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CN109069203B - 用于能量输送的系统和方法 - Google Patents

用于能量输送的系统和方法 Download PDF

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CN109069203B
CN109069203B CN201780023778.6A CN201780023778A CN109069203B CN 109069203 B CN109069203 B CN 109069203B CN 201780023778 A CN201780023778 A CN 201780023778A CN 109069203 B CN109069203 B CN 109069203B
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S.约翰逊
P.莫兰
D.安德森
R.W.舍弗科
C.L.巴尔塞
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Abstract

本发明涉及用于向组织输送能量以用于各种应用的综合系统和方法，包括医疗程序(例如，组织消融、切除、烧灼、血管血栓形成、心律失常和节律障碍的治疗、电外科、组织收获等)。在某些实施方案中，提供了用于识别和治疗靶组织区域的系统和方法，其针对消融相关的解剖学变化(例如，组织收缩)进行调整。

Description

用于能量输送的系统和方法
技术领域
本发明涉及用于向组织输送能量以用于各种应用的综合系统和方法，包括医疗程序(例如，组织消融、切除、烧灼、血管血栓形成、心律失常和节律障碍的治疗、电外科、组织收获等)。在某些实施方案中，提供了用于识别和治疗靶组织区域的系统和方法，其针对消融相关的解剖学变化(例如，组织收缩)进行调整。
背景技术
能量输送装置(例如，天线、探针、电极等)(例如，微波消融装置)(例如，射频消融装置)用于将能量输送到期望的组织区域，以“治疗”期望的组织区域。消融治疗(例如，微波消融、射频消融)是广泛使用的微创技术，用于治疗各种病症和/或疾病(例如，肿瘤细胞)。在这样的技术中，消融能量(例如，微波能量)(例如，射频能量)用于将期望的组织区域加热到期望的温度，以在加热的区域中引起组织破坏。
消融手术的成功通常取决于最大化所需组织消融的量并使不希望的组织消融的量最小化。这种成功取决于靶组织区域的精确和准确识别，能量输送装置在此类识别的靶组织区域处的定位，以及将这种能量输送到识别的组织区域。
需要用于准确且精确地识别针对消融手术的靶组织区域的改进技术。
本发明解决了这个需求。
发明内容
识别用于消融手术的靶组织区域的当前技术涉及例如使用CT成像或其他成像模态。例如，CT成像用于定位和识别要消融的特定解剖区域(例如，三维解剖学尺寸)并且基于所识别的位置，在该识别的位置处定位能量输送装置，以及将消融能量输送到所识别的位置。
然而，限制消融手术成功的问题涉及靶组织区域在被消融时经历的解剖学变化。实际上，经历消融手术的组织区域的解剖学尺寸随着组织区域被消融而改变。例如，组织区域的解剖学尺寸在消融期间经历收缩，这改变了组织区域的手术前和手术后解剖学尺寸。在手术期间发生的这种解剖学变化(例如，收缩)导致不期望的组织(例如，健康组织)暴露于消融能量。非靶向组织的这种不希望的消融不仅损害消融手术的成功，而且可能导致严重的不良健康后果，特别是如果消融区靠近健康的关键组织或结构。如果试图通过选择较小区进行补偿，则可能不会破坏所有预期组织，这可能使治疗效果降低，或者在肿瘤消融的情况下，允许肿瘤再生和转移。
当靶组织区域经历消融手术时，用于定位和识别待消融的特定解剖区域(例如，三维解剖学尺寸)的当前技术(例如，CT扫描)不能适应这种解剖学变化(例如，组织收缩)。
