SYSTEMS AND METHODS FOR IDENTIFYING AND LOCATING REFLECTORS USING ORTHOGONAL SEQUENCES OF REFLECTOR SWITCHING
20220400976 · 2022-12-22
Inventors
Cpc classification
A61B2017/00176
HUMAN NECESSITIES
A61B2090/397
HUMAN NECESSITIES
A61B5/6867
HUMAN NECESSITIES
A61B90/30
HUMAN NECESSITIES
International classification
A61B5/06
HUMAN NECESSITIES
A61B90/00
HUMAN NECESSITIES
Abstract
Systems and methods are provided for identifying and locating a plurality of reflector markers implanted within a target tissue region within a patient's body. A probe is provided that is activated to transmit electromagnetic signals into the patient's body, receive reflected signals from the patient's body, and in synchronization with transmitting the electromagnetic signals, deliver light pulses into the patient's body. The markers reflector tags modulate reflected signals from the respective markers based on orthogonal code sequences opening and closing respective switches of the markers to modulate the reflective properties of the markers. The probe processes the return signals to separate the reflected signals based at least in part on the code sequences to identify and locate each of the plurality of reflector tags substantially simultaneously.
Claims
1. A system for localization of a target tissue region within a patient's body, comprising: a probe comprising one or more antennas for transmitting electromagnetic signals into a patient's body and receiving reflected signals from the patient's body; and a plurality of markers sized for implantation within the patient's body, each marker comprising: a switch; an antenna coupled with the switch; and a sequence generator, the sequence generator coupled to the switch to open and close the switch to modulate the electromagnetic signals from the probe reflected by the marker based on the code sequence, wherein the code sequences generated by the sequence generators of the plurality of markers are orthogonal to one another, the probe comprising a processor configured to analyze the reflected signals to identify and locate each of the plurality of markers.
2. The system of claim 1, wherein each marker further comprises an energy converter configured for generating electrical energy.
3. The system of claim 3, wherein each marker further comprises a power harvesting block coupled to the energy converter to generate electrical energy to operate electrical components of the marker.
4. The system of claim 1, wherein the switch of each marker comprises a field effect transistor (FET).
5. The system of claim 1, wherein the clock circuit of each marker is configured to identify a beginning of each frame, whereupon the clock circuit resets the sequence generator of the respective marker to generate the respective code sequence to open and close the switch a predetermined number of times such that the modulation of the reflected signals from the plurality of markers is orthogonal and balanced.
6. The system of claim 5, wherein the processor of the probe is configured to separate the reflected signals from the plurality of markers based, at least in part, on the code sequences to identify and locate each of the plurality of markers substantially simultaneously.
7. The system of claim 1, wherein the processor is configured to separate individual waveforms reflected by respective markers from the reflected signals by multiplexing the reflected signals based on the orthogonal code sequences of the respective markers.
8. The system of claim 7, wherein the processor is further configured to process the separated individual waveforms to identify at least one of amplitude and time delay of the separated individual waveforms to provide an output corresponding to distances from the probe the respective markers.
9. The system of claim 1, wherein the processor comprises a synchronous analog-to-digital converter for digitizing the reflected signals, the processor configured to separate individual waveforms reflected by respective markers from the reflected signals by multiplying the digitized signals by the code sequences of the respective markers and summing the results to provide the modulation of the respective markers.
10. The system of claim 9, wherein the code sequences of the markers are balanced, and wherein the processor sums the results based on the orthogonal and balanced code sequences to provide the modulation of the separate individual waveforms of the respective markers.
11. The system of claim 10, wherein the processor is further configured to process the separated individual waveforms to identify at least one of amplitude and time delay of the separated individual waveforms to provide an output corresponding to distances from the probe the respective markers.
12. The system of claim 1, further comprising a display configured to provide an output corresponding to a location of the plurality of markers.
13. The system of claim 1, further comprising a display configured to provide an output corresponding to a distance from a tip of the probe to the plurality of markers.
