JP2022522168A - Tissue detection system and how to use it - Google Patents

Abstract

A tissue detection system and how to use it is provided. Tissue detection systems facilitate irradiation-mediated fluorescence stimulation in the target area (s) of the human body and detect areas of interest that are invisible or not easily visible for the purpose of such stimulation. Efficiently identify the area of interest. The tissue detection system captures the probe to facilitate irradiation / stimulation of the tissue of interest, at least one emitter to generate the radiation applied to the tissue of interest, and the radiation of the tissue emitting the tissue of interest. At least one detector for the purpose can be employed. [Selection diagram] Fig. 1

Description

Cross-reference to related applications This application is filed on February 26, 2019, US Provisional Patent Application No. 62 / 810,510, and filed on March 25, 2019, No. 62 / 823,252, And claims the interests of No. 62 / 840,609 filed April 30, 2019, which are incorporated herein by reference in their entirety.

The technique generally involves irradiating and stimulating a surgical area of interest in the human body that has areas that are not visible or readily visible to the human eye (s). And how to use the tissue detection system to detect these areas and allow the user to efficiently identify these areas.

In many processes, including surgery, areas of interest within the area of the human body (s) may not be visible to the person performing the process, but these areas may be detected by other means. It can be possible. However, fluorescence can be used to identify areas of the human body that include the area of interest (s) of surgery. Some substances may fluoresce at invisible wavelengths. Other areas of interest may be too low in contrast to the human eye to be easily visible. Therefore, by stimulating fluorescence in a target area (s) of the human body, it is possible to detect invisible or not easily visible areas that are the target of such stimulation, and to detect these target areas. There is a need for a tissue detection system and how to use it for efficient identification.

The techniques of the present disclosure generally relate to tissue detection systems and their use.

In one aspect, the present disclosure provides a tissue detection system for locally stimulating fluorescence within the surgical area and identifying the fluorescent area within the surgical area, wherein the system is a probe having a distal end. The distal end is a probe and at least one emitter and at least one emitter optical fiber configured to be in contact with or near contact with the tissue material of interest in the surgical area, at least one. One emitter is configured to emit radiation to stimulate fluorescence in the tissue material of interest, at least one emitter optical fiber is coupled to at least one emitter and at least a portion of the probe. At least one emitter and at least one emitter optical fiber extending through, and at least one detector and at least one detector optical fiber, where at least one detector is the tissue within the surgical area of interest. At least one detector configured to detect fluorescence from a substance, the at least one detector optical fiber is coupled to at least one detector and extends through at least a portion of the probe. And at least one detector optical fiber and a controller and user interface coupled to the emitter and detector, the controller being configured to initiate operation of at least one emitter and at least one detector. The user interface includes a controller and a user interface, which are configured to provide feedback to the operator regarding the operation of the tissue detection system, including at least one emitter optical fiber and at least one detector optical fiber. The distal end is juxtaposed with the distal end of the probe, at least one emitter optical fiber is configured to transmit radiation from the emitter to its distal end, and at least one detector optical fiber is fluorescent. It is configured to transmit the corresponding signal to the detector.

In another aspect, the present disclosure provides a tissue detection system for locally stimulating fluorescence within the surgical area and identifying the fluorescent area within the surgical area, the system being a probe having a distal end. The distal end is a probe and at least one emitter and at least one emitter optical fiber configured to be in contact with or near contact with the tissue material of interest in the surgical area. One emitter is configured to emit radiation to stimulate fluorescence in the tissue material of interest, at least one emitter optical fiber is coupled to at least one emitter and at least a portion of the probe. To at least one emitter and at least one emitter optical fiber extending through, and at least one camera, emitter and detector configured to detect fluorescence from tissue material in the surgical area of interest. A combined controller and user interface, the controller is configured to initiate the operation of at least one emitter and at least one camera, the user interface providing feedback to the operator regarding the operation of the tissue detection system. The distal end of at least one emitter optical fiber is juxtaposed with the distal end of the probe and at least one emitter optical fiber is from the emitter, including a controller and user interface configured to provide. The radiation is configured to be transmitted to its distal end, at least one camera is spaced above the surgical area and at least one camera detects fluorescence over a wide field of view.