本发明提供了允许识别和定位靶组织区域的系统、材料和方法，当靶组织区域经历消融手术时，所述靶组织区域适应这种解剖学变化(例如，组织收缩)。
在某些实施方案中，本发明提供了包括能量输送装置和处理器的系统，其中该处理器被配置成识别、选择和/或修改靶组织区域，针对消融相关的解剖学变化进行调整。
在一些实施方案中，识别针对消融相关的解剖学变化进行调整的靶组织区域包括接收关于组织区域和能量输送装置的信息，计算组织区域内的收缩区域，确定组织区域内的预期收缩点，计算组织区域内的预期收缩变形(例如，确定每个收缩点的预期的收缩距离(例如，最大和最小)和方向)，应用计算的预期收缩变形，以及识别并报告针对消融相关的解剖学变化而调整的靶组织区域。
在一些实施方案中，处理器与能量输送装置通信。在一些实施方案中，处理器被配置成将能量输送装置定位在期望的组织区域处并且/或者在消融手术期间控制能量输送。在一些实施方案中，期望的组织区域是针对消融相关的解剖学变化而调整的识别的靶组织区域。
在一些实施方案中，处理器向用户提供关于收缩点的信息(例如，经由基于处理器的视觉显示；经由无线通信等)。例如，在一些实施方案中，组织区域与手术期间的收缩点和针对每个点的计算的收缩点距离和方向一起提供(例如，在手术之前、之后以及在手术期间的任何点处)。在一些实施方案中，提供组织区域和每个收缩点的最小边缘距离和最大边缘距离。
在某些实施方案中，处理器被配置成测量消融(例如，收缩后的消融)之前和之后的靶组织区域之间的最小距离和最大距离。在一些实施方案中，这种测量的距离用于确定在消融手术期间和之后是否满足期望的边缘。
在一些实施方案中，处理器被配置成量化和比较在针对消融相关的解剖学变化进行调整之前的靶组织区域与在针对消融相关的解剖学变化进行调整之前的靶组织区域之间的距离差异和/或方向差异。在一些实施方案中，处理器被配置成量化和比较在未针对消融相关的解剖学变化而调整的靶组织区域与针对消融相关的解剖学变化而调整的靶组织区域之间的实际距离差异和/或方向差异(例如，在消融手术之前和消融手术之后)。
在某些实施方案中，处理器被配置成在消融手术期间监测和/或控制和/或提供关于一个或多个方面的反馈。例如，在一些实施方案中，处理器被配置成在消融手术期间监测每个收缩点的预测的收缩点距离和方向。在一些实施方案中，处理器被配置成如果一个或多个收缩点的预测的收缩点距离和/或方向与实际的相应收缩点距离和/或方向不一致，则停止消融手术。在一些实施方案中，处理器被配置成如果一个或多个收缩点的预测的收缩点距离和/或方向与实际的相应收缩点距离和/或方向不一致，则在消融手术期间调整所输送的能量的量(例如，升高或降低)。在一些实施方案中，处理器被配置成如果一个或多个收缩点的预测的收缩点距离和/或方向与实际的相应收缩点距离和/或方向不一致，则重新计算一个或多个收缩点的收缩点距离和/或方向。在一些实施方案中，处理器被配置成如果一个或多个收缩点的预测的收缩点距离和/或方向与每个收缩点的实际的收缩点距离和/或方向不一致，则识别新的收缩点并且/或者重新计算一个或多个现有收缩点的收缩点距离和/或方向。在一些实施方案中，处理器被配置成基于组织区域内的预测温度与实际温度的差异，能量输送装置中的预测温度与实际温度的差异等差异进行类似调整。
在一些实施方案中，系统还包括电连接到能量输送装置的电源。
在某些实施方案中，本发明提供了用于消融组织区域的方法，包括提供这样的系统，用处理器识别针对消融相关的解剖学变化而调整的靶组织区域，将能量输送装置定位在针对消融相关的解剖学变化而调整的所识别的靶组织区域处，并消融组织区域(例如，并且不消融靶组织区域外的组织)。在一些实施方案中，在消融手术期间识别和/或修改靶组织区域。
在一些实施方案中，组织区域在受试者(例如，人类受试者)内。
在一些实施方案中，消融的组织区域不包括未被包括在针对消融相关的解剖学变化而调整的所识别的靶组织区域中的组织。
附图说明
