US20080294155A1 - Radiation Applicator and Method of Radiating Tissue - Google Patents
Radiation Applicator and Method of Radiating Tissue Download PDFInfo
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- US20080294155A1 US20080294155A1 US12/158,831 US15883106A US2008294155A1 US 20080294155 A1 US20080294155 A1 US 20080294155A1 US 15883106 A US15883106 A US 15883106A US 2008294155 A1 US2008294155 A1 US 2008294155A1
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- ferrule
- applicator
- sleeve
- microwave applicator
- inner conductor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T7/00—Image analysis
- G06T7/30—Determination of transform parameters for the alignment of images, i.e. image registration
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
- A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
- A61B2018/00023—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids closed, i.e. without wound contact by the fluid
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
- A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
- A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00059—Material properties
- A61B2018/00071—Electrical conductivity
- A61B2018/00077—Electrical conductivity high, i.e. electrically conducting
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00059—Material properties
- A61B2018/00071—Electrical conductivity
- A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00172—Connectors and adapters therefor
- A61B2018/00178—Electrical connectors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
- A61B2018/183—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves characterised by the type of antenna
- A61B2018/1838—Dipole antennas
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
- A61B2018/1869—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves with an instrument interstitially inserted into the body, e.g. needles
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
- A61B2018/1892—Details of electrical isolations of the antenna
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/02—Radiation therapy using microwaves
- A61N5/04—Radiators for near-field treatment
- A61N5/045—Radiators for near-field treatment specially adapted for treatment inside the body
Abstract
A dipole microwave applicator emits microwave radiation into tissue to be treated. The applicator is formed from a thin coax cable having an inner conductor surrounded by an insulator, which is surrounded by an outer conductor. A portion of the inner conductor extends beyond the insulator and the outer conductor. A ferrule at the end of the outer conductor has a step and a sleeve that surrounds a portion of the extended inner conductor. A tuning washer is attached to the end of the extended inner conductor. A dielectric tip encloses the tuning washer, the extended inner conductor, and the sleeve of the ferrule. The sleeve of the ferrule and the extended inner conductor operate as the two arms of the dipole microwave antenna. The tuning washer faces the step in the ferrule, and is sized and shaped to cooperate with the step in balancing and tuning the applicator.
Description
- The present application is related to commonly owned copending International patent application no. WO 2006/002943, concerning a Radiation Applicator and Method of Radiating Tissue and which is hereby incorporated by reference in its entirety.
- 1. Field of the Invention
- The present invention relates generally to medical technology, and more specifically to microwave radiation applicators and methods of thermal ablative treatment of tissue using radiated microwaves.
- 2. Background Information
- Thermal ablative therapies may be defined as techniques that intentionally decrease body tissue temperature (hypothermia) or intentionally increase body tissue temperature (hyperthermia) to temperatures required for cytotoxic effect, or to other therapeutic temperatures depending on the particular treatment. Microwave thermal ablation relies on the fact that microwaves form part of the electromagnetic spectrum causing heating due to the interaction between water molecules and the microwave radiation. The heat being used as the cytotoxic mechanism. Treatment typically involves the introduction of an applicator into tissue, such as tumors. Microwaves are released from the applicator forming a field around its tip. Heating of the water molecules occurs in the radiated microwave field produced around the applicator, rather than by conduction from the probe itself. Heating is therefore not reliant on conduction through tissues, and cytotoxic temperature levels are reached rapidly.
- Microwave thermal ablative techniques are useful in the treatment of tumors of the liver, brain, lung, bones, etc.
- U.S. Pat. No. 4,494,539 discloses a surgical operation method using microwaves, characterized in that microwaves are radiated to tissue from a monopole type electrode attached to the tip of a coaxial cable for transmitting microwaves. Coagulation, hemostasis or transaction is then performed on the tissue through the use of the thermal energy generated from the reaction of the microwaves on the tissue. In this way, the tissue can be operated in an easy, safe and bloodless manner. Therefore, the method can be utilized for an operation on a parenchymatous organ having a great blood content or for coagulation or transaction on a parenchymatous tumor. According to the method, there can be performed an operation on liver cancer, which has been conventionally regarded as very difficult. A microwave radiation applicator is also disclosed.
- U.S. Pat. No. 6,325,796 discloses a microwave ablation assembly and method, including a relatively thin, elongated probe having a proximal access end, and an opposite distal penetration end adapted to penetrate into tissue. The probe defines an insert passage extending therethrough from the access end to the penetration end thereof. An ablation catheter includes a coaxial transmission line with an antenna device coupled to a distal end of the transmission line for generating an electric field sufficiently strong enough to cause tissue ablation. The coaxial transmission line includes an inner conductor and an outer conductor separated by a dielectric material. A proximal end of the transmission line is coupled to a microwave energy source. The antenna device and the transmission line each have a transverse cross-sectional dimension adapted for sliding receipt through the insert passage while the elongated probe is positioned in the tissue. Such sliding advancement continues until the antenna device is moved to a position beyond the penetration end and further into direct contact with the tissue.