In yet another embodiment, the disclosure provides a method of tissue detection and surgery using a tissue detection system, wherein the distal end of the probe of the tissue detection system is in contact with or near contact with the tissue substance of interest. At least one emitter is connected to at least one emitter optical fiber and at least one emitter optical fiber is of the probe. Producing, extending at least in part to the distal end of the probe, and radiating radiation through at least one emitter optical fiber, in contact with or near contact with the tissue material of interest. To stimulate the fluorescence of the tissue material of interest by transmitting to the distal end of the probe and using radiation from at least one emitter at the distal end of the probe, and using at least one detector At least one detector is connected to at least one detector optical fiber, the at least one detector optical fiber passing through at least a portion of the probe. Extends to the distal end of the probe, is detected, and the detected and stimulated radiation is used to identify the tissue substance of interest, and after identifying the tissue substance of interest, surgery It involves removing the tissue material of the target.

Details of one or more embodiments of the present disclosure are given in the accompanying drawings and the following description. Other features, objectives, and advantages of the techniques described in this disclosure will become apparent from the specification and drawings, as well as from the claims.

It is an overview of the tissue detection system showing the tissue detection system in relation to the patient and the user, the internal area of the patient is enlarged and the location of the internal area is shown for reference. It is a partial block diagram explaining tissue detection. FIG. 2A shows an enlarged distal end of the probe of the tissue detection system of FIG. 2A. FIG. 3 is a fluoroscopic view showing an endoscopic probe used in a tissue detection system. FIG. 3A shows the enlarged distal end of the endoscopic probe of FIG. 3A. An overview of the tissue detection system in which the camera is used, showing the tissue detection system and camera in the patient-user relationship, the patient's internal area is magnified, and the location of the internal area is shown for reference. FIG. 3 is a block diagram of a tissue detection system showing the use of a camera and corresponding lens. FIG. 3 is a block diagram of a tissue detection system showing the use of a near-infrared camera and a corresponding lens. It is a flowchart which shows the method for tissue detection. It is a flowchart which shows the calibration method for facilitating the tissue detection. It is a block diagram of a tissue detection system using a near-infrared camera with pixel-by-pixel demodulation. FIG. 3 is a block diagram of a tissue detection system with pixel-by-pixel demodulation using a camera and a near-infrared camera.

As described below, fluorescence is stimulated through irradiation of the target area (s) of the human body to detect invisible or not easily visible areas of the purpose of such stimulation and these purposes. Devices and methods are provided for efficiently identifying areas of. Tissue detection systems and methods of using tissue detection systems are used to facilitate such stimuli, detection, and identification. As discussed below, embodiments of tissue detection systems are used to stimulate fluorescence in tissues of interest and to detect fluorescence from those tissues of interest quickly and conveniently.

In some embodiments of the tissue detection system, the emitter and detector are in direct contact with potentially fluorescent tissue material in the area of interest (s), such that stimulation and detection occur in a limited area. Or they can be placed almost in contact. For illustration purposes, emitters and detectors can be separated from the probe or part of the probe with or without fiber optics, and the probe can be in the area (s). Fluorescence in an area (s) can be stimulated by the emitter, which can be positioned in contact or close to each other, and if such fluorescence exceeds a threshold, the area (s). Fluorescence in) can be detected by a detector. In some embodiments, emission and detection are in the near infrared (IR) spectral band, which can be selected, for example, to stimulate and detect fluorescence in parathyroid tissue.

A method of using autofluorescence to distinguish parathyroid material from thyroid material in the cervical region or other tissues is described in US Application No. 13 / 065,469, which is in its entirety by reference. Incorporated into the specification. U.S. Application No. 13 / 065,469 states that when exposed to radiation in a narrow wavelength range of approximately 785 nm, just outside the visible range, both the thyroid and parathyroid glands exceed 800 nm, and in some cases 822 nm. It discloses that it emits autofluorescence in the wavelength range centered on it. The wavelength range above 800 nm is also not visible, and the fluorescence intensity of the parathyroid material is significantly higher than the fluorescence intensity of the thyroid material.

