WO2014151646A1 - Tomosynthesis-guided biopsy in prone - Google Patents

Tomosynthesis-guided biopsy in prone Download PDF

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Publication number
WO2014151646A1
WO2014151646A1 PCT/US2014/026164 US2014026164W WO2014151646A1 WO 2014151646 A1 WO2014151646 A1 WO 2014151646A1 US 2014026164 W US2014026164 W US 2014026164W WO 2014151646 A1 WO2014151646 A1 WO 2014151646A1
Authority
WO
WIPO (PCT)
Prior art keywords
imaging system
breast
arm assembly
patient
stage arm
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/US2014/026164
Other languages
English (en)
French (fr)
Inventor
Kenneth F. Defreitas
Ian Shaw
John Laviola
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Hologic Inc
Original Assignee
Hologic Inc
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
Family has litigation
First worldwide family litigation filed litigation Critical https://patents.darts-ip.com/?family=51581003&utm_source=google_patent&utm_medium=platform_link&utm_campaign=public_patent_search&patent=WO2014151646(A1) "Global patent litigation dataset” by Darts-ip is licensed under a Creative Commons Attribution 4.0 International License.
Priority to US14/777,199 priority Critical patent/US10092358B2/en
Priority to AU2014233687A priority patent/AU2014233687B2/en
Priority to EP18153706.9A priority patent/EP3366217B1/en
Priority to EP14770362.3A priority patent/EP2967479B1/en
Priority to JP2016502068A priority patent/JP6388347B2/ja
Application filed by Hologic Inc filed Critical Hologic Inc
Publication of WO2014151646A1 publication Critical patent/WO2014151646A1/en
Anticipated expiration legal-status Critical
Priority to US16/127,564 priority patent/US10456213B2/en
Priority to US16/576,510 priority patent/US11589944B2/en
Priority to US18/102,207 priority patent/US12064291B2/en
Priority to US18/769,702 priority patent/US12324707B2/en
Priority to US19/201,042 priority patent/US20250339231A1/en
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/103—Treatment planning systems
    • A61N5/1039—Treatment planning systems using functional images, e.g. PET or MRI
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, 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
    • A61B90/10—Instruments, 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 for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/11—Instruments, 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 for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A61B6/025—Tomosynthesis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/04—Positioning of patients; Tiltable beds or the like
    • A61B6/0407—Supports, e.g. tables or beds, for the body or parts of the body
    • A61B6/0414—Supports, e.g. tables or beds, for the body or parts of the body with compression means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/04—Positioning of patients; Tiltable beds or the like
    • A61B6/0407—Supports, e.g. tables or beds, for the body or parts of the body
    • A61B6/0435—Supports, e.g. tables or beds, for the body or parts of the body with means for imaging suspended breasts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/502—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of breast, i.e. mammography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/0233—Pointed or sharp biopsy instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/04—Endoscopic instruments, e.g. catheter-type instruments
    • A61B2010/045—Needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/12—Arrangements for detecting or locating foreign bodies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/44—Constructional features of apparatus for radiation diagnosis
    • A61B6/4429—Constructional features of apparatus for radiation diagnosis related to the mounting of source units and detector units
    • A61B6/4452—Constructional features of apparatus for radiation diagnosis related to the mounting of source units and detector units the source unit and the detector unit being able to move relative to each other

