CN113424048A - Tissue detection system and method of use - Google Patents

Abstract

A tissue detection system and method of use thereof are provided. The tissue detection system facilitates stimulating fluorescence via illumination in one or more areas of interest in the human body, detecting invisible or non-visible areas of interest subjected to such stimulation, and effectively identifying such areas of interest. The tissue detection system may employ a probe for facilitating illumination/stimulation of the tissue of interest, at least one emitter for generating radiation for application to the tissue of interest, and at least one detector for capturing radiation related to fluorescing tissue.

Description

Tissue detection system and method of use

Cross Reference to Related Applications

The present application claims U.S. provisional application serial No. 62/810,510 filed on 26.2.2019; 62/823,252 filed on 3/25/2019; and 62/840,609, filed 2019, 4, 30, their entire contents are incorporated herein by reference.

Technical Field

The present technology relates generally to a tissue detection system and method of use thereof for illuminating and stimulating an associated surgical field in a human body having one or more regions that are not visible or readily visible to the human eye, detecting these regions, and effectively identifying these regions to a user.

Background

For many procedures, including surgery, one or more areas of interest in a body region may not be visible to the eye of the person performing the procedure, but these areas may be detected by other means. However, fluorescence can be used to identify areas of a body segment, including one or more surgically-relevant areas. Some materials may exhibit fluorescence at invisible wavelengths. Other areas of interest may present too low a contrast to the human eye to be easily seen. Accordingly, there is a need for a tissue detection system and method of use thereof for stimulating fluorescence in one or more areas of interest in a human body, detecting areas of interest that are not or are not readily visible when subjected to such stimulation, and effectively identifying those areas of interest.

Disclosure of Invention

The technology of the present disclosure relates generally to tissue detection systems and methods of use thereof.

In one aspect, the present disclosure provides a tissue detection system for locally stimulating fluorescence in a surgical site and locating a fluorescing area in the surgical site, the system comprising a probe having a distal end configured for placement in contact or proximate contact with an associated tissue material in the surgical site; at least one emitter and at least one emitter fiber, the at least one emitter configured to emit radiation for stimulating fluorescence in an associated tissue material, and the at least one emitter fiber coupled to the at least one emitter and extending through at least a portion of the probe; at least one detector configured to detect fluorescence from tissue material in an associated surgical field and at least one detector optical fiber coupled to the at least one detector and extending through at least a portion of the probe; a controller and a user interface coupled to the emitter and the detector, the controller configured to initiate operation of the at least one emitter and the at least one detector, and the user interface configured to provide feedback to an operator regarding operation of the tissue detection system; with the distal ends of the at least one emitter optical fiber and the at least one detector optical fiber juxtaposed with the distal end of the probe, the at least one emitter optical fiber is configured to transmit radiation from the emitter to the distal end thereof, and the at least one detector optical fiber is configured to transmit a signal corresponding to fluorescence to the detector.

In another aspect, the present disclosure provides a tissue detection system for locally stimulating fluorescence in a surgical site and locating a fluorescing area in the surgical site, the system comprising a probe having a distal end configured for placement in contact or proximate contact with an associated tissue material in the surgical site; at least one emitter and at least one emitter fiber, the at least one emitter configured to emit radiation for stimulating fluorescence in an associated tissue material, and the at least one emitter fiber coupled to the at least one emitter and extending through at least a portion of the probe; at least one camera configured to detect fluorescence from tissue material in an associated surgical field; a controller and a user interface coupled to the emitter and the detector, the controller configured to initiate operation of the at least one emitter and the at least one camera, and the user interface configured to provide feedback to an operator regarding operation of the tissue detection system; wherein a distal end of the at least one emitter optical fiber is juxtaposed with a distal end of the probe, the at least one emitter optical fiber is configured to transmit radiation from the emitter to the distal end thereof, the at least one camera is spaced above the surgical field, and the at least one camera detects fluorescence within the wide field of view.

In yet another aspect, the present disclosure provides a method of tissue detection and surgery using a tissue detection system, the method comprising positioning a distal end of a probe of the tissue detection system in contact or proximate contact with a tissue material of interest; generating radiation using at least one emitter, the at least one emitter connected to at least one emitter fiber, and the at least one emitter fiber extending through at least a portion of the probe to the distal end of the probe; transmitting radiation through at least one emitter fiber to a distal end of a probe positioned in contact or near contact with the tissue material of interest; stimulating fluorescence in the tissue material of interest using radiation from at least one emitter at a distal end of the probe; detecting the stimulated fluorescence using at least one detector, the at least one detector being connected to the at least one detector optical fiber, and the at least one detector optical fiber extending through at least a portion of the probe to a distal end of the probe; identifying tissue material of interest using the fluorescence of the detected stimulus; and removing the tissue-related material during the surgery after identifying the tissue-related material.

