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WO1999022814A1 - Systeme et methode d'application et de controle endoscopique d'une therapie photodynamique et d'un diagnostic photodynamique - Google Patents

Systeme et methode d'application et de controle endoscopique d'une therapie photodynamique et d'un diagnostic photodynamique Download PDF

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Publication number
WO1999022814A1
WO1999022814A1 PCT/US1998/021018 US9821018W WO9922814A1 WO 1999022814 A1 WO1999022814 A1 WO 1999022814A1 US 9821018 W US9821018 W US 9821018W WO 9922814 A1 WO9922814 A1 WO 9922814A1
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WIPO (PCT)
Prior art keywords
light
treatment site
fluorescence
site
channel
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
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PCT/US1998/021018
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English (en)
Inventor
Eli Talmor
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ESC Medical Systems Ltd
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ESC Medical Systems Ltd
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Filing date
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Application filed by ESC Medical Systems Ltd filed Critical ESC Medical Systems Ltd
Priority to AU96859/98A priority Critical patent/AU9685998A/en
Priority to EP98950947A priority patent/EP1030719A4/fr
Priority to IL13583198A priority patent/IL135831A0/xx
Publication of WO1999022814A1 publication Critical patent/WO1999022814A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0071—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by measuring fluorescence emission
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
    • A61B5/0086—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters using infrared radiation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A61N5/0601—Apparatus for use inside the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A61N5/0613—Apparatus adapted for a specific treatment
    • A61N5/062—Photodynamic therapy, i.e. excitation of an agent
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00057—Light
    • A61B2017/00066—Light intensity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0075—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy

