Abstract: Relief of urethral obstruction is achieved by heat ablation of prostatic tissue by an ablation probe passed within the urethra to a position in the prostate near the point of urethral obstruction. The probe is coupled to a power supply to deliver power to tissue near the probe and thus to ablatively heat the urethra and the prostatic tissue near the urethra. The temperature of the tissue is sensed at the probe to control the heating and ablation process. In one embodiment, the probe has a blunt tip to help prevent piercing of the wall of the urethra during insertion of the probe into the urethra through the penis and the positioning of the probe tip near to the point of urethral obstruction. Several forms of probes, apparatus, and methods accommodate the specific objectives.

Abstract: For heat ablating living tissue of a body, an ablation electrode, contacting a surface of the tissue or within tissue, is coupled to an RF power supply referenced to a second electrode contacting the body. Fluid coolant is circulated to cool the contact surface extending the ablation to an increased volume of tissue. Temperature may be sensed contiguous to the surface to control the flows of RF heating energy and fluid coolant. Computer capability implements control and provides graphics of data, preplans, or controls relative to the ablation. Several forms of electrode structures accommodate specific objectives.

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: 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 method and system for shaping a beam from a radiation delivery device includes a moving miniature multi-leaf collimator which can be moved into the field of radiation from the radiation device to shape the beam or moved out of the radiation field of the radiation device so that a second collimator can shape the beam. The movable miniature multi-leaf collimator comprises opposing banks of movable leaves to form a conformal shape when the collimator is within the radiation field. A translation or rotation mechanism can move the left and right leaf banks at the collimator away from and displaced significantly from the radiation beam of the radiation delivery device so that they will not intercept the radiation field. A second collimator device is then used to produce another independent beam shaping within the radiation field of the radiation device.

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: Relief of urethral obstruction is achieved by heat ablation of prostatic tissue by an ablation instrument passed within the urethra to a position in the prostate near the point of urethral obstruction. An electrode is coupled to a high-frequency power supply to ablatively heat the urethra and the prostatic tissue near the urethra. Guidance of the electrode placement may be monitored by an imaging device. The instrument may consist of a catheter with an inflatable balloon structure for positioning the instrument. The temperature of the tissue may be sensed at the electrode to control the high-frequency heating energy and ablation process.

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: 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: This invention relates to skin-based localizer markers that can be placed on the external anatomy of a patient during CT, MRI, or other scanning methods for producing identifiable index marks in stereotactic localization. In a preferred embodiment, the markers are of an annular or axially symmetric geometry, with provision for radiopaque and therefore CT-visible elements and also MRI-visible medium within the marker. The annular shape enables accurate identification of the centroid of the marker in the CT, MRI, or other tomographic image. Because the markers are visible in multi-modal imaging, such as CT and MR, registration of these images or stereotactic indexing can be done from one or both imaging types. In another embodiment, the marker has an index or concave central portion which enables a stereotactic digitized pointer to be placed stably within the indentation during calibration or marker identification in a surgical context.

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 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 method and apparatus for inducing large volume heat ablations of tissue in a patient involving electrodes that are in contact with the patient's external surface or the surface of an internal organ. A high frequency signal or output from a generator is applied to the tissue near the area electrodes by connection of the generator to the electrodes. Various applications and configurations of electrodes and temperature monitoring are appropriate for different clinical needs and thermal distributions. The use for interoperative ablation of a tumor site within an internal organ or for ablation of a tumor from electrodes placed on the surface of the patient provides a clinical advantage.

Abstract: This invention relates to the quantitative determination of a target or volume in the living body relative to external apparatus based on CT (computer tomography) or other image data. The invention describes a means of taking CT image data of the anatomy and of natural or implanted index positions on the patient's body, and relating the CT data to a coordinate system related to external apparatus which may be in fixed position relative to the patient. One implementation uses a transformation between the CT image data coordinate system and the second coordinate system. This makes it possible to do frame-based or frameless stereotactic target identification and approaches without the need for attaching a frame to the patient at the time of CT scanning.

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: A system for quantitative computer graphic determination of positions on a patient's anatomy and positions on associated equipment located near the patient's anatomy in relation to anatomical data, as from CT or MR scanning. A first camera produces a quantitative electronic readout of its field-of-view which provides a determination of relative spacial coordinates of uniquely identifiable points in its field-of-view. A second camera produces a quantitative electronic readout of its field-of-view which provides a determination of relative spacial coordinates of uniquely identifiable points in its field-of-view. The two cameras are located with respect to the patient's anatomy and the associated equipment so that the fields-of-view of the cameras include both the patient's anatomy and the equipment, but are taken from different directions. A body marker is positioned with respect to the patient's anatomy at a known position relative to said patient anatomy.

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: Stereotaxic Arc Systems are common instruments in neurosurgery for accurately directing a probe into the head and brain. Among the many types of arc concepts for such instruments is the target-centered arc. This involves an arc system which provides spherical radii from a multiplicity of directions depending on the rotation angles of the arc. All of the radii converge to the target point, thus the name target-centered arc. Prior to this invention, all such systems with two trunion bearings have an axis of arc rotation which has a fixed orientation relative to the patient's head. This causes a limitation in directions of approaches to desired targets. The present invention involves a new concept of target-centered arc, in which the access of rotation of the two trunions and their connected arc itself can be varied in orientation, leading to an unprecedented wide range of approaches to any anatomical target and great versatility of the arc system in surgery.

Abstract: A method and apparatus for inducing large volume heat ablations of tissue in a patient involving electrodes that are in contact with the patient's external surface or the surface of an internal organ. A high frequency signal or output from a generator is applied to the tissue near the area electrodes by connection of the generator to the electrodes. Various applications and configurations of electrodes and temperature monitoring are appropriate for different clinical needs and thermal distributions. The use for interoperative ablation of a tumor site within an internal organ or for ablation of a tumor from electrodes placed on the surface of the patient provides a clinical advantage.