TISSUE AND VASCULAR PATHWAY MAPPING USING SYNCHRONIZED PHOTOACOUSTIC AND ULTRASOUND PULLBACK TECHNIQUES
20230218266 · 2023-07-13
Inventors
Cpc classification
A61B8/12
HUMAN NECESSITIES
A61B5/0095
HUMAN NECESSITIES
A61B8/4416
HUMAN NECESSITIES
A61B5/0035
HUMAN NECESSITIES
International classification
A61B8/12
HUMAN NECESSITIES
A61B8/00
HUMAN NECESSITIES
Abstract
Imaging devices, systems, and methods are provided. Some embodiments of the present disclosure are particularly directed to imaging a region of interest in tissue with photoacoustic and ultrasound modalities. In some embodiments, a medical sensing system includes one or more external optical emitters and a measurement apparatus configured to be placed within a vascular pathway. The one or more optical emitters and the measurement apparatus may be moved together synchronously. The measurement apparatus may be configured to receive sound waves created by the interaction between emitted optical pulses and tissue, and transmit and receive ultrasound signals. The medical sensing system may also include a processing engine operable to produce images of the region of interest and a display configured to visually display the image of the region of interest.
Claims
1. A system, comprising: a non-imaging optical emitter configured to emit optical pulses to tissue inside of a body while the non-imaging optical emitter is positioned outside of the body, wherein interaction of the optical pulses with the tissue results in the tissue generating photoacoustic sound waves; an actuator configured to provide first movement of the non-imaging optical emitter outside of the body; a measurement apparatus separate from the non-imaging optical emitter and configured to receive the photoacoustic sound waves while the measurement apparatus is positioned within of a vascular pathway inside of the body; and a pullback device configured to provide second movement of the measurement apparatus within the vascular pathway, wherein the first movement and the second movement comprise a difference in at least one of a length or a shape, wherein, to account for the difference, at least one of: the actuator is configured to modify the first movement; or the pullback device is configured to modify the second movement, such that the photoacoustic sound waves generated by different parts of the tissue during the first movement are received by the measurement apparatus at different positions of the second movement.
2. The system of claim 1, wherein the first movement comprises a first shape, and wherein the second movement comprises a different, second shape.
3. The system of claim 2, wherein the first shape comprises one of a linear shape, a non-linear shape, or an arcuate shape, wherein the second shape comprises a different one of the linear shape, the non-linear shape, or the arcuate shape.
4. The system of claim 1, wherein the first movement comprises a first length, and wherein the second movement comprises a different, second length.
5. The system of claim 1, wherein, to modify the first movement, the actuator is configured to provide a first velocity for the non-imaging optical emitter; and wherein, to modify the second movement, the pullback device is configured to provide a second velocity for the measurement apparatus.
6. The system of claim 1, wherein the measurement apparatus comprises a photoacoustic transducer configured to receive the photoacoustic sound waves.
7. The system of claim 6, wherein the measurement apparatus comprises an ultrasound transducer different than the photoacoustic transducer, wherein the ultrasound transducer is configured to: emit ultrasound energy; and receive ultrasound echoes based on the ultrasound energy.
8. The system of claim 1, wherein the measurement apparatus comprises an ultrasound transducer configured to: receive the photoacoustic sound waves; emit ultrasound energy; and receive ultrasound echoes based on the ultrasound energy.
9. The system of claim 1, further comprising a processing engine configured for communication with the measurement apparatus, wherein the processing engine is operable to produce an image of the vascular pathway based on the photoacoustic sound waves.
10. The system of claim 9, further comprising a display configured for communication with the processing engine, wherein the display is configured to visually display the image of the vascular pathway.
11. The system of claim 1, wherein the actuator and the pullback are configured for communication with one another.
12. The system of claim 1, wherein the actuator and the pullback device are configured to move the non-imaging optical emitter and the measurement apparatus together.
13. The system of claim 1, further comprising a controller configured to control at least one of the actuator or the pullback device to account for the difference.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0018] Illustrative embodiments of the present disclosure will be described with reference to the accompanying drawings, of which:
[0019]
[0020]
[0021]
[0022]
[0023]
[0024]
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[0027]
DETAILED DESCRIPTION
[0028] For the purposes of promoting an understanding of the principles of the present disclosure, reference will now be made to the embodiments illustrated in the drawings, and specific language will be used to describe the same. It is nevertheless understood that no limitation to the scope of the disclosure is intended. Any alterations and further modifications to the described devices, systems, and methods, and any further application of the principles of the present disclosure are fully contemplated and included within the present disclosure as would normally occur to one skilled in the art to which the disclosure relates. For example, while the intravascular sensing system is described in terms of cardiovascular imaging, it is understood that it is not intended to be limited to this application. The system is equally well suited to any application requiring imaging within a lumen or cavity of a patient. In particular, it is fully contemplated that the features, components, and/or steps described with respect to one embodiment may be combined with the features, components, and/or steps described with respect to other embodiments of the present disclosure. For the sake of brevity, however, the numerous iterations of these combinations will not be described separately.
