ultrasound reflector operably connected to the downwardly depending sidewalls such that the reflector generally faces the ultrasound transducer, whereby the reflector reflects ultrasound back into the receptacle.
According to another aspect of invention, the ultrasound transducer includes a plurality of ultrasound transducers surrounding the receptacle. Moreover, the apparatus may further include a plurality of ultrasound reflectors operably connected to the downwardly depending sidewalls such that each reflector generally faces an ultrasound transducer, whereby the reflectors reflects ultrasound back into the receptacle.
Also disclosed is an ultrasound apparatus including an ultrasound transducer having a geometric focus Ftrans, the transducer producing ultrasound waves. An acoustic lens assembly including a focal layer is acoustically coupled to the ultrasound transducer such that the ultrasound waves are directed through the focal layer. The acoustic lens assembly defining a receptacle for receiving tissue to be treated, the receptacle bounded on top and encircled by downwardly depending sidewalls, the transducer directing ultrasound into the receptacle. The acoustic lens assembly may include a vacuum port or a needle access port. The focal layer may form either the top wall or the downwardly depending sidewalls of the receptacle.
Sound waves are focused or defocused by propagation from a medium of one speed of sound (c1) to a medium with a different speed of sound (c2).
In addition to having a sound speed different from tissue, a lens suitable for use with ultrasound requires low sound attenuation and acoustic impedance that is comparable to that of tissue to maximize transmitted power. Acoustic impedance is a function of sound speed and apparent density of the material. For tissue, with a density of 1 g/cm3 and a sound speed of approximately 1520 m/s, acoustic impedance is approximately 1.52 MRayl. Several polymers, including a low density polyethylene, such as LDPE-4012 from Dow Plastics or polymethylpentene thermoplastics such as TPX MX002 or TPX DX845 from Mitsui Plastics are suitable. These materials have acoustic impedances between 1.5 and 1.8 MRayl and sound speeds in the range of 1900-2200 m/s, in addition to reasonably low attenuation (1-2 dB/mm at 5 MHz). Several grades of castable urethane, such as Castall U-2941 from Lord Corp, also make suitable high velocity focusing lenses.
Alternatively, a focusing lens may incorporate a material with slower sound speed than water and tissue. The speed of sound is described with respect to water since the speed of sound in water is a known and well-established constant, and tissue is comprised to a large extent of water. RTV silicone rubbers, such as those from Dow Corning, are in this class. These materials can be matched to the acoustic impedance of tissue using higher density fillers such as aluminum oxide. They generally exhibit higher attenuation characteristics than the thermoplastics or urethanes previously described.
A flat, unfocused ultrasound transducer will generally emit plane waves, or waves characterized by planar phase fronts, having the same physical dimensions as the aperture in the very near field. Due to diffraction effects, the sound wave experiences a series of rapid fluctuations in intensity as it propagates into the tissue throughout the near field of the transducer before peaking at the natural focus and diverging beyond. The transition between the near and far field of the aperture occurs at a depth of roughly d2/3*λ, where d is the width of the aperture and λ is the sound wavelength in the medium.
For application of therapeutic ultrasound to superficial tissue, such as the dermis or subcutis, it is desirable to preferentially reduce the sound intensity beyond this region, while maintaining higher intensity in the superficial region.
In each of the embodiments described in this specification, the lens has a first surface acoustically coupled to the transducer by means of direct mechanical bonding or using a coupling fluid, and a second surface which, in use, is acoustically coupled to the treatment zone, preferably by means of an acoustic coupling medium.
The flat transducer 100 has a natural focus Fnatural, whereas the lens 102, comprised of material with a sound speed higher than water, includes at least two and preferably plural minor lenses 104 each having their own geometric foci Fminor. Importantly, Fminor is less than (closer to the transducer 100) Fnatural. The minor focusing lenses 104 serve to decrease the effective aperture size and produce local high intensity regions in the vicinity of Fminor that may result in a fractionated treatment pattern. According to one embodiment, Fnatural is between 10 mm and 50 mm, and Fminor is between 1 mm and 20 mm.
The minor lenses 104 may be positioned on the surface 102A (the surface abutting the transducer) or surface 102B (the surface abutting the tissue undergoing treatment), and may be convex or concave in shape, depending on the material. In the illustrated embodiment, plural minor lenses 104 are positioned on the surface 102B.