Definitions

  • the present invention relates in general to photodynamic therapy (PDT) and photodynamic diagnosis (PDD). More particularly, the present invention relates to a system and method for applying and concurrently monitoring PDT and/or PDD. Most particularly, the present invention relates to a system and method for endoscopically applying and concurrently monitoring PDT and/or PDD to tumors of internal organs.
  • PDT photodynamic therapy
  • PDD photodynamic diagnosis
  • Electromagnetic radiation is used to treat a variety of external and internal conditions including skin rumors and parasites and tumors of internal organs. This radiation is typically applied to the treatment site from a variety of radiation sources, such as lasers that emit coherent light, flash lamps or arc lamps emitting incoherent light and microwave radiation sources, among others.
  • radiation sources such as lasers that emit coherent light, flash lamps or arc lamps emitting incoherent light and microwave radiation sources, among others.
  • PDT photodynamic therapy
  • the PDT treatment is based on a systemic or topical application of a tumor-localizing photosensitizing agent, such as porphyrin, aminolevulinic acid (ALA), phthalocyanin, chlorine, etc., which after illumination and excitation with light of appropriate wavelength in the presence of oxygen, give rise to highly reactive and cytotoxic single molecular oxygen which causes tumor regression.
  • a tumor-localizing photosensitizing agent such as porphyrin, aminolevulinic acid (ALA), phthalocyanin, chlorine, etc.
  • light of the appropriate wavelength should be applied to the tumor until the photosensitizer agent is consumed by the beneficial chemical reaction. Once this reaction is complete and the agent is consumed, any additional light applied to the tumor may have little value. Termination of the treatment before the agent is consumed is even worse, since this may leave tumor residuals.
  • the light source should have been replaced back at the identical spot from which it was removed to apply light to the identical area. This often did not happen, however. Each time the light source was replaced, it was often replaced at a slightly different location. In this manner, the light source "migrates" across the treatment site causing irregular and nonhomogeneous treatment of the tumor.
  • the light source obscures the treatment site, and prevents the light source from being accurately positioned with respect to the treatment site, and, in the event that a larger area is treated, prevents the light source from being relocated to an adjacent area of the treatment site without leaving an untreated gap, or without overlapping an area that has already been treated, and thus treating an area twice, unnecessarily.
  • This problem is even more emphasized when the treated site is internal and an endoscope is used to deliver the light from the light source to the treated site.
  • PDD photodynamic diagnostics
  • the device includes a white light source, a laser light source which can be switched between therapy and diagnosis modes, a color camera for imaging, a spectrometer which includes a spectroscope, a high sensitivity camera and an analyzer, monitors for displaying color images obtained from the color camera and for displaying graphical presentations of the spectra.
  • the white light source, laser light source, color camera and the spectrometer each employ a dedicated light guide to deliver or retrieve light, as appropriate.
  • the device disclosed by Suzuki suffers few limitations.
  • the light employed for therapy is a laser light which renders the whole apparatus dedicated to very specific PDT or PDD compounds and which is costly.
  • the field of view of the spectrometer is not defined to the user.
  • using the disclosed device does not enable to obtain a fluorescence spectrum and a concurrent image of the treatment site.
  • the device disclosed fails to provide combined spatial-spectral information, such as a fluorescence image of the treatment site.
  • FIG. 2 illustrates a PDT/D and monitoring apparatus 10 according to U.S. patent application No. 08/708,080.
  • Apparatus 10 includes a housing 12, with an opening 14 disposed against a treatment site 16.
  • Housing 12 includes a camera 18 coupled to housing 12 and oriented to receive light entering housing 12 from opening 14. In this case, since opening 14 is disposed adjacent to treatment site 16, camera 18 receives images of treatment site 16 that is adjacent to opening 14.
  • Spectrometer 20 includes optical bench 22 disposed away from housing 12, and light guide 24 (typically an optical fiber or fiber bundle) coupled to housing 12 and optical bench 22 to direct radiation entering housing 12 through opening 14 into optical bench 22.
  • Spectrometer 20 is preferably of the type known in the art as an optical multichannel analyzer (OMA).
  • OMA optical multichannel analyzer
  • a light guide 26 is coupled to housing 12 to transmit light from light source 28 into housing 12 and toward opening 14.
  • the light is preferably generated either by a laser or a flashlamp, both of which have emissive qualities particularly suited to being coupled to housing 12. In this manner light for treatment is sent to treatment site 16.
  • Light source 28 is preferably a high intensity light source such as a xenon or mercury arc lamp. It may have one or more filters, such as a violet filter passing wavelengths in the range of 400 to 450 nanometers or a green filter passing wavelengths in the range of 505 to 590 nanometers. These wavelengths are particularly useful when using the system in PDT and PDD, since these are the frequencies that cause common photosensitizing chemicals to fluoresce significantly.
  • a window 30 is provided that extends across the opening 14.
  • Light guide 24 is coupled to window 30, preferably in the field of view of camera 18, such that an image produced by camera 18 indicates the point at which light guide 24 is coupled to window 30.