14. A probe for identifying and locating a plurality of markers implanted within a patient's body, comprising: one or more transmit antennas for transmitting electromagnetic signals into a patient's body; one or more receive antennas for receiving reflected signals from a plurality of markers in the patient's body, wherein the plurality of markers modulate the electromagnetic signals based on the code sequence based on orthogonal code sequences; and a processor for processing the reflected signals to separate the modulated signals from the plurality of markers based at least in part on the orthogonal code sequences to identify and locate each of the plurality of markers substantially simultaneously.
15. The probe of claim 14, wherein the processor is configured to separate individual waveforms reflected by respective markers from the reflected signals by multiplexing the reflected signals based on the orthogonal code sequences of the respective markers.
16. The probe of claim 15, wherein the processor is further configured to process the separated individual waveforms to identify at least one of amplitude and time delay of the separated individual waveforms to provide an output corresponding to distances from the probe the respective markers.
17. The probe of claim 14, wherein the processor comprises a synchronous analog-to-digital converter for digitizing the reflected signals, the processor configured to separate individual waveforms reflected by respective markers from the reflected signals by multiplying the digitized signals by the code sequences of the respective markers and summing the results to provide the modulation of the respective markers.
18. The probe of claim 17, wherein the code sequences of the markers are balanced, and wherein the processor sums the results based on the orthogonal and balanced code sequences to provide the modulation of the separate individual waveforms of the respective markers.
19. The probe of claim 18, wherein the processor is further configured to process the separated individual waveforms to identify at least one of amplitude and time delay of the separated individual waveforms to provide an output corresponding to distances from the probe the respective markers.
20. A plurality of markers sized for implantation within a patient's body, each marker comprising: an energy converter for generating electrical energy; a clock circuit coupled to the energy converter; one or more antennas a switch coupled to the one or more antennas; and a sequence generator coupled to the clock circuit to generate a code sequence, the sequence generator coupled to the switch to open and close the switch to modulate electromagnetic signals reflected by the marker based on the code sequence, wherein the code sequence generated by each of the sequence generators of the plurality of markers are orthogonal to one another.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0016] These and other features, aspects, and advantages of the present disclosure will become better understood with regard to the following description, appended claims, and accompanying drawings where:
[0017]
[0018]
[0019]
[0020]
[0021]
[0022]
[0023]
[0024]
[0025]
[0026]
[0027]
DETAILED DESCRIPTION OF THE EXEMPLARY EMBODIMENTS
[0028] In the following description, numerous details are set forth in order to provide a more thorough description of the system. It will be apparent, however, to one skilled in the art, that the disclosed system may be practiced without these specific details. In the other instances, well known features have not been described in detail so as not to unnecessarily obscure the system.
[0029] Turning to the drawings,
[0030] As shown, the probe 20 generally includes one or more antennas 22 for transmitting electromagnetic signals into a patient's body and receiving reflected signals from the patient's body, and a light source 24 for delivering light pulses into a patient's body synchronized with the electromagnetic signals, as described further elsewhere herein. In an exemplary embodiment, the antenna(s) 22 transmit ultrawide band (UWB) radar pulses that are used for simultaneous detection of the markers 40 based on modulated reflective properties, e.g., using a switch inside each marker 40, which is controlled by the light pulses from the light source 24.
[0031]
[0032] As shown in
[0033] As shown, each antenna 44 may include a first end 44a coupled to a printed circuit board (PCB) or other substrate 50 within the package 42 and a second free end 44b, e.g., terminating in an enlarged, rounded, and/or atraumatic tip 45. Optionally, the first ends 44a may include one or more bends, e.g., to facilitate coupling the first ends 44a to the substrate 50 and/or such that the antennas 44 extend tangentially from opposite sides of the package 42, as best seen in
[0034] Alternatively, the antennas 44 may be biased to assume a curvilinear or other configuration, e.g., a helical, serpentine or other curved shape, around the longitudinal axis 48. For example, the antennas 44 may be formed from elastic or superelastic material that is shape set such that the antennas 44 are biased to a helical configuration (not shown), yet may be resiliently straightened to a substantially linear configuration, e.g., to facilitate loading the marker 40 into a delivery device and/or otherwise introducing the marker 40 into a patient's body, e.g., as described in U.S. Pat. Nos. 8,892,185 and 9,713,437, the entire disclosures of which are expressly incorporated by reference herein.