[0029]
[0030] The medical sensing system 100 may be utilized in a variety of applications and can be used to assess vascular pathways and structures within a living body. To do so, the measurement apparatus 102 is advanced into a vascular passage 104. The vascular passage 104 represents fluid filled or surrounded structures, both natural and man-made, within a living body that may be imaged and can include for example, but without limitation, structures such as: organs including the liver, heart, kidneys, as well as valves within the blood or other systems of the body. In addition to imaging natural structures, the images may also include man-made structures such as, but without limitation, heart valves, stents, shunts, filters and other devices positioned within the body. The measurement apparatus 102 includes one or more sensors 106 disposed along the length of the apparatus 102 to collect diagnostic data regarding the vascular pathway 104. In various embodiments, the one or more sensors 106 correspond to sensing modalities such as IVUS imaging, pressure, flow, OCT imaging, transesophageal echocardiography, temperature, other suitable modalities, and/or combinations thereof.
[0031] In the exemplary embodiment of
[0032] The sensors 106 may be arranged around the circumference of the measurement apparatus 102 and positioned to emit ultrasound energy radially 110 in order to obtain a cross-sectional representation of the vascular pathway 104 and the surrounding anatomy. When the sensors 106 are positioned near the area to be imaged, the control circuitry selects one or more IVUS transducers to transmit an ultrasound pulse that is reflected by the vascular pathway 104 and the surrounding structures. The control circuitry also selects one or more transducers to receive the ultrasound echo signal. By stepping through sequences of transmit-receive sets, the medical sensing system 100 system can synthesize the effect of a mechanically scanned transducer element without moving parts.
[0033] In one embodiment, the sensors 106 are disposed circumferentially around a distal portion of the measurement apparatus 102. In another embodiment, the sensors 106 are contained within the body of the measurement apparatus 102. In other embodiments, the sensors 106 are disposed radially across the measurement apparatus 102, on a movable drive member connected to the measurement apparatus 102, or on one or more planar arrays connected to the measurement apparatus 102.
[0034] In some embodiments, the processing engine 134, which may be included in the console 116, combines the imaging data acquired from both the IVUS and photoacoustic modalities into a single visualization. This use of both IVUS and photoacoustic modalities may provide a number of advantages over traditional systems using a single modality. First, the addition of photoacoustic sensors may allow for higher resolution mapping than traditional IVUS methods alone. Second, the combination of IVUS and photoacoustic modalities may allow for faster imaging speeds than OCT imaging or other methods. Third, the combination may allow for two-dimensional and/or three-dimensional imaging of the tissue surrounding vascular pathways. Fourth, the use of photoacoustic imaging may expand the diagnostic scope of an IVUS mapping procedure by including more of the surrounding tissue. In particular, the combined IVUS and photoacoustic mapping can allow for detection of certain types of cancers, tissue damage, and the mapping of multiple vascular pathways without sacrificing the dependability of ultrasound in detecting plaques, stenosis, and other forms of vascular diseases. Fifth, combining these two modalities may allow substantial costs savings because existing IVUS systems may be adapted to mapping systems using both modalities. Sixth, due to the interaction of optical pulses with tissue and the omni-directional emission of photoacoustic waves from the tissue, an optical pulse need not be emitted along the same axis as the transducer. This allows for more flexibility in carrying out combined photoacoustic and IVUS procedures, and may allow for precise mapping procedures even along deep or convoluted vascular pathways. Seventh, the mapping capabilities of the present disclosure may be integrated with some forms of laser therapy. For example, diagnosis of diseases in tissue may be accomplished using the optical emitter in diagnostic mode. After a diagnosis, the optical emitter can be switched to a treatment mode. In this regard, the map of the vasculature and surrounding tissue may be used to guide the application of the treatment. After the optical treatment is finished, the optical emitter can be switched back to diagnostic mode to confirm treatment of the diseased portion of tissue.
[0035] Sensor data may be transmitted via a cable 112 to a Patient Interface Module (PIM) 114 and to console 116, as well as to the processing engine 134 which may be disposed within the console 116. Data from the one or more sensors 106 may be received by a processing engine 134 of the console 116. In other embodiments, the processing engine 134 is physically separated from the measurement apparatus 102 but in communication with the measurement apparatus (e.g., via wireless communications). In some embodiments, the processing engine 134 is configured to control the sensors 106. Precise timing of the transmission and reception of signals may be used to map vascular pathways 104 in procedures using both IVUS and photoacoustic modalities. In particular, some procedures may involve the activation of sensors 106 to alternately transmit and receive signals. In systems using one or more IVUS transducers that are configured to receive both photoacoustic and ultrasound signals, the processing engine 134 may be configured to control the state (e.g., send/receive) of one or more transducers during the mapping of the vascular pathway and surrounding tissue.
