WO1993014712A1 - Apparatus for treating a target such as a lesion with a tracer element - Google Patents

Apparatus for treating a target such as a lesion with a tracer element Download PDF

Info

Publication number
WO1993014712A1
WO1993014712A1 PCT/FR1993/000081 FR9300081W WO9314712A1 WO 1993014712 A1 WO1993014712 A1 WO 1993014712A1 FR 9300081 W FR9300081 W FR 9300081W WO 9314712 A1 WO9314712 A1 WO 9314712A1
Authority
WO
WIPO (PCT)
Prior art keywords
means
lesion
therapy
mo
apparatus according
Prior art date
Application number
PCT/FR1993/000081
Other languages
French (fr)
Inventor
Jean-Yves Chapelon
Frédéric PRAT
Emmanuel Blanc
Original Assignee
Technomed International
Institut National De La Sante Et De La Recherche Medicale
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to FR9200884A priority Critical patent/FR2686499A1/en
Priority to FR92/00884 priority
Application filed by Technomed International, Institut National De La Sante Et De La Recherche Medicale filed Critical Technomed International
Publication of WO1993014712A1 publication Critical patent/WO1993014712A1/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42Details of probe positioning or probe attachment to the patient
    • A61B8/4209Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames
    • A61B8/4218Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames characterised by articulated arms
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/225Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
    • A61B17/2256Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves with means for locating or checking the concrement, e.g. X-ray apparatus, imaging means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37Surgical systems with images on a monitor during operation
    • A61B2090/374NMR or MRI

Abstract

A therapeutical apparatus includes a device (12) for treating a lesion (L), a device (30 or 40) for locating the lesion (L), the locating device (30, 40) being connected, e.g. mechanically (34) or electronically, to the treatment device, a device for computing the position of the lesion (L) relative to the treatment device by means of the locating device, and a device (22, 60) for actuating the treatment device (12). At least one tracer element (M0, M1, M2, M3) implanted within the lesion is located by the locating device (30 or 40), and the computing device (22) computes the position co-ordinates of the tracer element (M0, M1, M2, M3) relative to the treatment device (12) said co-ordinates being used for moving the spatially movable treatment device (12) into a given position determined according to axes X, Y and Z. The apparatus provides accurate treatment of the lesion.

Description

TREATMENT APPARATUS FOR TARGET, AS INJURY UTI READING ELEMENT

MARKER PEN.

05

The present invention essentially relates to a appa¬ ring the treatment of a target, such as a lesion within the body of a mammal, particularly a human, using a marker element implanted in or in the vicinity of the target for

10 control the therapy of said target.

We know that current diagnostic tools put per¬ detect most benign or malignant tissue damage in the early stages of the disease. These dispo¬ sitifs, are the most common scanners (in English:

15 Co puterized Tomography, CT abbreviation), the Ima¬ Gerie devices ..ώsor.aπee.-Iεgr'éf that (-.nar τjé £ RM), nuclear imaging devices (referred scintigraphy), the conventional X-ray devices and, finally, ultrasonic imaging devices (ultrasound).

20 The first two devices, CT and MRI provide great image quality, but implement a very complex and expensive technology that limits their distribution to specialized hospital services in diagnostics such as radiology.

25 In contrast, the conventional radiology and ultrasound devices, lower cost and greater flexibility of use, are of much wider distribution, but does not however provide equivalent image quality to CT or MRI.

30 The complementarity between these different imaging devices is satisfactory during the diagnostic phase of a disease in a patient. Routine examinations are made of the most common devices (convention¬ tional radiology and ultrasound) and if necessary further investigation

35 are made later, with scanners and MRI. The problem is different for application of extracorporeal therapy. Indeed, it is necessary to perfectly identify and reference a lesion in a patient to guide the therapeutic procedure for performing processing effi- cient of the lesion. This phase of localization nécessai¬ must surely occur at the time of the therapy phase.

When the imaging means such as ultrasound or radiology offer the image quality necessary and sufficient for therapeutic act, their versatility allows easily integrate them into therapy devices. Extracorporeal lithotripsy for the destruction of stones, for example, combines an acoustic shock wave generator to calculations locating means such as * 1'échographie or X-rays The integration of these imaging devices on dis- positive therapy also allows for real-time monitoring of therapeutic act to ensure its quality (see FR-a-2,598,073 depositors; EP-a-0169311 or FR-A- 2587 893).

But when these same imaging means are no longer sufficient to identify in the therapeutic act the lesions to be treated as in the case of liver tumors and particularly of the prostate, due to a weak con¬ fret or weakness of echogenicity, it is necessary to use other tracking solutions.

In addition, it is often necessary to apply the positive dis- locating against the patient's body, to obtain a sufficient image quality, causing a displacement of the member, so that the identification of the lesion are distorted for the therapeutic act.

Therefore, we have already tried to make a preoperative imaging. In this context, especially for neuro¬ surgery, a geometric tracking was proposed using stereotactic frame fixed on the patient's skull. For example, the docu¬ ment W0 90/05494 describes the use of a stereotactic frame compor¬ as integral marker elements of the frame, arranged extêrieu- surely to the patient, allowing previously well in operation, to locate a lesion destruction within the patient's skull, and the reference relative to the stereotactic frame used by the leader sequence in which are placed the gicaux chirur¬ instruments.

This solution is in practice usable in the context of lesions whose position does not vary relative to the outer positive dis¬ stereotaxic used when determining the position of the lesion to be treated, which is applicable princi ¬ palely that brain whose position is substantially fixed in the skull. But in the case of intervention on mobile and non-referenceable organs accurately relative to bone structure, such as the liver, for example, this approach is no longer envi¬ sageable to accurately guide the therapeutic procedure.

The present invention therefore a main object to solve the new technical problem consisting in providing a solution for referencing accurately a lesion to be treated within a surrounding medium, preferably an organ lying in the within a mammal, such as animals or humans, and use this reference for guiding the act thera- peutique, and this, regardless of the difficulty of observing the lesion during phase per -opératoire, or the movement of said lesion occurred between the time was carried réfé¬ the No. of said lesion and the time the act thérapeu¬ tick is carried out. The present invention further main aim to solve the new technical problem consisting in providing a solution allowing the surgeon to quickly find the best surgical approach that avoids damaging a sensitive organ at the time of 'surgery. The present invention further primary purpose of to solve the new technical problem consisting in providing a solution to optimize the acoustic field therapy dispo¬ operative part comprising electrical piézo¬ transducer elements to avoid destroying biological structures identified preserve that are crossed by the acous- tic field. The invention preferably allows automatic tracking of the target constituted by a lesion to destroy.

The present invention also aims to solve these new technical problems in a particularly simple, inexpensive, used on an industrial scale, permet¬ both during the intraoperative phase of the use of inexpensive marker means, easy to use, available in hospitals, such as conventional radiology device or ultrasound imaging device (ultrasound). The present invention solves these new technical problems in a simple, safe and reliable, repro¬ ductile, in an inexpensive way. The invention allows the traite¬ ment consists of target area of ​​soft tissue such as organs, and particularly benign or malignant tumors in these organs, these organs can thus be mobile and not référeπçables bodies accurately with respect to a bone structure such as the liver for example.

Advantageously, the invention also allows to steer the therapy device, especially an ultrasound device therapy as the best route first.