[0035] With additional reference to
[0036] As described further elsewhere herein, the sequence generator 58 of each marker 40 may be pre-programmed such that the code sequences generated by the sequence generators are orthogonal to one another, i.e., the sequence generators 58 may open and close the respective switches 54, based on the light pulses from the light source 24 of the probe 20, to modulate the reflective properties of the markers 40 differently from one another, and the probe 20 may be configured to analyze the reflected signals to identify and locate each of the markers 40 substantially simultaneously based on the resulting modulation in the reflected signals received by the probe 20.
[0037] As shown in
[0038] In an exemplary embodiment, the energy converter 52 includes a plurality of photosensitive diodes capable of transforming incident light (e.g., infrared light) striking them into electrical energy (e.g., a predetermined minimum voltage). As shown, multiple pairs of diodes 52 may be connected in series, which may be arranged orthogonally to one another spatially within the package 42. For example, given that photosensitive diodes are directional, at least two pairs of diodes 52 may be mounted within the package 42 offset one hundred eighty degrees (180°) or otherwise relative to one another, e.g., as best seen in
[0039] Light from the light pulses intermittently striking the diodes 52 may generate a voltage that may be used by the clock circuit 56 to provide a control signal that may be used to activate the sequence generator 58 to open and close the switch 54, e.g., based on a pre-programmed code sequence, as described elsewhere herein. In addition, the power harvesting block 60 may harvest electrical energy, as needed, from the diodes 52 to provide voltage and/or other electrical energy to the sequence generator 58 and/or other components of the marker 40. As a result of the sequence generator 58, the marker 40 is made to change its structure between two form factors, thereby providing a passive reflector. By being able to change the switch 54 from closed to open, the reflection properties of the antennas 44 may be changed significantly and used by the probe 20 to identify, locate, and/or distinguish the markers 40 within the patient's body.
[0040] The ESD device 62 may be coupled in parallel across the switch 54, e.g., between the drain (D) and source (S), to provide protection against an electrostatic discharge event. For example, use of an E-pHEMT device as switch 54 sets restrictions on the absolute maximal voltage between the drain (D) and source (S) and, therefore, across the marker's antennas. In the exemplary embodiment of a VMMK-1225 E-pHEMT, the maximal voltage across the switch 54 may be no more than about five Volts (5 V). Modern breast surgery often involves the use of electro-cutting tools, electocautery tools, and/or other tools (not shown), which can generate electrical pulses of a few kV. If such a tool gets close to the marker 40, the tool can cause a very large voltage across antenna wires 44 and destroy the switch 54.
[0041] To increase survivability of the marker 40 during operation of such tools, the ESD protection device 62 truncates voltage on the switch 58 device when the voltage approaches the maximal value. Generally, the ESD protection device 62 in the marker 40 should have low capacitance that does not shunt the antennas 44 for the frequency range of the small amplitude UWB signal coming from the signals from the probe 20. In exemplary embodiments, the ESD protection device 62 may be a transient voltage suppressor, such as a Zener diode, a low-capacitance varistor, and the like. Alternatively or in addition, other ESD protection devices may be provided. For example, a capacitor (not shown) may be provided in series to one or both of the antennas 44 to provide additional ESD protection of the switch 58.
[0042] Returning to
[0043] In addition, the probe 20 includes a light source or transmitter 24 configured to transmit light pulses 25a into tissue contacted by the distal end 24, e.g., into breast tissue 90, as shown in
[0044] The probe 20 may include one or more processors within its housing or within the display unit 30 including one or more controllers, circuits, signal generators, gates, and the like (not shown) needed to generate signals for transmission by the transmit antennas 22t and/or to process signals received from the receive antennas 22r. The components of the processor(s) may include discrete components, solid state devices, programmable devices, software components, and the like, as desired. Optionally, the probe 20 and/or display unit 30 may include other features or components, such as one or more user interfaces, memory, transmitters, receivers, connectors, cables, power sources, and the like (not shown). In addition, the processor(s) may be coupled to a display 34 of the display unit 30 for displaying information to a user of the probe 20, e.g., spatial or image data obtained using the probe 20.