- However, a drawback with the existing techniques include the fact that they are not optimally mechanically configured for insertion into, and perforation of, the human skin, for delivery to a zone of soft tissue to be treated. Typically, known radiation applicator systems do not have the heightened physical rigidity that is desirable when employing such techniques.
- In addition, some radiation applicators made available heretofore do not have radiation emitting elements for creating a microwave field pattern optimized for the treatment of soft tissue tumors.
- Also, given the power levels employed in some applicators and treatments, there can be problems of unwanted burning of non-target, healthy tissue due to the very high temperatures reached by the applicator or the components attached thereto.
- Further, although small diameter applicators are known, and liquid cooling techniques have been used, there has been difficulty in designing a small diameter device with sufficient cooling in applications employing power levels required to deal with soft tissue tumors.
- Accordingly, there is a need for methods of treatment of soft tissue tumors, and for radiation applicators that overcome any or all of the aforementioned problems of the prior art techniques, and provide improved efficacy.
- In accordance with one aspect of the present invention, there is provided a dipole microwave applicator for emitting microwave radiation into tissue, the assembly comprising: an outer conductor having an end; an inner conductor disposed within the outer conductor, and including a section that extends outwardly beyond the end of the outer conductor; a ferrule disposed at the end of the outer conductor, and having a sleeve portion that surrounds a portion of the outwardly extending section of the inner conductor; and a dielectric tip surrounding the sleeve portion of the ferrule and the outwardly extending section of the inner conductor, whereby the sleeve portion of the ferrule and at least a portion of the outwardly extending section of the inner conductor operate as corresponding arms of the dipole microwave applicator.
- Particular embodiments are set out in the dependent claims.
- Briefly, the present invention is directed to a microwave applicator for ablating tissue. The applicator is a dipole microwave antenna that transmits microwave radiation into the tissue being treated. The applicator is formed from a thin coaxial cable having an inner conductor surrounded by an insulator, which is surrounded by an outer conductor or shield. The end of the coaxial cable is trimmed so that a portion of the insulator and inner conductor extend beyond the outer conductor, and a portion of the inner conductor extends beyond the insulator. The applicator further includes a tubular ferrule defining an aperture therethrough. One end of the ferrule is attached to the outer conductor, while the other end, which forms a sleeve, extends out beyond the end of the insulator and around a portion of the extended inner conductor. A step is preferably formed on the outer surface of the ferrule between its two ends. A solid spacer having a central bore to receive the inner conductor abuts an end of the ferrule and surrounds the extended inner conductor. A tuning element is attached to the end of the extended inner conductor, and abuts an end of the spacer opposite the ferrule. The tuning element faces the step in the ferrule, and the step and the tuning element are both sized and shaped to cooperate in balancing and tuning the applicator. A hollow tip, formed from a dielectric material, has an open end and a closed end. The tip encloses the tuning element, the spacer, and the extended inner conductor. The tip also encloses the sleeve of the ferrule, thus defining outer surface of the ferrule that is surrounded by the dielectric tip. The open end of the tip preferably abuts the step in the ferrule. A rigid sleeve surrounds the coaxial cable and extends away from the ferrule opposite the tip. The sleeve, which abuts the step of the ferrule opposite the tip, has an inner diameter that is larger than the coaxial cable, thereby defining an annular space between the outside of the coaxial cable and the inner surface of the sleeve. The sleeve further includes one or more drainage holes, which permit fluid communication between the annular space around the coaxial cable and the outside of the applicator.
- In operation, microwave energy from a source is applied to the coaxial cable, and is conveyed to the tip. The portion of the inner conductor that extends beyond the end of the ferrule forms one arm of the dipole, and emits microwave radiation. In addition, the microwave energy flowing along the inner conductor of the coaxial cable and in the aperture of the ferrule induces a current to flow along the outer surface of the sleeve of the ferrule that is surrounded by the tip. This, in turn, causes microwave radiation to be emitted from the sleeve of the ferrule, which operates as the second arm of the dipole. In this way, microwave energy is emitted along a substantial length of the applicator, rather than being focused solely from the tip. By distributing the emission of microwave radiation along a length of the applicator, higher power levels may be employed.
- To keep the coaxial cable and the applicator from overheating, a cooling fluid is introduced from a source into the annular space defined by the outside of the coaxial cable and the inside of the sleeve. The cooling fluid flows along this annular space, and absorbs heat from the coaxial cable. The cooling fluid, after having absorbed heat from the coaxial cable, then exits the annular space through the one or more drainage holes in the sleeve, and perfuses adjacent tissue.
- The closed end of the tip is preferably formed into a blade or point so that the Microwave applicator may be inserted directly into the tissue being treated. The tip, ferrule, and rigid sleeve, moreover, provide strength and stiffness to the applicator, thereby facilitating its insertion into tissue.
- The present invention further provides a method of treating target tissue, such as a tumor, the tumor being formed of, and/or being embedded within, soft tissue. The method includes inserting the microwave applicator into the tumor, and supplying electromagnetic energy to the applicator, thereby radiating electromagnetic energy into the tumor.