  • Light guide 24 preferably receives light emitted from a spot on treatment site 16 measuring between 1 and 10 mm . Window 30 transmits light from light source 28 out of housing 12 and onto treatment site 16. It also transmits light emitted from treatment site 16 into housing 12 and hence into camera 18.
  • Optical fiber 24 preferably extends through the window such that it receives light emitted directly from treatment site 16 without having to pass through window 30.
  • the inner and outer surfaces of window 30 preferably have an anti-reflective coating to attenuate any reflections internal to housing 12 from entering camera 18.
  • Window 30 is preferably recessed within opening 14 of housing 12. The depth of this recess is preferably between 3 and 10 mm.
  • Camera 18 is an electronic camera, preferably a color or black-and- white CCD camera. Camera 18 is disposed to provide an image that includes from 1 to 100 cm of treatment site 16. More preferably, the n image includes from 10 to 40 cm of treatment site 16. Most preferably, the n image includes from 15 to 25 cm of treatment site 16.
  • Camera 18 may include a filter 32 disposed in the camera's optical path to block particular frequencies of light, such as the frequencies emitted by light source 28.
  • the filter should transmit light in the range of 570 to 770 mm. This is of particular value when camera 18 is used to sense frequencies of light emitted by fluorescing photosensitizing agents (that typically emit in the 570-770 nm range) in response to the light emitted by light source 28.
  • the apparatus further includes a computer coupled to the spectrometer, the camera and to a computer display.
  • the computer receives signals from the spectrometer indicative of the spectrum of light received by spectrometer. These signals are processed by computer which then transmits an electrical signal to the display causing the display to generate a representation of the spectrum on the display.
  • the computer also transmits signals to the display indicative of the images received by the camera.
  • an operator of the system can monitor the spectral emissions of the treatment site simultaneously with an image of the treatment site.
  • these images and spectrums are displayed in real time, as the light from the treatment site is received by the spectrometer and the camera.
  • This mode of operation has a synergistic effect, allowing the operator of the system to provide and monitor a treatment by viewing a computer display rather than by viewing the treatment site itself. All the information required to determine where and when to move the housing with respect to the treatment site is provided on the screen. The image also indicates the point at which spectrum has been measured.
  • PDT involves damage to the tumor vascular bed, which in turn causes disruption of tumor blood flow and ultimately to a tissue necrosis.
  • the vascular damage produced by the PDT treatment in the tumor reduces its efficiency in cooling the tumor.
  • Hyperthermia by heating a tumor to a moderate temperature of up to
  • Hyperthermia has been proved to be selectively lethal to various malignant cells in the range of 41° to 46° C, thus being considered to be of a clinical value.
  • U.S. patent application No. 08/394,2308 it was found that the combination of PDT and HPT when applied simultaneously, is much more effective and provides better results that the two separate individual treatments. The benefit from this combination, besides the decrease of about 40% of the irradiation dose required to produce vascular damage is also a better penetration.
  • the photochemical reaction enhancement at elevated temperatures which results from the PDT, does produce a strong cytotoxic effect and reduces the required penetration depth in the tissue which is generally in the range of between 1 to 3 mm at 630 nm. Therefor, shallow tumors might be treated by PDT alone, but an efficient treatment could not be achieved in case of deeper tumors.
  • the treatment includes the administration of between 600 to 750 nm band and simultaneously heating the tumor to a temperature of up to 46 °C.
  • the total time of treatment is about 20 minutes, including only about 5 minutes of pure PDT, reaching the above maximum temperature during a simultaneous HPT treatment for about 15 minutes.
  • the hyperthermal effect may be obtained by a direct heating of the tumor.
  • electromagnetic irradiation is preferred. For example, by a simultaneous irradiation at 1.2 to 1.7 ⁇ m, the required heating of a tumor could be produced with an irradiance of only 30 to 70 mW/sq.cm. for a period of about 20 minutes.
  • a preferred apparatus according to the invention described in U.S. patent application 08/394,238, is characterized by simultaneous illumination in the range of between 600 to 750 nm in the "red” and between 1200 to 1700 nm in the near infra-red.
  • the ratio between the power emitted in the "red” to the power emitted in the near infra-red is preferably between 2:1 and 5:1 and most preferably about 3:1.
  • a preferred mode for applying the heating is by a CO2 laser or NdyaG laser.
  • the absorption of hemoglobin in the blood vessels is in the range of 600 to 750 nm, which produces an increase in the temperature and an enhanced PDT reaction rate.
  • the apparatus can also be incorporated in other systems, thus providing additional useful functions as known in the art.
  • a violet filter in the range of 400-450 nm, using means of a filter wheel, it can be used for excitation of photosensitizes in the photodynamic diagnostics or monitoring.
  • incorporation of a green filter in the spectral range of 505-590 nm using can be used for a superficial PDT treatment or for various dermatologic applications such as removal of tattoos and portwine stains.
  • the apparatus described in U.S. patent application 08/394,238, was found also to be useful with a variety of photosensitizes known in the art.
