Abstract: Ablative treatment of metastatic bone tumors and relief of pain associated with metastatic bone tumors is achieved by heat ablation of the bone tumor or tissue near the bone tumor by an ablation probe. In one form the probe is an electrode coupled to a high frequency power supply to provide ablative heating of tissue proximate to an electrode that is placed in or near the bone tumor. Cooling of the electrode by fluid circulation from a cooling apparatus outside the patient's body may be used to enlarge the region of high frequency heating around the electrode. Image guidance of the electrode placement may be monitored by an imaging device. Tracking of the electrode by an image-guided navigator helps in placement of the electrode with respect to the configuration of the bone and bone metastasis. A set of tools accommodates biopsy and various shapes of electrodes according to clinical requirements.

Abstract: A device for ablation of target tissue in the living body such as a tumor comprises an elongate member that can be guided over a guide element into the target tissue. The elongated element has an electrode at its distal portion. The electrode is configured to be energized with high frequency energy to ablate the target tissue. The elongate member has a guide hole through it and is configured to pass over a guide element that has perforated and penetrated the skin and tissue along a tract to the target volume. The elongate member can be made of a rigid metal tube or a flexible plastic tube. The elongate member can include a cooling channel within it so that cooling fluid can be circulated within the elongate member to cool the electrode, and thus to enlarge the ablation volume at the target tissue.

Abstract: Ablative treatment of metastatic bone tumors and relief of pain associated with metastatic bone tumors is achieved by heat ablation of the bone tumor or tissue near the bone tumor by an ablation probe. In one form the probe is an electrode coupled to a high frequency power supply to provide ablative heating of tissue proximate to an electrode that is placed in or near the bone tumor. Cooling of the electrode by fluid circulation from a cooling apparatus outside the patient's body may be used to enlarge the region of high frequency heating around the electrode. Image guidance of the electrode placement may be monitored by an imaging device. Tracking of the electrode by an image-guided navigator helps in placement of the electrode with respect to the configuration of the bone and bone metastasis. A set of tools accommodates biopsy and various shapes of electrodes according to clinical requirements.

Abstract: Camera system in combination with data processors, image scan data, and computers and associated graphic display provide tracking of instruments, objects, patients, and apparatus in a surgical, diagnostic, or treatment setting. Optically detectable objects are connected to instrumentation, a patient, or a clinician to track their position in space by optical detection systems and methods. The recognition of instruments by patterns of optically detectable structures provides data on three-dimensional position, orientation, and instrument type. Passive or active optical detection is possible via various light sources, reflectors, and pattern structures applicable in various clinical contexts.

Abstract: A system for positioning and repositioning of a portion of a patient's body with respect to a treatment or imaging machine includes multiple cameras to view the body and the machine. Index markers, either light-emitting, passive, geometric shapes, or natural landmarks, are identified and located by the cameras in 3D space. In one embodiment, such reference or index markers are in a determinable relationship to analogous markers used during previous image scanning of the patient. Anatomical targets determined from image scanning can be located relative to reference positions associated with the treatment or diagnostic machine. Several forms of camera, index markers, methods and systems accommodate different clinical uses. X-ray imaging of the patient further refines anatomical target positioning relative to the treatment or diagnostic imaging reference point.

Abstract: A device for enlarging a urethral passage includes an elongate member having a distal portion configured for intraurethral placement in the urethral passage, and an electrode at the distal portion. The electrode is configured to be energized with high frequency energy to necrose tissue of the urethral wall and surrounding prostate tissue to form a cavity in the urethral passage. The electrode has an adjustable working length. The electrode has a diameter greater than about 16 French to substantially occlude the urethra. The device includes multiple electrodes spaced apart a distance of about 1 to 5 mm to provide flexibility in the distal portion of the elongate member. A method of treating a urethral passage includes measuring a length of a patient's prostate, and selecting a length of an electrode based on the measured length of the prostate.