图1示出了用于生成针对消融相关的解剖学变化(例如，组织收缩)而调整的靶组织区域的示例性过程的示意图。
具体实施方式
当靶组织区域经历消融手术时，用于定位和识别待消融的特定解剖区域(例如，三维解剖学尺寸)的当前技术(例如，经由CT扫描)不能适应解剖学变化(例如，组织收缩)。这种解剖学变化导致不期望的健康组织消融或以其他方式导致组织过度消融或消融不足，与手术目标不一致。
本发明提供了允许识别、定位和消融靶组织区域的系统、材料和方法，其在靶组织区域经历消融手术时适应这种解剖学变化(例如，组织收缩)。
在一些实施方案中，处理器(例如，计算机)用于从组织成像数据中识别和定位一个或多个靶组织区域，所述组织成像数据适应这种解剖学变化(例如，组织收缩)。在一些实施方案中，处理器使用软件，评估与待消融的组织区域相关联的变量的存在和不存在以及与能量输送装置和待在该手术期间使用的能量的类型相关联的变量。
与待消融的组织区域相关联的这种变量以及与能量输送装置和待在该手术期间使用的能量的类型相关联的变量的示例包括但不限于待在手术期间使用的能量的类型(例如，微波或射频，或两者兼有)、手术的时间长度、手术期间要达到的温度范围(例如，组织处的温度)、经历手术的组织区域的类型(例如，肝、肺、心脏、肾、实体瘤等)、组织区域的温度、受试者的年龄、受试者的整体健康状况等。
在一些实施方案中，靶组织区域的识别涉及基于输入变量的计算(例如，与待消融的组织区域相关联的变量以及与能量输送装置和待在手术期间使用的能量的类型相关联的变量)。
在一些实施方案中，这种计算基于输入的变量信息预测期望的组织区域在手术期间将经历的解剖学变化的量和类型。
在一些实施方案中，这种计算涉及确定收缩点、计算收缩区域、计算收缩变形、应用这种收缩变形，以及生成针对消融相关的解剖学变化(例如，组织收缩)而调整的靶组织区域。
这种评估不限于确定收缩点和计算收缩区域的特定方式。在一些实施方案中，该方法通过计算在消融手术期间收缩的组织区域(例如，器官组织)的总范围的近似来确定收缩点。近似可以是形态学的或基于组织和附近结构的类型。在一些实施方案中，该方法通过利用在收缩点处组织将收缩最多并且将作为距该点的距离和方向的函数而减小的知识来计算收缩区域。在此类实施方案中，该方法计算消融区域内的一个或多个收缩点。计算可基于消融区域的几何形状或消融探针的定位。
这些方法不限于计算收缩变形的特定方式。在一些实施方案中，该方法利用以下知识：由于收缩的性质，收缩区域内的每个位置都被变换达某种程度，并且变换的量是距收缩点的距离和方向的函数。在一些实施方案中，计算的收缩变形可包括设定的距离和方向，或者可包括用于多个方向改变的多个距离。该函数可以是基于距收缩点的距离和方向的几何函数，或者基于该位置处的组织和该区域中的结构的特征的物理函数。在一些实施方案中，在消融前和消融后，预测每个收缩点的实际收缩距离。在一些实施方案中，在消融前和消融后，预测每个收缩点的实际收缩方向(包括可能的多个方向变化)。在一些实施方案中，在消融前和消融后，预测每个收缩点的实际收缩距离和方向(包括可能的多个方向变化)。例如，对于某个收缩点，测量收缩距离和方向的量(包括可能的多个方向变化)。在一些实施方案中，处理器被配置成比较每个收缩点的预测的收缩距离和方向以及实际的收缩距离和方向。
那些变换可被描述为存储在变形网格中的变形。每个位置处的变形可被描述为矢量，该矢量大小和方向描述了收缩的特征。例如，在一些实施方案中，变形网格的每个元素可由指向收缩点方向的矢量定义，并且其大小可定义为距收缩点的距离的线性函数。
这些方法不限于应用变形的特定方式。在一些实施方案中，该过程将如由变形所描述的收缩的特征应用于待消融的组织区域。在消融区域内的每个位置处，在确定其与目标相交时，确定在该对应位置处来自变形网格的变换量。在一些实施方案中，如果目标不与消融区域相交，则对变换的大小应用值(例如，零)。在一些实施方案中，基于这样的调整来调整待消融的组织区域的尺寸(例如，基于变换的方向和大小将组织区域变换到新位置)。
