Abstract: The invention relates to the field of radiation oncology, specifically the use of novel radio-opaque fiduciary markers which resist migration within tissues, which may be implanted in the body and imaged during radio-therapy to insure accurate treatment of target regions while avoiding irradiation of non-target regions. In one embodiment, the markers comprise oblong bodies from which a plurality of short tines protrude. Also provided are novel devices for implanting such markers. Additionally, the invention provides methods of delineating tumor resection beds and whole-bladder contours in the radiotherapeutic treatment of bladder cancer. Lastly, the invention encompasses novel methods of delivering fiduciary markers and other implants and materials by needle with sealing aids that increase the retention rate of the delivered markers, implants, or materials.

Abstract: Improved devices, systems, and methods treatment of patients can be used to help mitigate injury to the kidneys by applying cyclical mechanical pressure energy at low intensities. The energy often be selectively directed from non-invasive transducers disposed outside the patients. The energy will typically comprise low frequency ultrasound energy, shock wave energy, or the like, and may induce the generation and/or release of nitric oxide, thereby enhancing perfusion and ameliorating tissue damage. Superimposed micro and macro duty cycles may help avoid thermal and other injury to tissues of the patient during treatment. Bilateral treatments are facilitated by a support structure that orients at least one transducer toward each kidney.

Abstract: A pressure sensor for a medical injection system includes a cuff, a transducer embedded in the cuff, and a force transmitting member coupled to the transducer and exposed at an inner surface of the cuff, such that an outer surface of a tubing line of a fluid circuit of the system, when fitted within the cuff, contacts the force transmitting member. A limited length of the tubing line may have a greater compliance than a remainder of the line, in which case, the pressure sensor cuff fits around and encloses the limited length to provide support against plastic deformation, when pressures within the line are significantly greater than atmospheric. The pressure sensor may detect whether or not the cuff is properly fitted around the tubing line, and/or determine a characteristic of the tubing line.

Abstract: An embodiment in accordance with the present invention provides a method for non-invasively determining the functional severity of coronary artery stenosis. The method includes gathering patient-specific data related to concentration of a contrast agent within a coronary artery of a patient using a coronary computed tomography angiography scan (CCTA). The patient-specific data is used to calculate a patient-specific transarterial attenuation gradient for the coronary artery of the patient. The patient specific transarterial attenuation gradient is compared to previously collected data to determine an estimate of a pressure gradient and/or fractional flow reserve (FFR) for the patient. As more data is collected, the data can be added to the database in order to increase the accuracy of future assessments. The database can also be enhanced by adding data generated by canonical models and mathematical analysis.

Abstract: The invention generally relates to intravascular imaging and methods of improved image quality by triggering image operations with a vessel flush. The invention provides systems and methods for intravascular imaging in which a flush such as the influx of clear saline or radiopaque dye triggers the imaging operation. The flush is detected by a mechanism—such as a pressure sensor or optical device on the imaging catheter, an external angiography system, or other device—that uses detection as a trigger to initiate imaging. Thus, when the blood is flushed, the catheter automatically takes a picture of the vessel wall.

Abstract: An improved system for mammography analysis and methods of using the same. In one aspect, a clip comprises a first portion and at least one additional second portion connected to the first portion, the first and second portions adapted for elastic deformation for engaging tissue. In anther aspect, an improved actuator for performing a breast biopsy is used to deploy a clip. In yet another aspect of the invention, there is contemplated a system for marking an evacuated breast cyst.

Abstract: A method of a liquid surgery is described. The method may include introducing a cleansing solution, a diagnostic solution or therapeutic solution into the surface of the entire upper airway with a hand-operated pump. The liquid surgery can remove viruses, bacteria, fungi, allergens, and other harmful substance from the upper airway. The liquid surgery can help diagnose or treat a disease of the upper airway.

Abstract: A system and method are provided for determining individualized scan and injection protocols for contrast-enhanced diagnostic imaging. Taking into account parameters specific to the scan subject, injection-related parameters, and scan parameters, the system and method can determine an optimal timing for a scan sequence to begin, to ensure that the scan sequence coincides with a desired contrast enhancement. Some embodiments further provide for real-time triggering of the scan commencement based on bolus tracking, and can adapt the scan and injection protocols in real-time based on monitored dynamic scan subject parameters and/or actual enhancement values determined from image data.