This difference in the relative amount of fluorescence can be used to distinguish tissues that are beneficial for surgery (eg, parathyroid material, thyroid material, and other tissues in the cervical region). For the sake of explanation, although the general location of the parathyroid substance is known, the parathyroid substance is difficult to distinguish visually sufficiently accurately for surgery and requires the identification of the parathyroid substance. Treatment can be problematic.

The uses of the tissue detection systems 10, 10'and 10 "disclosed herein, as well as the tissue detection systems 10, 10', and 10" are applicable to surgical procedures requiring tissue identification. possible. Tissue detection systems 10, 10', and 10'to identify tissues such as, for example, parathyroid material, thyroid material, and other tissues in the cervical region to facilitate surgical removal. In other words, tissue identification by tissue detection systems 10, 10', and 10 "makes it possible to identify tissue material using positive or negative tissue identification. Once identified (via positive or negative identification), tissue material can be removed during surgery.

As shown in FIG. 1, the tissue detection system 10 includes a probe 100, a controller 140, and a user interface 150. The controller 140 and the user interface 150 can be combined with each other or separated from each other, and the controller 140 and / or the user interface 150 displays a video-like image created using, for example, the tissue detection system 10. Display for this purpose (such as the display 210 from FIGS. 5A and 5B) can be included.

As shown in FIG. 1, the probe 100 can be positioned by the operator O with respect to the patient P received in the operating table 160. FIG. 1 shows a probe 100 positioned by operator O during surgery and brought into contact with or in close proximity to a potentially fluorescent tissue material such as patient P's parathyroid substance 300. Therefore, according to embodiments of the present disclosure, the tissue detection system 10 is for detecting (via positive or negative discrimination) parathyroid substance 300 in the exposed internal cervical region of patient P during surgery. Can be used for.

The identification of the accessory thyroid substance 300 is performed by an operator O, for example, a surgeon, a nurse, a surgical assistant, or an individual in another operating room, using the tissue detection system 10 to visually identify the target area (s). It is an example of a process that can facilitate surgery in a desired area (s) that cannot be seen. In the case of identification of parathyroid material, the parathyroid material fluoresces in the near infrared and is not visible. The fluorescence intensity of adjacent thyroid substances is different from the fluorescence intensity of parathyroid substances. Therefore, it is possible to distinguish between a tissue substance that is a parathyroid substance (positive discrimination) and a tissue substance that is not a parathyroid substance (negative discrimination). Therefore, the probe 100 can be used in combination with the controller / user interface 140/150 to tactilely identify the region of interest. Specific parameters suitable for parathyroid tissue, including irritation and detection, are described below, but the basic concepts disclosed may apply to other applications where fluorescence can be stimulated.

FIG. 2A shows additional elements of the tissue detection system 10. The probe 100, in some embodiments, is tubular in shape or conveniently handheld and can be made of a variety of possible materials including metals, plastics, and / or complexes among others. It may include one or more probe bodies 130 that may be in shape.

As shown in FIG. 2A, a single probe body 130 is provided and the tissue detection system 10 also has an emitter (s) 105 coupled to an emitter optical fiber (s) 115 and a detector optical fiber (s). Possible) Includes each of the detectors (s) 110 coupled to 120. Emitter 105 may be configured to emit radiation at selected wavelengths to stimulate fluorescence in the region of interest via rotation and / or device selection, providing optical element 125 and via filtering. The radiation emitted from the emitter 105 can be changed lower or higher. Further, the detector 110 is configured to process the radiation captured by the probe 100. For identification of parathyroid material, the emitter 105 (with or without the use of optical element 125) emits radiation at a wavelength of about 785 nm to facilitate self-fluorescence of the parathyroid material, and the detector 110 emits radiation. , The parathyroid material captured by the probe 100 is configured to treat radiation with wavelengths in the range of 808-1000 nm self-fluorescent.

The emitter 105 and the detector 110 can be separated from or part of the probe body 130. The probe body 130 includes the distal end 135 (FIG. 2B), and at least a portion of the emitter optical fiber (s) 115 extends through at least the probe body 130 and is distal from the emitter 105 to the probe body 130. To facilitate the transmission of radiation to the end 135, at least a portion of the detector optical fiber (s) 120 extends through at least the probe body 130 and extends from the distal end 135 of the probe body 130 to the detector 110. Facilitates the capture and transmission of radiation. As shown in FIG. 2B, the emitter optical fiber (s) 115 and the detector optical fiber (s) 120 can be terminated at the distal end 135 of the probe body 130. However, other arrangements, such as multiple fibers in a plurality of bundled probe bodies, may also be suitable. In either case, the emission and detection fibers can be terminated together at the distal end 135 of the probe body 130 or close to each other.

