Systems and methods for locating and defining a target location within a human body
AssigneeNone recorded
InventorsDavid Krag, Eric Meier, Steve Dimmer, Duane Durbin, Trevor Moody, Fred Silverstein, Rosemary Harry, Richard Frecksa, Amy Kinsella, Jon Gilbert
Systems and methods for locating and defining a target location within a human body. The system can include at least one marker, a probe, and a detector for use in locating the markers by providing information to a surgeon that is representative of changes in proximity between the probe and the marker. The marker can have various detection characteristics, e.g., gamma radiation, that are detectable by an associated probe and detector. The tissue volume is removed by manipulating a cutting tool based on the proximity information provided by the detector, which can be used by the surgeon to define the boundary of the tissue volume. The systems and methods of the invention are particularly useful in locating and then removing a tissue volume or other target location from amorphous, pliable tissue (e.g., breast tissue) or other body parts.
Drawings
Claims86
A system for locating a target location within a human body, comprising:
a first wireless implantable marker configured to be implanted within the human body at a location relative to the target location;
an instrument having a function-site and a first instrument marker connected to the instrument at a first predetermined site relative to the function-site;
a position detection system having a sensor that detects a position of the first wireless implantable marker relative to a reference location and a position of the first instrument marker relative to the reference location, wherein the position detecting system includes a computer that determines a relative position between the first wireless implantable marker and the first instrument marker based on the positions of the first wireless marker and the first instrument marker relative to the reference location;
and
a user interface operatively coupled to the position detection system, the user interface having an indicator that denotes the position of the function-site of the instrument relative to the target location based on the relative position between the first wireless implantable marker and the first instrument marker.
2 more elements
A system for locating a target location, comprising:
a first wireless implantable marker configured to be implanted into a body at a location relative to the target location, wherein the first wireless marker emits a wireless signal;
and
a position detection system having an energy source that emits an excitation energy and a sensor that detects a position of the first wireless implantable marker relative to a reference location.
A wireless marker for implantation, comprising:
a biocompatible casing configured to be implanted into a human body relative to a target location within the human body;
a signal element in the casing, the signal element being configured to emit a response energy in reaction to an excitation energy;
and
a fastener configured to hold the wireless marker at a reference location in a human body relative to the target location within the human body
1 more element
A wireless marker for implantation, comprising:
a biocompatible casing configured to be implanted into a human body relative to a target location within the human body;
and
an identifier on and/or in the casing that can be observed by an imaging system to distinguish the casing from other casings that have been implanted into the human body.
A wireless marker for implantation, comprising:
a biocompatible casing configured to be implanted into a human body relative to a target location within the human body;
and
an identifier on and/or in the casing that can be observed visually to distinguish the casing from other casings that have been implanted into the human body.
An instrument for manipulation within a human, comprising:
a handle;
a function-site coupled to the handle, the function-site being aligned with an alignment axis;
a first instrument marker along the alignment axis;
and
a second instrument marker along the alignment axis.
2 more elements
An instrument for manipulation within a human, comprising:
a handle;
a function-site coupled to the handle, the function-site being aligned with an alignment axis;
and
a first wireless instrument marker along the alignment axis, wherein the first wireless instrument marker emits a wireless signal that can be detected by a position detection system to determine a position of the first wireless instrument marker relative to a reference location.
1 more element
An instrument for manipulation within a human, comprising:
a handle;
a function-site coupled to the handle, the function-site being aligned with an alignment axis;
a first wireless instrument marker along the alignment axis, wherein the first wireless instrument marker emits a wireless signal that can be detected by a position detection system to determine a position of the first wireless instrument marker relative to a reference location;
and
a user interface attached to the instrument and coupled to the detection system, wherein the user interface includes an indicator of a relative position between the function-site and a target location within the human.
2 more elements
A system for locating a target location within a human body, comprising:
an instrument having a handle, a function-site coupled to the handle, and at least one instrument maker attached to the instrument at a predetermined location relative to the function-site;
and
a detection system that detects a characteristic of the instrument marker and determines a configuration of the instrument and/or the function-site.
A method of providing information for a procedure in which a first wireless implantable marker is implanted in a human body relative to a target location and an instrument marker is coupled to an instrument at a predetermined site relative to a function-site on the instrument, the method comprising:
emitting a resonating energy from the first wireless implanted marker;
sensing a location of the first wireless marker relative to a reference location;
sensing a location of the instrument marker relative to the reference location;
correlating a relative position between the first wireless marker and the instrument marker based on the sensed locations;
and
determining a relative position between the function-site and the first wireless implanted marker by adding together the relative position between the first wireless marker and the target location, a relative position between the instrument marker and the function-site, and the relative position between the first wireless marker and the instrument marker.