图1示出了用于生成靶组织区域的示例性方法的示意图，其针对消融相关的解剖学变化(例如，组织收缩)而调整。可以看出，存储装置(例如，计算机)接收关于待消融的组织区域和附加因素的信息。接下来，系统确定收缩点并计算收缩区域。接下来，基于确定的收缩点和计算的收缩区域来计算收缩变形。最后，基于计算的收缩变形来应用变形，并且生成针对消融相关的解剖学变化(例如，组织收缩)而调整的靶组织区域。
在某些实施方案中，系统与能量输送装置或操作者通信，使得能量输送装置适当地定位在识别的靶组织区域，以便实现消融所需组织的消融，从而解决由消融过程引起的组织收缩。
在某些实施方案中，本发明提供了用于治疗受试者体内组织区域的系统。在一些实施方案中，此类系统包括如上所述的处理器(具有相关联的软件)，以及一个或多个能量输送装置。在一些实施方案中，处理器被配置成与能量输送装置通信。在一些实施方案中，系统还包括与能量输送装置通信的能量发生器。
在某些实施方案中，本发明提供用于输送消融能量的系统，该系统包括电源、输送功率管理系统(例如，用于控制向两个或更多个探针的功率输送的功率分配器)、处理器、能量发射装置(例如，消融探针)、冷却系统、成像系统、温度监测系统和/或手术跟踪系统。
在某些实施方案中，处理器还被配置成量化和比较在针对消融相关的解剖学变化进行调整之前的靶组织区域与在针对消融相关的解剖学变化进行调整之前的靶组织区域之间的距离和方向差异。类似地，在一些实施方案中，处理器被配置成量化和比较在未针对消融相关的解剖学变化调整的靶组织区域与针对消融相关的解剖学变化调整的靶组织区域之间的实际距离和方向差异(例如，在消融手术之前和消融手术之后)。
在某些实施方案中，处理器向用户提供关于收缩点的信息(例如，经由基于处理器的视觉显示，经由无线通信等)。例如，在一些实施方案中，组织区域与手术期间的收缩点和每个点的计算的收缩点距离和方向一起提供(例如，在手术之前、之后以及在手术期间的任何点处)。在一些实施方案中，提供组织区域和每个收缩点的最小和最大边缘距离和方向。
在某些实施方案中，处理器被配置成测量消融(例如，收缩后的消融)之前和之后的靶组织区域之间的最小距离和最大距离。在一些实施方案中，这种测量的距离用于确定在消融手术期间和之后是否满足期望的边缘。
在某些实施方案中，处理器被配置成在消融手术期间监测和/或控制和/或提供关于一个或多个方面的反馈。例如，在一些实施方案中，处理器被配置成在消融手术期间监测每个收缩点的预测的收缩点距离和/或方向。在一些实施方案中，处理器被配置成如果一个或多个收缩点的预测的收缩点距离和/或方向与实际的相应收缩点距离和/或方向不一致，则停止消融手术。在一些实施方案中，处理器被配置成如果一个或多个收缩点的预测的收缩点距离和/或方向与实际的相应收缩点距离和/或方向不一致，则在消融手术期间调整所输送的能量的量(例如，升高或降低)。在一些实施方案中，处理器被配置成如果一个或多个收缩点的预测的收缩点距离和/或方向与实际的相应收缩点距离和/或方向不一致，则重新计算一个或多个收缩点的收缩点距离和/或方向。在一些实施方案中，处理器被配置成如果一个或多个收缩点的预测的收缩点距离和/或方向与每个收缩点的实际收缩点距离和/或方向不一致，则识别新的收缩点并且/或者重新计算一个或多个现有收缩点的收缩点距离和/或方向。在一些实施方案中，处理器被配置成基于组织区域内的预测温度与实际温度的差异，能量输送装置中的温度差异等差异进行类似调整。
在某些实施方案中，处理器被配置成测量消融(例如，收缩后的消融)之前和之后的靶组织区域之间的最小距离和最大距离。在一些实施方案中，这种测量的距离用于确定在消融手术期间和之后是否满足期望的边缘。
本发明的系统可以组合在各种系统/套件实施方案中。例如，在一些实施方案中，系统包括具有处理器、发生器、配电系统和能量施加器的计算机，以及任何一个或多个附加部件(例如，外科器械、温度监测装置等)中的一个或多个或全部。示例性系统部件描述于美国专利No.7,101,369、No.9,072,532、No.9,119,649和No.9,192,438以及美国公布No.20130116679，这些专利中的每一个以引用方式全文并入本文。