[0045] With additional reference to
[0046] Before the procedure, a target tissue region, e.g., a tumor or other lesion, may be identified using conventional methods. For example, a lesion (not shown) within a breast 90 may be identified, e.g., using mammography and/or other imaging, and a decision may be made to remove the lesion. A plurality of marker 40s may be implanted within the breast 90 within or adjacent the target lesion, e.g., using individual delivery devices or successively from a single delivery device 70, similar to the methods described in the applications incorporated by reference.
[0047] Once the markers 40 are implanted, e.g., as shown in
[0048] For example, the display 34 may include a readout providing distance, angle, orientation, and/or other data based on predetermined criteria, e.g., based on the relative distance from the markers 40 to the distal end 24 of the probe 20. The distance information may be displayed as a numerical value representing the distance in units of length, such as in inches (in.) or centimeters (cm). For example, as shown in
[0049] Tissue may then be dissected, e.g., by creating an incision in the patient's skin and dissecting intervening tissue to a desired depth, e.g., corresponding to a target margin around the lesion is reached. A tissue specimen may be excised or otherwise removed using conventional lumpectomy procedures, e.g., with the markers 40 remaining within the removed specimen.
[0050] An exemplary method will now be presented describing operation of the system 10 during use. Initially, when the probe 20 is activated, the transmit antennas 22t may periodically transmit relatively short ultrawide band (UWB) radio frequency (RF) pulses 23t, which are reflected by the markers 40, surrounding tissue, and/or otherwise by the patient's body. The receive antennas 22r receive the reflected signals 23r, which include crosstalk, scattering, noise, and reflections from the implanted markers 40. The processor(s) of the probe 20 or display unit 30 may digitize the reflected signals and generate waveform data, e.g., generally including multiple RF pulses, e.g., as represented by the top row in
[0051] After acquisition of the waveform is completed, the light source 24 may be activated to generate a clock pulse, i.e., a plurality of light pulses 25a, e.g., in spaced-apart frames including a predetermined number of pulses (N), that triggers the change of internal states of the markers 40 in accordance with the preprogrammed code sequence implemented in each marker 40. As explained elsewhere herein (with particular reference to
[0052] The clock circuit 56 of each marker 40 processes the light signals, i.e., by detecting the changes in voltage output by the diodes 52 when the light pulses strike the diodes. The clock circuit 56 may detect clock pulses as the rising edge of the light pulses and framing events encoded as relatively long time intervals with no clocking pulses. Thus, when a frame event is detected (i.e., a relatively long period of time without a change in voltage from the diodes 52), the clock circuit 56 resets the sequence generator 58 to its initial state. The clock pulses following the frame event control timing for generation of the code sequence by the sequence generator 58, represented as g.sub.l(i), which is preprogrammed in each marker 40.
[0053] Turning to
[0054] The processor(s) of the probe 20 and/or display unit 30 may perform separation and analysis of waveforms associated with individual reflectors using the orthogonal code sequences and the exemplary algorithm described below. To describe a method for the use of orthogonal sequences we consider a set of sequences in the form of s.sub.l(i)={−1,1}, instead of g.sub.l(i)={0,1}, where index i=0 N−1. These sequences contain the same and even number of symbols N=2m. They are balanced and orthogonal, i.e.,
[0055] Waveforms acquired from the corresponding to reflected RF signals received from a reflector with index k for each state of s.sub.k(i) can be written as:
W.sub.k(n,i)=W.sub.k(n)+s.sub.k(i)w.sub.k(n)
where n is the index of the waveform sample, W.sub.k(n) is the average shape of the waveform for and w.sub.k(n) is the effect of antenna modulation caused by switching in the k-th reflector.