- Embodiments of the invention will now be described, by way of example, with reference to the accompanying drawings, in which:
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FIG. 1 is a schematic, partial cross-sectional view of a radiation applicator in accordance with one embodiment of the invention; -
FIG. 2A shows an axial cross-section, andFIG. 2B shows an end elevation of the radiating tip of the radiation applicator ofFIG. 1 ; -
FIG. 3 shows a partial transverse cross-section of the tube of the radiation applicator ofFIG. 1 ; -
FIG. 4A shows a transverse cross-section, andFIG. 4B shows an axial cross-section of the tuning washer of the radiation applicator ofFIG. 1 ; -
FIG. 5A shows an axial cross-section, andFIG. 5B shows an end elevation of the ferrule of the radiation applicator ofFIG. 1 ; -
FIG. 6A shows an axial cross-section, andFIG. 6B shows a transverse cross-section of a handle section that may be attached to the radiation applicator ofFIG. 1 ; -
FIG. 7 illustrates the portion of coaxial cable that passes through the tube of the radiation applicator ofFIG. 1 ; -
FIG. 8 is a plot of S11 against frequency for the radiation applicator ofFIG. 1 ; -
FIG. 9A illustrates the E-field distribution, andFIG. 9B illustrates the SAR values around the radiation applicator ofFIG. 1 , in use; -
FIGS. 10A-E show a preferred sequential assembly of the radiation applicator ofFIG. 1 ; -
FIG. 11 schematically illustrates a treatment system employing the radiation applicator ofFIG. 1 ; -
FIG. 12 is an exploded, perspective view of another embodiment of the present invention; -
FIGS. 13-18 show a preferred sequential assembly of the radiation applicator ofFIG. 12 ; and -
FIG. 19 is a schematic, partial cross-sectional view of the radiation applicator ofFIG. 12 . - In the following description, like references are used to denote like elements, and where dimensions are given, they are in millimeters (mm). Further, it will be appreciated by persons skilled in the art that the electronic systems employed, in accordance with the present invention, to generate, deliver and control the application of radiation to parts of the human body may be as described in the art heretofore. In particular, such systems as are described in commonly owned published international patent applications W095/04385, W099/56642 and WOOO/49957 may be employed (except with the modifications described hereinafter). Full details of these systems have been omitted from the following for the sake of brevity.
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FIG. 1 is a schematic, partial cross-sectional view of a radiation applicator in accordance with one embodiment of the invention. The radiation applicator, generally designated 102, includes a distal end portion of acoaxial cable 104 that is used to couple to a source (not shown) of microwaves, acopper ferrule 106, atuning washer 108 attached on theend 110 of the insulator part of thecoaxial cable 104, and atip 112. Preferably, theapplicator 102 further includes ametal tube 114.Tube 114 is rigidly attached to theferrule 106. Anannular space 116 is defined between theouter conductor 118 of thecable 104 and the inner surface of thetube 114, enabling cooling fluid to enter (in the direction of arrows A), contact the heated parts of theapplicator 102 and exit in the direction of arrows B throughradial holes 120 in thetube 114, thereby extracting heat energy from theradiation applicator 102. - In assembly of the
applicator 102, thewasher 108 is soldered to asmall length 122 of thecentral conductor 124 of thecable 104 that extends beyond theend 110 of theinsulator 126 of thecable 104. Theferrule 106 is soldered to a smallcylindrical section 128 of theouter conductor 118 of thecable 104. Then, thetube 114, which is preferably stainless steel, but may be made of other suitable materials, such as titanium or any other medical grade material, is glued to theferrule 106 by means of an adhesive, such as Loctite 638 retaining compound, at the contacting surfaces thereof, indicated at 130 and 132. Thetip 112 is also glued preferably, using the same adhesive, on the inner surfaces thereof, to corresponding outer surfaces of theferrule 106 and theinsulation 126. - When assembled, the
applicator 102 forms a unitary device that is rigid and stable along its length, which may be of the order of 250 or somillimeters including tube 114, thereby making theapplicator 102 suitable for insertion into various types of soft tissue. Thespace 116 andholes 120 enable cooling fluid to extract heat from theapplicator 102 through contact with theferrule 106, theouter conductor 118 of thecable 104 and the end of thetube 114. Theferrule 106 assists, among other things, in assuring the applicator's rigidity. Theexposed end section 134 ofcable 104 from which theouter conductor 118 has been removed, in conjunction with thedielectric tip 112, are fed by a source of radiation of predetermined frequency. Theexposed end section 134 anddielectric tip 112 operate as a radiating antenna for radiating microwaves into tissue for therapeutic treatment. Theapplicator 102 operates as a dipole antenna, rather than a monopole device, resulting in an emitted radiation pattern that is highly beneficial for the treatment of certain tissues, such as malignant or tumorous tissue, due to its distributed, spherical directly heated area. -
