EP2139420A2 - Marqueur de position - Google Patents
Marqueur de positionInfo
- Publication number
- EP2139420A2 EP2139420A2 EP08737008A EP08737008A EP2139420A2 EP 2139420 A2 EP2139420 A2 EP 2139420A2 EP 08737008 A EP08737008 A EP 08737008A EP 08737008 A EP08737008 A EP 08737008A EP 2139420 A2 EP2139420 A2 EP 2139420A2
- Authority
- EP
- European Patent Office
- Prior art keywords
- marker
- bio
- marker according
- polymeric material
- radiopaque material
- 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.)
- Withdrawn
Links
- 239000003550 marker Substances 0.000 title claims abstract description 111
- 239000000463 material Substances 0.000 claims abstract description 150
- 239000004696 Poly ether ether ketone Substances 0.000 claims abstract description 17
- 229920002530 polyetherether ketone Polymers 0.000 claims abstract description 17
- 238000003384 imaging method Methods 0.000 claims abstract description 16
- QCWXUUIWCKQGHC-UHFFFAOYSA-N Zirconium Chemical group [Zr] QCWXUUIWCKQGHC-UHFFFAOYSA-N 0.000 claims abstract description 12
- 229920006260 polyaryletherketone Polymers 0.000 claims abstract description 4
- 238000000034 method Methods 0.000 claims description 25
- RVTZCBVAJQQJTK-UHFFFAOYSA-N oxygen(2-);zirconium(4+) Chemical compound [O-2].[O-2].[Zr+4] RVTZCBVAJQQJTK-UHFFFAOYSA-N 0.000 claims description 14
- -1 polysiloxane Polymers 0.000 claims description 14
- MCMNRKCIXSYSNV-UHFFFAOYSA-N ZrO2 Inorganic materials O=[Zr]=O MCMNRKCIXSYSNV-UHFFFAOYSA-N 0.000 claims description 11
- 229910052751 metal Inorganic materials 0.000 claims description 10
- 239000002184 metal Substances 0.000 claims description 10
- 241001465754 Metazoa Species 0.000 claims description 9
- 229920001296 polysiloxane Polymers 0.000 claims description 8
- RTZKZFJDLAIYFH-UHFFFAOYSA-N Diethyl ether Chemical compound CCOCC RTZKZFJDLAIYFH-UHFFFAOYSA-N 0.000 claims description 6
- 229920001577 copolymer Polymers 0.000 claims description 6
- 238000004519 manufacturing process Methods 0.000 claims description 6
- 150000003839 salts Chemical class 0.000 claims description 5
- 239000000560 biocompatible material Substances 0.000 claims description 4
- 150000002148 esters Chemical class 0.000 claims description 4
- 239000004677 Nylon Substances 0.000 claims description 3
- 239000000919 ceramic Substances 0.000 claims description 3
- 229920001778 nylon Polymers 0.000 claims description 3
- 239000005022 packaging material Substances 0.000 claims description 3
- 239000011800 void material Substances 0.000 claims description 3
- NIXOWILDQLNWCW-UHFFFAOYSA-M Acrylate Chemical compound [O-]C(=O)C=C NIXOWILDQLNWCW-UHFFFAOYSA-M 0.000 claims description 2
- BVKZGUZCCUSVTD-UHFFFAOYSA-L Carbonate Chemical compound [O-]C([O-])=O BVKZGUZCCUSVTD-UHFFFAOYSA-L 0.000 claims description 2
- 239000004697 Polyetherimide Substances 0.000 claims description 2
- BZHJMEDXRYGGRV-UHFFFAOYSA-N Vinyl chloride Chemical compound ClC=C BZHJMEDXRYGGRV-UHFFFAOYSA-N 0.000 claims description 2
- 239000002253 acid Substances 0.000 claims description 2
- KPUWHANPEXNPJT-UHFFFAOYSA-N disiloxane Chemical class [SiH3]O[SiH3] KPUWHANPEXNPJT-UHFFFAOYSA-N 0.000 claims description 2
- 125000005702 oxyalkylene group Chemical group 0.000 claims description 2
- 229920000233 poly(alkylene oxides) Polymers 0.000 claims description 2
- 229920002492 poly(sulfone) Polymers 0.000 claims description 2
- 229920001281 polyalkylene Polymers 0.000 claims description 2
- 239000004417 polycarbonate Substances 0.000 claims description 2
- 229920000515 polycarbonate Polymers 0.000 claims description 2
- 229920000728 polyester Polymers 0.000 claims description 2
- 229920001601 polyetherimide Polymers 0.000 claims description 2
- 229920002635 polyurethane Polymers 0.000 claims description 2
- 239000004814 polyurethane Substances 0.000 claims description 2
- 125000001174 sulfone group Chemical group 0.000 claims description 2
- 229910052726 zirconium Inorganic materials 0.000 claims description 2
- JOYRKODLDBILNP-UHFFFAOYSA-N Ethyl urethane Chemical compound CCOC(N)=O JOYRKODLDBILNP-UHFFFAOYSA-N 0.000 claims 1
- 239000004800 polyvinyl chloride Substances 0.000 claims 1
- 229920000915 polyvinyl chloride Polymers 0.000 claims 1