The details of one or more aspects of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages described in the disclosure will be apparent from the description and drawings, and from the claims.

Drawings

FIG. 1 is an overview of a tissue detection system showing the tissue detection system in relation to a patient and user, with the interior region of the patient enlarged and the location of the interior region indicated for reference;

FIG. 2A is a partial block diagram illustrating tissue detection;

FIG. 2B is an enlarged distal end view of the probe of the tissue detection system of FIG. 2A.

FIG. 3A is a perspective photographic view showing an endoscopic probe used with the tissue detection system;

fig. 3B is an enlarged distal end view of the endoscopic probe of fig. 3A.

FIG. 4 is an overview of the tissue detection system used with a camera showing the tissue detection system and camera in relation to a patient and user, with the interior region of the patient enlarged and the location of the interior region indicated for reference;

FIG. 5A is a block diagram of a tissue detection system showing the use of a camera and corresponding lens;

FIG. 5B is a block diagram illustrating a tissue detection system using a near infrared camera and corresponding lens;

FIG. 6 is a flow chart illustrating a method for tissue detection;

FIG. 7 is a flow chart illustrating a calibration method that facilitates tissue detection;

FIG. 8 is a block diagram of a tissue detection system using a near infrared camera with pixel-by-pixel demodulation; and

fig. 9 is a block diagram of a tissue detection system using a camera with pixel-by-pixel demodulation and a near-infrared camera.

Detailed Description

As discussed below, devices and methods are provided for stimulating fluorescence via illumination in one or more areas of interest in a human body, detecting areas of interest that are not or not readily visible subject to such stimulation, and effectively identifying those areas of interest. Tissue detection systems and methods of using tissue detection systems are used to facilitate such stimulation, detection, and identification. As discussed below, embodiments of the tissue detection system are used to stimulate fluorescence in relevant tissues and to quickly and conveniently detect fluorescence from those relevant tissues.

In some embodiments of the tissue detection system, the emitter and detector may be placed in direct or near contact with potentially fluorescing tissue material of one or more regions of interest, such that stimulation and detection occurs in a confined area. To illustrate, the emitter and detector may be separate from or part of the probe with or without the use of optical fibers, the probe may be positioned in contact with or in close proximity to one or more regions in which fluorescence may be stimulated with the emitter, and the detector may detect fluorescence in the one or more regions if such fluorescence exceeds a threshold. In some embodiments, the emission and detection are in the near Infrared (IR) spectral band, which may be selected to stimulate and detect fluorescence in, for example, parathyroid tissue.

Methods of using autofluorescence to distinguish parathyroid material from thyroid material or other tissue in the cervical disc are described in U.S. application serial No. 13/065,469, which is incorporated herein by reference in its entirety. U.S. application serial No. 13/065,469 discloses that thyroid and parathyroid glands autofluorescence in a wavelength range above 800nm (and sometimes centered at 822 nm) when exposed to radiation in a narrow wavelength range of about 785nm, which is well outside the visible range. Wavelength ranges above 800nm are also not visible, and the fluorescence intensity of parathyroid material is significantly higher than that of thyroid material.

This difference in the relative amounts of fluorescence can be used to differentiate different tissues (e.g., parathyroid material, thyroid material, and other tissues in the cervical disc) for surgery. To illustrate, even if the approximate location of the parathyroid material is known, it is difficult to visually distinguish the parathyroid material sufficiently accurately to perform the procedure, and this is a problem for any surgical procedure requiring identification of the parathyroid material.

Thetissue detection systems 10, 10', and 10 "and methods of using thetissue detection systems 10, 10', and 10" disclosed herein may be adapted for use in surgical procedures requiring identification of tissue. Thetissue detection systems 10, 10', and 10 "may be used to identify tissue, such as parathyroid material, thyroid material, and other tissue in the cervical region, to facilitate removal during surgery. In other words, identification of tissue by thetissue detection systems 10, 10', and 10 "allows identification of tissue material using positive or negative identification of tissue. Once identified (either positively or negatively identified), tissue material may be removed during surgery.

As depicted in fig. 1, thetissue detection system 10 includes aprobe 100, acontroller 140, and auser interface 150. Thecontroller 140 and theuser interface 150 may be combined with each other or separate from each other, and thecontroller 140 and/or theuser interface 150 may include a display (such as thedisplay 210 from fig. 5A and 5B) for displaying images (e.g., videos created using the tissue detection system 10).

As depicted in fig. 1,probe 100 may be positioned by operator O relative to patient P received on surgical table 160. Fig. 1 depictsprobe 100 positioned by operator O in contact with or in close proximity to a potentially fluorescing tissue material, such asparathyroid gland material 300 of patient P, during surgery. Accordingly, thetissue detection system 10 according to embodiments of the present disclosure may be used to detect (via positive or negative identification)parathyroid material 300 of an exposed internal cervical disc region of a patient P during surgery.