FIG. 2A shows an axial cross-section, andFIG. 2B shows an end elevation of thetip 112 of theradiation applicator 102 ofFIG. 1 . As can be seen, thetip 112 has innercylindrical walls walls washer 108 and theferrule 106, respectively, during assembly. Suitably, thetip 112 is made of zirconia ceramic alloy. More preferably, it is a partially stabilized zirconia (PSZ) having yttria as the stabilizing oxidizing agent. Even more preferably, thetip 112 is made of Technox 2000, which is a PSZ commercially available from Dynamic Cerarnic Ltd. of Staffordshire, England, having a very fine uniform grain compared to other PSZs, and a dielectric constant (k) of 25. As understood by those skilled in the art, the choice of dielectric material plays a part in determining the properties of the radiated microwave energy. - It will be noted that the transverse dimensions of the
applicator 102 are relatively small. In particular, the diameter ofapplicator 102 is preferably less than or equal to about 2.4 mm. Thetip 112, moreover, is designed to have dimensions, and be formed of the specified material, so as to perform effective tissue ablation at the operating microwave frequency, which in this case is preferably 2.45 Gigahertz (GHz). Theapplicator 102 of the present invention is thus well adapted for insertion into, and treatment of, cancerous and/or non-cancerous tissue of the liver, brain, lung, veins, bone, etc. - The
end 210 of thetip 112 is formed by conventional grinding techniques performed in the manufacture of thetip 112. Theend 210 may be formed as a fine point, such as a needle or pin, or it may be formed with an end blade, like a chisel, i.e. having a transverse dimension of elongation. The latter configuration has the benefit of being well suited to forcing thetip 112 into or through tissue, i.e. to perforate or puncture the surface of tissue, such as skin. - In use, the
tip 112 is preferably coated with a non-stick layer such as silicone or paralene, to facilitate movement of thetip 112 relative to tissue. -
FIG. 3 shows a partial transverse cross-section of thetube 114. As mentioned above, thetube 114 is preferably made of stainless steel. Specifically, thetube 114 is preferably made from 13 gauge thin wall 304 welded hard drawn (WHD) stainless steel. Thetube 114 is also approximately 215 mm in length. As can be seen, two sets ofradial holes end 302 of thetube 114. Theseradial holes tube 114 is not compromised. In this embodiment, theholes end 302 is 12 or 13 mm, in alternative embodiments, this distance may range from 3 mm to 50 mm from theend 302, in order to control the length of track that requires cauterization. - Further, in an embodiment used in a different manner, the
tube 114 may be omitted. In this case the treatment may comprise delivering the applicator to the treatment location, e.g., to the tumorous tissue, by suitable surgical or other techniques. For example, in the case of a brain tumor, the applicator may be left in place inside the tumor, the access wound closed, and a sterile connector left at the skull surface for subsequent connection to the microwave source for follow-up treatment at a later date. -
FIG. 4A shows a transverse cross-section, andFIG. 4B shows an axial cross-section of thetuning washer 108. Thewasher 108 is preferably made of copper, although other metals may be used. Thewasher 108 has an innercylindrical surface 402 enabling it to be soldered to thecentral conductor 124 of the cable 104 (FIG. 1 ). Although the washer is small, its dimensions are critical. Thewasher 108 tunes theapplicator 102, which operates as a dipole radiator, i.e., radiating energy from two locations, so that more effective treatment, i.e., ablation, of tissue is effected. -
FIG. 5A shows an axial cross-section, andFIG. 5B shows an end elevation of theferrule 106. Theferrule 106 is preferably made of copper, and is preferably gold plated to protect against any corrosive effects of the cooling fluid. Theferrule 106 may be produced by conventional machining techniques, such as CNC machining. -
FIG. 6A shows an axial cross-section, andFIG. 6B shows a transverse cross-section at line B-B of ahandle section 602 that may be attached to thetube 114 of theradiation applicator 102. Thehandle section 602 is preferably made from the same material as thetube 114, i.e., stainless steel. Thehandle section 602 includes aforward channel 604 enabling insertion of thetube 114, and arear channel 606 enabling insertion of thecoaxial cable 104 during assembly. A transverse port 608 having an internal thread 610 enables the connection, through a connector, to a source of cooling fluid, discussed later. The connector may be formed from plastic. Once assembled, the arrangement ofhandle section 602 enables cooling fluid to pass in the direction of arrow C into the tube 114 (not shown). -
FIG. 7 illustrates the portion ofcoaxial cable 104 that passes through thetube 114. Thecable 104 suitably comprises a low-loss, coaxial cable such as SJS070LL-253-Strip cable. Aconnector 702, preferably a SMA female type connector permits connection of thecable 104 to a microwave source (not shown), or to an intermediate section of coaxial cable (not shown) that, in turn, connects to the microwave source. -
FIG. 8 is a plot of S11 against frequency for theradiation applicator 102 ofFIG. 1 . This illustrates the ratio of reflective microwave power from the interface of theapplicator 102 and treated tissue to total input power to theapplicator 102. As can be seen, the design of theapplicator 102 causes the reflected power to be a minimum, and therefore the transmitted power into the tissue to be a maximum, at a frequency of 2.45 GHz of the delivered microwaves. -
