Abstract: A method and system for treating a desired volume of tissue using HIFU or other energy modality includes ablating a pattern of elemental treatment volumes each having a volume that is greater than that of the focal zone of the HIFU transducer but smaller than the overall volume of the desired treatment volume. In at least one embodiment, the elemental treatment volumes are arranged to form a shell which partially or wholly encapsulates the desired volume of tissue, which then necroses in situ. The elemental treatment volumes are created by distributing HIFU energy in multiple doses with repeated passes of the focal zone of the HIFU transducer in a trajectory over or along a perimeter of each elemental treatment volume.

Abstract: A system and method for providing real-time, image-guided high intensity focused ultrasound (HIFU) targeting and treatment of tissue. In one embodiment, the system includes an HIFU applicator and a user interface with a touchscreen display for three-dimensional visualization of the tissue. Image frames displayed on the user interface depict real-time images of the tissue, including an image parallel to a feature of the applicator and an image orthogonal to the parallel image. Reference lines may be sketched using the touchscreen and displayed on the image frames. In one embodiment, tissue boundaries are detected and marked on the image frames, either by the user or automatically by the system. In another embodiment, the user interface includes a footswitch for the user to interact with the system. In another embodiment, the system includes an ultrasound imaging component configured to undock from the system for use as a stand-alone ultrasound imaging device.

Abstract: An applicator for providing HIFU therapy to a patient includes a HIFU transducer that is rotatably coupled to a frame. In one embodiment, the rotatable coupling is configured such that the HIFU transducer can be mechanically oriented to position a focal zone of the HIFU transducer at any desired location in a treatment volume radially outward from a longitudinal axis of the applicator while the HIFU transducer remains within a housing that is not more than a defined percentage (e.g., 50%) larger than the maximum diameter of the HIFU transducer. In one embodiment, the HIFU transducer is rotatably coupled to the frame with a ball and socket joint. In another embodiment, the HIFU transducer is rotatably coupled to the frame with an offset gimble assembly. A pair of linear actuators and drive shafts engage the HIFU transducer to orient HIFU transducer in a desired direction.

Abstract: A system and method for adjusting or selecting the treatment parameters for HIFU signals to treat a target treatment site, and/or to aid in visualizing the likely degree and location of HIFU effects on patient tissue. The system transmits one or more test signals into patient tissue and receives signals created in response to the test signals. The signals are analyzed to determine a response curve of how a characteristic of the signal varies with the one or more test signals. The response curve of the detected signals is used to select a treatment parameter.

Abstract: A method and apparatus for treating uterine tissue with ultrasound energy. The method manipulates the position of the patient's uterus to decrease its distance from an ultrasound therapy transducer while simultaneously engaging a partially filled bladder such that the bladder is compressed to force any bowel tissue out of an acoustic window between the patient's abdominal wall and uterus. Ultrasound energy is then applied to the uterine tissue.

Abstract: A method for treating a desired volume of tissue using HIFU or other energy modality to ablate a pattern of elemental treatment volumes each having a volume that is greater than that of the focal zone of the HIFU transducer but smaller than the overall volume of the desired treatment volume. In one embodiment, the pattern of elemental treatment volumes are arranged to form a shell which partially or wholly encapsulates the desired volume of tissue, which then necroses in situ due to effects other than direct HIFU damage (including some combination of ischemia, thermal conduction, inflammation, apoptosis, etc.). The necrosed tissue remains in the body and is subsequently resorbed and/or healed via normal body mechanisms.

Abstract: A method and system for adjusting a HIFU device compensates for shifts in transducer impedance so that the acoustic output from a HIFU transducer remains at a desired level. In accordance with a first aspect, the disclosure includes dynamically adjusting the tuning of a tuning network that causes the transducer/system to maintain an optimal power transfer to the acoustic output. In accordance with a second aspect, the disclosure monitors the acoustic output of the HIFU device and adjusts the electrical signal provided to the HIFU transducer to maintain a desired acoustic output.