  • a system for endoscopically irradiating and concurrently monitoring light during photo dynamic treatment of an internal treatment site comprising (a) at least one light source for providing an illuminating light for illumination of the treatment site, a fluorescence inducing light for inducing a fluorescence light emission from the treatment site and a treating light for activating a photodynamic chemical present at the treatment site; (b) an illumination light channel for tunneling the illuminating and fluorescence inducing lights from the light source to the treatment site; (c) a working light channel for tunneling the treating light from the light source to the treatment site; (d) an imaging light channel for retrieving light from the treatment site; and (e) a light analysis arrangement being optically coupled to the imaging light channel for analyzing the light retrieved from the treatment site, the light analysis arrangement including (i) a first camera for providing a reflected light image of the treatment site; (ii) a second camera for providing a fluorescence light
  • system further comprising a mechanism for alternately optically coupling the at least one light source with the illumination light channel and the working light channel.
  • imaging light channel is an imaging optic fiber bundle of an endoscope.
  • the illumination light channel is an illumination optic fiber bundle of an endoscope.
  • the working light channel includes an optic fiber insertable via a working channel of an endoscope.
  • a system combining with an existing endoscope, the endoscope having an illumination light channel, a working channel and an imaging light channel, the system being for endoscopically irradiating and concurrently monitoring light during photodynamic treatment of an internal treatment site, the system comprising (a) at least one light source for providing an illuminating light for illumination of the treatment site, a fluorescence inducing light for inducing a fluorescence light emission from the treatment site and a treating light for activating a photodynamic chemical present at the treatment site; (b) a working light channel being insertable via the working channel of the endoscope for tunneling the treating light from the light source to the treatment site; (c) a mechanism for alternately optically coupling the light source with the illumination light channel and the working light channel, for tunneling the illuminating and fluorescence inducing lights
  • the illuminating light is a white light
  • the fluorescence inducing light is a blue light
  • the treating light is a red light
  • the heating light is an infrared light.
  • the first camera is a color camera.
  • the second camera is a monochromatic camera.
  • the spectrum is of at least part of a light fluorescing from the treatment site when illuminated with the fluorescent inducing light.
  • the light source includes a Xenon arc lamp and a filters wheel for selecting among the illuminating light, the fluorescence inducing light, the treating light and a combination of the treating light and the heating light.
  • the working light channel includes a light diffuser at its treating end.
  • a method of endoscopically monitoring a photodynamic freatment of an internal treatment site comprising the steps of (a) applying to an organism a phtodynamic chemical having a strong affinity for the treatment site; (b) irradiating the treatment site with a fluorescence inducing light, the fluorescence inducing light is selected such that is induces the phtodynamic chemical to emit a fluorescent light; (c) monitoring the fluorescent light via a first camera; and (d) displaying a fluorescence image of the treatment site, thereby providing spatial data of a distribution of the phtodynamic chemical in the treatment site.
  • a method of endoscopically monitoring the efficiency of a photodynamic therapy of an internal treatment site comprising the steps of (a) applying to an organism a phtodynamic chemical having a strong affinity for the treatment site; (b) irradiating the treatment site with a treating light selected such that when it impinges the phtodynamic chemical a formation of free radicals is induced; (c) irradiating the treatment site with a fluorescence inducing light, the fluorescence inducing light is selected such that is induces the phtodynamic chemical to emit a fluorescent light; (d) monitoring the fluorescent light via a camera; and (e) displaying a fluorescence image of the treatment site, thereby providing spatial data of a remaining distribution of the phtodynamic chemical in the treatment site.
  • the methods further comprising the steps of irradiating the treatment site with an illumination light; monitoring light reflected from the treatment site via a second camera; and displaying a reflected light image of the freatment site.
  • the methods further comprising the steps of monitoring the fluorescent light via a spectrometer; and (f) displaying a fluorescence spectrum of at least some of the fluorescent light.
  • the present invention successfully addresses the shortcomings of the presently known configurations by providing a system and method for monitoring PDT and PDD which provides a user with spatial-spectral information on the course of treatment.
  • FIG. 1 illustrates a typical absorption spectra of monomeric porphyrins (solid line), chlorins (dashed line) and phthalocyanines (broken line);
  • FIG. 2 is a partial cross-sectional diagram of a monitoring apparatus in accordance with the invention disclosed in U.S. patent application No. 08/708,080;
  • FIG. 3 is a schematic depiction of the system according to the present invention.
  • the present invention is of a system and method which can be used for applying and concurrently monitoring photodynamic therapy (PDT), combined, for example, with hiperthermic therapy (HPT), and/or photodynamic detection (PDD).
  • PDT photodynamic therapy
  • HPT hiperthermic therapy
  • PDD photodynamic detection
  • the present invention can be used to provide an endoscope for applying and concurrently monitoring PDT, HPT and/or PDD of an internal treatment site, such as, but not limited to, trachea, colon, vagina, bladder and others.
  • Figure 3 schematically presents a prefered embodiment of the system according to the present invention, which is referred to hereinbelow as system 100.