FIG. 9A shows the E-field distribution around theradiation applicator 102 ofFIG. 1 , in use. Darker colors adjacent to theapplicator 102 indicate points of higher electric field. InFIG. 9A , the position of thewasher 108 is indicated at 902, and the position of the tip-ferrule junction is indicated at 904. Two limited, substantially cylindrical zones 906, 908, of highest electric field are formed around theapplicator 102 at thepositions -
FIG. 9B shows the specific absorption rate (SAR) value distribution around theradiation applicator 102 ofFIG. 1 , in use. Darker colors adjacent theapplicator 102 indicate points of SAR. InFIG. 9B , the position of thewasher 108 is indicated at 902, the position of the tip-ferrule junction is indicated at 904, and the position of the ferrule-tube junction is indicated at 905. Two limited, substantially cylindrical zones 910, 912, of highest SAR are formed around theapplicator 102 at thepositions 902 and between 904 and 905, respectively. -
FIGS. 10A-E show a preferred sequential assembly of components forming theradiation applicator 102 ofFIG. 1 . InFIG. 10A , thecoaxial cable 104 is shown with theouter conductor 118 and theinner insulator 126 trimmed back, as illustrated earlier inFIG. 7 . - As shown in
FIG. 10B , thetube 114 is then slid over thecable 104. Next, theferrule 106 is slid over the cable 104 (FIG. 10C ), and fixedly attached to thetube 114 and to thecable 104, as described earlier. Then, thewasher 108 is attached to theinner conductor 124 by soldering, as shown inFIG. 1D . Finally, thetip 112 is slid over thecable 104 and part of theferrule 106, and affixed thereto, as described earlier. The completed applicator is shown inFIG. 10E . This results in a construction of great rigidity and mechanical stability. -
FIG. 11 schematically illustrates atreatment system 1102 employing theradiation applicator 102 ofFIG. 1 .Microwave source 1104 is couple to the input connector 1106 onhandle 602 bycoaxial cable 1108. In this embodiment, the microwave power is supplied at up to 80 Watts. However this could be larger for larger size applicators, e.g., up to 200 Watts for 5 mm diameter radiation applicators. -
Syringe pump 1110 operates asyringe 1112 for supplyingcooling fluid 1114 viaconduit 1116 andconnector 1118 attached to handle 602, to the interior of thehandle section 602. The fluid is not at great pressure, but is pumped so as to provide a flow rate of about 1.5 to 2.0 milliliter(ml)/minute through thepipe 114 in the illustrated embodiment. However, in other embodiments, where theradiation applicator 102 is operated at higher powers, higher flow rates may be employed, so as to provide appropriate cooling. The cooling fluid is preferably saline, although other liquids or gases may be used, such as ethanol. In certain embodiments, a cooling liquid having a secondary, e.g., cytotoxic, effect could be used, enhancing the tumor treatment. In the illustrative embodiment, the cooling fluid 1114 exits thetube 1114, as shown by arrows B inFIG. 1 , at a temperature on the order of 10° C. higher than that at which it enters thetube 114, as shown by arrows A inFIG. 1 . Thus, substantial thermal energy is extracted from the coaxial cable. The cooling fluid 1114 may, for example, enter thetube 114 at room temperature. Alternatively, the cooling fluid 1114 may be pre-cooled to a temperature below room temperature by any suitable technique. - As shown, the cooling system is an open, perfusing cooling system that cools the coaxial cable connected to the
radiation applicator 102. That is, after absorbing heat from the coaxial cable, the cooling fluid perfuses the tissue near theradiation applicator 102. - The methodology for use of the
radiation applicator 102 of the present invention may be as conventionally employed in the treatment of various soft tissue tumors. In particular, theapplicator 102 is inserted into the body, laparoscopically, percutaneously or surgically. It is then moved to the correct position by the user, assisted where necessary by positioning sensors and/or imaging tools, such as ultrasound, so that thetip 112 is embedded in the tissue to be treated. The microwave power is switched on, and the tissue is thus ablated for a predetermined period of time under the control of the user. In most cases, theapplicator 102 is stationary during treatment. However, in some instances, e.g., in the treatment veins, theapplicator 102 may be moved, such as a gentle sliding motion relative to the target tissue, while the microwave radiation is being applied. - As described above, and as shown in
FIGS. 9A and 9B ,radiation applicator 102, is a dipole antenna. The portion of theinner conductor 124 that extends beyond theferrule 106 operates as one arm of the dipole antenna. In addition, the transmission of microwave energy along theinner conductor 124 and in the aperture of the ferrule induces a current to flow on that portion of the outer surface of theferrule 106 that is located underneath thetip 112. This induced current causes this enclosed, outer surface of theferrule 106 to emit microwave radiation, thereby forming a second arm of the dipole antenna. The bipolar configuration of the applicator effectively spreads the microwave radiation that is being transmitted by theapplicator 102 along a greater transverse, i.e., axial, length of theantenna 102, rather than focusing the radiation transmission solely from thetip 112 of theapplicator 102. As a result, theapplicator 102 of the present invention may be operated at much higher power levels, e.g., up to approximately 80 Watts, than prior art designs. - An alternative embodiment of the present invention is shown in