The identification ofparathyroid material 300 is an example of a procedure in which an operator O, such as a surgeon, nurse, surgical assistant, or other operating room personnel, may use thetissue detection system 10 to facilitate surgery on one or more regions of interest, which may not be visible to the eye. In the case of identifying parathyroid substance material, parathyroid substance material fluoresces in the near IR and is therefore not visible. The fluorescence intensity of the adjacent thyroid material and other materials is different from that of parathyroid material. Therefore, it is possible to identify a tissue material that is a parathyroid gland material (positive identification) and a tissue material that is not a parathyroid gland material (negative identification). Thus, the use ofprobe 100 in conjunction with controller/user interface 140/150 may be used for tactile identification of the relevant patch. Specific parameters suitable for parathyroid tissue, including stimulation and detection, are discussed below, but the basic concepts disclosed will be applicable to other applications in which fluorescence may be stimulated.

Fig. 2A depicts additional elements of thetissue detection system 10. In some embodiments, theprobe 100 may include one ormore probe bodies 130, which may be tubular or some other shape that is convenient to hold by hand, and may be made of a variety of possible materials, including metals, plastics, and/or composite materials, among others.

As depicted in fig. 2A, asingle probe body 130 is provided and thetissue detection system 10 further includes one ormore emitters 105 and one ormore detectors 110 coupled to the one ormore emitter fibers 115 and the one ormore detector fibers 120, respectively.Emitter 105 may be configured to emit radiation of a selected wavelength via rotation and/or device selection to stimulate fluorescence in the relevant area, andoptical element 125 may be provided to alter the emitted radiation fromemitter 105 lower or higher via filtering. Furthermore, thedetector 110 is configured to process radiation captured by theprobe 100. In the case of identifying parathyroid material, emitter 105 (with or without optical element 125) emits radiation at a wavelength of about 785nm to promote autofluorescence of parathyroid material, anddetector 110 is configured to process radiation captured byprobe 100, which is at a wavelength in the range 808-1000nm for parathyroid material undergoing autofluorescence.

Theemitter 105 and thedetector 110 may be separate from theprobe body 130 or be part of theprobe body 130. Also, theprobe body 130 includes a distal end 135 (fig. 2B), at least a portion of the one or more emitteroptical fibers 115 extends at least through theprobe body 130 and facilitates transmission of radiation from theemitter 105 to thedistal end 135 of theprobe body 130, and at least a portion of the one or more detectoroptical fibers 120 extends at least through theprobe body 130 and facilitates capture and transmission of radiation from thedistal end 135 of theprobe body 130 to thedetector 110. As depicted in fig. 2B, the one ormore emitter fibers 115 and the one ormore detector fibers 120 may terminate at adistal end 135 of theprobe body 130. However, other arrangements of the plurality of fibers, such as in a plurality of bundled probe bodies, may also be suitable. In any case, the emitting and detecting fibers may terminate or come together at thedistal end 135 of theprobe body 130.

Acontroller 140 may be used to control the transmission of radiation from theemitter 105 and control the detection of radiation at thedetector 110, and auser interface 150 may be used to interact with and control the operation of thecontroller 140. In use, emitter 105 (via control using controller/user interface 140/150) along with optical element(s) 125 (such as one or more optical lenses and/or filters, etc.) are configured to deliver radiation selected to be illuminated so as to stimulate fluorescence todistal end 135 ofprobe body 130 through one or more emitteroptical fibers 115. And in use, the detector 110 (via control using the controller/user interface 140/150) along with the optical element(s) 125 are configured to detect radiation collected at thedistal end 135 of theprobe body 130 by the one or more detectoroptical fibers 120. Theoptical element 125 is provided at the end of theprobe body 130 in fig. 2A, but other arrangements for filtering in the fiber optic coupling or the emitter and detector themselves are possible. Further, theuser interface 150 may include a switch (not shown) in the form of, for example, a manual or foot switch to initiate emission of illumination and detection of fluorescence from theemitter 105 anddetector 110, respectively. Furthermore, there may be an audio and/or visual indication that a suitable fluorescent signal has been detected.

During intra-operative use, thedistal end 135 of theprobe body 130 physically contacts or is in near contact (i.e., within at least 1-2 cm) with the underlying fluorescing tissue material of the relevant patch within the body, and the operator O directs thecontroller 140 to emit and detect through theuser interface 150 when thedistal end 135 of theprobe body 130 is in contact or near contact with the surface of the relevant patch. The detected fluorescence signal of the associated tissue is then compared to a threshold fluorescence signal of a reference tissue to determine whether the detected fluorescence signal is indicative of the presence of the reference tissue. Because the one ormore emitter fibers 115 and the one ormore detector fibers 120 terminate in a small area on the order of the size of the one or more fiber ends at thedistal end 135 of theprobe body 130, and because this small area is in contact or near contact with the surface, the area exposed to illumination/stimulation and detection is quite small, allowing for precise positioning of the tissue of interest.