Thus, the present invention provides a lesion therapy device to be treated, situated in a surrounding medium such as an organ, in particular within the body of a fère mammi¬, such as an animal or a human being, comprising therapy means of said lesion, locating means of said lesion, said indexing means being related, for example mech * -_τ_qu_-ι * eπt or e_ £ c uιiqu - τιeπt, means therapy; a central ccππiande cα renaπt means for calculating the position of the lesion with respect to therapy means using the indexing means; and means for activating the therapy means to provide said therapy after acquisition of the position coordinates of said lesion, characterized in that said identification means performs the repé¬ rage of at least one marker element, made of a material REPE - maple by said locating means, previously implanted within said lesion, or in its vicinity or within the body wherein said lesion is located, said member optionally being capable of movement; said calculating means calculates the said marker element position coordinates relative to the therapy means which are used to position itself planned therapy means movable in space in any position along the axes X, Y, Z so that, upon activation of the activating means means of therapy, targeted treatment of said lesion is achieved.

According to an advantageous embodiment, said marker element is substantially previously located in the center of the lesion to be treated.

According to another advantageous alternative embodiment, multiple marker elements are previously implanted into the lesion to be treated so as to substantially mark all or most of the volume of the lesion to be treated.

According to an alternative embodiment particularly avan¬ tageuse at least four marker elements are previously implanted into the lesion to be treated, so as to form a Cartesian coordinate system within the lesion to be treated or body con- taining said lesion . Preferably, one of said elements is substantially four markers located in the center of the lesion to be treated, the other three marker elements being located such that all four marker elements is not located in the same plane. According to another advantageous embodiment, the aforementioned marker element is made of a compatible material bio¬.

According to another particular embodiment, the aforementioned marker element is made of a material not interfering with the treatment process or the process of tick diagnos¬, particularly not interfering acoustic waves focused avan¬ tageusement used for said therapy . Thus, preferably, the material of the marker element does not interfere with ultrasonic acoustic waves focused or focused acoustic shock waves emitted by means of therapy. In the case of ultrasonic therapy focused acoustic waves, it is preferred that the size of the marker element does not exceed a quarter of the ultrasound wavelength used.

According to another advantageous embodiment, the size of the marker element is less than about 2 mm, more preferably less than 1 mm and most preferably less than about 500 micrometers. In particular, the marker element is in the form of a ball or ring. The realization in the form of a ring is preferred because it limits or prevents migra¬ tion movement. According to a particularly advantageous embodiment, the marker element is made of a material selected from the group consisting of a biocompatible metal, preferably a noble metal such as gold, titanium or platinum; of contrast agent at least visible by said locating means associated with means of therapy, in particular by X and / or ultrasound rays; radioactive material for example of technetium and visible by any positive dis¬ ionizing radiation detector, for example a & - camera; a magnetic material; an emitter material of acoustic or electromagnetic waves. According to an advantageous embodiment, the marking of the target area is carried out by injection of air microbubbles visible marking means such as ultrasound. This embodiment has the advantage of not using foreign objects in the body to treat. One can observe that the marker elements according to the invention are readily implaπtables so extremely pré¬ cise inside the lesion to be treated at an earlier stage in therapy, for example in a radiology department physique¬ ment away from the operating room or even outside the hospital environment, with the use of tracking devices providing high-quality image such as scanners or so-called MRI imaging devices. A particularly inté¬ method ressant implantation of marker elements is to proceed by the use of a biopsy needle inserted into the lesion to be treated in the organ containing it within needle which is introduced the marker element to be brought inside said lesion, this operation being renou¬ calved as many times as is needed to introduce the desired number of markers, this operation being guided under ultrasound observation or permanently with the device repé¬ rage previously indicated.

Thus, when proceeding to the therapy of said lesion using the locating means of the therapy device, associated with means of therapy, to identify the one or more ele- ents markers in said lesion for guiding the very precise positioning therapy means relatively to the lesion to improve the lesion processing efficiency and in the entire volume of the lesion that is to be treated.

Thanks to the presence of at least one marker element implanted in the body and in a phase prior to the processing, especially shortly after the implantation, it is possible plans sections images of the lesion or organ containing the , from the tracking device providing high-quality image such as scanners or so-called MRI imaging devices, and in different orientation angles. The doctor can mentally imagine what will be the path of the sound field within the patient and what the biological structures to avoid and accordingly determine the best path first. This determination of the best surgical approach can be made easier and friendly to him using informa¬ ticks tools that are mostly commercially available and associated with the imaging device, to build a représen¬ tion in three dimensions cuts the patient.

Note that the first path is completely determined from a target point coordinates x, y, z which according to the invention will preferably the marker member and a direction or viewing direction, angular coordinates Ox, Oy, Oz. These data, to be usable at the time of treatment must be defined in a geometric reference that can be found at treatment which is achieved by the invention through the use of marker elements implanted in the body and which are visible on both image planes réa¬ ized at the time of, or shortly after implantation and the time of treatment. Thus, according to a particularly advantageous embodiment, the invention provides a therapy appliance comprising a central control means of therapy, which may be taken into account data defining the best route first means of therapy, said control unit controlling the movement therapy means for posi¬ OPERATE with the correct orientation according to the best path thus defined first. These data can be entered into the control unit for example by means of an interface or périphé¬ America member such as a keyboard. Thus, at the time of treatment, the presence of at least one marker element indicating the position of the lesion, such as a tumor, for example into a surrounding member, will greatly faci¬ liter labor physician. Indeed, by placing at least one élé¬ ment marker in the target area, it offers the physician a perfectly identifiable landmark that somehow allows him to aim the target area immediately and finally to be able to consecrate entirely to con¬ searching for the best surgical approach.

The invention thus eliminates the disadvantages of the prior art which contained no solution to intervene on moving parts and not referenceable with préci¬ sion over a bony structure, as is usually the case of tumors. However, tumors often have poorly defined and are, moreover, few easily identifiable. Their détec¬ tion should be generally conducted by experts such as radiologists. Under these conditions, the research work of a surgical approach is made more difficult because the manipulator must simultaneously target the tumor, which in itself is not easy, and even direct its detection device, especially an ultrasound probe around the tumor to identify the best surgical approach without losing the target point. The invention, as is apparent from the foregoing and the following description, allows to eliminate these drawbacks by the use of a marker element in the target area.

The invention provides according to yet another variant, to physically represent the ideal first path, marking the surface passage window patient ultrasonic waves.

For this, the invention proposes to use in an advantageous embodiment, a standard graphic écho¬ locator probe, giving an image plane "B mode", centered on the longitudinal axis of the probe. In addition, a device mar¬ quage, for marking the patient's skin, is made soli¬ dary of the imaging probe. The marking device may, for example, include a pen. The user then moves the ultrasonic probe on the patient's skin to visualize the treatment area as well as biological barriers to avoid. It can define the optimal acoustic window. During this déplace¬ ment, the marking device marks the patient's skin and marking in some way represents the projection on the patient's skin, the ideal surface of the ultrasound field that will prevent biological barriers.

According to yet another advantageous embodiment of the invention, it is possible to optimize the acoustic field therapy device comprising at least one multi-element transducer piezoelectric element such that the interaction between the sound field of the device therapy and biological struc¬ tures that make it barrier are practically inexis¬ aunts. In this case, it provides a therapeutic device trans¬ ducer multi-elements, such as rows of networks that can be annular, or mosaic structure, well known to the skilled artisan. In a first phase, is operated each of the transducer elements of the ultrasound therapy device user, that is to say in a manner identical to the operation of ultrasound imaging waves to detect by an electronic circuit acoustic echoes reflected by biological structures. This electronic circuit is completely identical to those used in ultrasound imaging. From these signals, it is possible to reconstruct images of biolo¬ cal structures through which the acoustic field therapy device that should be preserved. In case of detection of biological structures to be preserved in the path of certain elements trans¬ ducers, it is expected that the control unit does not control the power of the corresponding transducer elements to avoid destroying the identified biological structures. The inven¬ tion thus enables fully optimize the ultrasonic acoustic field vis-à-vis therapy device bio¬ logical obstacles, this automatically and perfectly reliable since the detecting agent (acoustic wave) congestion is the same as that used for making the therapy with the therapy device. The invention also enables a tick automa¬ target tracking due to the presence of the marker element at the center of the lesion to be destroyed which is used for an automatic détec¬ tion of the target formed by the lesion as well as 'to an automatic monitoring thereof, in particular upon movement for example under the effect of breathing, with respect to the therapy device in a fixed position assumed. implementation of devices of such an automatic tracking are well known to those skilled in the art.

