MAGNETIC MARKERS FOR SURGICAL GUIDANCE
20220054224 · 2022-02-24
Assignee
Inventors
Cpc classification
A61B2090/397
HUMAN NECESSITIES
A61B34/20
HUMAN NECESSITIES
A61B90/39
HUMAN NECESSITIES
International classification
A61B90/00
HUMAN NECESSITIES
Abstract
An implantable magnetic marker comprising at least one piece of a large Barkhausen jump material (LBJ) containing at least one loop. The coiled marker is deployed to mark a tissue site in the body for subsequent surgery, and a magnetic detection system with a handheld probe excites the marker above or below the switching field required for bistable switching of the marker causing a harmonic response to be generated in a bistable or sub-bistable mode that allows the marker to be detected and localised.
Claims
1.-17. (canceled)
18. A magnetic marker comprising: an implantable marker comprising a magnetic material that exhibits a large Barkhausen jump (LBJ) in its magnetization curve, wherein the magnetic material defines a loop, the loop being retained in the implantable marker during detection of the marker following implantation.
19. The magnetic marker of claim 18, wherein the loop comprises one or more sections, wherein the one or more sections define a substantially straight side.
20. The magnetic marker of claim 19, wherein the loop defines one or more angles.
21. The magnetic marker of claim 20, wherein the loop is continuous.
22. The magnetic marker of claim 21, wherein the loop defines one or more angles.
23. The magnetic marker of claim 22, wherein the loop defines three or more angles.
24. The magnetic marker of claim 22, wherein the loop defines four or more angles.
25. The magnetic marker of claim 22, wherein the magnetic material is deployable in final implantable form without needing a shape transition.
26. The magnetic marker of claim 21, wherein the loop is formed integrally.
27. The magnetic marker of claim 20, wherein the one or more sections are four sections, wherein each section defines a substantially straight side.
28. The magnetic marker of claim 20, wherein the magnetic material is coated with a coating or provided within a housing, the coating or housing having a relatively low conductivity.
29. The magnetic marker of claim 28 wherein the coating or housing is formed from a material having a resistivity greater than 2×10.sup.−7 Ωm.
30. The magnetic marker of claim 22, wherein a length of the loop is several time.
31. A magnetic marker comprising: an implantable marker comprising a magnetic material, wherein the magnetic material defines a loop, wherein implantable marker is detectable and localizable using a non-invasive handheld probe, wherein the loop comprises one or more sections, wherein the one or more sections define a substantially straight side, wherein the loop defines one or more angles, the loop being retained in the implantable marker during detection of the marker following implantation.
32. The magnetic marker of claim 31, wherein the magnetic material exhibits a large Barkhausen jump (LBJ) in its magnetization curve.
33. The magnetic marker of claim 31, wherein the magnetic material is deployable in final implantable form without needing a shape transition.
34. The magnetic marker of claim 31, wherein the loop is continuous.
35. The magnetic marker of claim 32, wherein the loop is continuous.
36. The magnetic marker of claim 35, wherein the one or more sections are at least two sections, wherein each section defines a substantially straight side.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0053] For a better understanding of the present invention and to show more clearly how it may be carried into effect, reference will now be made by way of example only, to the accompanying drawings, in which:
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DETAILED DESCRIPTION OF THE INVENTION
[0080] The present invention relates to a magnetic marker that can be implanted for marking a site in the body, for example the site of a lesion and subsequently be detected and localised using a handheld probe. The invention also describes a detection system and method for locating the position of the implanted marker in the body.
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detection system further contains one or more sense coils 10 arranged to detect the changes in the magnetic field caused by the change in magnetisation of the marker.
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[0083] It is desirable to provide improved markers for enhanced localisation by the probe. The Applicant's co-pending Application No. GB1801224.5 describes one such marker. The marker comprises at least one piece of magnetic marker material having a large Barkhausen discontinuity in its magnetisation curve, also known as a large Barkhausen jump material (or a LBJ material). When the LBJ material is exposed to an external magnetic field whose field strength opposing the instantaneous magnetic polarization of said length of material exceeds a predetermined threshold value, the switching field H.sub.SW, its magnetic polarization undergoes a rapid reversal. This reversal of magnetisation generates a magnetic pulse with rich harmonic components. Conventionally, the markers are sized to be above the so-called ‘critical length’, that is the length at which the magnetization can undergo the full bistable transition or ‘flipping’ behaviour which is required to generate a significant harmonic response. However, the inventors found that a harmonic response can be obtained from markers significantly below their critical length and/or below the switching field H.sub.SW in a newly recognized “sub-bistable” mode and that this is advantageous for use for localization of the implantable marker.