The controller 140 can be used to control the transmission of radiation from the emitter 105 and control the detection of radiation at the detector 110, and the user interface 150 interacts with and operates with the controller 140. Can be used to control. In use, the emitter 105 (via control using the controller / user interface 140/150), along with an optical element (s) 125 (such as one or more optical lenses and / or filters), is an emitter. It is configured to deliver selected radiation to irradiate to stimulate fluorescence through the optical fiber (s) 115 to the distal end 135 of the probe body 130. In use, the detector 110 (via control using the controller / user interface 140/150), along with the optical element (s) 125, is distant from the probe body 130 through the detector fiber optics (s) 120. It is configured to detect the radiation collected at the distal end 135. An optical element (s) 125 is provided at the end of the probe body 130 of FIG. 2A, but other arrangements for filtering in fiber coupling, or the emitter and detector itself are possible. Further, the user interface 150 may include, for example, a switch (not shown) in the form of a hand or foot switch for initiating emission of irradiation and detection of fluorescence from the emitter 105 and the detector 110, respectively. In addition, there may be audio and / or visual indications indicating that a suitable fluorescent signal has been detected.

During surgical use, the distal end 135 of the probe body 130 is in physical or near contact (ie, at least within 1-2 cm) with potentially fluorescent tissue material in the area of interest in the body and the user. The operator O via the interface 150 causes the controller 140 to perform both emission and detection when the distal end 135 of the probe body 130 is in contact with or nearly in contact with the surface of the region of interest. To instruct. Next, the fluorescent signal detected for the target tissue is compared with the threshold fluorescent signal for the reference tissue to determine whether or not the detected fluorescent signal indicates the presence of the reference tissue. The emitter optical fiber (s) 115 and the detector optical fiber (s) 120 terminate at the distal end 135 of the probe body 130 at a small area approximately the size of the fiber end (s), where this small area is. When in contact with or near the surface, the area exposed to irradiation / stimulation and detection is very small, allowing accurate identification of the tissue of interest.

For identification of parathyroid material, the emitter 105 can be a narrowband light source such as a solid-state laser, laser diode, or other suitable light source, tuning using the optical element (s) 125, device selection, and /. Alternatively, its radiation output wavelength via a combination of filtering is in the narrow band at or near 785 nm. The detector 110 can be an avalanche photodiode or other 2D array of near-infrared detectors or IR detectors, which have wavelengths higher than the source wavelength (eg, above 800 nm and in the range 808-1000 nm). ) Can be used in conjunction with demodulation using a high-pass (or long-pass) optical filter (of optical elements (s) 125) such that radiation is detected. The radiation wavelengths output by the emitter 105 (through the use of tuning, device selection, and / or filtering using the optical element (s) 125) are secondary to facilitate identification of other tissue material. It can be changed lower or higher than that used to identify thyroid material 300.

The advantage of contacting the surface of the region of interest in a small area of the distal end 135 of the probe body 130 (where the emitter optical fiber (s) 115 and the detector optical fiber (s) 120 terminate). One is that in the case of an operating room, the optical signal is unaffected by ambient light, as it can have significant amounts of near-infrared components. Tolerance to such ambient light can be further increased by modulating the emitter radiation and collecting the fluorescent signal using phase locking techniques such as lock-in detection or FFT (Fast Fourier Transform) techniques.

As shown in FIG. 3A, the tissue detection system 10 or at least the probe 100 can be integrated with the endoscopic probe 170. In this arrangement, the endoscope probe 170 includes an endoscope camera 175 and an endoscope probe main body 180, and the emitter optical fiber (s) 115 and the detector optical fiber (s) 120 include at least an endoscope. At the distal end 190 of the probe body 180 (FIG. 3B), it is brought to the endoscope probe body 180 and integrated with the endoscopic optical system 185. The endoscopic probe body 180 includes a lumen 195 that terminates at the distal end 190 and extends through it, and the endoscopic camera 175 captures the region of interest adjacent to the distal end 190 through the lumen 195. Can be visualized. This allows probing to be performed using the endoscope camera 175 as a guide so as to place the distal end 190 of the endoscope probe body 180, which needs to be surgically opened accordingly. Supports the use of much smaller areas.