  • system 100 serves for endoscopically irradiating and concurrently monitoring light during a photodynamic freatment (PDT, HPT and/or PDD) of an internal treatment site, typically a tumor of an internal organ, such as but not limited to trachea tumor, colon tomor, vaginal tumor, bladder tumor and other tumors.
  • a photodynamic freatment typically a tumor of an internal organ, such as but not limited to trachea tumor, colon tomor, vaginal tumor, bladder tumor and other tumors.
  • System 100 includes at least one light source 102 for providing several types of light irradiation.
  • One type of light is an illuminating light which serves for illumination of the treatment site.
  • the illuminating light is typically a white light having a wavelength range of about 400-700 nm. Illuminating lights in other spectral ranges are also applicable for some applications.
  • Another type of light is a fluorescence inducing light which serves for inducing a fluorescence light emission from the freatment site.
  • the fluorescence inducing light is typically a blue light having a wavelength range within about 400-450 nm.
  • the spectral range of the fluorescence inducing light is determined by the nature of chemical employed for PDT or PDD.
  • the chemicals whose absorption specfra are presented in Figure 1 fluoresce when irradiated with light in the blue range. However, other chemicals are expected to fluoresce when irradiated with light having a wavelength range different than blue.
  • Yet another type of light is a treating light which serves for activating a photodynamic chemical present at the treatment site to produce free radicals.
  • the treating light is typically a red light having a wavelength range within about 580-720 nm.
  • the spectral range of the freating light is determined by the nature of the chemical employed for PDT.
  • the chemicals whose absorption specfra are presented in Figure 1 become photodynamically activated as described when irradiated with light in the red range. However, other chemicals are expected to be activated when irradiated with light having a different wavelength range.
  • Still another type of light is a heating light which serves for heating the treatment site. It is shown in U.S. patent application 08/394,238, that a combination of HPT with PDT improves the treatment results.
  • the heating light is an infrared light having a wavelength range within about 1,200- 1,700 nm.
  • the heating light and treating light may be irradiated either separately or concomitantly.
  • light source 102 includes a Xenon arc lamp 104 supplemented with a reflector 106 which serves for reflecting the light generated by lamp 104 generally in a single direction.
  • Light source 102 further includes a window, a wide band filter (e.g., 400-750 and 1,200-2,000 nm) 110, focusing lenses 111 and a motorized 112 filters wheel 114 for selecting among the illuminating light, fluorescence inducing light, treating light, heating light and a combination of treating light and heating light.
  • a wide band filter e.g. 400-750 and 1,200-2,000 nm
  • a Xenon arc lamp is presently prefered since it is a single light source which is capable of providing sufficient photons required for illumination, PDT, PDD and/or HPT, using a simple filters wheel. It is therefore both flexible and economic as compared with laser light sources.
  • System 100 further includes an illumination light channel 116 which serves for tunneling the illuminating and fluorescence inducing lights from light source 102 to the freatment site.
  • illumination light channel 116 is an illumination optic fiber bundle 118 of a conventional endoscope 120. The construction and operation of a conventional endoscope is described, for example, in
  • PENT AX® owner's manual upper GI fiberscopes, models FG-16X, 24X, 27X, 29X, 32X and 34X), which is incorporated by reference as if fully set forth herein.
  • System 100 further includes a working light channel 122 which serves for tunneling the freating light and/or the heating light from light source 102 to the treatment site.
  • working light channel 122 includes a light diffuser 124 at its treating end 126.
  • working light channel 122 includes an optic fiber 126 insertable via a working channel 128 (also known in the art as the instrument channel) of conventional endoscope 120.
  • System 100 further includes a mechanism, indicated by arrow 130, for alternately optically coupling light source 102 with illumination light channel 116 and working light channel 122.
  • Mechanism 130 is preferably a motorized mechanism.
  • System 100 further includes an imaging light channel 132 which serves for retrieving light from the freatment site for analysis.
  • imaging light channel 132 is an imaging optic fiber bundle 134 of conventional endoscope 120.
  • System 100 further includes a light analysis arrangement 136.
  • Arrangement 136 is optically coupled to imaging light channel 132 for analyzing light retrieved from the treatment site.
  • Light analysis arrangement 136 includes a first camera 138 for providing a reflected light image 146a of the freatment site.
  • the reflected light is typically the reflection of the illuminating white light from the freatment site.
  • First camera 138 is typically a color camera, such as, but not limited to, an RGB-CCD.
  • a suitable color camera is distributed by SONY (Model DXC-LS1P). Camera 138 does not require a high dynamic range and is therefore simple and cost effective.
  • Light analysis arrangement 136 further includes a second camera 140 for providing a fluorescence light image 146b of the treatment site.
  • the fluorescent light is typically the light fluorescing from the treatment site upon irradiance with the fluorescence inducing light. Therefore camera 140 is supplemented with a filter 142 for blocking light outside the fluorescence emission range.
  • Second camera 140 is typically a monochromatic camera having a high dynamic range, such as, but not limited to, a monochromatic CCD.
  • a suitable monochromatic camera is distributed by WATEC (Model WAT 704R). Selecting camera 140 monochromatic is presently prefered since is enables to employ a cost effective camera with a high dynamic range. Nevertheless, a monochromatic camera (as opposed to color camera) is sufficient to capture the distribution and intensity of fluorescence in the treatment site.
