JP2009536531A - コンフォーマルレーザ治療手順を用いてサンプルの少なくとも一部分に電磁放射を放射する方法及びシステム。 - Google Patents
コンフォーマルレーザ治療手順を用いてサンプルの少なくとも一部分に電磁放射を放射する方法及びシステム。 Download PDFInfo
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Classifications
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- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
- A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
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Abstract
【選択図】なし
Description
(連邦政府により支援された研究に関する声明)
罹患率と転移に伴う死亡率を劇的に減少させる可能性があるとして、初期癌の特定および治療方法と技術が広く探求されてきた。上皮癌と前駆病変はしばしば巣状をなし、広い範囲に渡り不均一に分布することがある、高感度診断が特に要求される。診断は、10億個以上にも及びうる細胞で構成されたフィールドにおいて単一細胞大のスケールで行なう必要がある。
バレット食道
管理可能な治療
代表的なモニタリング
代表的なコンフォーマルレーザ治療法
代表的な広視野スクリーニング
光周波数領域撮像(OFDI)
代表的なバルーンカテーテル
豚の食道の予備撮像
人体食道の予備撮像
レーザ熱傷のモニタリング
代表的な微視的変形
スペックル非相関
複屈折
散乱
血流
代表的な制御方法
波長
出力及び暴露時間
手順時間
代表的なコンフォーマルレーザ治療技術では、手順遂行時間は2At/(π r v)で見積もってもよい。ここにAtは治療面積、rはレーザスポット半径、およびvはレーザスポット走査速度である。食道治療長60mmに対して食道直径は20mmであった。
代表的なシステムの設計
代表的な治療用レーザ装置
代表的な卓上型システム
レーザおよびOFDIビームの代表的な位置決めおよび登録方法
代表的な波長スケーリング
を一定に保持されるようにレーザ出力が調節してもよい。これは、損傷深度が約0.25から1.5mmの範囲で幅が一定の線となる。
代表的な走査速度スケーリング
レーザおよびOFDIビームの代表的な位置決めおよび登録
代表的な内視鏡プローブの設計
代表的な回転ジャンクション
代表的な高速データ収集および処理
代表的なレーザ
代表的なユーザインターフェイス
代表的な参考文献
2. Barr H, Stone N and Rembacken B.、Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer(バレット食道の内視鏡治療)、Gut 2005;54:875−884.
3. Johnston MH.Technology insight: ablative techniques for Barrett’s esophagus − current and emerging trends.(技術的所見:バレット食道の切除技術−現在及び今後のトレンド)Nature Clinical Practice、Gastroenterology & Hepatology2005;2:323−330.
4. FaIk GW, Chittajallu R, Goldblum JR, Biscotti CV, Geisinger KR, Petras RE, Birgisson S, Rice TW and Richter JE.、Surveillance of patients with Barrett’s esophagus for dysplasia and cancer with balloon cytology.(バルーン細胞診によるバレット患者の異形成および癌調査)、Gastroenterology 1997;112: 1787−1797.
5. Spechler SJ.「バレット食道:この急増する問題を無視すべきか?」、Gastroenterology 1997;112:2138−2142.
6. Kubba AK, Poole NA and Watson A.assessment in management of Barrett’s esophagus(バレット食道管理におけるp53評価の役割)、Dig Dis Sci 1999;44:659−667.
7. Reid BJ.、neoplastic progression in Barrett’s esophagus(バレット食道におけるp53および腫瘍の進行)、Am J Gastroenterol 2001;96:1321−1323.
8. Sharma P, Weston AP, Topalovski M, Cherian R, Bhattacharyya A, Sampラインr RE.、Magnification chromoendoscopy for the detection of intestinal metaplasia and dysplasia in Barrett’s oesophagus(バレット食道における腸上皮化成および異形成検出のための拡大色素内視鏡検査法)、GUT 2003;52: 24−27.
9. Kuipers EJ and Haringsma J.、Diagnostic and therapeutic endoscopy. Journal of Surgical Oncology(診断および治療用内視鏡検査法)、Journal of Surgical Oncology、 2005;92:203−209.