Probing using the tissue detection system 10 can be enhanced by using an external camera 200 that can be used as a detector to capture radiation from the fluorescent tissue of interest, as shown in FIG. The use of the external camera 200 with the tissue detection system 10 may provide increased irradiation and clarity as opposed to visually instructing the operation of the tissue detection system 10. This is because the external camera 200 can point to potentially fluorescent tissue material over a wider field of view. When using only the tissue detection system 10 and the probe 100, it is necessary to visually identify potential candidates for potentially fluorescent tissue material, but the use of probe 100 is mediated by the fluorescence of the potential candidates. Make it easy to provide confirmation information. By using the external camera 200 in combination with the probe 100, the imaging area provided by the external camera 200 can be used to identify potential tissue material candidates that fluoresce over a wider field of view. The probe 100 is then identified via fluorescence information obtained from each of the potential fluorescent tissue material candidates by contacting or nearly contacting the surface of the potentially fluorescent tissue material. Can be used for. The external camera 200 provides image contrast levels that may be useful but not definitive, while the probe 100 provides sensitive and quantitative measurements for each of the potentially fluorescing tissue materials. Can be used to provide, the distal end 135 of the probe body 130 can be positioned in contact with or near contact with it to obtain and measure a definitive indicator of fluorescence. Therefore, combining the use of the tissue detection system 10 and the probe 100 with the external camera 200 can provide a powerful solution for identifying the areas with the highest fluorescence.

FIG. 5A schematically illustrates another arrangement of the tissue detection system 10 using a camera including an endoscopic camera 175, an external camera 200, or the like, camera optical system 205 (one or more optical lenses). And / or a display 210 (such as a filter) and a display 210 (such as a computer monitor / screen) are used with the tissue detection system 10 using the probe 100 and the controller / user interface 140/150. Although not shown in FIG. 5A, the emitter 105 can be inserted between the controller / user interface 140/150, which is the endoscope camera 175, external camera 200, and display 210. Can be used to control the behavior of. Further, the display 210 may be separated from or integrated with the controller 140 and / or the user interface 150.

FIG. 5B schematically illustrates yet another arrangement of the tissue detection system 10 using an alternative probe 220 and an alternative camera 225 embodiment, the probe 220 providing irradiation only and detection. It is due to the camera 225. The probe 220 is a handheld flexible irradiation probe that can be positioned in contact with or near the surface of a potentially fluorescent tissue material by operator O. In addition, the camera 225 is used as a detector to capture radiation from the fluorescent tissue of interest. Although not shown in FIG. 5B, the emitter 105 can be inserted between the controller / user interface 140/150, which is used to control the operation of the camera 225 and the display 210. Can be done. Further, the display 210 may be separated from or integrated with the controller 140 and / or the user interface 150.

The probe 220 can be in contact with or nearly in contact with a potentially fluorescent tissue material or with a fluorescence-excited tissue at any desired angle. The use of the probe 220 allows irradiation / stimulation of areas of interest that irradiation normally does not reach. However, the fluorescence stimulated by the tissue of interest may be difficult to see on the detector optical fiber (s) 120 incorporated in the probe body 130. An example of this could be a subsurface region where the fluorescence is usually too weak to be detected by the detector optical fiber (s) 120. Another example could be to fluoresce the tissue material at or just outside the boundaries of the field of view of the detector optical fiber (s) 120. The probe 220 brings the light source closer to the region of interest, which in turn increases the emitted fluorescence, allowing the camera 225 to see and capture it. The external camera 225 can point to potentially fluorescent tissue material over a wider field of view, including the entire region of interest. The probe 220 can include only irradiation fibers selected to maximize the transmission of radiation from them, and only one fiber. The irradiation fiber (s) may also have one or more lenses and / or filters, etc. at its ends (s) (eventually directed towards the tissue), which respond to irradiation. Any fluorescence emitted by the fiber material can be eliminated.