Definitions

  • the table may have an aperture through which the breast undergoing biopsy extends with the patient in a prone position.
  • Nonlimiting examples of known prone approaches for imaging and/or biopsy include PCT Publication No. WO 2012/1 12627, U.S. Patent Application Publication Nos. 2009/0080604 and 2009/171244, and U.S. Patent Nos. 6,480,565, 6,987,331, and 7,697,660, each of which is incorporated by reference herein in their entireties.
  • the aperture may be disposed approximately midway along the length of the table so that the table may accommodate 180 degree repositioning of the patient.
  • the stage arm assembly and imaging system may be independently rotatable for set up, e.g., each through a 180° range of arc, without being detached and reattached or using optional parts.
  • Various linear adjustments may also be possible. Consequently, the breast of a patient in a prone position can be accessed through a range of 360 degrees in various planes via a combination of reversing the position of the patient and simple rotational and linear adjustments of the stage arm assembly and imaging system.
  • the central section 1 14 supports the head, abdomen and hip of the patient. Transitions between the end sections and the central section are angled to provide comfortable head, abdomen and hip support.
  • An aperture 1 16 in the central section 1 14 of the table enables a portion of the body of the patient to extend below the table when the patient is situated in a prone position. For example, the breast being biopsied may extend through the aperture. Other parts of the patient's body may also extend through the aperture, e.g., an arm, for enhanced comfort or positioning for the biopsy procedure.
  • Some aspects of the table may be consistent with features described in International Application Number PCT/US1 1/61186, titled TABLE FOR PERFORMING MEDICAL PROCEDURES, filed November 17, 201 1, and U.S. Patent 5,289,520, titled STEREOTACTIC MAMMOGRAPHY IMAGING SYSTEM WITH PRONE POSITION EXAMINATION TABLE AND CCD CAMERA, filed October 6, 1992, both of which are incorporated by reference.
  • the orientation of the stage arm assembly may be such that the operational path of travel of the biopsy gun needle intersects the Z-axis about which the stage arm assembly and support arm rotate at a particular point within the field of view of the tomosynthesis imaging system.
  • the carriage slide assembly enables manual or motor-driven adjustment of the distance between the needle and the rotational Z-axis intersection point.
  • the stage arm (and thus the gun mount and biopsy needle) may be oriented at a fixed inclination, e.g., 10°, relative to the X-Y plane in which the stage arm assembly is rotatable. Inclination of the stage arm allows a "zero degree" offset configuration in which the stage arm assembly is aligned with the imaging system as specifically shown in FIG. 2.
  • the stage arm assembly 104 and imaging system 102 are independently rotatable for set up, e.g., each through a 180 degree range of arc in the X-Y plane. More particularly, the furthest extent to which the stage arm assembly protrudes from the Z-axis of rotation is less than the minimum distance between the first upright portion of the support arm and the Z-axis of rotation. Consequently, the stage arm assembly can be rotated to either side of the receptor without interference. Similarly, the stage arm assembly can be rotated to either side of the breast support assembly without interference, (compare, e.g., FIG. 3 with FIG. 7) As specifically illustrated in FIG. 2, the stage arm assembly and breast support assembly may also be optionally aligned.
  • the patient is positioned on the table with one or both breasts and possibly one arm protruding through the aperture in step 800.
  • the patient can be oriented in at least two different positions which are offset horizontally by 180 degrees in the X-Y plane.
  • the breast which is the subject of the biopsy procedure may be approximately centered in the Z-axis about which the stage arm assembly and support arm rotate.
  • the equipment support platform may then be moved in one or more dimensions orthogonal to the Z-axis to help center the breast in the axis of rotation in step 802.
  • the imaging system orientation is then adjusted until a desired orientation is obtained for the procedure to be performed, as indicated in step 804.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Biomedical Technology (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Veterinary Medicine (AREA)
  • Pathology (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Molecular Biology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Radiology & Medical Imaging (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Optics & Photonics (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Apparatus For Radiation Diagnosis (AREA)
PCT/US2014/026164 2013-03-15 2014-03-13 Tomosynthesis-guided biopsy in prone Ceased WO2014151646A1 (en)

Priority Applications (10)

Application Number Priority Date Filing Date Title
US14/777,199 US10092358B2 (en) 2013-03-15 2014-03-13 Tomosynthesis-guided biopsy apparatus and method
AU2014233687A AU2014233687B2 (en) 2013-03-15 2014-03-13 Tomosynthesis-guided biopsy in prone
EP18153706.9A EP3366217B1 (en) 2013-03-15 2014-03-13 Tomosynthesis-guided biopsy in prone
EP14770362.3A EP2967479B1 (en) 2013-03-15 2014-03-13 Tomosynthesis-guided biopsy in prone
JP2016502068A JP6388347B2 (ja) 2013-03-15 2014-03-13 腹臥位におけるトモシンセシス誘導生検
US16/127,564 US10456213B2 (en) 2013-03-15 2018-09-11 Tomosynthesis-guided biopsy apparatus and method
US16/576,510 US11589944B2 (en) 2013-03-15 2019-09-19 Tomosynthesis-guided biopsy apparatus and method
US18/102,207 US12064291B2 (en) 2013-03-15 2023-01-27 Tomosynthesis-guided biopsy in prone
US18/769,702 US12324707B2 (en) 2013-03-15 2024-07-11 Tomosynthesis-guided biopsy in prone
US19/201,042 US20250339231A1 (en) 2013-03-15 2025-05-07 Tomosynthesis-guided biopsy in prone

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201361787825P 2013-03-15 2013-03-15
US61/787,825 2013-03-15

Related Child Applications (3)

Application Number Title Priority Date Filing Date
US14/777,199 A-371-Of-International US10092358B2 (en) 2013-03-15 2014-03-13 Tomosynthesis-guided biopsy apparatus and method
EP18153706.9A Previously-Filed-Application EP3366217B1 (en) 2013-03-15 2014-03-13 Tomosynthesis-guided biopsy in prone
US16/127,564 Continuation US10456213B2 (en) 2013-03-15 2018-09-11 Tomosynthesis-guided biopsy apparatus and method

Publications (1)

Publication Number Publication Date
WO2014151646A1 true WO2014151646A1 (en) 2014-09-25

Family

ID=51581003

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2014/026164 Ceased WO2014151646A1 (en) 2013-03-15 2014-03-13 Tomosynthesis-guided biopsy in prone

Country Status (5)

Country Link
US (6) US10092358B2 (https=)
EP (2) EP2967479B1 (https=)
JP (1) JP6388347B2 (https=)
AU (1) AU2014233687B2 (https=)
WO (1) WO2014151646A1 (https=)

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