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[0087] The alternating magnetic field excites the marker 6 and the magnetisation of the marker leads to the generation of harmonic components in the field. Depending on the arrangement of the marker, the harmonics may be odd harmonics, (3.sup.rd, 5.sup.th, 7.sup.th etc.) or even harmonics (2.sup.nd, 4.sup.th, 6.sup.th etc.) or a combination of both odd and even harmonics. The marker is detected by measuring the magnitude of one or more of the harmonic frequencies directly or by measuring the ratio of the magnitude of one or more harmonics to others or to the magnitude of the fundamental frequency.
[0088] The response from the marker is detected by one of more sense coils 10 to generate a sense voltage or current. The sense coils may be in a handheld or robotic probe. A high-pass or notch filter 14 may be arranged to filter out or attenuate at least components of the sense signal at the drive frequency so that the resulting signal has minimal content at the drive frequency and comprises higher harmonic components of the signal, for example the second, third, fourth, fifth or seventh order harmonics or combinations of these. The filter may take the form of a passive LCR type filter comprising a known arrangement of for example capacitors, inductors and resistors or an active filter comprising a known arrangement for example based on one or more op-amps.
[0089] The filtered signal may be fed to a harmonic detection circuit 16 which amplifies one or more harmonic components of the signal and converts the signal 18 to a measure of distance from the probe to the marker. A user display and sound generator 20 provides a visual and audio output to the user indicating for example, the proximity of the marker or the magnitude of the magnetic signal. The system may indicate the proximity, size, distance to, direction or orientation of the marker, or combinations of these.
[0090] When a straight piece of LBJ wire is excited, the magnetic response it gives is directional, that is there is a greater response along the axis of the wire and a much lower response in a direction perpendicular to the wire. For this reason, the inventors co-pending Application GB1801224.5 describes how the dipole length of the LBJ material in the direction of the drive field is an important parameter for enabling harmonic response and detection and discloses the use of a number of wires, for example in a tripod arrangement, such that the dipole length in any given direction is substantially similar. However, such markers have thin sections making them fragile or vulnerable to movement. This can make satisfactory deployment of the marker difficult.
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[0092] It is critical that the marker 6 deploys correctly from the needle because otherwise the similarity or identity of the dipole length in each direction will be affected, leading to a non-uniform and inaccurate response.
[0093] The present invention provides improved markers that contain LBJ material which may be detected using their conventional bistable behaviour or using the recently identified “sub-bistable” mode. The inventors have surprisingly found that markers that have a LBJ material formed into a coil or loop produce a measurable harmonic response. This was not to be expected because classic switching behaviour occurs through a cascade or domino effect in which the magnetic domains in the LBJ wires all flip at one time, and thus alignment of all the domains with the driving magnetic field is key. Domains not substantially aligned with the field will not flip or switch, thus resulting in the use of straight wires for detection. Thus, the skilled person would consider the use of any other configuration to be counter-intuitive based on the prior art literature. The coiled markers according to the invention demonstrate switching response similar qualitatively to the classic bistable switching described in the prior art at higher fields and larger diameter coils, while at lower fields and with smaller diameter coils, the response is ‘sub-bistable’ as described in GB1801224.5.
[0094] Furthermore, while a single straight LBJ wire provides an axial response that is much greater than the transverse (perpendicular to the axis) response, more surprisingly, the inventors have found that a coil of LBJ wire when excited in the sub-bistable mode (and indeed the bistable mode), has a larger transverse response than axial response, even when its length is several times its diameter.
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[0099] Further embodiments of a marker according to the present invention are shown in
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[0102] The LBJ magnetic material that is wound into coil as herein described may be combined with other materials to improve the marker. For example, the marker may be packaged within other materials. In this respect, markers for implantation need to be both biocompatible to prevent a reaction with body tissue, and robust. Some preferred magnetic materials are thin (wires below 0.15 mm in diameter), and contain non-biocompatible materials. Therefore, to improve the biocompatibility and robustness of the marker, it is preferable to provide a housing or coating for the magnetic material.