According to a second aspect, the present invention also covers a method of therapeutic treatment of a lesion in a surrounding medium, such as an organ located within the body of a mammal, such as animal or human com¬ taking providing a therapy device comprising means for locating the lesion, therapy means the lesion, the locating means being associated with therapy means; a control unit comprising means for calculating the lesion coor¬ position data relative to the therapy means, and control means including means for therapy via the control unit for positioning a rea- Liser thereof in any position in space along the axes X, Y, Z based on the positional coordinates of said lesion, characterized in that realizes the prior implantation of at least one detectable marker member by said locating means attached to said means of therapy in said lesion at or near the lesion Inside said body;

- is carried out a tracking of said marker element by said means for identifying linked by means of therapy in the intraoperative phase; - is calculated using the aforementioned computing means of the marker element the position coordinates in a coordinate system related to therapy means;

- is carried out in relatively precise positioning of said marker element therapy means; and - one proceeds to the therapy of said lesion with the therapy means and positioned.

According to a preferred embodiment, is carried to the implantation of multiple marker elements in said lesion or organ in said prior to therapy. According to a particularly preferred embodiment, one uses at least four marker elements which is implanted préa¬ viously in said lesion and / or in said non-aligned way organ in a plane, to allow tracking of all or most of the volume of the lesion to be treated. According to another embodiment particularly avan¬ geous the method, at the time of implantation of at least the above-mentioned marker element or just after said implantation is carried out several shots of image cuts in different angular orientations, said element containing marker to determine the best route first, and is denoted by the coordinates of the path comprising the first coordonnnées of a target point x, y, z cons¬ tituées preferably by the marker element itself, and a coordinate orientation direction .theta.x, .theta.y, θz determined by the orientation marker means giving the picture cutting plan the best surgical approach, and finally notes or record all these data as the data in the best way first. Advantageously, these recorded or recorded data is used at the time of therapy for positioning the therapy means relatively to one 'marq- eur element related to the injury according to the best way to abrrα.

Other process embodiments are imme diately ¬ apparent to those skilled in the art from the foregoing description of the apparatus and also from the following explanatory description made with reference to a presently preferred embodiment a therapy device according to the invention.

For one or other of the foregoing aspects, it is pre ferred that ¬ Therapy means are com ¬ therapy means taking at least a focused ultrasonic transducer device, such as a spherical cup; or an acoustic shock wave generator device focused, for example by electro way as is known in the context of the lithotripsy.

On the other hand, as aforementioned locating means, it will preferably utili¬ an ultrasound device and / or a ray radiology device X. One can also use an electromagnetic wave sensor or acoustic waves or ionizing radiation detector as γ-camera.

In the present description and the claims, the term "stage intraoperative" The research phase of the ele- ments markers prior to the actual therapy. This research can be done naturally at the beginning of therapy but can be renewed as many times as desired by the practitioner during therapy or be continued in per¬ manence during the therapy while performing a real-time monitoring therapy through the marker elements. The invention thus allows an automatic detection of the lesion with the marker element and automatic tracking of the lesion in case of movement thereof for example under the effect of the res¬ piration, and a automated therapy controlled by a control unit comprising the aforementioned calculating means. Other objects, features and advantages of the invention will become apparent in light of the description expli¬ cant which follows with reference to the accompanying drawings repré¬ feeling a currently preferred embodiment of the invention given simply by way of illustration and can not therefore in any way limit the scope of the invention. In the drawings:

- Figure 1 shows schematically and in side view a therapy apparatus of the present invention for the treatment of a lesion, such as a tumor, located inside of an organ, e.g., liver, mammal, here a human being;

- Figure 2 schematically shows the pre-implantation procedure for at least one marker element uti l ized in the context of the present invention and showing an alternative embodiment for calculating the lesion position coordinates to be treated in the mark of the marker elements; and Figure 3 schematically represents the general method of therapy. ? - Figure 4 shows schematically a ¬ say positive therapy 12 'with its focal point F coincides with the MO marker element 0 in the organ, and its acoustic field with its path partially through a biological structure

BS; 5 - Figure 5 shows the acoustic signal emitted by the piezoelectric transducer element T2, not meeting with obstacles in its path with the echo signal of the marker element symbolized SMO exceeding the echo signal threshold set by reference, symbolically represented in dotted line, the functioning 0 ment of the transducer element being in A mode, that is to say linear signal; and Figure 6 shows an echo curve signal emitted by the piezoelectric transducer element T1 and showing an echo signal returned by the biological structure, referenced SBS a time t less than the time T of the echo signal The marker element MO identifying that T1 The transducer element has its acoustic field across a biological structure.

Referring to FIG 1, a therapy device is shown according to the present invention carrying the réfé¬ No. general numeral 10. This apparatus comprises means therapy represented by the general reference number 12. These means may therapy, for example, include a therapy device proper 14 by emitting surface 16 focusing naturelle¬ lies in having a shape of a spherical cup for focusing acoustic waves at a focal point f. These acoustic waves can be of acoustic shock waves, or sound ultra¬ acoustic CW. 12 therapy means may also comprise an integrated manner of the imaging means 18 here preferably arranged along the axis of symmetry of the device 14 acoustic wave generator to continuously observe the focal point F. These imaging means 18 may, for example, be constituted by an echographic probe, for example capable of performing a sector scan type B.

It should be noted that the therapy means 12 are preferably supported by an unillustrated supporting device capable of being controlled movement in space and rotating about these axes, through control means 20 suitable displacement, themselves controlled by a control unit 22 advantageously comprising calculation means such as a Calculation- Lateur, computer or microcomputer. According to an advantageous embodiment, the apparatus 10 also includes locating means represented by the general reference number 30, or 40. For example, the tracking means 30 are by way ultrasonic locating means comprising at least one ultrasound probe 32, for example mounted at the end

SUBSTITUTE SHEET of a robot arm 34 provided with elements position encoders in a Cartesian coordinate system x, y, z and the angular direction according to .theta.x angles .theta.y, θz, itself mounted on the frame of the apparatus 10, thereby allowing to determine the positional coordinates of 5 in the cartesian coordinate system x, y, z as well as angu¬ lar orientation as .theta.x angles .theta.y, θz tracking means 30 relative to the frame 36 of the '10 and thus apparatus relative to the therapy means 12. These position coordinates and the images provided by the tracking means 30 are transmitted to the 0 central control 22 by appropriate means 38. Similarly, other means of register 40 may, for example, comprise at least one source register 42 to X-rays, preferably that described in the previous patent Techno ed F -A-2,665,545 and which is movable between two distinct positions as symbolized - 5 by the fl che R and whose data are transmitted to the control unit 22 by means of transmission appro¬ invited 48 well known to the man of art.

On the frame 36 of the apparatus, in particular a generally horizontal table 50, it has been provided an opening

__ 52 allowing the passage of acoustic waves therapy symbo¬ lisées by the cone C of focus. On this table, a patient P is elongated member including a 0, for example by the liver has a lesion L, such as a benign or malignant tumor which can understand that it occupies a certain volume within

<-.-. the member 0.