In the case of identifying parathyroid material, theemitter 105 may be a narrow band source, such as a solid state laser, laser diode, or other suitable source, whose radiation output wavelength is in or near a narrow band near 785nm by tuning, device selection, and/or using a filtered combination of optical element(s) 125. Thedetector 110 may be an avalanche photodiode or other near-IR detector or a 2D array of IR detectors that may be used in conjunction with demodulation using, for example, a high-pass (or long-pass) filter (of the optical element(s) 125) such that radiation having a wavelength above the source wavelength (e.g., above 800nm and in the range 808 and 1000nm) is detected. The wavelength of radiation output by emitter 105 (via use of tuning, device selection, and/or filtering with optical element(s) 125) may be changed to be lower or higher than the wavelength of radiation used to identifyparathyroid material 300 to facilitate identification of other tissue materials.

One of the advantages of contacting the surface of the relevant patch with a small area at thedistal end 135 of theprobe body 130 where the emitter fiber(s) 115 and detector fiber(s) 120 terminate is that the optical signal is less affected by ambient light, which in the case of an operating room may have a significant near-IR component. Immunity to such ambient light can be further improved by modulating the emitter radiation and collecting the fluorescent signal using a phase-locking technique, such as lock-in detection or FFT (fast fourier transform) techniques.

As depicted in fig. 3A, thetissue detection system 10, or at least theprobe 100, may be integrated with anendoscopic probe 170. In this arrangement, theendoscopic probe 170 includes anendoscopic camera 175, anendoscopic probe body 180, and the one ormore emitter fibers 115 and the one ormore detector fibers 120 are brought into theendoscopic probe body 180 and integrated with theendoscopic optics 185 at least at a distal end 190 (fig. 3B) of theendoscopic probe body 180. Theendoscopic probe body 180 includes alumen 195 extending therethrough terminating at thedistal end 190, and theendoscopic camera 175 can visualize a region of interest adjacent thedistal end 190 via thelumen 195. This allows probing to be performed using theendoscopic camera 175 as a guide for placement of thedistal end 190 of theendoscopic probe body 180 and correspondingly supports the use of a much smaller area that needs to be surgically opened.

Detection using thetissue detection system 10 may be enhanced by using anexternal camera 200, whichexternal camera 200 may be used as a detector to capture radiation from the relevant fluorescing tissue, as depicted in fig. 4. In contrast to guiding the operation of thetissue detection system 10 by vision, the use of theexternal camera 200 with thetissue detection system 10 may provide increased illumination and clarity because theexternal camera 200 may be directed at potentially fluorescing tissue material over a larger field of view. Where only thetissue detection system 10 and probe 100 are used, potential candidates for potentially fluorescent tissue material will have to be identified by the eye, and use of theprobe 100 facilitates providing confirmation information via fluorescence of the potential candidates. By using theexternal camera 200 in combination with theprobe 100, the imaging region provided by theexternal camera 200 can be used to identify candidates of potentially fluorescent tissue materials within a larger field of view, and then theprobe 100 can be used to confirm via fluorescence information acquired from each of those candidates of potentially fluorescent tissue materials by placing the probe in contact or near contact with the surface of the potentially fluorescent tissue materials. Theexternal camera 200 provides a potentially helpful but not definitive level of image contrast, while theprobe 100 can be used to provide highly sensitive and quantitative measurements, since at each potentially fluorescing tissue material, thedistal end 135 of theprobe body 130 can be positioned in contact or near contact therewith, and a definitive indication of fluorescence can be obtained and measured. Thus, thetissue detection system 10 and the combined use of theprobe 100 and theexternal camera 200 may provide a powerful solution to identify one or more areas of highest fluorescence.

Fig. 5A schematically illustrates another arrangement of thetissue detection system 10 using a camera (including anendoscopic camera 175external camera 200 or otherwise) in which camera optics 205 (such as one or more optical lenses and/or filters, etc.) and a display 210 (such as a computer monitor/screen) are used with thetissue detection system 10 using theprobe 100 and a controller/user interface 140/150. Although not shown in fig. 5A, thetransmitter 105 may be interposed between the controller/user interface 140/150, and the controller/user interface 140/150 may be used to control the operation of theendoscope camera 175, theexternal camera 200, and thedisplay 210. Further, thedisplay 210 may be separate from or integrated with thecontroller 140 and/or theuser interface 150.