[0103] In a preferred embodiment a biocompatible and insulating coating or sheath such as FEP, Parylene, PTFE, ETFE, PE, PET, PVC or silicone further surrounds the tube 24. This insulating layer stops conduction between the turns within the coils further reducing the effects of Eddy current on the magnetic response of the marker.
[0104] Table 2 below shows the influence of the conductivity of the tube material on the harmonic response for straight lengths of an LJB wire in different tube materials. The signal from the LBJ wire in the copper tube with a material resistivity of 0.17×10.sup.−7 Ωm is at least 16 times lower than the signal from similar wires in tubes made with other materials with a higher resistivity of greater than 2×10.sup.−7 Ωm. The use of selective cutting of the tube such as with an interrupted laser cut spiral, which also supplies flexibility for coiling, may also be used to increase resistance and reduce the production of Eddy currents. The polymer coating may be applied before or after the material or tube is formed into a coil.
[0105] In a preferred embodiment, the marker housing could be formed from a moulded or extruded material. For example, a polymer may be extruded around the magnetic wire to form a coated wire that can then be formed into a loop or coil. Any of the embodiments above could also be overmoulded with a polymer to form a marker. The advantage of such an embodiment is that the polymer could provide biocompatibility and also make the manufacturing process simpler and less costly. The use of polymers also minimises any Eddy current effects seen with metal coatings or housings that could affect the magnetic response. Suitable materials for the coating or overmoulding include PEEK, PEKK, polyethylene, polypropylene, polyester, polyurethane, polyimide, polyether block amide, polyamide, PTFE, FEP, PET and silicones.
[0106] In another preferred embodiment, a marker according to the present invention includes a housing comprising one or more strands of material 26 which are wound around the magnetic material to form a more robust construction prior to forming into the final marker shape.
[0107] In any of the above embodiments, the marker may comprise a resiliently deformable member (tube, wire strands or coating) containing the LBJ wire such that the coil expands on deployment to a larger size. The expansion may be driven elastically by a resiliently deformable material or by a shape memory transition material such as nitinol.
[0108] In a further embodiment, the cross section of the marker may take a number of forms including round, rectangular or triangular, as shown in
[0109] Table 1 below illustrates characteristics of markers according to the invention and their H3 magnetic response. Embodiments shown in
TABLE-US-00001 TABLE 1 Ratio max:min Diameter Length Number of Pitch Aspect ratio H3 magnetic Dominant Housing Marker (mm) (mm) Turms (mm) (length:diameter) response Direction Material Prior Art straight 0.1 4 none N/A 40.0 39.1 Axial None length of wire Single Coil 1.26 7 22 0.32 5.6 19.8 Perp. Cu Single Coil 1.26 7 11 0.64 5.6 6.6 Perp. Cu Single Coil 1.26 7 8 0.88 5.6 5.5 Perp. Cu Single Coil 1.26 7 4.5 1.56 5.6 1.4 None Cu Single Coil 1.06 8 1.5 5.3 7.5 4.7 Axial Cu Single Coil 1.16 6 2 3.0 5.2 1.6 None Cu Single Coil (FIG. 6A) 1.03 6 17 0.35 5.8 10.9 Perp. Cu Coil & Axial wire (FIG. 6B) Coil: 1.03 6 17 0.35 5.8 1.2 None Cu Axial wire: 0.1 3.2 none N/A None Single Coil (FIG. 7B) 1.01 7 8.5 0.82 5.6 1.2 None Ti Variable Pitch 1.01 8 1 2.5 7.9 2.2 Perp. Cu Coil 9 0.33 (FIG. 8A) 1 2.5 Mullti-coil, 3 coils 1.06 7 3 × 3 2.33 6.6 1.6 None Cu (FIG. 10B)
[0110] Table 2 below illustrates the effect of the housing material of the marker on the magnitude of H3 response at a distance of 20 mm for a probe of a straight length of Co—Fe LBJ material of 4 mm.