本发明的系统可用于涉及将能量(例如，射频能量、微波能量、激光、聚焦超声等)输送到组织区域的任何医疗程序。
该系统不限于治疗特定类型或种类的组织区域(例如，脑、肝、心脏、血管、足、肺、骨等)。在一些实施方案中，该系统可用于消融肿瘤区域。其他治疗方法包括但不限于治疗心律失常、肿瘤消融(良性和恶性)、手术期间出血控制、创伤后出血控制、用于任何其他出血控制、软组织移除、组织切除和收获、治疗静脉曲张、腔内组织消融(例如，治疗食管病变，诸如巴氏食管和食管腺癌)、骨肿瘤治疗、正常骨和良性骨病、眼内使用、用于整容手术、中枢神经系统的病理包括脑肿瘤和电干扰的治疗、绝育手术(例如，输卵管消融)，以及用于任何目的的血管或组织烧灼。在一些实施方案中，外科应用包括消融治疗(例如，以实现凝固性坏死)。在一些实施方案中，外科应用包括肿瘤消融以靶向例如原发性或转移性肿瘤。在一些实施方案中，外科应用包括控制出血(例如，电烙术)。在一些实施方案中，外科应用包括组织切割或移除。
能量输送系统设想使用被配置成输送(例如，发射)能量的任何类型的装置(例如，消融装置、外科装置等)(参见，例如，美国专利号7,101,369、7,033,352、6,893,436、6,878,147、6,823,218、6,817,999、6,635,055、6,471,696、6,383,182、6,312,427、6,287,302、6,277,113、6,251,128、6,245,062、6,026,331、6,016,811、5,810,803、5,800,494、5,788,692、5,405,346、4,494,539，美国专利申请序列号11/728,460、11/728,457、11/728,428、11/237,136、11/236,985、10/980,699、10/961,994、10/961,761、10/834,802、10/370,179、09/847,181；英国专利申请号2,406,521、2,388,039；欧洲专利号1395190；以及国际专利申请号WO 06/008481、WO 06/002943、WO 05/034783、WO 04/112628、WO04/033039、WO 04/026122、WO 03/088858、WO 03/039385、WO95/04385；这些专利中的每一个全文以引用方式并入本文中)。这些装置包括被配置用于能量发射的任何和所有医学、兽医和研究应用装置，以及用于农业环境、制造环境、机械环境或要输送能量的任何其他应用的装置。
在一些实施方案中，能量输送系统利用处理器来监测和/或控制和/或提供关于系统的一个或多个部件的反馈。在一些实施方案中，处理器在计算机模块内提供。例如，在一些实施方案中，系统提供用于通过监测组织区域的一个或多个特征来调节提供给组织区域的微波能量的量的软件，包括但不限于靶组织的大小和形状、组织区域的温度等(例如，通过反馈系统)(参见，例如，美国专利申请序列号11/728,460、11/728,457和11/728,428；这些专利中的每一个全文以引用方式并入本文中)。在一些实施方案中，该软件被配置成实时提供信息(例如，监测信息)。在一些实施方案中，该软件被配置成与能量输送系统交互，使得其能够升高或降低(例如，调谐)输送至组织区域的能量的量。在一些实施方案中，该软件被设计用于调节冷却剂。在一些实施方案中，将被治疗的组织类型(例如，肝脏)输入到软件中以便允许处理器基于针对该特定类型的组织区域的预校准方法来调节(例如，调谐)向组织区域的能量输送。在其他实施方案中，处理器基于显示对系统用户有用的特征的特定类型的组织区域生成图表或图。在一些实施方案中，处理器提供能量输送算法，以便例如缓慢地增加功率，从而避免由于高温产生的快速排气而导致的组织破裂。在一些实施方案中，处理器允许用户选择功率、治疗持续时间、针对不同组织类型的不同治疗算法、以多天线模式同时向天线施加功率、在天线之间切换功率输送、相干和非相干定相等。在一些实施方案中，处理器被配置用于基于具有相似或不相似的患者特征的先前治疗来创建与特定组织区域的消融治疗有关的信息数据库(例如，基于特定患者特征的组织区域的所需能量水平、治疗持续时间)。在一些实施方案中，处理器通过远程控制操作。