[0056] Total signal received by the receive antennas 22r of the probe 20 may be digitized, e.g., in a synchronous Analog-to-Digital Converter, and include stationary scattering and crosstalk W.sub.S(n), signals from reflectors and noise, which can be written as follows:
The processor(s) may perform detection and localization of each marker by separating the modulation waveform from the specific marker, e.g., w.sub.l(n) for marker with index l and performing further analysis of the waveform characteristics. Separation of the marker modulation waveform w.sub.l(n) from the received signal W.sub.Rx(n, i) is achieved using multiplication of W.sub.Rx(n, i) with the corresponding code symbol s.sub.k(i) and calculating the sum of the results for the complete number of symbols in the sequence. i.e., N. The result of this multiplication and summation, i.e.,
R.sub.w(n,l)=Σ.sub.i=0.sup.N-1s.sub.l(i)W.sub.Rx(n,i)
may be unfolded by substituting waveforms W.sub.Rx(n, i) with its components, and written as follows:
The equation for R.sub.w(n,l) is a sum three terms. The first one gives zero due to the balance property of the code sequence, i.e.,
The second term may be written as two double sums:
Σ.sub.k=1.sup.KW.sub.k(n)Σ.sub.i=0.sup.N-1s.sub.l(i)+Σ.sub.k=1.sup.Kw.sub.k(n)Σ.sub.i=0.sup.N-1s.sub.l(i)s.sub.k(i),
where the first sum equals to zero, due to balance property, and the second sum may be split into a correlated part, that gives Nw.sub.l(n), and an uncorrelated part, that equals zero due to orthogonal property of the sequences, as shown below:
Therefore, the result of the described processing gives the modulation of the selected marker and the remaining third term, corresponding to noise, can be written as:
All other components of the received reflected RF signals equal zero due to the orthogonal properties and balanced selection of sequences.
[0057] To obtain waveforms of the modulation of the other markers, the processor(s) may perform the same processing, i.e., repeated using the code sequences preprogrammed in the respective markers. The sets of orthogonal sequences may be designed by utilizing a periodic sequence, such as that shown in
[0058] These sequences use a Gold Code algorithm to generate a set of sequences of length thirty one (31) symbols, modified to support the balance property by adding an extra symbol at the beginning of each sequence. As a result, the cross-correlation E.sub.i=0.sup.N-1 s.sub.l(i) s.sub.k(i+i.sub.delay) between each two sequences has zero value as shown in
[0059] With the reflected signals separated for each marker, the processor(s) may then process the individual signals to locate the individual markers, i.e., process the separated signals to determine a distance from the probe 20 to the respective markers 40. This processing may be performed substantially simultaneously, allowing information regarding each of the markers 40 to be presented to the user at the same time, e.g., on the display 34 of the display unit 30.
[0060] For example, each individual signal associated with a marker may be processed initially to identify the amplitude (or power envelope) of the signal waveform, and then determine the time delay of the return pulse in the signal to locate the marker. For example, to provide a distance measurement, time delay of the returned pulse may be measured with respect to the time of cross talk pulse, associated with a reflection from the probe antenna interfacing the tissue, to evaluate propagation delay in the path, e.g., from the probe 20 to the marker 40 and back to the probe 20, e.g., as shown in
[0061] Alternatively, Gold Code sequences may be used in a continuous wave (CW) radar system, such as those disclosed in U.S. Publication No. 2017/0319102, where amplitude and phase shift of the separated signals characterizing the propagation time and attenuation of the CW signal in the tissue on the path from the probe 20 to the marker 40 and back to the probe, e.g., as shown in
[0062] It will be appreciated that the multiplexing processing, e.g., code division processing, described herein may be used with other radar systems and/or other medical or non-medical applications using radar.
[0063] Turning to
[0064]
[0065] It will be appreciated that elements or components shown with any embodiment herein are exemplary for the specific embodiment and may be used on or in combination with other embodiments disclosed herein.
[0066] While the invention is susceptible to various modifications, and alternative forms, specific examples thereof have been shown in the drawings and are herein described in detail. It should be understood, however, that the invention is not to be limited to the particular forms or methods disclosed, but to the contrary, the invention is to cover all modifications, equivalents and alternatives falling within the scope of the appended claims.