According to the present invention and by a prior step shown in FIG 2, it was implanted in the organ 0, more particularly into the lesion L or the vicinity of said lesion, at least one marker element M, preferably here four elements identified markers respect tively MO, M1, M2 and M3. One of said marker elements, here the MO element is preferably incorporated substantially at the center of the lesion L, as the three marker elements M1, M2 and M3 have been implanted in voisi¬ swimming said lesion, eg 'M1 marker element is incor- pore 35 at the border of the lesion L and elements markers M2 and M3 are incorporated in the vicinity of the lesion L in the organ 0. It should be noted that preferably all of the marker elements MO, Ml, M2 and M3 are not contained in the same plane. All of these marker elements to define a geometric reference as tésien ¬ x, y and z and the angular directions .theta.x, .theta.y, θz. In addition, to the right of Figure 1, OX arrows

OY and OZ defining the geometric Cartesian reference détermina¬ tion of position coordinates x, y, z direction and angu¬ lar .theta.x, .theta.y, θz in the space therapy means 12, these axes OX, OY and OZ being the movement axes in the space therapy means 12 by the moving means ¬ 20. Furthermore, the actuating means therapy means 12 are indicated by reference numeral 60, these means actuation being themselves controlled by the central com¬ Mande 22. Finally, the control unit 22 may also receive by appropriate means 70 oositioπ coordinates x, y, x, and directing .theta.x angular orientation, .theta.y, θz, of the lesion L to be treated in the reference markers elements MO, M1, M2 and M3 calculated separately, after implantation of the marker elements in the lesion L.

Thus, Figure 2 schematically shows the step of implanting the marker elements MO, M1, M2 and M3 in the lesion L within the organ 0 itself inside the body a patient P, for example with the aid of a biopsy needle 80. the marker elements are, for example, constituted by a ball that is slid inside the biopsy needle 80 until to arrive at the indicated positions. This place has implanta¬ tion under control of imaging means providing a very accurate picture of the lesion L, preferably a scanner or imaging means magnetic resonance imaging, MRI, available (s) in a specialized radiology center allowing the highly accurate, reliable and repeatable positioning of the marker elements posi¬ desired tions in the lesion L and / or the organ 0 containing the lesion L. can also achieve the same location under ultrasound or X-ray was shown schematically in 2 shows a scanner 90 operative part dispo¬ moving successively from the position 1 to the position n to obtain n image planes in serially cut to obtain a complete image of the organ 0, L of the lesion and elements MO to M3 markers through conventional imaging means combined referenced 92, whose data are transmitted to a data center 94 comprising at least one calculat eur, computer or microcomputer. According to a preferred feature of the invention will, this central computer 94 is integrated with the control unit 22. In this case, the scanner 90, as is also conventional, comprises means for storing all data collected, for example on a floppy disk which can then be used with the control unit 22 so that the stored data is analyzed and processed by the calculating means of the control unit 22, the input of these data being symbo¬ Lisée by the box 70. Thus, the calculation means 94 either separate or integrated to the control unit 22 calculates the position coordinates x, y, z and advantageously towards .theta.x angular orientation, .theta.y, θz, of the lesion L to be treated in the coordinate system of the marker elements MO, Ml, M2 and M3, where this additional step not currently required is desired. The invention ppr and so determine the best surgical approach.

Referring to Figure 3, the general method is shown therapy that includes two variants. According to the basic embodiment, it com¬ therapy method takes two steps A and B, a first step A of implanting the marker elements in the lesion L or the vicinity thereof, of the organ to be treated as clearly 0 understandable from a consideration of Figure 2; and a second step B of treat- ment itself comprising firstly the identification of markers MO, M1, M2 and M3 with the locating means 30 or 40, then a step of calculation of the lesion L position coordinate in the geometric reference 0X, 0Y, 0Z 12 therapy means; then the positioning in space by moving along the axes OX, OY and OZ therapy means 12 so that the point or focal zone F is positioned with respect to the lesion to be treated to achieve treatment of a point the lesion and then by successive displacement item by item, is performed processing of the full volume of the lesion L. the efficacy of treatment of each point is monitored in real time thanks to the presence of the auxiliary display means 18, 32 or 42 , continuously giving an image of the focal point by the imaging means 96, 38 or 48, whose data can also be transmitted to the control unit 22 and can be used at the end of treatment to control post-operative imaging .

According to an embodiment variant shown in Figure 2, which represents an intermediate step C between Step A and Step B, one can proceed with the calculation of the lesion position coordinates to be treated in the coordinate system of the marker elements MO M1, M2 and M3, using imaging techniques, such as those 90 that were used to achieve the precise location of marker elements in the lesion L. One technique is to iden- tify on each image Mapping The body of the lesion to be treated and markers to obtain a three-dimensional presentation repré¬. A calculation then determines the coordinates of each point of the lesion to be treated in the geometric reference markers elements MO, M1, M2 and M3. These coordinates are then used to perform the calculation of the lesion position coordinates in the coordinate system OX, OY and OZ of displacement 12 therapy means.

The invention also makes from successive image cutting planes in particular in different angular orientations, from the locating means in particular high definition image as used for implanting the marker element such as scanner or MRI, to determine the best way initially and so the coordinates of .theta.x angular orientation, and .theta.y

θz SUBSTITUTE SHEET of the best route first which are then used at the time of processing for setting the angu¬ lar orientation position of the best route first therapy means 12, particularly in the mark OX, OY and OZ. This can be achieved simply by entering these θz angular position coordinates, βy and θz with the X position coordinate, Y, Z in the control unit 22 of the treatment means 12, for example using an interface or a peripheral device such as a keyboard.

It is understood that when the lesion L has a simple geometric shape, for example substantially spherical, as is the case of some tumors, it is only necessary to uti¬ Liser a marker element MO advantageously substantially at the center of the lesion L and in this case said step C is super¬ flue. However, when the lesion L with complex geometric shapes, while it is essential for precise full therapeutic treatment of the lesion, to install several marker elements, and preferably at least four, as shown, to obtain a geometric tracking wherein one can geometrically define the volume of the lesion. In that case. The calculations are complex, it is preferable to carry out step C which allows to separately and previously calculated the lesion position coordinates to be treated in the reference markers elements MO, M1, M2 and M3, which enables the calculation of the coordinates of the lesion in the coordinate system OX, OY and OZ after repé¬ rage of marker elements by the means for identifying 30 or 40.

It is thus understood that the invention allows for a precise processing, efficient, safe and reproducible by prati¬ cians not specialists in imaging technology, which is the case of the doctor who is obviously not a radiologist.

Furthermore, the invention allows decisively to achieve a fully automated process that is made possible by the presence of at least one marker element to provide a significant contrast to enable automatic detection of this marker element by the means of identification 30 or 40, so the position of the lesion then to automatically position the therapy means next to the injury and treat it without the intervention par¬ ticular the treating physician. It should be noted that the accompanying drawings of Figures 1 to 3 are part of the invention and thus of the present description. The invention also covers all the means appa¬ raissent be new vis-à-vis a state of technical quel¬ conch. Furthermore, the invention allows the traite¬ ment of any lesion that can be treated by acoustic waves, as is the case for all the benign or malignant tumors such as cancers. Particularly preferred applications are currently primitive and secondary liver cancer, the pan 5 créas. prostate cancer, breast cancer, bladder cancer, kidney and in general of all organs.

On the other hand. The invention also provides the decisive advantage that even in the case of bodies that move for example under the effect of breathing, the presence of elements 0 markers can automatically follow the movement of the body, thus ensuring effectively an automatic treatment of the lesion in said movable member. The invention also enables a monitoring of the same target in the case of movement of the positive dis¬ therapy with respect to the target, which may occur in the 5 case of a treatment or therapy device would simply be hand held. The invention thus advantageously consider manual treatments. détec¬ devices ae tion and automatic tracking of the target are known to those skilled in

1'art. 0 Finally, the invention also enables a sent of all lesions trai¬ located in a mobile body and not refer- rençable accurately with respect to a bone structure, and preferably in the best way initially, which was very difficult to achieve and even less reproducibly

- * • - -. under the previous solutions. The Figures 1 to 6 attached are an integral part of the invention and therefore the description.