[0036] Moreover, in some embodiments, the processing engine 134, PIM 114, and console 116 are collocated and/or part of the same system, unit, chassis, or module. Together the processing engine 134, PIM 114, and/or console 116 assemble, process, and render the sensor data for display as an image on a display 118. For example, in various embodiments, the processing engine 134, PIM 114, and/or the console 116 generates control signals to configure the sensor 106, generates signals to activate the sensor 106, performs amplification, filtering, and/or aggregating of sensor data, and formats the sensor data as an image for display. The allocation of these tasks and others can be distributed in various ways between the processing engine 134, PIM 114, and the console 116.
[0037] Sill referring to
[0038] In addition to various sensors 106, the measurement apparatus 102 may include a guide wire exit port 120 as shown in
[0039]
[0040]
[0041] In the example of
[0042] The systems of the present disclosure may also include one or more features described in U.S. Provisional Patent Application Nos. 62/315,117, 62/315,220, 62/315,251, and/or 62/315,275, each of which was filed on Mar. 30, 2016 and incorporated by reference in its entirety.
[0043]
[0044] An operator may move the measurement apparatus 102 through the vascular pathway 104 to image and/or map the vascular pathways 104. In some cases, the optical emitter 220 is configured to emit optical pulses 230 toward the sensors 106 of the measurement apparatus. The optical emitter 220 may also be moved externally in a way that corresponds to the movements of the measurement apparatus 102 so that the measurement apparatus 102 receives photoacoustic waves along the length of the vascular pathway 104. In some embodiments, the optical emitter 220 is moved at a similar speed and direction as the measurement apparatus 102. In some embodiments, the measurement apparatus 102 is moved by a pullback device 138 that is attached to an end of the measurement apparatus. This pullback device may be the pullback device 138 of
[0045] In some embodiments, an actuator 232 is connected to the optical emitter 220 by a connector 250. In some cases, this actuator 232 may be a pullback device, and the connector 250 may be a fastening device. In other cases, the connector 250 is a rigid device such as a rigid elongate member, such as a rod, bar, frame, etc. The connector 250 may be selectively coupled to the optical emitter 220 and actuator 232 by mechanical connections such as male/female plug interactions, mechanical couplings, fasteners, and/or combinations thereof. Alternatively, the connector 250 may be permanently attached and/or integrally formed with one or more of the actuator 232 and/or the optical emitter 220. The actuator 232 may be mechanically coupled to the pullback device 138 so that the actuator 232 and pullback device 138 move with corresponding movements. In some embodiments, the actuator 232 is configured to travel with the optical emitter 220. Additionally, the actuator 232 and optical emitter 220 may be configured to travel along a track, frame, or wire disposed outside the patient's body.
[0046] The actuator 232 and pullback device 138 (connected to the measurement apparatus 102) may be synched together to move the optical emitter 220 and measurement apparatus 106 together. In some cases, the actuator 232 and pullback device 138 are in communication with a control device. This control device may send the actuator 232 and pullback device 138 signals to synchronize their movements. Alternatively, the actuator 232 and pullback device 138 communicate directly to one another to provide for synchronized movements of the optical emitter 220 and measurement apparatus 102. Synchronous movements may describe two or more objects moving in an identical direction with the same velocity. However, synchronous movements may also describe two or more objects moving in a corresponding manner, while not in an identical direction or with the same velocity. In some cases, corresponding motions can be applied to objects to move them together in some way. For example, a measurement apparatus 102 may be moved through a convoluted vascular pathway while an external optical emitter 220 is moved linearly along the outside of a patient's body. In this case, the motions of the measurement apparatus 102 and optical emitter 220 correspond but are not identical. The measurement apparatus 102 and optical emitter 220 may travel in different directions and at different velocities while still being synchronized. In some embodiments, movements between the optical emitter 220 and the measurement apparatus 102 allow the measurement apparatus 102 to receive photoacoustic waves along a mapping route through a vascular pathway. In some embodiments, the measurement apparatus 102 and optical emitter 220 are moved so that they stay within an operable zone. More specifically, the operable zone may be defined as an area where sound waves 240 created as a result of the optical pulses 230 may be received by the sensors 106 of the measurement device 102. Synchronized movements will be explained further in reference to
[0047] In some cases, the distance that an optical pulse 230 travels through tissue may be controlled by varying the frequency and length of the pulse. In the example of
[0048]
[0049]
[0050]
[0051] In the example of
[0052]
[0053] At step 602, the method 600 can include activating an external laser source. This laser source may be the optical emitter 220 of
[0054] At step 604, the method 600 can include focusing a laser pulse on tissue in a region of interest having a measurement device with a sensor array including sensors of two or more types. In some embodiments, the region of interest includes a portion of tissue including a portion of at least one vascular pathway 104. The measurement device may be disposed within the vascular pathway 104. The region of interest may be chosen based on a suspected or diagnosed problem in the tissue, or based on the proximity of a region of tissue to problems within a vascular pathway 104. In other embodiments, the region of interest is part of a more general mapping plan. For example, a mapping plan for a section of a vascular pathway 104 may involve the mapping of tissue surrounding the vascular pathway 104 along its length. The interaction of the emitted laser pulse and tissue in the region of interest may create a number of photoacoustic waves 240 that emanate from the tissue.