Fig. 5B schematically illustrates yet another arrangement of thetissue detection system 10 using analternative probe 220 andalternative camera 225 embodiment, where theprobe 220 provides only illumination and detection is by means of thecamera 225.Probe 220 is a hand-held flexible illumination probe that can be positioned by operator O in contact or near contact with the surface of the potentially fluorescing tissue material. Further,camera 225 may be an external near IR camera that functions as a detector to capture radiation from the relevant fluorescing tissue. Although not shown in fig. 5B, thetransmitter 105 may be interposed between the controller/user interface 140/150, and the controller/user interface 140/150 may be used to control the operation of thecamera 225 and thedisplay 210. Further, thedisplay 210 may be separate from or integrated with thecontroller 140 and/or theuser interface 150.

Theprobe 220 may be brought into contact or near contact with the potentially fluorescent tissue material, or at any desired angle relative to the tissue in which fluorescence is excited. The use of theprobe 220 enables illumination/stimulation of the relevant area that is not normally reached by illumination. However, fluorescence stimulated in the tissue of interest may be difficult to observe with one ormore detector fibers 120 incorporated in theprobe body 130. An example of this is a subsurface region where fluorescence is typically too weak to be detected with one ormore detector fibers 120. Other examples would be fluorescent tissue material at or just outside the boundaries of the field of view of the one ormore detector fibers 120. Theprobe 220 brings the light source close to the area of interest, which in turn increases the emitted fluorescence and enables thecamera 225 to view and capture it. And theexternal camera 225 may be directed at the potentially fluorescing tissue material over a larger field of view that includes the entire region of interest. Theprobe 220 may include only illumination fibers, and as few as one fiber is selected to maximize transmission of radiation therefrom. Such one or more illumination fibers may also have one or more lenses and/or filters or the like at one or more of its ends (ultimately oriented toward the tissue) that may eliminate any fluorescence emitted by the fiber material in response to the illumination.

Where illumination/stimulation is done with a hand-heldillumination probe 220, but detection is done by viewing an image of the entire relevant area using, for example, acamera 225, the problem of background light from, for example, operating room lights is different than if both illumination and detection were done at thedistal end 135 of theprobe 100. Since thecamera 225 essentially behaves as a plurality of parallel detectors and the fluorescence field can be anywhere within the imaging field, the demodulation techniques described above cannot be applied directly.

Fig. 6 illustrates an embodiment of a method of using thetissue detection system 10. First, at 20, aprobe 100 is provided and theprobe 100 includes one ormore emitter fibers 115 and one ormore detector fibers 120 extending therethrough to a distal end of aprobe body 135. At 22, the operator O receives an indication ((visual or otherwise) that thedistal end 135 of theprobe body 130 is in contact or near contact) with the surface of the potentially fluorescent tissue material at 24, the potentially fluorescent tissue material is illuminated with radiation from theemitter 105 via the optical element(s) 125 and the one ormore emitter fibers 115. at 26, the fluorescence (if any) is detected by thedetector 110 via the optical element(s) 125 and the one ormore detector fibers 120. at 28, thecontroller 140 and/or theuser interface 150 may provide an indication when the fluorescence detected by thedetector 110 exceeds a threshold value.Steps 24, 26, and 28 may also be performed with other embodiments disclosed herein.

FIG. 7 illustrates an embodiment of a method for calibrating thetissue detection system 10. First, at 30, thedistal end 135 of theprobe body 130 is positioned at various locations on the surface of the potentially fluorescent tissue material. At 32, transmission and detection using theemitter 105 anddetector 110, respectively, begins at each of the various locations. The detected fluorescent signal corresponding to the detected fluorescent light (if any) is acquired by thecontroller 140. At 34, thecontroller 140 discards any data corresponding to the detected fluorescent signal that is outside of the predetermined range. At 36, a threshold level is statistically derived from the remaining data of the corresponding detected fluorescent signal. Thus, using such calibration, threshold levels of potentially fluorescent tissue material and other tissue significantly different from the potentially fluorescent tissue material may be obtained. These threshold levels may be used to calculate a ratio, and when the ratio is below or above the threshold ratio, thecontroller 140 and/or theuser interface 150 may provide an indication.Steps 32, 34, and 36 may also be performed with other embodiments disclosed herein.

Referring to FIG. 8, an alternative embodiment of a tissue detection system, generally indicated by the numeral 10', is shown. The tissue detection system 10' includes an emitter 230 (which may be similar to the emitter 105) such as a solid state laser, laser diode, or other suitable source that may be configured to emit radiation at a selected wavelength and may be modulated by amodulator 235 to alter the emitted radiation lower or higher. Themodulator 235 may be of various types, such as a chopper, pockel cell, acousto-optic modulator, or other light modulation device. The modulated emitter signal is delivered fromemitter 230 to probe 240 (which may be similar to substitute probe 220) throughmodulator 235, and the modulated probe signal fromprobe 240 is applied to the relevant tile. Thereafter, anear IR camera 245, with or without camera optics 250 (e.g., one or more optical lenses and/or filters, etc.), views the relevant slice. NearIR camera 245 may be used as a detector to capture radiation from the fluorescing tissue of interest. The signal from thenear IR camera 245 may pass through thedemodulator 255, and thedemodulator 255 may also use the modulator frequency from themodulator 235 as an input before the demodulated signal from thedemodulator 255 is passed on to thedisplay 260. As with thedisplay 210, thedisplay 260 may be separate from or integrated with thecontroller 140 and/or theuser interface 150.