Referring to Figure 4, there is shown an alternative embodiment of the treatment device 12 'as a transparent multi-element piezoelectric ducer. The transducers multi elements are well known to the skilled artisan. They may be rows of networks that can be annular, or mosaic structure as shown in Figure 4 being composed of a plurality of elements T, T, T. The therapy device 12 'focuses the acoustic field at the focal point F which is brought into coincidence with the marker element MO in the center of the lesion L, such as a tume ur benign or malignant, located itself in the member 0 which can be for example the liver, this member being movable relative to the patient's bony structures P (Figure 1). BS biological structures can be partielle¬ lies in the path of the individual transducer elements such as particular T .. For against, for example, T. The transducer element, has no obstacles formed by a biological structure in its path acoustic. This biological structure may, for example, be bone, or a sensitive organ such as a lung for example, as shown in Figure 4.

In this case, the invention optimizes the acoustic field of the treatment device 12 'such that the interaction between the sound field of the treatment device and the biological structures that make it obstacle are pratique¬ ment nonexistent. According to the invention, is operated in a first time each of the transducer elements such that T .., T, to T-mode ultrasound, that is to say in a manner identical to the operation of imaging probes ultrasound. Each element such as T, T, sends a pulse acous¬ tick and detects an electronic circuit by acoustic echoes reflected by the biological structures. This electronic circuit

SUBSTITUTE SHEET being completely identical to those used in graphic imaging écho¬. From these signals, it is possible to reconstruct images of biological structures BS traversed by the acoustic field of the treatment device 12 'and in particular deter- mine αuels are the transducer elements tslε "" uǫ siqnal T which passes through the structure biological BS.

As shown in Figures 5 and 6, it is possible to use directly the electrical signal of linear echo return, or A mode before being used for the forma¬ tion of images. Therefore, it is possible, for example, give the desired that any echo signal or an amplitude greater than a threshold déter¬ undermined shown in Figures 5 and 6 by the dotted line, and appearing before the time T corresponding to an echo signal from the focal point and resulting from the presence of the marker element MO (referenced signal SMO), is detected as an echo emitted by a highly reflective biological structure and therefore may obstruct the ultrasonic field such as a tissue / air interface or tissue / bone is shown in Figure 6 by the signal biological structure abbreviated SBS appearing at instant t much less than time T of the normal echo signal of the marker element at the point focal.

Thus, we can identify the individual trans¬ ducers items such as T have their acoustic path an obstacle to preserve. It is thus possible to integrate the control unit 22 the data relating to the transducer elements such as T. not activate during therapy to avoid destroying biological structures identified to perfectly optimize the ultrasonic sound field vis-a -vis biological barriers. It is understood that the invention allows to do automatically and completely reliable since the detection agent (SAW) BS barriers is the same as that used to perform the therapy.

Furthermore, the invention covers any characteristic resulting from the description, incorporating drawings, which appears to be novel vis-à-vis a state of the any technique.

Claims

1. Therapy device (10) of a lesion (L) to be treated, situated in a surrounding medium such as an organ (0), in particu- link within the body of a mammal, such that an animal or a human being, of the type comprising means (12) for therapy of said lesion (L), locating means (30 or 40) of said lesion (L), said locating means (30 or 40) for example linked mechanically (34, 36) or electronically, the therapy means (12); ? A central control (22) c-_πp enaπt means for calculating the position of the lesion with respect to therapy means using the indexing means (30 or 40); and activation means (22,60), therapy means (12) for performing said therapy after acqui¬ sition position coordinates of said lesion (L), characterizes in that said locating means (30 or 40) perform identification of at least one marker member (MO, M1, M2, M3), made of a material detectable by said locating means (30 or 40), previously implanted within said lesion (L ), or in its vicinity or inside of the member (0) wherein said lesion is located, said member (0) optionally being capable of movement; said calculating means (22, 70) calculates the coor¬ position data of said marker element (MO, M1, M2, M3) relative to the therapy means (12) which are used to posi¬ OPERATE therapy means (12 ) provided movable in space in any position along the axes X, Y, Z (by means 20) so that, upon activation means activa¬ tion (22, 60) of the therapy means ( 12), a targeted treatment of said lesion (L) is achieved.
2. Apparatus according to claim 1, characterized in that the aforesaid marker element (MO), is established previously sen¬ siblement the center of the lesion to be treated (L).
3. Apparatus according to claim 1 or 2, characterized in that a plurality of marker elements (MO, M1, M2, M3) are préala¬ ably implanted into the lesion (L) to be treated so as to substantially mark all or Much the volume of the lesion to be treated.
4. Apparatus according to one of claims 1 to 3, carac¬ terized in that it comprises at least four marker elements (MO, M1, M2, M3) which are previously implanted into the lesion (L) to be treated, to form a Cartesian coordinate system within the lesion (L) to be treated or of the member (0) containing Said
injury; preferably, one (MO) of said four marker elements is substantially located in the center of the lesion to be treated, the other three marker elements (M1, M2, M3) being located so that all four markers elements is not located in the same plane.
5. Apparatus according to one of claims 1 to 4, carac¬ acterized in that the aforesaid marker element (MO, M1, M2, M3) is made of a biocompatible material, preferably a material which does not disturb the process The therapeutic or diagnostic process, in particular not disrupting acous¬ waves focused ticks advantageously used for therapy.
6. Apparatus according to one of claims 1 to 5, carac¬ terized in that the tracer material (MO, M1, M2, M3) does not interfere with ultrasonic acoustic waves focused or acoustic shock waves focused issued by therapy means (12).
7. An apparatus according to Claim 6, characterized in that in the case of a therapy by ultrasonic acoustic waves focused Issued by therapy means (12), the dimension of the marker element (MO, M1, M2, M3) does not exceed one quarter of the
used ultrasound wavelength.
8. Apparatus according to one of claims 1 to 7, carac¬ terized in that the size of the marker element (MO, M1, M2, M3) is less than about 2 mm, more preferably less than 1 mm and ideally less than about 500 .mu.m, in particular the marker element is in the form of a ball or ring.
9. Apparatus according to one of claims 1 to 7, carac¬ terized in that the marker element (MO, M1, M2, M3) mentioned above is made of a material selected from the group consisting of a biocompatible metal, preferably a noble metal such as gold, titanium or platinum; of contrast agent at least visible by said locating means (30 or 40) Related to therapy means (12), in particular by X and / or ultrasonic radiation, air microbubbles; a radioactive substance for example technetium-type; a magnetic material; maté.iau a transmitter of acoustic or electromagnetic waves.
10. Apparatus according to one of the preceding claims, characterized in that the means of treatment (12) are therapy means comprising at least one ultra-sonic transducer means focused (14), for example in the form of cup sphé- America ; or an acoustic shock wave generator device focused, for example by electrohydraulic means.
11. Apparatus according to one of the preceding claims, characterized in that the locating means comprises an ultrasound device (32) and / or a ray radiology device X (42) or an ionizing radiation detector as that γ- camera, an electromagnetic wave detector or wave acous¬ ticks.
12. Apparatus according to one of the preceding claims, characterized in that it is a therapy device of all lesions treatable by acoustic waves, such as benign or malignant tumors such as cancers, in particular primitive and secondary liver cancers, pancreas, prostate cancer, breast cancer, bladder cancer, kidney and in general all organs, these organs may optionally be movable, for example under the effect breathing.
13. Apparatus according to any preceding claim, characterized in that the activation means pré¬ mentioned (22, 60) comprises a control unit (22) by locating means (30, 40 and 18) auto¬ matically detecting the marker elements (MO, Ml, M2, M3) and thus the lesion to be treated.
14. Apparatus according to any preceding claim, characterized in that the aforesaid activatioπ means (22, 60) comprises a control unit (22) by .'30 locating means, 40 and 18) identifying the ele ments ¬ markers (MO, Ml, M2, M3), to automatically track the movements of the body containing the lesion (L), thereby effectively providing automatic treatment of the lesion in said same member if mobile .
15. Apparatus according to any preceding claim, characterized in that it comprises fine imaging means, in particular computed tomography, magnetic resonance by said MRI to proceed before the operation at a Localisa¬ tion space of the target area relative to the marker, the means of the aforementioned calculations to determine the position coordinates of the lesion relative to the coordinate system defined by the marker elements (MO, M1, M2, M3).
16. Apparatus according to any preceding claim, characterized in that the locating means (30 or 40) allow to perform several successive sectional planes according to different angular orientations, containing said at least one marker element, for determining a data set including the lesion position coordinates of the x, y, z and a direction of angular orientation & x, .theta.y, θz according to the best route first.
17. Apparatus according to any preceding claim, characterized in that the com¬ therapy device takes a plurality of transducer elements T, T "T for example disposed in mosaic, and the control unit (22) pré¬ cited does not activate the transducer elements such that the ultrasonic path T. whose cross biological structures BS (Figure 4).
PCT/FR1993/000081 1992-01-28 1993-01-27 Apparatus for treating a target such as a lesion with a tracer element WO1993014712A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
FR9200884A FR2686499A1 (en) 1992-01-28 1992-01-28 An apparatus for processing a target, such as a lesion within the body of a mammal, especially a human being, using a marker element implanted in or adjacent the target to control the therapy of said target.
FR92/00884 1992-01-28