Abstract: A membrane visualization instrument may include a flow control mechanism having a flow control mechanism distal end and a flow control mechanism proximal end, a visualization fluid chamber of the flow control mechanism, a visualization fluid guide having a visualization fluid guide distal end and a visualization fluid guide proximal end, and a hypodermic tube having a hypodermic tube distal end and a hypodermic tube proximal end. The visualization fluid guide proximal end may be disposed within the flow control mechanism. The hypodermic tube proximal end may be disposed within the visualization fluid guide. A visualization fluid, e.g., indocyanine green dye, kenalog, trypan blue dye, etc., may be disposed within the visualization fluid chamber. A compression of the flow control mechanism may be configured to irrigate the visualization fluid out of the hypodermic tube proximal end.

Abstract: A disposable set (5) for establishing a fluid connection between a fluid dispensing unit (17) and a dosing device adapted to dispense the fluid into a patients' vein, the disposable set comprising a length of a tubing (15) for establishing a fluid connection from the fluid dispensing unit towards and into the dosing device, wherein the tubing (15) comprises a first (1) and a second (10) tubing part, and a releasable connection (11,12), wherein the first tubing part (1) comprises two or more one-way valves (3, 24) which are provided to prevent a backflow from the patient in the direction of the fluid dispensing unit (17) in the closed position of the releasable connection.

Abstract: A control module for a medical injection system generates an injection control signal based on sensed internal pressure of a user activated control device, for example, in response to an applied external force that causes the sensed internal pressure to increase from a baseline pressure, and continues to sense the internal pressure of the device, following release of the applied external force, so that, if the sensed internal pressure drops below the baseline pressure, the control module may generate a notification. Thus, an operator of the system may monitor internal pressure of the control device for a drop below the baseline pressure, and then, if such a drop is detected, inspect the control device for leaks and reconnect, replace or repair the control device, or simply reconnect or replace the control device.

Abstract: An imaging method uses a plurality of sets of carbon nanotubes. Within a set the carbon nanotubes carry markers for a respective receptor that is specific for the set and the carbon nanotubes have a geometry, characterized for example by a chiral number that gives rise to an electromagnetic absorption peak at a wavelength specific to the set. An image is formed by transmitting electromagnetic radiation to a body, substantially at the wavelengths of the absorption peaks of the sets, e.g. time multiplexed with each other, and detecting for example an ultrasound response to absorption of the transmitted electromagnetic radiation. Different images of the electromagnetic absorption as a function of position in the body are formed for different wavelengths.

Abstract: A localizing wire includes an anchor portion that can change shape from a collapsed shape to an expanded shape and thereby anchor within a tissue mass. The localizing wire has an exterior portion that can lie flat against the tissue mass. The localizing wire can be repositioned or withdrawn without the need for the reinsertion of an introducer.

Abstract: Apparatus and methods for measuring radiation levels in vivo in real time. Apparatus and methods include a scintillating material coupled to a retention member.

Abstract: In a method and system for planning and implementing a selective internal radiation therapy (SIRT), the liver volume and the tumor volume are automatically calculated in a processor by analysis of items segmented from images obtained from the patient using one or more imaging modalities, with the administration of a contrast agent. The volume of therapeutic agent that is necessary to treat the tumor is automatically calculated from the liver volume, the tumor volume, and the body surface area of the patient and the lung shunt percentage for the patient. The therapeutic agent can be administered via respective feeder vessels in respectively different amounts that correspond to the percentage of blood supply to the tumor from the respective feeder vessels, this distribution also being automatically calculated by analysis of one or more parenchymal blood volume (PBV) images.

Abstract: A method for generating time-resolved 3D medical images of a subject by imparting temporal information from a time-series of 2D medical images into 3D images of the subject. Generally speaking, this is achieved by acquired image data using a medical imaging system, generating a time-series of 2D images of a ROI from at least a portion of the acquired image data, reconstructing a 3D image substantially without temporal resolution from the acquired image data, and selectively combining the time series of 2D images with the 3D image. Selective combination typically involves registering frames of the time-series of 2D images with the 3D image, projecting pixel values from the 2D image frames “into” the 3D image, and weighting the 3D image with the projected pixel values for each frame of the time-series of 2D images.