FIGS. 12-19 .FIG. 12 is an exploded, perspective view of analternative radiation applicator 1202. As shown, theapplicator 1202 includes acoaxial cable 1204 having anouter conductor 1206 that surrounds aninsulator 1208 that, in turn, surrounds an inner orcentral conductor 1210. Theapplicator 1202 further includes aferrule 1212. Theferrule 1212 is generally tubular shaped so as to define an aperture therethrough, and has first andsecond ends 1212 a, 1212 b. Theferrule 1212 also has three parts or sections. Afirst section 1214 of theferrule 1212 has an inner diameter sized to fit over theouter conductor 1206 of thecoaxial cable 1204. Asecond section 1216 of theferrule 1212 has an inner diameter that is sized to fit over theinsulator 1208 of thecoaxial cable 1204. Thesecond section 1216 thus defines an annular surface or flange (not shown) around the inside theferrule 1212. The outer diameter of thesecond section 1216 is preferably larger than the outer diameter of thefirst section 1214, thereby defining a step or flange around the outside of theferrule 1212. Athird section 1218 of theferrule 1212 has an inner diameter also sized to fit around theinsulator 1208 of thecoaxial cable 1204. Thethird section 1218 has an outside diameter that is less than the outside diameter of thesecond section 1216. Thethird section 1218 thus defines an outer, cylindrical surface or sleeve. -
Applicator 1202 further includes aspacer 1220. Thespacer 1220 is preferably cylindrical in shape with acentral bore 1222 sized to receive theinner conductor 1210 of thecoaxial cable 1204. The outer diameter of thespacer 1220 preferably matches the outer diameter of thethird section 1218 of theferrule 1212.Applicator 1202 also includes atuning element 1224 and atip 1226. Thetuning element 1224, which be may be disk-shaped, has acentral hole 1228 sized to fit around theinner conductor 1210 of thecoaxial cable 1204. Thetip 1226 is a hollow, elongated member, having anopen end 1230, and aclosed end 1232. Theclosed end 1232 may be formed into a cutting element, such as a trocar point or a blade, to cut or pierce tissue.Applicator 1202 also includes arigid sleeve 1234. Thesleeve 1234 has an inner diameter that is slightly larger than outer diameter of thecoaxial cable 1204. As described below, an annular space is thereby defined between the outer surface of thecoaxial cable 1204 and the inner surface of thesleeve 1234. Thesleeve 1234 further includes one ormore drainage holes 1236 that extend through the sleeve. -
FIGS. 13-18 illustrate a preferred assembly sequence of theapplicator 1202. As shown inFIG. 13 , thecoaxial cable 1204 is trimmed so that there is a length “m” ofinsulator 1208 that extends beyond anend 1206 a of theouter conductor 1206, and a length “l” ofinner conductor 1210 that extends beyond anend 1208 a of theinsulator 1208. Theferrule 1212 slides over the exposedinner conductor 1210 and over the exposedinsulator 1208 such that thefirst section 1214 surrounds theouter conductor 1206, and the second andthird sections insulator 1208. The inner surface or flange formed on thesecond section 1216 of theferrule 1212 abuts theend 1206 a of theouter conductor 1206, thereby stopping theferrule 1212 from sliding any further up thecoaxial cable 1204. Theferrule 1212 is preferably fixedly attached to thecoaxial cable 1204, such as by soldering theferrule 1212 to theouter conductor 1206 of thecoaxial cable 1204. In the preferred embodiment, thethird section 1218 of theferrule 1212 extends past theend 1208 a of the exposedinsulator 1208 as shown by the dashed line inFIG. 14 . - Next, the
spacer 1220 is slid over the exposed portion of theinner conductor 1210, and is brought into contact with the second end 1212 b of theferrule 1212. In the preferred embodiment, thespacer 1220 is not fixedly attached to theferrule 1212 or theinner conductor 1210. Thespacer 1220 is sized so that asmall portion 1210 a (FIG. 15 ) of theinner conductor 1210 remains exposed. Thetuning element 1224 is then slid over this remaining exposedportion 1210 a of theinner conductor 1210. Thetuning element 1224 is preferably fixedly attached to theinner conductor 1210, e.g., by soldering. Thetuning element 1224, in cooperation with theferrule 1212, thus hold thespacer 1220 in place. - With the
tuning element 1224 in place, the next step is to install thetip 1226 as shown inFIG. 16 . Theopen end 1230 of thetip 1226 is slid over thetuning element 1224, thespacer 1224 and thethird section 1218 of theferrule 1212. Theopen end 1230 of thetip 1226 abuts the second section orstep 1216 of theferrule 1212. Thetip 1226 is preferably fixedly attached to theferrule 1212, e.g., by bonding. With thetip 1226 in place, the next step is to install the sleeve 1234 (FIG. 17 ). Thesleeve 1234 is slid over thecoaxial cable 1234, and up over thefirst section 1214 of theferrule 1212. Thesleeve 1234 abuts thestep 1216 in theferrule 1212 opposite thetip 1226. - Those skilled in the art will understand that the
applicator 1202 may be assembled in different ways or in different orders. - As illustrated in
FIG. 18 , upon assembly, thetip 1226,second section 1216 of theferrule 1212, andsleeve 1234 all preferably have the same outer diameter, thereby giving the applicator 1202 a smooth outer surface. - Preferably, the
sleeve 1234 is formed from stainless steel, and theferrule 1212 is formed from gold-plated copper. Thetip 1226 and thespacer 1220 are formed from dielectric materials. In the illustrative embodiment, thetip 1226 and thespacer 1220 are formed from an itrium stabilized zirconia, such as the Technox brand of ceramic material commercially available from Dynamic Ceramic Ltd. of Stoke-on-Trent, Staffordshire, England, which has a dielectric constant of 25. Thetip 1226 may be further provided with a composite coating, such as a polyimide undercoat layer, for adhesion, and a paralyne overcoat layer, for its non-stick properties. Alternatively, silicone or some other suitable material could be used in place of paralyne. The composite coating may also be applied to the ferrule and at least part of the stainless steel sleeve, in addition to being applied to the tip. - Those skilled in the art will understand that alternative materials may be used in the construction of the