Demodulator 255 may be in the form of a fast digital processor such as a graphics or game processor or FPGA (field programmable gate array) capable of executing a large number of fast parallel processing algorithms. Successive image frames from thenear IR camera 245 undergo a pixel-by-pixel demodulation function, i.e., each pixel is demodulated by a demodulator by a fast parallel processor. The pixel-by-pixel demodulation function may include digital lock-in or fourier transform demodulation of the modulation frequency.

The rolling window of demodulated video frames can be continuously passed ontodisplay 260 for display fromdemodulator 255, which results in a slight start-up delay, and then a real-time demodulated video with very high gain to the emitted light stimulated by the modulated probe signal and high rejection of background illumination from, for example, an operating room light.

In one embodiment, thenear IR camera 245 may include an output that directly corresponds to the fluorescence detected by each detector in the camera imaging array of thenear IR camera 245. For this case, the brightness values of the detected fluorescence can be resolved in pixels, and the demodulation functions are performed in parallel in the fast digital processor ofdemodulator 255. In one embodiment. The Nvidia Tegra processor can be programmed to parse and perform digital lock operations for hundreds of pixels in parallel at the video rate.

In fig. 9, an alternative embodiment of a tissue detection system is shown, indicated by the numeral 10 ".Tissue detection system 10 "is similar to tissue detection system 10', buttissue detection system 10" instead employs a standard video camera 270 (which may employ camera optics 205) and a near IR camera 275 (which may employ camera optics 250), both of which image the same relevant slice. Near IR camera 275 may be used as a detector to capture radiation from the fluorescing tissue of interest. In this embodiment,demodulator 255 performs pixel locking on the output from near IR camera 275, and pixels meeting predetermined criteria are mixed with the output fromstandard video camera 270 bydemodulator 255 to produce a highlight of the video fromstandard video camera 270 for pixels showing fluorescence in the image ultimately displayed ondisplay 260.

Aspects of the embodiments may include any combination of processing elements and memory that may include computing devices executing software routines, including computers and personal electronic devices, as well as programmable electronic products, logic circuits, and other electronic implementations. Various combinations of optical elements may be employed including lasers, LEDs and other light sources, filters, lenses, mirrors, beam splitters, and the like. The details of the optical, electronic, and processing embodiments described herein are illustrative and not intended to be limiting, as alternative methods using other combinations of similar elements may be used to achieve the same results in substantially the same way.

It should be understood that the various aspects disclosed herein may be combined in different combinations than those specifically presented in the description and drawings. It will also be understood that, depending on the example, certain acts or events of any of the processes or methods described herein may be performed in a different sequence, may be added, merged, or omitted altogether (e.g., all described acts or events may not be necessary for performing these techniques), and further for clarity purposes, while certain aspects of the disclosure are described as being performed by a single module or unit, it should be understood that the techniques of this disclosure may be performed by a unit or combination of modules associated with, for example, a medical device.

Claims (20)