Abstract: The present invention provides systems, devices, and methods employing fiber optic shape and position tracking. The systems, devices, and methods permit measurement of and continuous tracking of the shape and position of objects whose shape dynamically changes with time. Applications include tracking and monitoring of endoscopes for diagnostic and surgical procedures.

Abstract: Apparatuses and methods for performing a procedure on a uterine cavity of a patient are disclosed. The methods can include visualizing the uterine cavity, biopsying a tissue with a biopsy device, and ejecting fluid from the biopsying device into the uterine cavity. The apparatuses can have a sealable acorn tip, a handle, a repositioning clip, a distal indicia, proximal indicia, and a fluid reservoir. The biopsying device can be configured to biopsy and eject fluid under the control of a single hand of a user of the device.

Abstract: Systems and methods for detecting circulatory anomalies such as, for example, right-to-left cardiac and pulmonary shunts. A fluorescing indicator is injected into the bloodstream of a subject. An optical sensor is used to transcutaneously excite the indicator into fluorescence and to transcutaneously detect the fluorescence, and a relative concentration of the indicator is determined as a function of time. An indicator dilution curve is generated from the relative concentration readings, the curve shape is analyzed for the indication of a shunt and, if a shunt is detected, a ratiometric area under the curve analysis is performed and combined with a calculated cardiac output value to provide a shunt conductance value. A Valsalva maneuver may be performed as a part of the method. System embodiments may include a controller/monitor that monitors, times, cues and/or analyzes various steps of a shunt detection test.

Abstract: An intracorporeal site marker has high ultrasound reflectivity, presents a substantial acoustic signature from a small marker, so as to avoid obscuring diagnostic tissue features in subsequent imaging studies, and can be readily distinguished from biological features. The biopsy site marker may include features to fix the marker to the biopsy site so as to resist migration from the biopsy cavity.

Abstract: An X-ray perfusion-image creating unit creates an X-ray perfusion image indicating blood flow dynamics in a certain organ from an X-ray projection image of a subject given with a contrast agent. An image correction unit extracts thickness information indicating the thickness of a myocardium from a three-dimensional image taken by an X-ray Computed Tomography (CT) apparatus. Moreover, the image correction unit creates a corrected perfusion image in which the thickness of the myocardium in the X-ray perfusion image is corrected, based on the thickness information. A display unit then displays the corrected perfusion image.

Abstract: A method for implanting a cardiac support device (CSD) on a patient's heart. An amount of contrast agent sufficient to cause structures on the heart to be visible upon fluoroscopic or other imaging is introduced into the pericardial space surrounding the heart. The heart and contrast agent are imaged to provide a visual indication of the location of the structures of the heart. The CSD is placed on the heart using the visual indications provided by the imaging.

Abstract: The invention provides a method, an image analysis software product, and a system for medical imaging analysis for estimating contrast agent extravasation in contrast agent based perfusion imaging such as MRI dynamic contrast enhanced (DCE) imaging, and in particular correction, compensation, or visualization of extravascular leakage of contrast agent in tumors. According to the invention, the effect of extravasation is directly manifested in the tail part of an observed, apparent residue function, R?(t), obtained directly by de-convoluting the expression C(t)=R?(t)Cp?(t) with the arterial input function (AIF). A leakage rate or extravasation constant is determined directly from the tail part of the determined apparent residue function.

Abstract: A system and method to compensate for respiratory motion in imaging of instruments introduced into the subject anatomy is provided. The system can include an imaging system in communication with a controller. The controller can include a memory with program instructions for execution by the processor to perform the steps of: detecting an illustration of at least a portion of the plurality of instruments introduced into the subject anatomy in a first image and a second image, comparing and calculating a displacement of the plurality of instruments between the first and second images, calculating one of an average or median displacement of the plurality of instruments between the first and second images, and applying one of the average and the median displacement to adjust at least a portion of the first or second images or a pre-acquired three-dimensional model of the internal region of interest.