To avoid repetition it should be understood that the ultrasound transducer disclosed in any of the embodiments described in this specification may be configured to produce sound pressures below the cavitation threshold of tissue and below the emulsification threshold of tissue. The ultrasound transducer produces ultrasound in which the predominant waveform is one of unfocused, focused, and defocused. According to a presently preferred embodiment, the transducer is configured to yield ultrasound having a mechanical index between 1.9 and 2.5, and the minor lenses of the multifocal lens increase the mechanical index within the treatment region to between 2 and 8.
It should further be understood that the minor lenses in any of the embodiments disclosed herein may be arranged in either a symmetric or a non-symmetric pattern. Moreover, a given lens may include minor lenses having different configurations. Thus the size and/or shape of selected ones of the plurality of minor lenses may be configured to create one of a different minor focus Fminor or a different peak acoustic pressure in the treatment region.
Lenses 102 or 202 may optionally include a wear layer 110, 210 (shown shaded in
According to a presently preferred embodiment, the focal layer is formed of TPX and the wear layer 110, 210, if used, is formed of an RTV such as RTV 30, 60, 90 or similar.
The lens in each of the embodiments described in this specification may be removably connected to the transducer and may be a disposable component replaced independent of the transducer. This feature of the invention enables the user to adjust the focal depth simply by selecting a lens whose focal layer has the desired minor foci Fminor. For example, the apparatus may be sold as a kit including a plurality of lenses (each having different minor foci Fminor) thereby enabling the user to choose the desired treatment pattern.
The portion of the lens through which ultrasound is transmitted and which surrounds the minor lenses 412 is referred herein as the “major lens” or the “major portion” of the lens. The major portion of the lens 410-1 (
In contrast, the diverging lens 410-2 (
An optional wear layer 414 (shown in dashed lines) that is selected to have different acoustic properties from the lens 410-1, 410-2 provides a smooth surface to present to the tissue being treated. Moreover, depending on the acoustic properties of the material used, the wear layer 414 may provide additional focusing.
The lens assembly 602 may be any of the lens embodiments disclosed in this specification. In particular, the lens assembly 602 may include a lens 102 (
Turning once again to
The lens assembly 702 may optionally include a needle access port 712 providing access for injecting cavitation nuclei such as microbubbles or the like into the tissue undergoing treatment.
In this embodiment, the sidewalls 802B form the acoustic lens whereas in the embodiment shown in
The lens assembly 802 may optionally include an acoustic reflector 814 which may be molded into sidewall 802B or may be attached to the interior or exterior sides of sidewall 802B. The acoustic reflector 814 is preferably provided in a facing relationship with the ultrasound transducer 804. If desired the device 800 may include two or more transducers 804 with an equal number of acoustic reflectors 814 provided in a facing relationship (not illustrated). Transducer 804 may be molded into sidewall 802B or may be provided on the interior or exterior sides of sidewall 802B.
The lens assembly 1002 may optionally include a vacuum port (not shown) for fluidically coupling the receptacle 1006 to a source of reduced pressure (not shown), e.g., a vacuum pump, and may include an optional needle access port (not shown).
The minor lenses 1002C may be positioned on the inner surface of the sidewall 1002B or on the surface abutting the transducer 1004 and may be a converging lens or a diverging lens. Moreover, the lens assembly 1002 may be provided with a wear layer 1014 (shown in dashed lines) to present a smooth surface to the tissue undergoing treatment.
Lenses 1100, 1200 and 1300 can provide comparable ultrasound focusing characteristics to those lenses shown in
The invention may be embodied in other forms without departure from the spirit and essential characteristics thereof The embodiments described therefore are to be considered in all respects as illustrative and not restrictive. Although the present invention has been described in terms of certain preferred embodiments, other embodiments that are apparent to those of ordinary skill in the art are also within the scope of the invention. Accordingly, the scope of the invention is intended to be defined only by reference to the appended claims.
This application claims priority from U.S. Provisional Application No. 60/978,607, filed Oct. 9, 2007 incorporated by reference in its entirety.
Number | Date | Country | |
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60978607 | Oct 2007 | US |