Translated fromChinese

1.一种用于在手术片区中局部刺激荧光并定位所述手术片区中的发荧光区域的组织检测系统，其包含；1. A tissue detection system for locally stimulating fluorescence in a surgical patch and locating a fluorescent region in the surgical patch, comprising;具有远端的探针，所述远端被配置成用于放置成与所述手术片区中的有关组织接触或接近接触；a probe having a distal end configured for placement in contact or proximate contact with tissue of interest in the surgical patch;至少一个发射器和至少一根发射器光纤，所述至少一个发射器被配置成发射用于在所述有关组织中刺激荧光的辐射，并且所述至少一根发射器光纤联接到所述至少一个发射器并延伸穿过所述探针的至少一部分；at least one transmitter and at least one transmitter fiber, the at least one transmitter configured to emit radiation for stimulating fluorescence in the tissue of interest, and the at least one transmitter fiber coupled to the at least one an emitter extending through at least a portion of the probe;至少一个检测器和至少一根检测器光纤，所述至少一个检测器被配置成检测来自有关所述手术片区中的所述组织的荧光，并且所述至少一根检测器光纤联接到所述至少一个检测器并延伸穿过所述探针的至少一部分；at least one detector and at least one detector fiber, the at least one detector configured to detect fluorescence from the tissue in the surgical patch associated with the at least one detector fiber, and the at least one detector fiber is coupled to the at least one detector fiber a detector extending through at least a portion of the probe;联接到所述发射器和所述检测器的控制器和用户界面，所述控制器被配置成启动所述至少一个发射器和所述至少一个检测器的操作，并且所述用户界面被配置成向操作员提供关于所述组织检测系统的操作的反馈；a controller and a user interface coupled to the transmitter and the detector, the controller configured to initiate operation of the at least one transmitter and the at least one detector, and the user interface configured to providing feedback to the operator regarding the operation of the tissue detection system;其中所述至少一根发射器光纤和所述至少一根检测器光纤的远端与所述探针的所述远端并置，所述至少一根发射器光纤被配置成将所述辐射从所述发射器传送到其所述远端，并且所述至少一根检测器光纤被配置成将对应于所述荧光的信号传送到所述检测器。Wherein the distal ends of the at least one transmitter fiber and the at least one detector fiber are juxtaposed with the distal end of the probe, the at least one transmitter fiber being configured to transmit the radiation from the The emitter transmits to the distal end thereof, and the at least one detector fiber is configured to transmit a signal corresponding to the fluorescence to the detector.2.根据权利要求1所述的组织检测系统，其中所述有关组织是甲状旁腺组织。2. The tissue detection system of claim 1, wherein the tissue of interest is parathyroid tissue.3.根据权利要求2所述的组织检测系统，其中所述发射器包括含窄带辐射源，所述窄带辐射源的频率以785nm加或减10nm为中心。3. The tissue detection system of claim 2, wherein the transmitter comprises a narrowband radiation source having a frequency centered at 785 nm plus or minus 10 nm.4.根据权利要求3所述的组织检测系统，其进一步包含进一步限制发射器带宽的滤波器，并且其中所述发射器是固态激光器或激光二极管。4. The tissue detection system of claim 3, further comprising a filter that further limits the bandwidth of the transmitter, and wherein the transmitter is a solid state laser or a laser diode.5.根据权利要求4所述的组织检测系统，其中所述检测器是具有高通滤波器的近IR相机，并且其中所述高通滤波器被配置成使高于所述发射器的发射波长的光波长通过。5. The tissue detection system of claim 4, wherein the detector is a near-IR camera with a high-pass filter, and wherein the high-pass filter is configured to pass light above an emission wavelength of the emitter wavelengths pass.6.根据权利要求5所述的组织检测系统，其中所述高通滤波器被配置成使高于800nm的光波长通过。6. The tissue detection system of claim 5, wherein the high pass filter is configured to pass light wavelengths above 800 nm.7.根据权利要求1所述的组织检测系统，其中所述探针是内窥镜探针系统的一部分。7. The tissue detection system of claim 1, wherein the probe is part of an endoscopic probe system.8.根据权利要求1所述的组织检测系统，其进一步包含被配置成调制来自所述发射器的所述辐射的至少一个调制器，以及被配置成解调对应于所述荧光的所述信号的至少一个解调器。8. The tissue detection system of claim 1, further comprising at least one modulator configured to modulate the radiation from the emitter, and configured to demodulate the signal corresponding to the fluorescence of at least one demodulator.9.根据权利要求8所述的组织检测系统，其中在逐像素基础上通过所述解调器解调对应于所述荧光的所述信号。9. The tissue detection system of claim 8, wherein the signal corresponding to the fluorescence is demodulated by the demodulator on a pixel-by-pixel basis.10.