radiation applicator 1202. -
FIG. 19 is a schematic, partial cross-sectional view of theradiation applicator 1202. As shown, at least part of thefirst section 1214 of theferrule 1212 overlies and is attached to theouter conductor 1206. Theinsulator 1208 extends partially through the inside of theferrule 1212. In particular, theend 1208 a of theinsulator 1208 is disposed a predetermined distance back from the second end 1212 b of theferrule 1212. Theinner conductor 1210 extends completely through and beyond theferrule 1212. Thesleeve 1234 slides over and is bonded to thefirst section 1214 of theferrule 1212. As shown, the inside diameter of thesleeve 1234 is greater than the outside diameter of thecoaxial cable 1204, thereby defining anannular space 1238 between the outside of thecoaxial cable 1204 and the inside of thesleeve 1234. Cooling fluid, such as saline, is pumped through thisannular space 1238, as shown by arrows A. The cooling fluid absorbs heat from the coaxial cable that feeds radiation toapplicator 1202. The cooling fluid is then discharged throughholes 1236 in thesleeve 1234, as shown by arrows B. - In the preferred embodiment, the
holes 1236 are placed far enough behind theclosed end 1232 of thetip 1226 such that the discharged cooling fluid does not enter that portion of the tissue that is being heated by theradiation applicator 1202. Instead, the discharged cooling fluid preferably perfuses tissue outside of this heated region. Depending on the tissue to be treated, a suitable distance between theclosed end 1232 of thetip 1226 and theholes 1236 may be approximately 30 mm. - A
first end 1220 a of thespacer 1220 abuts the second end 1212 b of theferrule 1212, while a second end 1220 b of thespacer 1220 abuts thetuning element 1224. Accordingly a space, designated generally 1240, is defined within theferrule 1212 between theend 1208 a of the insulator and the second end 1212 b of the ferrule. In the illustrative embodiment, thisspace 1240 is filled with air. Those skilled in the art will understand that the space may be filled with other materials, such as a solid dielectric, or it may be evacuated to form a vacuum. The inside surface of thetip 1226 preferably conforms to the shape of thetuning element 1224, thespacer 1220, and thethird section 1218 of theferrule 1212 so that there are no gaps formed along the inside surface of thetip 1226. - As indicated above, operation of the
radiation applicator 1202 causes a current to be induced on the outer surface of thethird section 1218 of theferrule 1212, which is enclosed within the dielectric material of thetip 1226. This induced current results in microwave energy being radiated from this surface of theferrule 1212, thereby forming one arm of the dipole. The section of theinner conductor 1210 that extends beyond theferrule 1212 is the other arm of the dipole. Both the length of theinner conductor 1210 that extends beyond theferrule 1212, and the length of thethird section 1218 of theferrule 1212, which together correspond to the two arms of the dipole, are chosen to be approximately ¼ of the wavelength in thedielectric tip 1226, which in the illustrative embodiment is approximately 6 mm. Nonetheless, those skilled in the art will understand that other factors, such as tissue permittivity, the action of the tuning element, etc., will affect the ultimate lengths of the dipole arms. For example, in the illustrative embodiment, the two arms are approximately 5 mm in length. - The
tuning element 1224, moreover, cooperates with the second section orstep 1216 of the ferrule to balance the radiation being emitted by the two arms of the dipole. In particular, the size and shape of thetuning element 1224 and thestep 1216 are selected such that the coherent sum of the microwave power reflected back toward the cable at the aperture of the ferrule is minimized. Techniques for performing such design optimizations are well-known to those skilled in the relevant art. - In use, the
radiation applicator 1202 is attached to a source of microwave radiation in a similar manner as described above in connection with theapplicator 102 ofFIG. 1 . The coaxial cable is also attached to a source of cooling fluid in a similar manner as described above. With the present invention, it is the dielectric tip, ferrule and stainless steel sleeve that cooperate to provide the necessary stiffness and mechanical strength for the applicator to be used in treatment procedures. The applicator does not rely on the coaxial cable for any of its strength. Indeed, a flexible coaxial cable, having little or no rigidity, could be used with the radiation applicator of the present invention. - The foregoing has been a detailed description of illustrative embodiments of the invention. Various modifications and additions can be made without departing from the spirit and scope thereof. For example, the materials described herein are not exhaustive, and any acceptable material can be employed for any component of the described system and method. In addition, modifications can be made to the shape of various components. Accordingly, this description is meant to be taken only by way of example, and not to otherwise limit the scope of the invention.