Abstract: A method for treating a desired volume of tissue using HIFU or other energy modality to ablate a pattern of elemental treatment volumes each having a volume that is greater than that of the focal zone of the HIFU transducer but smaller than the overall volume of the desired treatment volume. In one embodiment, the pattern of elemental treatment volumes are arranged to form a shell which partially or wholly encapsulates the desired volume of tissue, which then necroses in situ due to effects other than direct HIFU damage (including some combination of ischemia, thermal conduction, inflammation, apoptosis, etc.). The necrosed tissue remains in the body and is subsequently resorbed and/or healed via normal body mechanisms.

Abstract: HIFU therapy to a desired tissue site is controlled based on detected changes in one or more characteristics of a received backscatter signal resulting from exposure of the tissue to HIFU or other interrogation signals. In one embodiment, the bloom of backscatter signals outward from a treatment region (e.g., towards the HIFU transducer) is detected and monitored. Once the bloom reaches a predetermined location, treatment is stopped. Other signal characteristics such as angular distribution of frequency components in the backscatter signal, changes in reflection, power required to saturate a tissue characteristic, changes in attenuation and changes in a cumulative energy distribution function of the backscatter signal that change as a result of the application of HIFU power are also used to control the delivery of HIFU signals in accordance with other embodiments of the disclosed technology.

Abstract: A catheter for insertion into and treatment of tissue in a patient comprises a radio frequency (RF) electrode having an elongated body that conducts electrical RF energy to a conductive tip. An insulating sleeve surrounds the elongated body. In a first mode of operation, the conductive tip is exposed outside the insulating sleeve and the RF electrode delivers RF energy that erodes the tissue of the patient and creates a tunnel through which the catheter can advance into the tissue of the patient. In a second mode of operation, the insulating sleeve and/or the RF electrode is retracted and a second treatment apparatus treats the tissue.

Abstract: A probe having a high intensity focused ultrasound (HIFU) transducer is positioned in a female patient. The HIFU transducer is deployed within the vagina of the patient outside of the cervix and uterine cavity and is configured to direct HIFU energy to a treatment site within the uterus of the patient. An imaging component positioned relative to the patient images a portion of the patient's uterus that includes the treatment site to help guide the delivery of the HIFU energy to the treatment site. A liquid medium may be infused into the uterine cavity of the patient where it is maintained during imaging and delivery of the HIFU therapy. The HIFU transducer produces a thermal heating of tissue at a focus within the treatment site to initiate necrosis of the tissue. The location of the focus is controlled in accordance with an image obtained by the imaging component.

Abstract: A system and method for dynamically adjusting the energy of HIFU signals delivered to a patient, and/or to aid in visualizing the likely degree and location of HIFU effects on patient tissue. The system transmits a HIFU signal into a patient and receives echoes therefrom. The echo signals are analyzed to determine the energy of the signals in a first range, such as at one or more harmonics and/or sub-harmonics of the fundamental frequency of the HIFU signal, and energy of the echo signals in a second range such as at the fundamental frequency of the HIFU signal. Based on the comparison, the energy and/or focus of the HIFU signals delivered to the patient is adjusted. An image of the compared echo signal powers in two or more frequency ranges may also be displayed for a user or used to adjust the focus point of the HIFU signals.

Abstract: A catheter for insertion into and treatment of tissue in a patient comprises a radio frequency (RF) electrode having an elongated body that conducts electrical RF energy to a conductive tip. An insulating sleeve surrounding the elongated body prevents leakage of RF energy from the elongated body when the catheter is being inserted into the tissue of the patient. In a first mode of operation, the conductive tip is exposed outside the insulating sleeve and the RF electrode delivers first RF energy capable of producing sparks that erode the tissue of the patient and create a tunnel through which the catheter can advance into the tissue of the patient. In a second mode of operation, the insulating sleeve is retracted to expose a portion of the RF electrode. Second RF energy is delivered to the volume of tissue around the catheter to necrotize the tissue by heating without producing sparks.