一种用于在手术片区中局部刺激荧光并定位所述手术片区中的发荧光区域的组织检测系统，其包含；10. A tissue detection system for locally stimulating fluorescence in a surgical patch and locating a fluorescent region in the surgical patch, comprising;具有远端的探针，所述远端被配置成用于放置成与所述手术片区中的有关组织接触或接近接触；a probe having a distal end configured for placement in contact or proximate contact with tissue of interest in the surgical patch;至少一个发射器和至少一根发射器光纤，所述至少一个发射器被配置成发射用于在有关组织中刺激荧光的辐射，并且所述至少一根发射器光纤联接到所述至少一个发射器并延伸穿过所述探针的至少一部分；at least one transmitter and at least one transmitter fiber, the at least one transmitter configured to emit radiation for stimulating fluorescence in the tissue of interest, and the at least one transmitter fiber coupled to the at least one transmitter and extend through at least a portion of the probe;至少一个相机，其被配置成检测来自所述有关手术片区中的所述组织的荧光；at least one camera configured to detect fluorescence from the tissue in the relevant surgical patch;联接到所述发射器和所述检测器的控制器和用户界面，所述控制器被配置成启动所述至少一个发射器和所述至少一个相机的操作，并且所述用户界面被配置成向操作员提供关于所述组织检测系统的操作的反馈；A controller and a user interface coupled to the transmitter and the detector, the controller configured to initiate operation of the at least one transmitter and the at least one camera, and the user interface configured to an operator providing feedback on the operation of the tissue detection system;其中所述至少一根发射器光纤的远端与所述探针的所述远端并置，所述至少一根发射器光纤被配置成将所述辐射从所述发射器传送到其所述远端，并且所述至少一个相机被隔开在所述手术片区上方，并且所述至少一个相机在宽视野内检测荧光。wherein the distal end of the at least one transmitter fiber is juxtaposed with the distal end of the probe, the at least one transmitter fiber is configured to transmit the radiation from the transmitter to its distal end and the at least one camera is spaced over the surgical patch, and the at least one camera detects fluorescence in a wide field of view.11.根据权利要求10所述的组织检测系统，其中所述有关组织是甲状旁腺组织。11. The tissue detection system of claim 10, wherein the tissue of interest is parathyroid tissue.12.根据权利要求11所述的组织检测系统，其中所述发射器包含窄带辐射源，所述窄带辐射源的频率以785nm加或减10nm为中心。12. The tissue detection system of claim 11, wherein the transmitter comprises a narrowband radiation source having a frequency centered at 785 nm plus or minus 10 nm.13.根据权利要求12所述的组织检测系统，其进一步包含进一步限制发射器带宽的滤波器，并且其中所述发射器是固态激光器或激光二极管。13. The tissue detection system of claim 12, further comprising a filter that further limits the bandwidth of the transmitter, and wherein the transmitter is a solid state laser or a laser diode.14.根据权利要求13所述的组织检测系统，其中所述相机是具有高通滤波器的近IR相机，并且其中所述高通滤波器被配置成使高于所述发射器的发射波长的光波长通过。14. The tissue detection system of claim 13, wherein the camera is a near-IR camera with a high-pass filter, and wherein the high-pass filter is configured to allow wavelengths of light above the emission wavelength of the transmitter pass.15.根据权利要求14所述的组织检测系统，其中所述高通滤波器被配置成使高于800nm的光波长通过。15. The tissue detection system of claim 14, wherein the high pass filter is configured to pass light wavelengths above 800 nm.16.一种使用组织检测系统的组织检测和手术的方法，所述方法包含：16. A method of tissue detection and surgery using a tissue detection system, the method comprising:将所述组织检测系统的探针的远端定位成与有关组织接触或接近接触；positioning the distal end of the probe of the tissue detection system in contact or proximate contact with the tissue of interest;使用至少一个发射器产生辐射，所述至少一个发射器连接到至少一根发射器光纤，并且所述至少一根发射器光纤延伸穿过所述探针的至少一部分到所述探针的所述远端；Radiation is generated using at least one transmitter connected to at least one transmitter fiber and extending through at least a portion of the probe to the probe's remote;将所述辐射通过所述至少一根发射器光纤传送到定位成与所述有关组织接触或接近接触的所述探针的所述远端；delivering the radiation through the at least one transmitter fiber to the distal end of the probe positioned in contact or proximate contact with the tissue of interest;使用来自所述探针的所述远端处的所述至少一个发射器的所述辐射，在所述有关组织中刺激荧光；stimulating fluorescence in the tissue of interest using the radiation from the at least one emitter at the distal end of the probe;使用至少一个检测器检测刺激的荧光，所述至少一个检测器连接到至少一根检测器光纤，并且所述至少一根检测器光纤延伸穿过所述探针的至少一部分到所述探针的所述远端；The stimulated fluorescence is detected using at least one detector connected to at least one detector fiber, and the at least one detector fiber extending through at least a portion of the probe to the probe's the distal end;使用检测到的刺激的荧光识别所述有关组织；和identifying the tissue of interest using the detected stimulated fluorescence; and在识别所述有关组织之后，在所述手术期间移除所述有关组织。After identifying the tissue of interest, the tissue of interest is removed during the procedure.17.根据权利要求16所述的方法，其中所述有关组织是甲状旁腺组织。17. The method of claim 16, wherein the tissue of interest is parathyroid tissue.18.根据权利要求16所述的方法，其中所述发射器包含窄带辐射源，所述窄带辐射源的频率以785nm加或减10nm为中心。18. The method of claim 16, wherein the transmitter comprises a narrowband radiation source having a frequency centered at 785 nm plus or minus 10 nm.19.根据权利要求18所述的方法，其中滤波器用于进一步限制发射器带宽，并且其中所述发射器是固态激光器或激光二极管。19. The method of claim 18, wherein a filter is used to further limit the transmitter bandwidth, and wherein the transmitter is a solid state laser or a laser diode.20.根据权利要求19所述的方法，其中所述检测器是具有高通滤波器的近IR相机，并且其中所述高通滤波器被配置成使高于所述发射器的发射波长的光波长通过。20. The method of claim 19, wherein the detector is a near-IR camera with a high-pass filter, and wherein the high-pass filter is configured to pass light wavelengths above the emission wavelength of the emitter .

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