Irradiation / stimulation is achieved with the handheld irradiation probe 220, but detection is achieved, for example, by using a camera 225 to view an image of the entire area of interest, eg, from operating room lighting. The problem of background light is different from when both irradiation and detection are achieved at the distal end 135 of the probe 100. The camera 225 is essentially equivalent to a plurality of detectors in parallel, and the fluorescence area may be anywhere in the imaged area, so the demodulation technique described above cannot be applied directly.

FIG. 6 shows an embodiment of a method for using the tissue detection system 10. First, at 20, a probe 100 is provided, the probe 100 having an emitter optical fiber (s) 115 extending through it to the distal end of the probe body 135 and a detector optical fiber (s) 120. ,including. At 22, operator O receives an indicator (visual or other) that the distal end 135 of the probe body 130 is in contact with or nearly in contact with the surface of a potentially fluorescent tissue material. At 24, the potentially fluorescent tissue material is irradiated with radiation from the emitter 105 via the optical element (s) 125 and the emitter optical fiber (s) 115. At 26, the fluorescence (if any) is detected by the detector 110 via the optical element (s) 125 and the detector optical fiber (s) 120. At 28, the controller 140 and / or the user interface 150 can provide an indicator when the fluorescence detected by the detector 110 exceeds a threshold. Steps 24, 26, and 28 can also be performed using other embodiments disclosed herein.

FIG. 7 shows an embodiment of the method used to calibrate the tissue detection system 10. First, at 30, the distal end 135 of the probe body 130 is located at various locations on the surface of the potentially fluorescent tissue material. At 32, emission and detection using the emitter 105 and the detector 110, respectively, are initiated at each of the various locations. The detected fluorescence signal corresponding to the detected fluorescence (if any) is acquired by the controller 140. At 34, the controller 140 discards any data corresponding to the detected fluorescence signal outside the predetermined range. At 36, the threshold level is statistically derived from the remaining data of the corresponding detected fluorescence signal. Therefore, such calibration can be used to obtain threshold levels of potentially fluorescent tissue material and other tissues that are clearly different from the potentially fluorescent tissue material. These threshold levels can be used to calculate the ratio, and the controller 140 and / or the user interface 150 can provide an indicator if the ratio is lower or higher than the threshold ratio. Steps 32, 34, and 36 can also be performed using other embodiments disclosed herein.

Referring to FIG. 8, an alternative embodiment of the tissue detection system, generally referred to by number 10', is shown. The tissue detection system 10'includes an emitter 230 (which may be similar to the emitter 105) such as a solid-state laser, a laser diode, or any other suitable light source that can be configured to emit radiation at selected wavelengths. , The emitter may be modulated by the modulator 235 to change the emitted radiation lower or higher. The modulator 235 can be of various types such as a chopper, a pocket cell, an acousto-optic modulator, or other optical modulator. The modulated emitter signal is delivered from the emitter 230 via the modulator 235 to the probe 240 (which may be similar to the alternative probe 220) and the modulated probe signal from the probe 240 is applied to the region of interest. Will be done. The near-infrared camera 245 then looks at the area of interest with or without the use of camera optics 250 (such as one or more optical lenses and / or filters). The near-infrared camera 245 can be used as a detector for capturing radiation from a fluorescent tissue of interest. The signal from the near-infrared camera 245 can pass through the demodulator 255, which can also use the modulator frequency from the modulator 235 as an input, before the demodulated signal from the demodulator 255 is passed to the display 260. .. Like the display 210, the display 260 may be separated from or integrated with the controller 140 and / or the user interface 150.

The demodulator 255 may be in the form of a high speed digital processor such as a graphics or game processor, or an FPGA (field programmable gate array) capable of implementing a number of high speed parallel processing algorithms. Consecutive frames of images from the near-infrared camera 245 are subject to pixel-by-pixel demodulation, i.e., each pixel is demodulated by a high-speed parallel processor with a demodulator. Pixel-by-pixel demodulation features can include digital lock-in to modulation frequency or Fourier transform demodulation.