Publications (1)

Publication Number Publication Date
WO1993014712A1 true WO1993014712A1 (en) 1993-08-05

Family

ID=9426042

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/FR1993/000081 WO1993014712A1 (en) 1992-01-28 1993-01-27 Apparatus for treating a target such as a lesion with a tracer element

Country Status (2)

Country Link
FR (1) FR2686499A1 (en)
WO (1) WO1993014712A1 (en)

Cited By (37)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998038919A2 (en) * 1997-03-04 1998-09-11 Biotrack, Inc. Medical sensing and imaging system
US6161034A (en) * 1999-02-02 2000-12-12 Senorx, Inc. Methods and chemical preparations for time-limited marking of biopsy sites
US6662041B2 (en) 1999-02-02 2003-12-09 Senorx, Inc. Imageable biopsy site marker
US6725083B1 (en) 1999-02-02 2004-04-20 Senorx, Inc. Tissue site markers for in VIVO imaging
US6731966B1 (en) 1997-03-04 2004-05-04 Zachary S. Spigelman Systems and methods for targeting a lesion
US6862470B2 (en) 1999-02-02 2005-03-01 Senorx, Inc. Cavity-filling biopsy site markers
US7787936B2 (en) 2004-01-23 2010-08-31 Traxyz Medical, Inc. Methods and apparatus for performing procedures on target locations in the body
US7981051B2 (en) 2005-08-05 2011-07-19 Senorx, Inc. Biopsy device with fluid delivery to tissue specimens
US7983734B2 (en) 2003-05-23 2011-07-19 Senorx, Inc. Fibrous marker and intracorporeal delivery thereof
US8157862B2 (en) 1997-10-10 2012-04-17 Senorx, Inc. Tissue marking implant
US8311610B2 (en) 2008-01-31 2012-11-13 C. R. Bard, Inc. Biopsy tissue marker
US8343071B2 (en) 2004-12-16 2013-01-01 Senorx, Inc. Biopsy device with aperture orientation and improved tip
US8361082B2 (en) 1999-02-02 2013-01-29 Senorx, Inc. Marker delivery device with releasable plug
US8401622B2 (en) 2006-12-18 2013-03-19 C. R. Bard, Inc. Biopsy marker with in situ-generated imaging properties
US8437834B2 (en) 2006-10-23 2013-05-07 C. R. Bard, Inc. Breast marker
US8447386B2 (en) 2003-05-23 2013-05-21 Senorx, Inc. Marker or filler forming fluid
US8486028B2 (en) 2005-10-07 2013-07-16 Bard Peripheral Vascular, Inc. Tissue marking apparatus having drug-eluting tissue marker
US8498693B2 (en) 1999-02-02 2013-07-30 Senorx, Inc. Intracorporeal marker and marker delivery device
US8579931B2 (en) 1999-06-17 2013-11-12 Bard Peripheral Vascular, Inc. Apparatus for the percutaneous marking of a lesion
US8634899B2 (en) 2003-11-17 2014-01-21 Bard Peripheral Vascular, Inc. Multi mode imaging marker
US8668737B2 (en) 1997-10-10 2014-03-11 Senorx, Inc. Tissue marking implant
US8670818B2 (en) 2008-12-30 2014-03-11 C. R. Bard, Inc. Marker delivery device for tissue marker placement
US8718745B2 (en) 2000-11-20 2014-05-06 Senorx, Inc. Tissue site markers for in vivo imaging
US8784433B2 (en) 2002-06-17 2014-07-22 Senorx, Inc. Plugged tip delivery tube for marker placement
USD715442S1 (en) 2013-09-24 2014-10-14 C. R. Bard, Inc. Tissue marker for intracorporeal site identification
USD715942S1 (en) 2013-09-24 2014-10-21 C. R. Bard, Inc. Tissue marker for intracorporeal site identification
USD716451S1 (en) 2013-09-24 2014-10-28 C. R. Bard, Inc. Tissue marker for intracorporeal site identification
USD716450S1 (en) 2013-09-24 2014-10-28 C. R. Bard, Inc. Tissue marker for intracorporeal site identification
US8915864B2 (en) 2005-08-05 2014-12-23 Senorx, Inc. Biopsy device with fluid delivery to tissue specimens
US9095325B2 (en) 2005-05-23 2015-08-04 Senorx, Inc. Tissue cutting member for a biopsy device
US9149341B2 (en) 1999-02-02 2015-10-06 Senorx, Inc Deployment of polysaccharide markers for treating a site within a patient
US9327061B2 (en) 2008-09-23 2016-05-03 Senorx, Inc. Porous bioabsorbable implant
US9408592B2 (en) 2003-12-23 2016-08-09 Senorx, Inc. Biopsy device with aperture orientation and improved tip
US9579077B2 (en) 2006-12-12 2017-02-28 C.R. Bard, Inc. Multiple imaging mode tissue marker
US9820824B2 (en) 1999-02-02 2017-11-21 Senorx, Inc. Deployment of polysaccharide markers for treating a site within a patent
US9848956B2 (en) 2002-11-18 2017-12-26 Bard Peripheral Vascular, Inc. Self-contained, self-piercing, side-expelling marking apparatus
US10010380B2 (en) 1998-06-22 2018-07-03 Devicor Medical Products, Inc. Biopsy localization method and device