3 more elements
A method of treating a target location within a human body, comprising:
exciting a wireless marker implanted in the body by emitting an excitation energy in a manner that causes the marker to emit a response energy;
sensing the response energy;
and
determining a position of the wireless marker relative to a reference location based on the sensed response energy.
Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00,…
Life of this patent
Term end not estimated
Priority claimedParent application 09/078,982
Application filedUS 10/438,550
Published
Assigned to Varian Medical Systems, Inc.assignment of assignor's interest
Description21,817 words
Summary1,957 words
#Several aspects of the present invention relate to systems and methods for locating a target tissue within a human body with wireless markers. Other aspects of the invention relate to wireless markers, instruments, user interfaces, and methods for using such systems in treating or monitoring a target location.
#Many medical procedures require monitoring or treating an internal tissue mass or other body part within a human body. In such applications, medical procedures must accurately locate a small target location within a soft tissue region, an organ, a bone structure, or another body part (e.g., colon, vascular system, etc.). The small target location can be a lesion, polyp, tumor, or another area of interest for monitoring or treating a patient. One particular application involving the surgical treatment of cancer is particularly challenging because physicians often need to treat small, non-palpable lesions that cannot be observed. This problem is compounded in soft tissue applications because the soft tissue is mobile and can move with respect to a reference point on the patient. In the case of breast cancer, for example, the location of a non-palpable lesion in the breast is identified at a preoperative stage using an imaging system. The actual surgical procedure, however, occurs in an operating room at a subsequent point in time, and the patient is typically in a different position during the surgical procedure than during the preoperative imaging stage. The breast and the lesion may accordingly be in a different location relative to a reference point on the patient during the surgical procedure than the imaging stage. The physician, therefore, generally estimates the location of lesion during surgery.
#One problem with treating non-palpable lesions in soft tissues is that the physicians may incorrectly estimate the location of the lesions. As a result, the physician may not remove all of the lesion, which is not desirable because some of the lesion will accordingly remain in the soft tissue. Another result is that the physicians may remove a significant amount of tissue proximate to the lesion, which can cause undesirable collateral damage to healthy tissue. Therefore, it would be desirable to know the precise location of the lesion or other type of target location during the surgical procedure.
Brief description of the drawings38 figures
#FIG. 1 is an isometric view representative of a tissue mass and surrounding tissue volume that is bracketed by the markers, with two markers being positioned on opposite ends of each of mutually orthogonal X, Y and Z-axes intersecting the tissue mass so as to define the boundary of the tissue volume, and with the probe and detector being positioned adjacent the tissue volume in accordance with one embodiment of the invention.
#FIG. 1A is an isometric view of the tissue mass illustrated in FIG. 1, with two markers being positioned on opposite ends of each of mutually orthogonal X1, Y1 and Z-axes and with two markers being positioned on opposite ends of mutually orthogonal X2 and Y2-axes which are mutually orthogonal with respect to the Z-axis and offset along with Z-axis with respect to the X1 and Y1-axes.
#FIG. 1B is an isometric view of the tissue volume illustrated in FIG. 1, with two markers being positioned on opposite ends of each of V, W, X and Y-axes, all of which lie in a common plane and are mutually orthogonal with respect to a Z-axis, all of these axes intersecting the tissue mass.
Detailed description18,732 words
#The following description is directed toward systems and methods for locating and defining a target location within a human body. Several aspects of one system in accordance with an embodiment of the invention directed toward bracketing a target location with at least one marker are described below in Section I. Similarly, aspects of other systems in accordance with embodiments of the invention directed toward locating a target mass within a human body using the relative orientation between an implanted marker and an instrument are described below in Section II. Other aspects of embodiments of the invention directed toward defining and displaying a virtual boundary relative to a target location based on the location of an implanted marker are also described below in Section II.
#I. Systems and Methods for Delineating a Target Location Using Bracketing
#FIGS. 1-20 illustrate a system and several components for delineating a target location within a human body in accordance with several embodiments of invention. Several of the components described below with reference to FIGS. 1-20 can also be used in the systems set forth with respect to FIGS. 21-61. Therefore, like reference numbers refer to like components and features throughout the various figures.