Abstract: A dependency-based startup method in a multi-modality medical processing system that includes receiving initialization information about a plurality of executable components to be started, the plurality of executable components including an executable modality component configured to communicate with a medical device communicatively coupled to the multi-modality medical processing system. The method also includes receiving dependency information about the executable modality component, the dependency information identifying one or more of the executable components upon which the executable modality component depends and transforming the initialization information and the dependency information into a dependency map that represents the dependencies between the plurality of executable components.

Abstract: Aspects of the invention include methods for visualizing lymphatic tissue in an ocular region, e.g., the cornea, of a living subject, such as a mouse or human. In certain embodiments, the methods include contacting the region with a fluorescently-labeled lymphatic tissue-specific dye, e.g., FITC or rhodamine labeled dextran, and detecting the labeled dye to visualize lymphatic tissue in the region, where the visualization may vary, from an image obtained at a single time to a video over a period of time. The invention finds use in a variety of different applications, including research and therapeutic applications.

Abstract: Novel methods and imaging agents for functional imaging of lymph structures are disclosed herein. Embodiments of the methods utilize highly sensitive optical imaging and fluorescent spectroscopy techniques to track or monitor packets of organic dye flowing in one or more lymphatic structures. The packets of organic dye may be tracked to provide quantitative information regarding lymph propulsion and function. In particular, lymph flow velocity and pulse frequency may be determined using the disclosed methods.

Abstract: Systems and methods which utilize stress first and then rest imaging techniques to provide for improved medical imaging results are provided herein. One embodiment may administer a stress regime, such as exercise stress, and administer a tracer to a patient and retrieve a stress image. Then a second tracer is administered to a patient and a resting image is retrieved. Embodiments may implement this method with PET/CT scanning techniques. Additionally, embodiments may utilize a single CT scan when obtaining both the stress and rest images.

Abstract: Apparatus and methods are described for use with a plurality of angiographic image frames of a moving lumen of a subject, including aligning the image frames with each other. Using the aligned image frames, a time it takes a contrast agent to travel a known distance through the lumen is determined. At least partially in response thereto, a characteristic of the lumen is determined, and, in response to the determined characteristic, an output is generated on a display. Other applications are also described.

Abstract: An image-monitoring method for an electroporation treatment with an electroporation appliance is provided. The electroporation appliance comprises at least two treatment electrodes and an image-monitoring appliance. At least one image monitoring measurement is performed by the image-monitoring appliance after the administration of a contrast agent and after the electroporation treatment.

Abstract: Apparatus and methods for use with a set of angiographic images of a lumen of a subject's body are described. Temporal changes in a density of a contrast agent at a given location within the lumen are analyzed via image processing. In response to the analysis, a characteristic of the lumen at the location is determined, and, in response thereto, an output is generated. Other applications are also described.

Abstract: A method for providing CT fluoroscopy of an internal procedure site during a medical procedure so as to visualize patient anatomy and a high-contrast medical element during the procedure without subjecting the patient to unacceptable quantities of X-ray radiation, comprising: (1) taking a standard intensity CT scan of the internal procedure site; (2) taking a reduced intensity CT scan of the procedure site while the high-contrast medical element is inserted into the procedure site; (3) extracting the high-contrast medical element portion of the reduced intensity CT scan from the reduced intensity CT scan; (4) merging the high-contrast medical element portion of the reduced intensity CT scan extracted in Step 3 with the standard intensity CT scan of the procedure site taken in Step 1 so as to provide a composite CT scan; (5) displaying the composite CT scan; and (6) returning to either Step 1 or Step 2.

Abstract: Apparatus and methods are described for use with an imaging device (12) configured to acquire a set of angiographic images of a lumen. At least one processor (10) determines blood velocity within the lumen, via image processing. The processor determines a value of a flow-related parameter at the location based upon the determined blood velocity. The processor additionally receives an indication of a value of a second flow-related parameter of the subject, and determines a value of a luminal-flow-related index of the subject at the location, by determining a relationship between the value of the current flow-related parameter and the value of the second flow-related parameter. Other applications are also described.