10. Georgakoudi I, Jacobson BC, Van Dam J, Backman V, Wallace MB, Muller MG, Zhang Q, Badizadegan K, Sun D, Thomas GA,Perelman LT and FeId MS.、Fluorescence, reflectance, and light−scattering spectroscopy for evaluating dysplasia in patients with Barrett’s esophagus(バレット食道患者の異形成評価のための蛍光、反射率、および光散乱スペクトロスコピー)、Gastroenterology 2001;120: 1620−1629.
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50. Nadkarni S, HeIg T, Bouma BE, Chan RC, Minsky MS, Chau AH, Motz J, Houser SL and Tearney GJ.、Characterization of atherosclerotic plaques by laser speckle analysis(レーザスペックル分析による動脈硬化性プラークの特性解析法)、Circulation 2005; 112:885−892.
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実際に、本発明の代表的な実施の形態による装置、システム、および方法は、どのようなOCTシステム、OFDIシステム、スペクトル領域OCT(SD−OCT)システム、または他の画像化システム、例えば、2004年9月8日出願の国際特許出願第PCT/US2004/029148号、2005年11月2日出願の米国特許出願第11/266,779号、および2004年7月9日出願の米国特許出願第10/501,276号に記載されているものに対しても使用および/または実施可能であり、これらの開示の全てを本明細書の一部として援用する。従って、当業者にとっては、本明細書に明確に提示又は説明されていなくとも、本発明の原理を具現化する数多くのシステム、装置、及び方法に工夫を凝らすことが可能であり、これは本発明の趣旨と範囲内に含まれることが理解されるであろう。さらに、上述の明細書に前記の先行技術の知識が明示的に援用されていない範囲においても、その全体を明示的に本明細書に援用する。本明細書で引用した上述の全ての文献は、その全体を本明細書の一部として援用する。
Claims (20)
- 生物構造体の少なくとも一部分にレーザ放射を適用する処理であって、
(a)前記レーザ放射のビームを前記少なくとも一部分に照射するステップと
(b)(i)所定のパターンに基づく、(ii)前記レーザ放射の波長を変調しながら、又は、(iii)前記レーザ放射を適用する深度をモニタしながら、の少なくとも一つで、前記ビームを前記少なくとも一部分に適用するステップと、を含み、
前記ビームの断面積は最大で、前記少なくとも一部分の全体の面積の略10分の1である、処理。 - 前記レーザ放射はサンプルの前記少なくとも一部分に特定の波長で送出され、さらに、
(c)前記ステップ(a)の間、前記サンプルの温度分布を、前記レーザ放射の前記特定の波長を変更することによって制御するステップを含む、請求項1記載の処理。 - さらに、(d)ステップ(a)に先だって、サンプルの前記少なくとも一部分の近傍又は内部にある、前記サンプルの部位に温度変化を引き起こすステップと、
(e)複数の深度における前記部位の変形を、(i)前記部位からもたらされる少なくとも一つのさらなるレーザ放射の位相、又は(ii)前記少なくとも一つのさらなるレーザ放射の前記位相又は振幅の少なくとも一つの変化のレート、の少なくとも一つの関数として特定するステップと、を含む、請求項1記載の処理。 - 前記レーザ放射の走査速度又は出力の少なくとも一つを調節しながら、前記ビームを前記少なくとも一部分に適用する、請求項1記載の処理。
- 前記ビームは、前記レーザ放射の出力の少なくとも50%を含む、第1の断面幅を有し、
前記ビームを前記少なくとも一部分の所定の経路に沿って前記生物構造体に適用する時、前記所定の経路を含む、第2の幅を有する前記生物構造体の第2の領域に適用される前記レーザ放射のエネルギーの量は、略一定であり、
前記第1の断面幅と前記第2の幅は、略同一であり、前記ビームの併進方向に対して横断して(transverse)測定する、請求項1記載の処理。 - 前記ビームは、前記レーザ放射の走査方向に対して略平行な方向の前記レーザ放射の出力の積分(integration)が略一定となるような形状を有する、請求項1記載の処理。