TABLE-US-00002 TABLE 2 Housing Hosing Housing Housing Material H3 response relative Ratio max:min H3 Material Diameter (mm) Length (mm) Resistivity (Ωm) to copper magnetic response Copper 0.29 4 1.7 × 10.sup.−8 1 3 316 Stainless Steel 0.50 4 7.4 × 10.sup.−7 16 23 Titanium 0.51 4 5.2 × 10.sup.−7 17 26 Nitinol 0.33 4 7.6 × 10.sup.−7 19 41
[0111] Table 3 below shows how the magnitude of H3 response varies with diameter at a distance of 20 mm for a marker with similar coil pitches for coils in both 304ss and PET as well as demonstrating the increased response from coils in a material where there is less opposing eddy currents e.g. coils (PET), showing the increase in relative response per turn for the single coils with diameter. It also demonstrates the increased signal from a coil of smaller diameter inside a coil of larger diameter (
TABLE-US-00003 TABLE 3 Signal per Turn/ H3 response Magnetic Coil 304ss relative Coil Material Length No of Pitch Ø0.88 mm ø0.88 mm 304ss Coil Material Diameter (mm) (mm) Turns (mm) Signal per turn coil Single Coil A 304ss 0.88 5 13 0.39 1 1 Single Coil E 304ss 0.99 7 17 0.41 1.8 2.3 Single Coil B 304ss 1.10 5 14 0.36 2.9 3.1 Single Coil C 304ss 1.25 5 14 0.36 3.3 3.5 Single Coil D 304ss 2.02 5 11.5 0.43 6.2 5.5 Coil C inside 304ss 1.25 inside 2.02 5 14 inside 11.5 0.36 inside 0.43 N/A 6.7 Coil D (9) Single Coil F PET 1.1 8 15 0.53 3.9 4.5 Single Coil G PET 1.2 6 10 0.60 4.6 3.5 Single Coil H PET 1.46 5.8 10 0.58 5.9 4.5 Single Coil I PET 2.22 5.4 10 0.54 7.7 5.9 Single Coil J PET 3.26 5.8 10 0.58 10.1 7.8
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of response would be expected from a straight length of LBJ wire based on the prior art literature, for example von Gutfeld (von Gutfeld, R J et al., Amorphous magnetic wires for medical locator applications, Appl. Phys. Lett., Vol. 81, No. 10, 2 Sep. 2002) which describes an axial response many times stronger than the transverse response.
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[0115] The inventors have found that such markers can be combined to create a marker with a more optimal or preferred harmonic response profile. Specifically, it is preferable if the harmonic response at a given distance from the marker is substantially uniform.
[0116] Thus for example, the prior art single straight wire can be combined with the coil of
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[0118] It is demonstrated in
of coil parameters and choice of additional axial components, the uniformity of the harmonic response can be adjusted and optimised to obtain the profile of response versus direction that is desired. This could be increased transverse response or axial response, but is most preferably a uniform or equal response regardless of the direction of excitation or sensing. The advantage of a uniform response is that the signal can be reliably and consistently converted into a distance measurement from the probe to the marker. If the uniformity is poor, the user will obtain a different distance measurement depending on the orientation of the marker with respect to the probe which would be confusing. The uniformity of response can be estimated by measuring the variation of response with orientation of the marker relative to the probe, and calculating the ratio of the maximum to minimum response.
[0119] In the context of this disclosure, a uniform response means that the ratio of the maximum to minimum magnitude of the response being measured (be it H3, or other magnetic response) is less than 3 and preferably less than 2. Because the magnetic response when being detected with an arrangement similar to that in
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[0121] The uniformity of response can also be varied by adjusting the pitch, number of turns/convolutions, length, diameter, shape, cross section and end configuration of the coil, and by varying the diameter or pitch of the turns at different points along the length of the coil.
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[0123] By increasing the pitch compared with the marker of
[0124] If the pitch is increased to improve the uniformity of the response, the length of the marker for a given magnitude of response will increase, or the number of convolutions in a given length of marker will be reduced. The inventors have found that in this case, more than one coil can be combined in the form of a multi-start helix to increase the response while maintaining the small size of the marker.
[0125] The present invention provides a new and improved magnetic marker that may be used in a system and method for detecting the marker, thereby enabling a lesion for surgical excision to be located. The marker contains at least a piece of LBJ magnetic material that is wound into a coil having at least one, preferably more, convolutions. The marker may be excited at the switching field (bistable mode) or at a field lower than the bistable switching field (sub-bistable mode) and the generated harmonics measured from any direction to determine the position and orientation of the marker. In embodiments, the marker may also be provided below the critical length of the LBJ material required to enable bistable switching behaviour.