The rolling window of the demodulated video frame can be passed continuously to the display 260 for display from the demodulator 255, resulting in a slight start-up delay and radiation stimulated by the modulated probe signal. Real-time demodulated video can be produced where the gain of light is very high, for example the background lighting from the operating room lighting is significantly removed.

In one embodiment, the near-infrared camera 245 may include an output that directly corresponds to the fluorescence detected by each detector in the camera imaging array of the near-infrared camera 245. In this case, the detected fluorescence luminance value can be analyzed pixel by pixel, and the demodulation function can be performed in parallel by the high-speed digital processor of the demodulator 255. In one embodiment. The Nvidia Tegra processor can be programmed to analyze hundreds of pixels in parallel at video rates to perform digital lock-in operations.

FIG. 9 shows an alternative embodiment of the tissue detection system referenced by the number 10 ". The tissue detection system 10" is similar to the tissue detection system 10', but the tissue detection system 10 ". Alternatively, a standard video camera 270 (camera optical system 205 can be employed) and a near infrared camera 275 (camera optical system 250 can be employed), both of which image the same region of interest. ) Can be adopted. The near-infrared camera 275 can be used as a detector for capturing radiation from the fluorescent tissue of interest. In this embodiment, the pixel lock-in is near by the demodulator 255. To generate video highlights from a standard video camera 270 for pixels that are performed on the output from the infrared camera 275 and that meet certain criteria will eventually fluoresce the image displayed on the display 260. Is mixed with the output from the standard video camera 270 by the demodulator 255.

Various aspects of the embodiment include computing devices that perform software routines, such as devices including computers and personal electronic devices, as well as processing elements and processing elements that may include programmable electronic devices, logic circuits, and other electronic implementations. It may contain any combination of memories. Various combinations of optical elements can be employed, including lasers, LEDs, and other light sources, filters, lenses, mirrors, beam splitters, and the like. The details of the optical, electronic, and processing embodiments described herein are exemplary and have the same results in essentially the same way using an alternative approach that uses other combinations of similar elements. Is not intended to be limited, as it can be achieved.

It should be appreciated that the various aspects disclosed herein can be combined in different combinations than those specifically presented in the description and accompanying drawings. Certain acts or events of any of the processes or methods described herein may be performed in different order depending on the embodiment, may be added, merged, or omitted altogether (eg, all). It should also be understood that the acts or events described in may not be necessary to perform this technique). In addition, certain aspects of the present disclosure are described as being carried out by a single module or unit for clarity, but the techniques of the present disclosure are described, for example, in units or modules related to medical devices. Please understand that it can be carried out by a combination of.

Claims (20)