Claims (15)
1. A dipole microwave applicator for emitting microwave radiation into tissue, the assembly comprising:
an outer conductor having an end;
an inner conductor disposed within the outer conductor, and including a section that extends outwardly beyond the end of the outer conductor;
a ferrule disposed at the end of the outer conductor, and having a sleeve portion that surrounds a portion of the outwardly extending section of the inner conductor; and
a dielectric tip surrounding the sleeve portion of the ferrule and the outwardly extending section of the inner conductor,
whereby the sleeve portion of the ferrule and at least a portion of the outwardly extending section of the inner conductor operate as corresponding arms of the dipole microwave applicator.
2. The dipole microwave applicator of claim 1 , further comprising a dielectric spacer disposed within the dielectric tip, the dielectric spacer surrounding at least a portion of the inner conductor that extends beyond the sleeve portion of the ferrule.
3. The dipole microwave applicator of claim 1 , wherein the ferrule has a first end that is attached to the end of the outer conductor.
4. The dipole microwave applicator of claim 1 , further comprising a tuning element disposed within the dielectric tip, and attached to an end of the inner conductor.
5. The dipole microwave applicator of claim 4 , wherein
the ferrule further includes a step adjacent to the sleeve portion, and
the tuning element and step cooperate to balance the corresponding arms of the dipole microwave applicator.
6. The dipole microwave applicator of claim 5 , wherein the tuning element is substantially disc shaped.
7. The dipole microwave applicator of claim 5 , further comprising a rigid sleeve adjacent to the ferrule, and surrounding and spaced from at least a portion of the outer conductor so as to define a space between the outer conductor and the rigid sleeve.
8. The dipole microwave applicator of claim 7 , wherein one or more holes extend through the rigid sleeve, the one or more holes providing a fluid communication path from the space within the rigid sleeve to an area outside of the rigid sleeve.
9. The dipole microwave applicator of claim 1 , wherein the ferrule is formed from copper, and the tip is formed from itrium stabilized zirconia.
10. The dipole microwave applicator of claim 8 , wherein the sleeve is formed from stainless steel, the ferrule is formed from copper, and the tip is formed from itrium stabilized zirconia.
11. The dipole microwave applicator of claim 1 , wherein microwave energy at a frequency of approximately 2.45 Gigahertz (GHz) and a power level of up to 80 watts is applied to the applicator.
12. The dipole microwave applicator of claim 2 , further comprising an insulator disposed between the outer conductor and the inner conductor, wherein the spacer abuts an end of the sleeve of the ferrule and the insulator terminates within the sleeve so as to define a gap within the sleeve of the ferrule around the inner conductor.
13. The dipole microwave applicator of claim 10 , wherein the gap is filled with air.
14. The dipole microwave applicator of claim 5 , wherein
the dielectric tip has open end that abuts the step in the ferrule and a closed end opposite the open end, and
the closed end is configured for one of cutting or piercing tissue.
15. The dipole microwave applicator of claim 1 , wherein at least one of the dielectric tip and the ferrule is coated with an inner layer of polyimide and an outer layer of paralyne.
Applications Claiming Priority (3)
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GB0600018A GB2434314B (en) | 2006-01-03 | 2006-01-03 | Microwave applicator with dipole antenna |
GB0600018.6 | 2006-01-03 | ||
PCT/EP2006/012144 WO2007076924A2 (en) | 2006-01-03 | 2006-12-15 | Radiation applicator and method of radiating tissue |
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US14/940,354 Active US9907613B2 (en) | 2005-07-01 | 2015-11-13 | Radiation applicator and method of radiating tissue |
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Also Published As
Publication number | Publication date |
---|---|
CN101631506A (en) | 2010-01-20 |
EP1968469B1 (en) | 2016-11-02 |
AU2006332213A1 (en) | 2007-07-12 |
IL192469A0 (en) | 2009-02-11 |
EP1968469A2 (en) | 2008-09-17 |
CN101631506B (en) | 2011-12-28 |
JP2009521967A (en) | 2009-06-11 |
AU2006332213B2 (en) | 2013-01-10 |
US20160262832A1 (en) | 2016-09-15 |
EP1968469B8 (en) | 2017-01-11 |
US9907613B2 (en) | 2018-03-06 |
JP5318581B2 (en) | 2013-10-16 |
CA2635316A1 (en) | 2007-07-12 |
GB0600018D0 (en) | 2006-02-08 |
BRPI0620875A2 (en) | 2011-11-29 |
WO2007076924A2 (en) | 2007-07-12 |
WO2007076924A3 (en) | 2007-08-30 |
GB2434314B (en) | 2011-06-15 |
US20070203551A1 (en) | 2007-08-30 |
GB2434314A (en) | 2007-07-25 |
KR20080092402A (en) | 2008-10-15 |
TW200740407A (en) | 2007-11-01 |
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