  • Light analysis arrangement 136 further includes a spectrometer 144 for providing a spectrum 146c of at least part of the light retrieved from freatment site.
  • the spectrum is typically of at least part of the light fluorescing from the treatment site as a result of irradiating the treatment site with the fluorescence inducing light.
  • Spectrometer 144 is preferably of the type known in the art as an optical multichannel analyzer (OMA).
  • OMA optical multichannel analyzer
  • a suitable spectrometer is distributed by OCEAN OPTICS (Model S-2000).
  • light arriving from imaging channel 132 is distributed among cameras 138 and 140 and spectrometer 144 via a set of beam splitters 145 and lenses 143.
  • Light analysis arrangement 136 further includes at least one display 146 for displaying the reflected light image 146a, the fluorescence light image 146b and the spectrum 146c, described above.
  • System 100 preferably further includes a computer 150 for confrolling its operation.
  • Computer 150 is therefore preferably coupled to and controls the operation of spectrometer 144, cameras 138 and 140, display 146, motor 112 of motorized filter wheel 114, light source 102 and mechanism 130.
  • Computer 150 may also be coupled to and serve to control various functions of a conventional endoscope, as further detailed below.
  • computer 150 receives signals from spectrometer 144 indicative of the spectrum of light received by spectrometer 144. These signals are processed by computer 150 which then transmits an electrical signal to display 146 causing display 146 to generate a representation 146c of the spectrum on display 146.
  • Computer 150 also receives signals from cameras 138 and 140 indicative of the images received by cameras 138 and 140.
  • Computer 150 which then transmits an electrical signal to display 146 causing display 146 to generate representations 146a/b of the images on display 146.
  • Computer 150 also receives signals from a user indicative of the user's will with respect to the operation of motor 112 of motorized filter wheel 114, light source 102 and mechanism 130. These signals are produced by any computer signalling mechanism, such as, but not limited to, a mouse, a keyboard, an active screen, etc. These signals are processed by computer 150 which then fransmits an electrical signal to operate the listed components as required.
  • an operator of system 100 can monitor the spectral emissions of the treatment site simultaneously with a fluorescence image of the treatment site.
  • these images and spectrums are displayed in real time, as the light from the treatment site is received by spectrometer 144 and camera 140.
  • This mode of operation has a synergistic effect, allowing the operator of the system to provide and monitor a treatment by viewing computer display 146 rather than by viewing the treatment site itself. All the information required to determine where and when to move endoscope 120 with respect to the treatment site is provided on the screen.
  • the image also indicates the point or area at which spectrum has been measured.
  • the operator may also be provided with a reflected light, color image of the freatment site.
  • the system according to the present invention is combinable with existing endoscopes.
  • a suitable endoscope to which the system may combine is distributed by PENTAX® (Model FG-34X).
  • Such an endoscope typically has an illumination light channel, a working channel and an imaging light channel, all as further described above.
  • Such an endoscope typically further includes water, air and suction channels, as well known in the art.
  • a method of endoscopically monitoring a photodynamic treatment of an internal treatment site includes the following steps.
  • a phtodynamic chemical having a strong affinity for the treatment site is applied to an organism, e.g., systemically (by injection, orally) or locally, etc.
  • the treatment site is irradiated with a fluorescence inducing light
  • the fluorescence inducing light is selected such that is induces the phtodynamic chemical to emit a fluorescent light.
  • the fluorescence inducing light would be in the blue range.
  • the fluorescent light is monitored via a first camera
  • a fluorescence image of the treatment site is displayed, thereby providing spatial data of a distribution of the phtodynamic chemical in the treatment site.
  • a method of endoscopically monitoring the efficiency of a photodynamic therapy of an internal treatment site includes the following steps.
  • a phtodynamic chemical having a strong affinity for the freatment site is applied to an organism, e.g., systemically (by injection, orally) or locally, etc.
  • the treatment site is irradiated with a treating light selected such that when it impinges the phtodynamic chemical a formation of free radicals is induced.
  • the treating light is typically in the red range.
  • the freatment site is irradiated with a fluorescence inducing light
  • the fluorescence inducing light is selected such that is induces the phtodynamic chemical to emit a fluorescent light.
  • the fluorescence inducing light would be in the blue range.
  • the fluorescent light is monitored via a first camera
  • a fluorescence image of the freatment site is displayed, thereby providing spatial data of a distribution of the phtodynamic chemical in the treatment site.
  • any of the methods further include the steps of irradiating the treatment site with an illumination light, monitoring light reflected from the freatment site via a second camera, and displaying a reflected light image of the freatment site.
  • any of the methods further include the steps of monitoring the fluorescent light via a spectrometer, and displaying a fluorescence spectrum of at least some of the fluorescent light. While the invention has been described with respect to a limited number of embodiments, it will be appreciated that many variations, modifications and other applications of the invention may be made.