Families Citing this family (20)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5411026A (en) * 1993-10-08 1995-05-02 Nomos Corporation Method and apparatus for lesion position verification
US6175760B1 (en) * 1998-02-17 2001-01-16 University Of Iowa Research Foundation Lesion localizer for nuclear medicine
EP1341465B1 (en) 1998-05-14 2010-01-27 Calypso Medical, Inc System for locating and defining a target location within a human body
US20020193685A1 (en) 2001-06-08 2002-12-19 Calypso Medical, Inc. Guided Radiation Therapy System
US9682253B2 (en) 2002-06-05 2017-06-20 Varian Medical Systems, Inc. Integrated radiation therapy systems and methods for treating a target in a patient
US9248003B2 (en) 2002-12-30 2016-02-02 Varian Medical Systems, Inc. Receiver used in marker localization sensing system and tunable to marker frequency
US7912529B2 (en) 2002-12-30 2011-03-22 Calypso Medical Technologies, Inc. Panel-type sensor/source array assembly
US7926491B2 (en) 2002-12-31 2011-04-19 Calypso Medical Technologies, Inc. Method and apparatus for sensing field strength signals to estimate location of a wireless implantable marker
US7684849B2 (en) 2003-12-31 2010-03-23 Calypso Medical Technologies, Inc. Marker localization sensing system synchronized with radiation source
US9623208B2 (en) 2004-01-12 2017-04-18 Varian Medical Systems, Inc. Instruments with location markers and methods for tracking instruments through anatomical passageways
US8437449B2 (en) 2004-07-23 2013-05-07 Varian Medical Systems, Inc. Dynamic/adaptive treatment planning for radiation therapy
WO2006023055A2 (en) 2004-07-23 2006-03-02 Calypso Medical Technologies, Inc. Systems and methods for real time tracking of targets in radiation therapy and other medical applications
US8095203B2 (en) 2004-07-23 2012-01-10 Varian Medical Systems, Inc. Data processing for real-time tracking of a target in radiation therapy
US7899513B2 (en) 2004-07-23 2011-03-01 Calypso Medical Technologies, Inc. Modular software system for guided radiation therapy
US9586059B2 (en) 2004-07-23 2017-03-07 Varian Medical Systems, Inc. User interface for guided radiation therapy
BRPI0515007A (en) 2004-08-12 2008-07-01 Navotek Medical Ltd computerized system for tracking and radiated ionization source location, direction sensor located in a source of ionizing radiation, method to determine the device's location, location, device manufacturing method and use of ionizing radiation protection
AT499055T (en) 2007-12-18 2011-03-15 Storz Medical Ag Navigation in the focused pressure wave treatment
EP2293720A4 (en) 2008-06-05 2017-05-31 Varian Medical Systems, Inc. Motion compensation for medical imaging and associated systems and methods
US10043284B2 (en) 2014-05-07 2018-08-07 Varian Medical Systems, Inc. Systems and methods for real-time tumor tracking
US9919165B2 (en) 2014-05-07 2018-03-20 Varian Medical Systems, Inc. Systems and methods for fiducial to plan association

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3919592A1 (en) * 1988-08-19 1990-02-22 Olympus Optical Co Ultrasonic treatment system
DE3902249A1 (en) * 1989-01-26 1990-08-02 Bodenseewerk Geraetetech Method of fixing the position of predetermined sites in the human body
EP0382392A1 (en) * 1989-02-06 1990-08-16 C.R. Bard, Inc. Ultrasound targeting system for shockwave lithotripsy
DE3940260A1 (en) * 1989-03-04 1990-09-13 Werner Weitschies Position determining appts. for objects or body constituents - introduces ferromagnetic substances to enable location of objects due to their magnetic field using field sensors
EP0429148A1 (en) * 1989-11-15 1991-05-29 George S. Allen Method and apparatus for imaging the anatomy
EP0444680A1 (en) * 1990-02-28 1991-09-04 Kabushiki Kaisha Toshiba Apparatus for performing medical treatment by using electroacoustic transducer element

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3919592A1 (en) * 1988-08-19 1990-02-22 Olympus Optical Co Ultrasonic treatment system
DE3902249A1 (en) * 1989-01-26 1990-08-02 Bodenseewerk Geraetetech Method of fixing the position of predetermined sites in the human body
EP0382392A1 (en) * 1989-02-06 1990-08-16 C.R. Bard, Inc. Ultrasound targeting system for shockwave lithotripsy
DE3940260A1 (en) * 1989-03-04 1990-09-13 Werner Weitschies Position determining appts. for objects or body constituents - introduces ferromagnetic substances to enable location of objects due to their magnetic field using field sensors
EP0429148A1 (en) * 1989-11-15 1991-05-29 George S. Allen Method and apparatus for imaging the anatomy
EP0444680A1 (en) * 1990-02-28 1991-09-04 Kabushiki Kaisha Toshiba Apparatus for performing medical treatment by using electroacoustic transducer element