A tissue detection system for locally stimulating fluorescence in a surgical area and identifying a fluorescent area in the surgical area.
A probe having a distal end, wherein the distal end is configured to be placed in contact with or substantially in contact with the tissue material of interest in the surgical area.
At least one emitter and at least one emitter optical fiber, wherein the at least one emitter is configured to emit radiation to stimulate fluorescence in the tissue material of interest, said at least one. The emitter optical fiber comprises at least one emitter and at least one emitter optical fiber coupled to the at least one emitter and extending through a portion of the probe.
At least one detector and at least one detector optical fiber, wherein the at least one detector is configured to detect fluorescence from the tissue material in the surgical area of interest, said at least. One detector optical fiber comprises at least one detector and at least one detector optical fiber coupled to the at least one detector and extending through at least a portion of the probe.
A controller and user interface coupled to the emitter and the detector, wherein the controller is configured to initiate operation of the at least one emitter and the at least one detector. Equipped with a controller and a user interface, which are configured to provide feedback to the operator regarding the operation of the tissue detection system.
The distal end of the at least one emitter optical fiber and the at least one detector optical fiber is juxtaposed with the distal end of the probe, and the at least one emitter optical fiber emits the radiation from the emitter. A tissue detection system configured to transmit to the distal end, wherein the at least one detector optical fiber is configured to transmit a signal corresponding to the fluorescence to the detector. The tissue detection system according to claim 1, wherein the tissue substance of interest is parathyroid tissue. The tissue detection system according to claim 2, wherein the emitter includes a narrow band radiation source having a frequency centered on 785 nm ± 10 nm. The tissue detection system according to claim 3, further comprising a filter that further limits the emitter bandwidth, wherein the emitter is a solid-state laser or laser diode. The tissue detection system according to claim 4, wherein the detector is a near-infrared camera having a high-pass filter, and the high-pass filter is configured to pass an optical wavelength exceeding the emitted wavelength of the emitter. .. The tissue detection system according to claim 5, wherein the high-pass filter is configured to pass a light wavelength exceeding 800 nm. The tissue detection system according to claim 1, wherein the probe is a part of an endoscopic probe system. Claimed to further include at least one modulator configured to modulate the radiation from the emitter and at least one demodulator configured to demodulate the signal corresponding to the fluorescence. Item 1. The tissue detection system according to Item 1. The tissue detection system according to claim 8, wherein the signal corresponding to the fluorescence is demodulated by the demodulator for each pixel. A tissue detection system for locally stimulating fluorescence in a surgical area and identifying a fluorescent area in the surgical area.
A probe having a distal end, wherein the distal end is configured to be placed in contact with or substantially in contact with the tissue material of interest in the surgical area.
At least one emitter and at least one emitter optical fiber, wherein the at least one emitter is configured to emit radiation to stimulate fluorescence in a tissue of interest, said at least one emitter. The optical fiber comprises at least one emitter and at least one emitter optical fiber coupled to the at least one emitter and extending through at least a portion of the probe.
With at least one camera configured to detect fluorescence from said tissue material in said surgical area of interest.
A controller and user interface coupled to the emitter and the detector, wherein the controller is configured to initiate operation of the at least one emitter and the at least one camera. , A controller and a user interface, which are configured to provide feedback to the operator regarding the operation of the tissue detection system.
The distal end of the at least one emitter optical fiber is juxtaposed with the distal end of the probe so that the at least one emitter optical fiber transmits the radiation from the emitter to the distal end thereof. A tissue detection system configured, wherein the at least one camera is spaced above the surgical area and the at least one camera detects fluorescence over a wide field of view. The tissue detection system according to claim 10, wherein the tissue substance of interest is parathyroid tissue. The tissue detection system according to claim 11, wherein the emitter comprises a narrow band radiation source centered on a frequency of 785 nm ± 10 nm. 12. The tissue detection system of claim 12, further comprising a filter that further limits the emitter bandwidth, wherein the emitter is a solid-state laser or laser diode. The tissue detection system according to claim 13, wherein the camera is a near-infrared camera having a high-pass filter, and the high-pass filter is configured to pass a light wavelength exceeding the emitted wavelength of the emitter. The tissue detection system according to claim 14, wherein the high-pass filter is configured to pass a light wavelength exceeding 800 nm. A method of tissue detection and surgery using a tissue detection system, wherein the method is
Positioning the distal end of the probe of the tissue detection system in contact with or near contact with the tissue material of interest.
Using at least one emitter to generate radiation, the at least one emitter being connected to the at least one emitter optical fiber, the at least one emitter optical fiber being at least the probe. Producing, extending through a portion to the distal end of the probe,
To transmit the radiation through the at least one emitter optical fiber to the distal end of the probe located in contact with or near contact with the tissue material of interest.
Using the radiation from the at least one emitter at the distal end of the probe to stimulate the fluorescence of the tissue material of interest.
By using at least one detector to detect the stimulated fluorescence, the at least one detector is connected to at least one detector optical fiber and the at least one detector light. Detecting that the fiber extends through at least a portion of the probe to the distal end of the probe.
Using the detected and stimulated fluorescence to identify the tissue material of interest,
A method comprising removing the tissue substance of interest during the surgery after identifying the tissue substance of interest. The method of claim 16, wherein the tissue material of interest is parathyroid tissue. 16. The method of claim 16, wherein the emitter comprises a narrowband radiation source centered on a frequency of 785 nm ± 10 nm. 18. The method of claim 18, wherein the filter is used to further limit the emitter bandwidth, wherein the emitter is a solid-state laser or laser diode. 19. The method of claim 19, wherein the detector is a near-infrared camera with a high-pass filter, wherein the high-pass filter is configured to pass an optical wavelength that exceeds the emitted wavelength of the emitter.

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