Abstract: Relief of urethral obstruction is achieved by heat ablation of prostatic tissue by an ablation electrode passed within the urethra to a position in the prostate near the point of urethral obstruction. The electrode is coupled to a high frequency power supply to ablatively heat the urethra and the prostatic tissue near the urethra. Image guidance of the electrode placement is monitored by an imaging device. The temperature of the tissue is sensed at the electrode to control the high frequency heating energy and ablation process. The electrode has a blunt tip to help prevent piercing of the wall of the urethra during insertion of the electrode into the urethra through the penis and the positioning of the electrode tip near to the point of urethral obstruction. Several forms of electrodes, apparatus, and methods accommodate the specific objectives.

Abstract: Dental-based stereotactic localizers for non-invasively inducing computer tomographic (CT) slice images of the anatomy of a patient are disclosed. The localizer includes a dental piece configured and adapted to be received in the mouth of the patient, a support structure secured to the dental piece, the support structure defining an arcuate configuration which extends to the posterior margins of the teeth of the patient thus allowing an occipital region of the head of the patient to directly contact a surface of a treatment table, and a plurality of graphic reference elements, wherein the plurality of graphic reference elements produce index information on an image scan when intersected by a plane of a scan slice, wherein the index information is used to develop a mapping of data from the image scan so as to reference the data from the image scan to a coordinate system of the dental tray.

Abstract: An apparatus and method for treating an intervertebral disc having an inner nucleus pulpous and an outer annulus fibrous includes a thermal probe defining proximal and distal ends and having a guidable region adjacent the distal end thereof. The guidable region is characterized by having sufficient rigidity to advance within the annulus fibrous of the intervertebral disc in response to an axial force exerted on the proximal end of the thermal probe while having sufficient flexibility to substantially follow and conform to an azimuthal course defined by the natural striata of the annulus fibrous. The thermal probe is adapted for connection to a thermal energy source to provide thermal energy to the annulus fibrous to alleviate pain associated with the intervertebral disc.

Abstract: Camera systems in combination with data processors, image scan data, and computers and associated graphic display provide tracking of instruments, objects, patients, and apparatus in a surgical, diagnostic, or treatment setting. Optically detectable objects are connected to instrumentation, a patient, or a clinician to track their position in space by optical detection systems and methods. The recognition of instruments by patterns of optically detectable structures provides data on three-dimensional position, orientation, and instrument type. Passive or active optical detection is possible via various light sources, reflectors, and pattern structures applicable in various clinical contexts.

Abstract: A system for positioning and repositioning a portion of a patient's body with respect to a treatment or imaging machine includes multiple cameras to view the body and the machine. Index markers are identified and located by the cameras in 3D space. In one embodiment, such index markers are in a determinable relationship to analogous markers used during previous image scanning of the patient. Anatomical targets determined from image scanning can be located relative to reference positions associated with the treatment of diagnostic machine. Several forms of camera, index markers, methods and systems accommodate different clinical uses. X-ray imaging of the patient further refines anatomical target positioning relative to the treatment of diagnostic imaging reference point. Movements of the patient based on comparative analysis of imaging determined anatomical targets relative to reference points on treatment or diagnostic apparatus are controlled by the system and process of the invention.

Abstract: This patent application is a continuation-in-part of the patent application of the present authors related to target volume ablation in the body using a cooled-tip tissue-heating probe such as a fluid cooled (perfusion cooled) high frequency electrode. The present application relates in part to examples of specific embodiments of high frequency and radiofrequency electrode designs and heating and cooling system designs. It further describes embodiments in conjunction with 3-D or 2-D image data and computer graphic workstions to control, monitor, and pre-plan the process of target ablation. Specific examples of cooled-tip electrode constructions will be given which have utility for percutaneous or intraoperative cancerous tumor ablation. Cooled tip electrode systems with modular or separable components involving an insertion cannula, a radiofrequency electrode element, a cooling element, and a thermo-monitoring and/or radiofrequency connection electrode will be given.

Abstract: For repeat localization and immobilization of the head, neck and/or torso of a patient's body, immobilizing structures are used to secure the head and the neck and torso in a relative orientation in the position and relative orientation. A reference structure determines the relative position of the head and neck or torso so that the same configuration of these portions of the body can be achieved on a scanner couch or treatment machine couch repeatedly. Several forms of head and neck or torso immobilizers accommodate specific objectives and several forms of reference structures accomplish repositioning and patient position orientation.