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Abstract

L'invention concerne un système d'irradiation endoscopique et de contrôle simultané de la lumière pendant le traitement photodynamique d'un site de traitement interne, le système comprenant au moins une source (102) de lumière destinée à produire une lumière illuminant le site de traitement, une lumière induisant une fluorescence destinée à induire une émission de lumière fluorescente à partir du site de traitement, et une lumière de traitement destinée à activer un agent chimique photodynamique présent sur le site de traitement; un canal de lumière d'illumination destiné à conduire l'illumination, et des lumières induisant une fluorescence (116, 118) de la source de lumière jusqu'au site de traitement; un canal de lumière de travail destiné à conduire la lumière de traitement de la source de lumière au site de traitement (122, 126, 128); un canal de lumière d'imagerie destiné à récupérer la lumière du site de traitement (132, 134); et un agencement (136) d'analyse de lumière couplé optiquement au canal de lumière d'imagerie et destiné à analyser la lumière récupérée du site de traitement, l'agencement d'analyse de lumière comprenant une première caméra destinée à fournir une image de lumière réfléchie du site de traitement (138); une seconde caméra destinée à fournir une image de lumière à fluorescence du site de traitement (140); un spectromètre (144) destiné à fournir un spectre d'au moins une partie de la lumière récupérée du site de traitement; ainsi qu'au moins un affichage (146, 146a-146c) destiné à afficher l'image de lumière réfléchie, l'image de lumière fluorescente et le spectre.
PCT/US1998/021018 1997-10-30 1998-10-05 Systeme et methode d'application et de controle endoscopique d'une therapie photodynamique et d'un diagnostic photodynamique Ceased WO1999022814A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
AU96859/98A AU9685998A (en) 1997-10-30 1998-10-05 System and method for endoscopically applying and monitoring photodynamic therapy and photodynamic diagnosis
EP98950947A EP1030719A4 (fr) 1997-10-30 1998-10-05 Systeme et methode d'application et de controle endoscopique d'une therapie photodynamique et d'un diagnostic photodynamique
IL13583198A IL135831A0 (en) 1997-10-30 1998-10-05 System and method for endoscopically applying and monitoring photodynamic therapy and photodynamic diagnosis

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US96101497A 1997-10-30 1997-10-30
US08/961,014 1997-10-30