Cited By (67)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6731966B1 (en) 1997-03-04 2004-05-04 Zachary S. Spigelman Systems and methods for targeting a lesion
WO1998038919A3 (en) * 1997-03-04 1998-12-30 Biotrack Inc Medical sensing and imaging system
US6119033A (en) * 1997-03-04 2000-09-12 Biotrack, Inc. Method of monitoring a location of an area of interest within a patient during a medical procedure
WO1998038919A2 (en) * 1997-03-04 1998-09-11 Biotrack, Inc. Medical sensing and imaging system
US8157862B2 (en) 1997-10-10 2012-04-17 Senorx, Inc. Tissue marking implant
US8668737B2 (en) 1997-10-10 2014-03-11 Senorx, Inc. Tissue marking implant
US9039763B2 (en) 1997-10-10 2015-05-26 Senorx, Inc. Tissue marking implant
US10010380B2 (en) 1998-06-22 2018-07-03 Devicor Medical Products, Inc. Biopsy localization method and device
US10172674B2 (en) 1999-02-02 2019-01-08 Senorx, Inc. Intracorporeal marker and marker delivery device
US6862470B2 (en) 1999-02-02 2005-03-01 Senorx, Inc. Cavity-filling biopsy site markers
US6725083B1 (en) 1999-02-02 2004-04-20 Senorx, Inc. Tissue site markers for in VIVO imaging
US6996433B2 (en) 1999-02-02 2006-02-07 Senorx, Inc. Imageable biopsy site marker
US7047063B2 (en) 1999-02-02 2006-05-16 Senorx, Inc. Tissue site markers for in vivo imaging
US7565191B2 (en) 1999-02-02 2009-07-21 Senorx, Inc. Tissue site markers for in vivo imaging
US6662041B2 (en) 1999-02-02 2003-12-09 Senorx, Inc. Imageable biopsy site marker
US6567689B2 (en) 1999-02-02 2003-05-20 Senorx, Inc. Methods and chemical preparations for time-limited marking of biopsy sites
US9044162B2 (en) 1999-02-02 2015-06-02 Senorx, Inc. Marker delivery device with releasable plug
US6427081B1 (en) 1999-02-02 2002-07-30 Senorx, Inc. Methods and chemical preparations for time-limited marking of biopsy sites
US8219182B2 (en) 1999-02-02 2012-07-10 Senorx, Inc. Cavity-filling biopsy site markers
US6161034A (en) * 1999-02-02 2000-12-12 Senorx, Inc. Methods and chemical preparations for time-limited marking of biopsy sites
US9861294B2 (en) 1999-02-02 2018-01-09 Senorx, Inc. Marker delivery device with releasable plug
US9149341B2 (en) 1999-02-02 2015-10-06 Senorx, Inc Deployment of polysaccharide markers for treating a site within a patient
US8361082B2 (en) 1999-02-02 2013-01-29 Senorx, Inc. Marker delivery device with releasable plug
US9820824B2 (en) 1999-02-02 2017-11-21 Senorx, Inc. Deployment of polysaccharide markers for treating a site within a patent
US8965486B2 (en) 1999-02-02 2015-02-24 Senorx, Inc. Cavity filling biopsy site markers
US9237937B2 (en) 1999-02-02 2016-01-19 Senorx, Inc. Cavity-filling biopsy site markers
US9649093B2 (en) 1999-02-02 2017-05-16 Senorx, Inc. Cavity-filling biopsy site markers
US8498693B2 (en) 1999-02-02 2013-07-30 Senorx, Inc. Intracorporeal marker and marker delivery device
US8626270B2 (en) 1999-02-02 2014-01-07 Senorx, Inc. Cavity-filling biopsy site markers
US6993375B2 (en) 1999-02-02 2006-01-31 Senorx, Inc. Tissue site markers for in vivo imaging
US9579159B2 (en) 1999-06-17 2017-02-28 Bard Peripheral Vascular, Inc. Apparatus for the percutaneous marking of a lesion
US8579931B2 (en) 1999-06-17 2013-11-12 Bard Peripheral Vascular, Inc. Apparatus for the percutaneous marking of a lesion
US8718745B2 (en) 2000-11-20 2014-05-06 Senorx, Inc. Tissue site markers for in vivo imaging
US8784433B2 (en) 2002-06-17 2014-07-22 Senorx, Inc. Plugged tip delivery tube for marker placement
US9848956B2 (en) 2002-11-18 2017-12-26 Bard Peripheral Vascular, Inc. Self-contained, self-piercing, side-expelling marking apparatus
US8639315B2 (en) 2003-05-23 2014-01-28 Senorx, Inc. Marker or filler forming fluid
US9801688B2 (en) 2003-05-23 2017-10-31 Senorx, Inc. Fibrous marker and intracorporeal delivery thereof
US8626269B2 (en) 2003-05-23 2014-01-07 Senorx, Inc. Fibrous marker and intracorporeal delivery thereof
US7983734B2 (en) 2003-05-23 2011-07-19 Senorx, Inc. Fibrous marker and intracorporeal delivery thereof
US8880154B2 (en) 2003-05-23 2014-11-04 Senorx, Inc. Fibrous marker and intracorporeal delivery thereof
US10045832B2 (en) 2003-05-23 2018-08-14 Senorx, Inc. Marker or filler forming fluid
US8447386B2 (en) 2003-05-23 2013-05-21 Senorx, Inc. Marker or filler forming fluid
US8634899B2 (en) 2003-11-17 2014-01-21 Bard Peripheral Vascular, Inc. Multi mode imaging marker
US9408592B2 (en) 2003-12-23 2016-08-09 Senorx, Inc. Biopsy device with aperture orientation and improved tip
US7787936B2 (en) 2004-01-23 2010-08-31 Traxyz Medical, Inc. Methods and apparatus for performing procedures on target locations in the body
US8343071B2 (en) 2004-12-16 2013-01-01 Senorx, Inc. Biopsy device with aperture orientation and improved tip
US10105125B2 (en) 2004-12-16 2018-10-23 Senorx, Inc. Biopsy device with aperture orientation and improved tip
US8360990B2 (en) 2004-12-16 2013-01-29 Senorx, Inc. Biopsy device with aperture orientation and improved tip
US9095325B2 (en) 2005-05-23 2015-08-04 Senorx, Inc. Tissue cutting member for a biopsy device
US9750487B2 (en) 2005-05-23 2017-09-05 Senorx, Inc. Tissue cutting member for a biopsy device
US8915864B2 (en) 2005-08-05 2014-12-23 Senorx, Inc. Biopsy device with fluid delivery to tissue specimens
US10064609B2 (en) 2005-08-05 2018-09-04 Senorx, Inc. Method of collecting one or more tissue specimens
US7981051B2 (en) 2005-08-05 2011-07-19 Senorx, Inc. Biopsy device with fluid delivery to tissue specimens
US8486028B2 (en) 2005-10-07 2013-07-16 Bard Peripheral Vascular, Inc. Tissue marking apparatus having drug-eluting tissue marker
US8437834B2 (en) 2006-10-23 2013-05-07 C. R. Bard, Inc. Breast marker
US9901415B2 (en) 2006-12-12 2018-02-27 C. R. Bard, Inc. Multiple imaging mode tissue marker
US9579077B2 (en) 2006-12-12 2017-02-28 C.R. Bard, Inc. Multiple imaging mode tissue marker
US8401622B2 (en) 2006-12-18 2013-03-19 C. R. Bard, Inc. Biopsy marker with in situ-generated imaging properties
US9042965B2 (en) 2006-12-18 2015-05-26 C. R. Bard, Inc. Biopsy marker with in situ-generated imaging properties
US8311610B2 (en) 2008-01-31 2012-11-13 C. R. Bard, Inc. Biopsy tissue marker
US9327061B2 (en) 2008-09-23 2016-05-03 Senorx, Inc. Porous bioabsorbable implant
US8670818B2 (en) 2008-12-30 2014-03-11 C. R. Bard, Inc. Marker delivery device for tissue marker placement
US10258428B2 (en) 2008-12-30 2019-04-16 C. R. Bard, Inc. Marker delivery device for tissue marker placement
USD715442S1 (en) 2013-09-24 2014-10-14 C. R. Bard, Inc. Tissue marker for intracorporeal site identification
USD715942S1 (en) 2013-09-24 2014-10-21 C. R. Bard, Inc. Tissue marker for intracorporeal site identification
USD716451S1 (en) 2013-09-24 2014-10-28 C. R. Bard, Inc. Tissue marker for intracorporeal site identification
USD716450S1 (en) 2013-09-24 2014-10-28 C. R. Bard, Inc. Tissue marker for intracorporeal site identification

Also Published As

Publication number Publication date
FR2686499A1 (en) 1993-07-30

Similar Documents

Publication Publication Date Title
Kosugi et al. An articulated neurosurgical navigation system using MRI and CT images
US9521961B2 (en) Systems and methods for guiding a medical instrument
US6434415B1 (en) System for use in displaying images of a body part
EP1691860B1 (en) System for radar-assisted catheter guidance and control
EP0869745B8 (en) Surgical navigation systems including reference and localization frames
EP0699050B1 (en) Indicating the position of a probe
EP0936889B8 (en) Enhanced breast imaging/biopsy system employing targeted ultrasound
Reinhardt et al. A computer-assisted device for the intraoperative CT-correlated localization of brain tumors
JP4527546B2 (en) Catheter guide system using the image registered
EP1779802B1 (en) Controlling direction of ultrasound imaging catheter
EP0931516B1 (en) Surgical probe locating system for head use
EP1041918B1 (en) Surgical positioning system
JP4974164B2 (en) Frameless radiosurgery system and method
US6144875A (en) Apparatus and method for compensating for respiratory and patient motion during treatment
JP4265698B2 (en) x-ray guided surgery positioning system using an extended mapping space
CA2346613C (en) Method and apparatus for positioning a device in a body
JP5819609B2 (en) Motion compensated image-guided focused ultrasound therapeutic system
JP4902095B2 (en) Apparatus for performing a medical procedure on the subject in the body of the organization
US6235038B1 (en) System for translation of electromagnetic and optical localization systems
CA2642481C (en) System utilizing radio frequency signals for tracking and improving navigation of slender instruments during insertion into the body
US6332089B1 (en) Medical procedures and apparatus using intrabody probes
US20060182320A1 (en) Guidance of invasive medical devices by wide view three dimensional ultrasonic imaging
CN100391414C (en) Medical device positioning system and method
US20120046542A1 (en) Method and Apparatus for Performing a Navigated Procedure
US20090118620A1 (en) System and method for tracking an ultrasound catheter

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): CA JP US

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): AT BE CH DE DK ES FR GB GR IE IT LU MC NL PT SE

DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
122 Ep: pct application non-entry in european phase
NENP Non-entry into the national phase in:

Ref country code: CA