在一些实施方案中，提供用户界面软件用于监测和/或操作能量输送系统的部件。在一些实施方案中，用户界面软件由触摸屏界面操作。在一些实施方案中，用户界面软件可在无菌环境(例如，手术室)内或在非无菌环境中实现和操作。在一些实施方案中，用户界面软件在手术装置集线器内(例如，经由处理器)实现和操作。在一些实施方案中，用户界面软件在手术推车内(例如，经由处理器)实现和操作。用户界面软件不限于特定功能。与用户界面软件相关联的功能的示例包括但不限于跟踪能量输送系统内每个部件的使用次数(例如，跟踪能量输送装置的使用次数)，提供并跟踪每个部件或每个部件的部分的实时温度(例如，沿着能量输送装置提供不同位置的实时温度(例如，在柄部处、在杆处、在尖端处))(例如，提供与能量输送系统相关联的电缆的实时温度)，提供并跟踪被处理组织的实时温度，为能量输送系统的部分或全部提供自动关闭(例如，紧急关闭)，基于例如在手术之前、期间和之后累积的数据生成报告，向用户提供听觉和/或视觉警报(例如，指示手术已开始和/或已完成的警报，指示温度已达到异常水平的警报，指示手术的长度已超出默认值的警报，等等)。
在一些实施方案中，能量输送系统利用包括成像装置的成像系统。能量输送系统不限于特定类型的成像装置(例如，内窥镜装置、立体定向计算机辅助的神经外科导航装置、热传感器定位系统、运动速率传感器、线控转向系统、过程内超声、间质超声、微波成像、声波层析成像、双能量成像、荧光检查、计算机断层扫描磁共振成像、核医学成像装置三角测量成像、热声成像、红外和/或激光成像、电磁成像)(参见，例如，美国专利号6,817,976、6,577,903和5,697,949、5,603,697)，以及国际专利申请WO 06/005,579；这些专利中的每一个全文以引用方式并入本文中)。在一些实施方案中，系统利用内窥相机、成像部件和/或导航系统，其允许或帮助放置、定位和/或监视与本发明的能量系统一起使用的任何制品。
在一些实施方案中，能量输送系统利用调谐元件来调整输送到组织区域的能量的量。在一些实施方案中，调谐元件由系统的用户手动调整。在一些实施方案中，调谐系统被结合到能量输送装置中，以便允许用户根据需要调整装置的能量输送(参见，例如，美国专利号5,957969、5,405,346；这些专利中的每一个全文以引用方式并入本文中)。
在一些实施方案中，能量输送系统利用冷却剂系统以便减少在能量输送装置(例如，组织消融导管)内部以及沿着该装置的不期望的加热。系统不限于特定的冷却系统机构。
在一些实施方案中，能量输送系统利用温度监测系统。在一些实施方案中，温度监测系统用于监测能量输送装置的温度(例如，使用温度传感器)。在一些实施方案中，温度监测系统用于监测组织区域(例如，被治疗的组织、周围组织)的温度。在一些实施方案中，温度监测系统被设计成与处理器通信，以便向用户或向处理器提供温度信息，从而允许处理器适当地调整系统。
该系统还可采用一个或多个附加部件，其直接或间接地利用或辅助本发明的特征。例如，在一些实施方案中，一个或多个监测装置用于监测和/或报告系统的任何一个或多个部件的功能。另外，可以直接或间接地与本发明的装置一起使用的任何医疗装置或系统可包括在系统中。这些部件包括但不限于灭菌系统、装置和部件，其他外科、诊断或监测装置或系统、计算机设备、手册、说明书、标签和指南、机器人设备等。