Abstract: The present continuation-in-part application shows several specific embodiments of the invention and claims described in the parent patent application. In particular, it shows certain specific geometries of a dental-attached localizer which would be convenient for ear, nose, and throat (ENT) surgical applications or other localization applications related to the front of the face, the skull base, and similar areas. The localizer described in this continuation-in-part has rods and diagonals which allow quasi-coronal CT or other tomographic slices to be made through the face, skull base, and neck anatomy so as to locate structures accurately and repeatedly relative to the coordinate reference frame established by the dental impression piece.

Abstract: Relief of urethral obstruction is achieved by heat ablation of prostatic tissue by an ablation electrode passed within the urethra to a position in the prostate near the point of urethral obstruction. The electrode is coupled to a high frequency power supply to ablatively heat the urethra and the prostatic tissue near the urethra. Image guidance of the electrode placement is monitored by an imaging device. The temperature of the tissue is sensed at the electrode to control the high frequency heating energy and ablation process. The electrode has a blunt tip to help prevent piercing of the wall of the urethra during insertion of the electrode into the urethra through the penis and the positioning of the electrode tip near to the point of urethral obstruction. Several forms of electrodes, apparatus, and methods accommodate the specific objectives.

Abstract: A multiplicity of high frequency electrodes in a cluster configuration may be inserted into tissue of a patient's body for producing heat ablation of abnormal tissue such as a tumor. The electrodes are connected coherently to the voltage output of a high frequency generator. An enlarged ablation volume is accomplished by the electrode cluster with reduced risk of hemorrhage because of the smaller diameter of the individual electrodes of the cluster. The electrodes terminate in conductive tips, which are cooled by a fluid coolant to further facilitate enlarged ablation volumes. Very large ablation volumes are accomplished by this process and apparatus. Various cluster electrode configurations may be adapted to meet specific clinical requirements.

Abstract: Ablative treatment of metastatic bone tumors and relief of pain associated with metastatic bone tumors is achieved by heat ablation of the bone tumor or tissue near the bone tumor by an ablation probe. In one form the probe is an electrode coupled to a high frequency power supply to provide ablative heating of tissue proximate to an electrode that is placed in or near the bone tumor. Cooling of the electrode by fluid circulation from a cooling apparatus outside the patient's body may be used to enlarge the region of high frequency heating around the electrode. Image guidance of the electrode placement may be monitored by an imaging device. Tracking of the electrode by an image-guided navigator helps in placement of the electrode with respect to the configuration of the bone and bone metastasis. A set of tools accommodates biopsy and various shapes of electrodes according to clinical requirements.

Abstract: A high frequency generator system with a computer graphic two-dimensional user-interactable interface is achieved to allow selection of menus associated with the function, state, and output parameters of the high frequency generator system. A two-dimensional graphics display is coupled directly or remotely to a high frequency power source system which is further connected to electrodes in contact or proximity to the tissue of a patient's body. A two-dimensional display allows the user to see, in a compact, convenient, and comprehensive way, selection menus for use of the high frequency generator system, control of its parameters, monitoring of its processes during clinical application, and graphics displays related to historic or current image scan data and real-time monitoring of output parameters related to the application. Pre-set or user-selectable arrays of parameters can be selected through the two-dimensional user interface to the high frequency generator system.

Abstract: A method and apparatus for altering a function of neural tissue in a patient. An electromagnetic signal is applied to the neural tissue through an electrode. The electromagnetic signal has a frequency component above the physiological stimulation frequency range and an intensity sufficient to produce an alteration of the neural tissue, the alteration causing the patient to experience a reduction in pain, and a waveform that prevents lethal temperature elevation of the neural tissue during application of the electromagnetic signal to the neural tissue.

Abstract: A method and apparatus for altering a function of neural tissue in a patient. An electromagnetic signal is applied to the neural tissue through an electrode. The electromagnetic signal has a frequency component above the physiological stimulation frequency range and an intensity sufficient to product an alteration of the neural tissue, the alteration causing the patient to experience a reduction in pain, and a waveform that prevents lethal temperature elecation of the neural tissue during application of the electromagnetic signal to the neural tissue.