Abstract: A system for at least partially filling and marking a cavity within a patient includes a delivery device. A quantity of marker forming fluid is located within the delivery device. The quantity of marker forming fluid is configured to at least partially fill the cavity and form therein a bioabsorbable body after delivery into the cavity from the delivery device. A radiopaque marker, separate from the quantity of marker forming fluid and releasably attached to a portion of the delivery device, is configured to be delivered into the quantity of marker forming fluid in the cavity from the delivery device and configured to remain in the bioabsorbable body upon the formation of the bioabsorbable body in the cavity.

Abstract: A physical phantom reference to control for variability of computed tomography measurement results duplicates the density curve of blood perfusion of contrast material in a healthy aorta or large artery to normalize observed changes in healthy arterial blood perfusion when calculating the reduction in tumor blood perfusion between two examination times. In one embodiment, a plurality of compartments with different concentrations of contrast material corresponding to a density curve of blood perfusion of a healthy tissue are positioned-in a screening field of a CT machine so the CT machine images the compartments when it linages the healthy tissue. In another embodiment, a pipe containing fluid receives an injection of contrast material from the injector when the injector injects the contrast material into the patient, the pipe having sections of varying diameter so the sections together correspond to a blood perfusion curve of the contrast material in a healthy tissue.

Abstract: This patent document discusses assemblies and methods for remotely detecting a position of a surgical instrument in the presence of a magnetic field. In varying examples, a position detection system includes an encoder coupled to move in concert with the instrument. The encoder includes an a translucent substrate and light blocking indicia disposed thereon. A light source and a light detector array are effectively disposed outside of the magnetic field. Light from the light source is carried to an encoder first side using an input optical fiber, while the light passing through the encoder is received at an encoder second side by an output optical fiber. The light received by the output optical fiber is transmitted to the light detector array, which converts the received light to position representative electrical signals. Such signals are subsequently transmitted to a control module adapted to formulate and convey a position of the instrument.

Abstract: A catheter device comprising a chamber containing an opacity enhancing substance is disclosed. The opacity enhancing substance is in a dried or semi-dried form within the chamber of the device. Release of a liquid into the chamber suspends the substance and forms an opacity enhancing solution that is released into the lumen of the device in order to enhance the opacity of the device for imaging.

Abstract: A contrast liquid injector has a controller that calculates a necessary volume of the contrast medium based on a read out necessary dose of effective component per unit weight, weight of the subject, and concentration of the effective component. The injection rate of a base-operation condition is changed based on the calculated necessary volume of the contrast medium, wherein the predetermined injection time is unchanged, for all volumes of the contrast medium, when making the injection pattern, whereby a timing of an optimum concentration of the contrast medium will be substantially unchanged for all volumes of the contrast medium.

Abstract: A method for planning to treat tissue by administering a substance which emits energy or can interact with administered energy to a body, such as body tissue, wherein a dispersion of the substance in the body is simulated, and to a system or device for planning administering a substance and administering energy to a body or in body tissue.

Abstract: Apparatus and methods are described for use with a lumen including, without generating a virtual three-dimensional model of the lumen, and by performing image processing on two-dimensional angiographic images, determining blood velocity within the lumen, and determining geometry of the lumen at a given location. A value of a current flow-related parameter at the location is determined based upon the determined blood velocity and the geometry of the lumen at the location. An indication of a value of a second flow-related parameter of the subject is received, and a value of a luminal-flow-related index of the subject at the location is determined, by determining a relationship between the value of the current flow-related parameter and the value of the second flow-related parameter. Other applications are also described.

Abstract: A device for interventional surgical or medical procedures is presented. The device is generally in the form of a balloon and is used to position itself or other working elements up against or through lumen walls in the body. The balloon is comprised of at least two materials of different elastic modulus, which allows for a flexible but relatively non-distensible, unfolding component of the balloon as well as an elastomeric, inflatable component of the balloon. The elastomeric component is fixedly attached to the flexible but relatively non-distensible component and together they form a pressure vessel that can be inflated within the lumens of the body.

Abstract: Disclosed are vascular access devices, implantable dialysis grafts, and systems including them useful for improved access to implanted medical devices. Also disclosed are implantable hemodialysis vascular access graft devices that facilitate easy, accurate and reproducible cannulation or needle entry into the implanted device by magnetically-locating a portion of the graft that includes one or more paramagnetic materials operably defining the physical boundaries of the target cannulation site/entry port.