系统不限于特定用途。实际上，本发明的能量输送系统被设计用于其中能量发射适用的任何环境中。此类用途包括任何和所有医学、兽医和研究应用。此外，本发明的系统和装置可用于农业环境、制造环境、机械环境或要输送能量的任何其他应用。在一些实施方案中，系统被配置用于开放手术、经皮、血管内、心内、内窥镜、腔内、腹腔镜或外科能量输送。在一些实施方案中，能量输送装置可通过导管、通过手术开发的开口和/或通过身体孔口(例如，嘴、耳、鼻、眼、阴道、阴茎、肛门)定位在患者体内(例如，N.O.T.E.S.手术)。在一些实施方案中，系统被配置用于将能量输送到靶组织或区域。
本发明不受靶组织或区域的性质限制。用途包括但不限于治疗心律失常、肿瘤消融(良性和恶性)、手术期间出血控制、创伤后出血控制、用于任何其他出血控制、软组织移除、组织切除和收获、治疗静脉曲张、腔内组织消融(例如，治疗食管病变，诸如巴氏食管和食管腺癌)、骨肿瘤治疗、正常骨和良性骨病、眼内使用、用于整容手术、中枢神经系统的病理包括脑肿瘤和电干扰的治疗、绝育手术(例如，输卵管消融)，以及用于任何目的的血管或组织烧灼。在一些实施方案中，外科应用包括消融治疗(例如，以实现凝固性坏死)。在一些实施方案中，外科应用包括肿瘤消融以靶向例如转移性肿瘤。在一些实施方案中，装置被配置用于在任何期望的位置(包括但不限于脑、颈、胸、腹和骨盆)处对组织或生物体的损伤最小的运动和定位。在一些实施方案中，系统被配置用于引导的输送，例如，通过计算机断层扫描、超声、磁共振成像、荧光检查等进行。
在某些实施方案中，本发明提供了治疗组织区域的方法，包括提供组织区域和本文所述的系统(例如，能量输送装置，以及以下部件中的至少一种：利用本发明的算法的处理器、电源、温度监测器、成像器、调谐系统和/或温度降低系统)；识别并定位靶组织区域，调整预期的消融相关的解剖学变化(例如，组织收缩)；将能量输送装置的一部分定位在组织区域附近，并将一定量的能量与装置一起输送到组织区域。在一些实施方案中，组织区域为肿瘤。在一些实施方案中，能量的输送导致例如组织区域的消融和/或血管的血栓形成，和/或组织区域的电穿孔。在一些实施方案中，组织区域为肿瘤。在一些实施方案中，组织区域包括心脏、肝脏、生殖器、胃、肺、大肠、小肠、脑、颈、骨、肾、肌肉、肌腱、血管、前列腺、膀胱和脊髓中的一者或多者。
上述说明书所提到的所有出版物和专利的全文均出于所有目的以引用方式并入本文。在不脱离所描述的技术的范围和精神的情况下，所描述的技术的组合物、方法和用途的各种修改和变化对于本领域技术人员而言将是显而易见的。尽管已经结合具体的示例性实施方案描述了该技术，但是应该理解，要求保护的本发明不应该不适当地限于这些特定实施方案。实际上，对于本领域技术人员显而易见的，用于实施本发明的所述模式的各种修改旨在落入以下权利要求的范围内。

Claims (7)

1.一种系统，包括能量输送装置和处理器，其中所述处理器被配置成识别针对消融相关的解剖学变化而调整的靶组织区域，
其中识别针对预期的消融相关的解剖学变化而调整的所述靶组织区域包括：
a) 接收关于所述组织区域和所述能量输送装置的信息，
b) 计算所述组织区域内的收缩区域，
c) 确定所述组织区域内的收缩点，
d) 计算所述组织区域内的收缩变形，
e) 应用所计算的收缩变形，以及
f) 识别针对消融相关的解剖学变化而调整的所述靶组织区域。
2.根据权利要求1所述的系统，其中所述处理器与所述能量输送装置通信。
3.根据权利要求2所述的系统，其中所述处理器被配置成引导所述能量输送装置定位到期望的组织区域。
4.根据权利要求3所述的系统，其中所述期望的组织区域是识别的靶组织区域。
5.根据权利要求1所述的系统，还包括电连接到所述能量输送装置的电源。
6.根据权利要求1所述的系统，其中收缩变形包括每个收缩点的收缩点距离和收缩点方向。
7.根据权利要求6所述的系统，其中每个收缩点的收缩点方向包括一个或多个方向变化。
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