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AU (1) AU9685998A (fr)
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WO (1) WO1999022814A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2169590C1 (ru) * 2000-03-17 2001-06-27 Закрытое акционерное общество "БИОСПЕК"-"BIOSPEC"JSC Спектральное устройство для контроля и мониторинга процесса фотодинамической терапии
EP1281370A3 (fr) * 2001-08-03 2004-01-02 Susann Edel Dispositif d'irradiation
CN100361630C (zh) * 2005-12-20 2008-01-16 哈尔滨工业大学 二极管激光光谱肿瘤成像诊断仪
RU2382660C1 (ru) * 2008-06-17 2010-02-27 Институт общей физики им. А.М. Прохорова Российской академии наук (ИОФ им. А.М. Прохорова РАН) Устройство и способ флюоресцентной диагностики и фотодинамической терапии заболеваний кожи
RU2483678C1 (ru) * 2012-03-15 2013-06-10 Федеральное государственное бюджетное учреждение науки Институт радиотехники и электроники им. В.А. Котельникова Российской академии наук Устройство для люминесцентной диагностики новообразований
EP2997999A4 (fr) * 2013-05-13 2016-06-01 Arai Medphoton Res Lab Corp Dispositif et méthode de surveillance du niveau de progression d'une thérapie
RU2649211C2 (ru) * 2016-08-25 2018-03-30 Михаил Викторович Муравьев Автоматизированный лазерный комплекс для диагностики и лечения заболеваний методом фотодинамической терапии в онкологии

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4768513A (en) 1986-04-21 1988-09-06 Agency Of Industrial Science And Technology Method and device for measuring and processing light
US4913142A (en) * 1985-03-22 1990-04-03 Massachusetts Institute Of Technology Catheter for laser angiosurgery
US5707401A (en) 1994-03-10 1998-01-13 Esc Medical Systems, Ltd. Apparatus for an efficient photodynamic treatment
US5851181A (en) 1996-08-30 1998-12-22 Esc Medical Systems Ltd. Apparatus for simultaneously viewing and spectrally analyzing a portion of skin

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS5940830A (ja) * 1982-08-31 1984-03-06 浜松ホトニクス株式会社 レ−ザ光パルスを用いた癌の診断装置
DE9112188U1 (de) * 1991-09-30 1991-12-19 Steiger, Erwin, Dipl.-Phys., 8038 Gröbenzell Laser-Diagnose- und Therapie-Gerät zur Tumorbehandlung
JP3411737B2 (ja) * 1995-03-03 2003-06-03 ペンタックス株式会社 生体の蛍光診断装置

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4913142A (en) * 1985-03-22 1990-04-03 Massachusetts Institute Of Technology Catheter for laser angiosurgery
US4768513A (en) 1986-04-21 1988-09-06 Agency Of Industrial Science And Technology Method and device for measuring and processing light
US5707401A (en) 1994-03-10 1998-01-13 Esc Medical Systems, Ltd. Apparatus for an efficient photodynamic treatment
US5851181A (en) 1996-08-30 1998-12-22 Esc Medical Systems Ltd. Apparatus for simultaneously viewing and spectrally analyzing a portion of skin

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of EP1030719A4

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2169590C1 (ru) * 2000-03-17 2001-06-27 Закрытое акционерное общество "БИОСПЕК"-"BIOSPEC"JSC Спектральное устройство для контроля и мониторинга процесса фотодинамической терапии
EP1281370A3 (fr) * 2001-08-03 2004-01-02 Susann Edel Dispositif d'irradiation
CN100361630C (zh) * 2005-12-20 2008-01-16 哈尔滨工业大学 二极管激光光谱肿瘤成像诊断仪
RU2382660C1 (ru) * 2008-06-17 2010-02-27 Институт общей физики им. А.М. Прохорова Российской академии наук (ИОФ им. А.М. Прохорова РАН) Устройство и способ флюоресцентной диагностики и фотодинамической терапии заболеваний кожи
RU2483678C1 (ru) * 2012-03-15 2013-06-10 Федеральное государственное бюджетное учреждение науки Институт радиотехники и электроники им. В.А. Котельникова Российской академии наук Устройство для люминесцентной диагностики новообразований
EP2997999A4 (fr) * 2013-05-13 2016-06-01 Arai Medphoton Res Lab Corp Dispositif et méthode de surveillance du niveau de progression d'une thérapie
RU2649211C2 (ru) * 2016-08-25 2018-03-30 Михаил Викторович Муравьев Автоматизированный лазерный комплекс для диагностики и лечения заболеваний методом фотодинамической терапии в онкологии

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EP1030719A1 (fr) 2000-08-30
AU9685998A (en) 1999-05-24
EP1030719A4 (fr) 2002-11-27
IL135831A0 (en) 2001-05-20

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