Abstract: An imaging method for enhanced visualization of vessels in an examination region of a patient, in particular during an intervention, is proposed. A 3D reconstruction image of the examination region is generated using a preoperatively recorded 3D image dataset of the examination region. At least one current 2D fluorescence image of the examination region is recorded by a fluorescence angiography. The vessels are identified. The 3D image dataset with the image dataset of the 2D fluorescence or ultrasound image is registered based on the result of the identification. The 3D reconstruction image and the 2D image are overplayed. The overlaid images are 3D played back.

Abstract: The invention relates to an expandable marker device having a pre-delivery state, a delivery state and at least one active region. The at least one active region incorporates electroactive polymer material. In addition, the expandable marker includes at least one radiopaque material to enhance observation through a medical imaging device.

Abstract: The invention provides materials, devices and methods for marking biopsy sites for a limited time. The biopsy-marking materials are ultrasound-detectable bio-resorbable powders, with powder particles typically between about 20 microns and about 800 microns in maximum dimension, more preferably between about 300 microns and about 500 microns. The powders may be formed of polymeric materials containing cavities sized between about 10 microns and about 500 microns, and may also contain binding agents, anesthetic agents, hemostatic agents, and radiopaque markers. Devices for delivering the powders include tubes configured to contain the powders and to fit within a biopsy cannula, the powders being ejected by action of a syringe. Systems may include a tube containing powder, and a syringe containing sterile saline. The tube may be configured to fit within a biopsy cannula such as a Mammotome® or SenoCor 360™ cannula.

Abstract: A site marker delivery system is provided. The site mark delivery system includes an outer cannula having an open distal end. The outer cannula defines an inner lumen in which an inner cannula may be received. A marker is also positioned within the inner lumen of the outer cannula. The inner cannula further includes a trigger mechanism that when actuated injects the marker through the open distal end of the outer cannula into a biopsy site.

Abstract: Functional imaging for localization in biological tissue entails measuring a response in the tissue (240) to electromagnetic radiation. A catheter (200) for real-time monitoring of cardiac ablation is employed to distinguish a hemorrhage zone (232) from the sandwiching necrotic and healthy tissue, or to distinguish exogenous photoacoustic contrast agent from bordering native tissue. A pair of wavelengths is selected for differential absorption (244) of the radiation in, correspondingly, the hemorrhage zone or where the contrast agent exists, and relatively similar absorption elsewhere. Near infrared laser or LED light may be used photoacoustically to serially acquire (S310, S320) the two datasets to be compared, each representative of a time waveform. Alternatively, acquisition is for a pair of wavelength bands of microwave-induced thermoacoustic data.

Abstract: A method for identifying a molecule that binds an irradiated tumor in a subject and molecules identified thereby. The method includes the steps of: (a) exposing a tumor to ionizing radiation; (b) administering to a subject a library of diverse molecules; and (c) isolating from the tumor one or more molecules of the library of diverse molecules, whereby a molecule that binds an irradiated tumor is identified. Also provided are therapeutic and diagnostic methods using targeting ligands that bind an irradiated tumor.

Abstract: The present invention relates to a positioning marker intended to be inserted in tissue. The marker is an elongated object with a longitudinal axis A and with a diameter perpendicular to said longitudinal axis, wherein the diameter is at the most 1,2 mm. The marker further has a predetermined total length LTOT. The marker comprises a plurality of first segments 1 and a plurality of second segments 2, wherein the first and the second segments are arranged alternately after each others. The marker comprises a first material with a density of at least 10 g/cm3, and this material constitute at least 90% by volume of the marker, and a second material that is magnetic and that constitute at the most 10% by volume of the marker.

Abstract: A method for puncturing a pericardial membrane of a human patient, the method comprising inserting a needle into the chest of the human patient, detecting a phase of a mechanical activity of the heart of the human patient, advancing the needle toward the heart of the human patient in synchronization with the detected phase of the mechanical activity of the heart of the human patient, and repeating the detecting and advancing steps until the pericardial membrane of the human patient is punctured.