[0055] In some embodiments, the measurement device is the measurement apparatus 102 depicted in
[0056] At step 606, the method 600 can include receiving sound waves generated by the interaction of the laser pulse and tissue with the sensors. In some cases, the sensors can function with the traditional IVUS functionality to receive ultrasound waves. In other cases, some or all of the sensors are dedicated to receive photoacoustic waves. In some embodiments, the sensors are controlled by a communication system 250 like that depicted in
[0057] At step 608, the method 600 can include transmitting ultrasound signals into the vascular pathway 104 with the sensors. Ultrasound signals may be transmitted toward the walls of the vascular pathway 104 and may be deflected off the walls of the vascular pathway 104 and propagate through the vascular pathway 104 as ultrasound echo signals.
[0058] At step 610, the method 600 can include receiving the ultrasound echo signals with the sensors. In some embodiments, the sensors may be operable to receive sound waves as well as ultrasound signals. The sensors of step 608 and the sensors of step 610 may be combined in a single sensor, or alternatively, the sensors may be separate.
[0059] At step 612, the method 600 includes synching a laser source actuator with a pullback device. The laser source actuator may be the actuator 232 of
[0060] At step 614, the method 600 includes moving the laser source and the measurement device synchronously. In some embodiments, the laser source and the measurement device are moved relative to each other such that photoacoustic waves reach the photoacoustic sensor at different locations along a mapping route. In some cases, the laser source is moved at the same velocity and direction of travel as the measurement device. In other cases, the laser source is moved at a different velocity and direction of travel as the measurement device, such as the case where the measurement device is moved along a convoluted path. The laser source and the measurement device may be moved so that they stay within a zone such that sound waves produced by the laser source may be received by the measurement device.
[0061] Steps 604, 606, 608, 610, 612, and 614 may be coordinated in the method 600 and occur in various orders based on the desired outcome of a medical procedure. For example, transmission of ultrasound signals and reception of ultrasound echo signals can occur at regular intervals throughout the method 600, while reception of photoacoustic waves may occur sporadically. This may be the case in a medical procedure to map a vascular pathway 104 and spot-check trouble areas of tissue surrounding sections of the vascular pathway 104. Furthermore, the steps 612 and 614 may occur during various orders of steps 604, 606, 608, and 610. For example, the laser source and the measurement device may be moved during the transmission and reception of signals. In some embodiments, steps 604, 606, 608, and 610 may be performed successively. For example, steps 604, 606, 608, and 610 may be performed successively before proceeding to the next step to avoid signal noise and allow for adequate signal processing. This may be the case when method 600 is used in a system where a photoacoustic sensor and an ultrasound transducer are each included in a transducer array. Furthermore, the steps of method 600 may be interleaved in various orders.
[0062] At step 616, the method 600 can include producing an image of the region of interest, including the vascular pathway 104 and surrounding tissue, based on the sound waves and the ultrasound echo signals. In some embodiments, a processing engine (such as the processing engine 134 of
[0063] At step 618, the method 600 includes outputting the image of the region of interest to a display 118. This display 118 can include a computer monitor, a screen on a patient interface module (PIM) 114 or console 116, or other suitable device for receiving and displaying images.
[0064] In an exemplary embodiment within the scope of the present disclosure, the method 600 repeats after step 618, such that method flow goes back to step 602 and begins again. Iteration of the method 600 may be utilized to map a vascular pathway and surrounding tissue.
[0065] Persons skilled in the art will recognize that the apparatus, systems, and methods described above can be modified in various ways. Accordingly, persons of ordinary skill in the art will appreciate that the embodiments encompassed by the present disclosure are not limited to the particular exemplary embodiments described above. In that regard, although illustrative embodiments have been shown and described, a wide range of modification, change, and substitution is contemplated in the foregoing disclosure. It is understood that such variations may be made to the foregoing without departing from the scope of the present disclosure. Accordingly, it is appropriate that the appended claims be construed broadly and in a manner consistent with the present disclosure.