- さらに、少なくとも一つの非円形の開口を用いて前記ビームを成形するステップを含む、請求項1記載の処理。
- さらに、前記ビームの形状を非円形に修正するステップを含む、請求項1記載の処理。
- 前記所定の経路は、少なくとも、(i)略螺旋形、(ii)略円形、又は(iii)略平行線の群、の少なくとも一つである、請求項1記載の処理。
- 前記生物構造体は、管状の形状を有する、請求項1記載の処理。
- 生物構造体の少なくとも一部分にレーザ放射を適用するシステムであって、
前記レーザ放射のビームを前記少なくとも一部分に照射するように構成された第1の構成部と、
(i)所定のパターンに基づく、(ii)前記レーザ放射の波長を変調しながら、又は、(iii)前記レーザ放射を適用する深度をモニタしながら、の少なくとも一つで、前記ビームを前記少なくとも一部分に適用するように構成された第2の構成部と、を含み、
前記ビームの断面積は最大で、前記少なくとも一部分の全体の面積の略10分の1である、システム。 - 前記レーザ放射はサンプルの前記少なくとも一部分に特定の波長で送出され、さらに、
前記ビームを前記少なくとも一部分に照射する際、前記サンプルの温度分布を、前記レーザ放射の前記特定の波長を変更することによって制御するように構成された第3の構成部を含む、請求項11記載のシステム。 - さらに、前記ビームを前記少なくとも一部分に照射する前に、サンプルの前記少なくとも一部分の近傍又は内部にある、前記サンプルの部位に温度変化を引き起こすように構成された第4の構成部と、
複数の深度における前記部位の変形を、(i)前記部位からもたらされる少なくとも一つのさらなるレーザ放射の位相、又は(ii)前記少なくとも一つのさらなるレーザ放射の前記位相又は振幅の少なくとも一つの変化のレート、の少なくとも一つの関数として特定するように構成された第5の構成部と、を含む、請求項11記載のシステム。 - 前記レーザ放射の走査速度又は出力の少なくとも一つを調節しながら、前記ビームを前記少なくとも一部分に適用する、請求項11記載のシステム。
- 前記ビームは、前記レーザ放射の出力の少なくとも50%を含む、第1の断面幅を有し、
前記ビームを前記少なくとも一部分の所定の経路に沿って前記生物構造体に適用する時、前記所定の経路を含む、第2の幅を有する前記生物構造体の第2の領域に適用される前記レーザ放射のエネルギーの量は、略一定であり、
前記第1の断面幅と前記第2の幅は、略同一であり、前記ビームの併進方向に対して横断して(transverse)測定する、請求項11記載のシステム。 - 前記ビームは、前記レーザ放射の走査方向に対して略平行な方向の前記レーザ放射の出力の積分(integration)が、略一定であるような形状を有する、請求項11記載のシステム。
- さらに、少なくとも一つの非円形の開口を用いて前記ビームを成形するように構成された第6の構成部を含む、請求項11記載のシステム。
- さらに、前記ビームの形状を非円形に修正するように構成された第7の構成部を含む、請求項11記載のシステム。
- 前記所定の経路は、少なくとも、(i)略螺旋形、(ii)略円形、又は(iii)略平行線の群、の少なくとも一つである、請求項11記載のシステム。
- 前記生物構造体は、管状の形状を有する、請求項11記載のシステム。
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PCT/US2007/061479 WO2007149602A2 (en) | 2006-02-01 | 2007-02-01 | Methods and systems for providing electromagnetic radiation to at least one portion of a sample using conformal laser therapy procedures |
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EP1983921B1 (en) | 2016-05-25 |
WO2007149602A3 (en) | 2008-04-03 |
WO2007149602A2 (en) | 2007-12-27 |
US10426548B2 (en) | 2019-10-01 |
US20070282403A1 (en) | 2007-12-06 |
EP1983921A2 (en) | 2008-10-29 |
JP5524487B2 (ja) | 2014-06-18 |
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