Abstract: An applicator for providing HIFU therapy to a patient includes a HIFU transducer that is rotatably coupled to a frame. In one embodiment, the rotatable coupling is configured such that the HIFU transducer can be mechanically oriented to position a focal zone of the HIFU transducer at any desired location in a treatment volume radially outward from a longitudinal axis of the applicator while the HIFU transducer remains within a housing that is not more than a defined percentage (e.g., 50%) larger than the maximum diameter of the HIFU transducer. In one embodiment, the HIFU transducer is rotatably coupled to the frame with a ball and socket joint. In another embodiment, the HIFU transducer is rotatably coupled to the frame with an offset gimble assembly. A pair of linear actuators and drive shafts engage the HIFU transducer to orient HIFU transducer in a desired direction.

Abstract: An apparatus for delivering HIFU energy may include a probe with a plurality of leaves that provide a bowl-shaped HIFU therapy transducer. In once case, pins may slide within grooves in the leaves to deploy the leaves. In another case, spines may be configured to slide in a channel defined in each leaf. In other cases, a spring or a shape memory alloy may be used to deploy the leaves. In another implementation, a probe may be fitted with a flexible material that couples the HIFU therapy transducer to the probe and allows the transducer to be drawn to the side of the probe for insertion. In another implementation, a probe may have one or more inflatable bladders that form the HIFU therapy transducer. In yet another implementation, a probe may have an imaging component and a HIFU therapy transducer disposed thereon that rotate, as a unit, about a hinge.

Abstract: A combined imaging/HIFU probe includes an imaging scan head, a HIFU transducer, and an outlet port that delivers a flow of fluid across the HIFU transducer. At least a portion of the body cavity is filled with fluid in which the probe is immersed. The fluid provides a coupling for transmission of ultrasound energy between the probe and the patient. A flow of fluid may also be used to flush obstructions from an area of tissue near the HIFU transducer. Further described herein is a cuff to help retain fluid in the body cavity, a regulator to regulate fluid flow with respect to the body cavity according to a desired fluid pressure, and a cover for the HIFU transducer that has at least one perforation defined therethrough to allow fluid to flow through the cover. Further disclosed herein are methods of deploying a combined imaging/HIFU probe in a body cavity.

Abstract: A method for treating a desired volume of tissue using HIFU or other energy modality to ablate a pattern of elemental treatment volumes each having a volume that is greater than that of the focal zone of the HIFU transducer but smaller than the overall volume of the desired treatment volume. In one embodiment, the pattern of elemental treatment volumes are arranged to form a shell which partially or wholly encapsulates the desired volume of tissue, which then necroses in situ due to effects other than direct HIFU damage (including some combination of ischemia, thermal conduction, inflammation, apoptosis, etc.). The necrosed tissue remains in the body and is subsequently resorbed and/or healed via normal body mechanisms.

Abstract: An ultrasound treatment system includes an applicator in which a therapeutic ultrasound transducer is surrounded by an annular imaging transducer. Illumination signals generated by the therapy or imaging transducer are sequentially or simultaneously delivered to tissue in a viewing space to create corresponding echo signals that are received by the elements of the annular imaging transducer. These echo signals are analyzed with a processor to produce an image of tissue in the viewing space.

Abstract: A method for treating a desired volume of tissue using HIFU or other energy modality to ablate a pattern of elemental treatment volumes each having a volume that is greater than that of the focal zone of the HIFU transducer but smaller than the overall volume of the desired treatment volume. In one embodiment, the pattern of elemental treatment volumes are arranged to form a shell which partially or wholly encapsulates the desired volume of tissue, which then necroses in situ due to effects other than direct HIFU damage (including some combination of ischemia, thermal conduction, inflammation, apoptosis, etc.). The necrosed tissue remains in the body and is subsequently resorbed and/or healed via normal body mechanisms.

Abstract: A noninvasive technique that can be used to deny blood flow to a particular region of tissue, without the inherent risks associated with invasive procedures such as surgery and minimally-invasive procedures such as embolization. Blood flow in selected portions of the vasculature can be occluded by selectively treating specific portions of the vasculature with high intensity focused ultrasound (HIFU). The occlusion denies undesired tissue the nutrients and oxygen provided by blood flow, causing necrosis in the undesired tissue. An imaging technology (such as magnetic resonance imaging, magnetic resonance angiography, ultrasound imaging, Doppler based ultrasound imaging, or computed tomographic angiography) is used to identify the undesired tissue, and the vascular structures associated with the undesired tissue.