- 229920000642 polymer Polymers 0.000 description 17
- 230000005856 abnormality Effects 0.000 description 9
- 238000002595 magnetic resonance imaging Methods 0.000 description 9
- 229910052715 tantalum Inorganic materials 0.000 description 9
- GUVRBAGPIYLISA-UHFFFAOYSA-N tantalum atom Chemical compound [Ta] GUVRBAGPIYLISA-UHFFFAOYSA-N 0.000 description 9
- 238000011282 treatment Methods 0.000 description 8
- 239000000945 filler Substances 0.000 description 7
- 125000004430 oxygen atom Chemical group O* 0.000 description 6
- 125000001997 phenyl group Chemical group [H]C1=C([H])C([H])=C(*)C([H])=C1[H] 0.000 description 6
- 229910001220 stainless steel Inorganic materials 0.000 description 6
- 238000013170 computed tomography imaging Methods 0.000 description 5
- 229920001519 homopolymer Polymers 0.000 description 5
- 238000001356 surgical procedure Methods 0.000 description 5
- 238000007794 visualization technique Methods 0.000 description 5
- 238000012307 MRI technique Methods 0.000 description 4
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 4
- JUPQTSLXMOCDHR-UHFFFAOYSA-N benzene-1,4-diol;bis(4-fluorophenyl)methanone Chemical compound OC1=CC=C(O)C=C1.C1=CC(F)=CC=C1C(=O)C1=CC=C(F)C=C1 JUPQTSLXMOCDHR-UHFFFAOYSA-N 0.000 description 4
- 239000010935 stainless steel Substances 0.000 description 4
- 241000284156 Clerodendrum quadriloculare Species 0.000 description 3
- 239000004698 Polyethylene Substances 0.000 description 3
- 239000004743 Polypropylene Substances 0.000 description 3
- 238000002591 computed tomography Methods 0.000 description 3
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 3
- 229910052737 gold Inorganic materials 0.000 description 3
- 239000010931 gold Substances 0.000 description 3
- 229920001652 poly(etherketoneketone) Polymers 0.000 description 3
- 229920000573 polyethylene Polymers 0.000 description 3
- 229920001155 polypropylene Polymers 0.000 description 3
- WFKWXMTUELFFGS-UHFFFAOYSA-N tungsten Chemical compound [W] WFKWXMTUELFFGS-UHFFFAOYSA-N 0.000 description 3
- 229910052721 tungsten Inorganic materials 0.000 description 3
- 239000010937 tungsten Substances 0.000 description 3
- 229910001928 zirconium oxide Inorganic materials 0.000 description 3
- AEMRFAOFKBGASW-UHFFFAOYSA-N Glycolic acid Chemical compound OCC(O)=O AEMRFAOFKBGASW-UHFFFAOYSA-N 0.000 description 2
- 229930040373 Paraformaldehyde Natural products 0.000 description 2
- NINIDFKCEFEMDL-UHFFFAOYSA-N Sulfur Chemical group [S] NINIDFKCEFEMDL-UHFFFAOYSA-N 0.000 description 2
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 2
- 229920001400 block copolymer Polymers 0.000 description 2
- 238000002512 chemotherapy Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000001125 extrusion Methods 0.000 description 2
- 239000008187 granular material Substances 0.000 description 2
- JVTAAEKCZFNVCJ-UHFFFAOYSA-N lactic acid Chemical compound CC(O)C(O)=O JVTAAEKCZFNVCJ-UHFFFAOYSA-N 0.000 description 2
- 229910052760 oxygen Inorganic materials 0.000 description 2
- 239000001301 oxygen Substances 0.000 description 2
- 239000002245 particle Substances 0.000 description 2
- 239000011236 particulate material Substances 0.000 description 2
- 229920001643 poly(ether ketone) Polymers 0.000 description 2
- 229920000139 polyethylene terephthalate Polymers 0.000 description 2
- 239000005020 polyethylene terephthalate Substances 0.000 description 2
- 229920006324 polyoxymethylene Polymers 0.000 description 2
- 239000000843 powder Substances 0.000 description 2
- 230000005855 radiation Effects 0.000 description 2
- 238000001959 radiotherapy Methods 0.000 description 2
- 229920005604 random copolymer Polymers 0.000 description 2
- 239000007787 solid Substances 0.000 description 2
- 239000010936 titanium Substances 0.000 description 2
- 229910052719 titanium Inorganic materials 0.000 description 2
- 238000004736 wide-angle X-ray diffraction Methods 0.000 description 2
- VGGSQFUCUMXWEO-UHFFFAOYSA-N Ethene Chemical compound C=C VGGSQFUCUMXWEO-UHFFFAOYSA-N 0.000 description 1
- 239000005977 Ethylene Substances 0.000 description 1
- VVQNEPGJFQJSBK-UHFFFAOYSA-N Methyl methacrylate Chemical group COC(=O)C(C)=C VVQNEPGJFQJSBK-UHFFFAOYSA-N 0.000 description 1
- 206010028980 Neoplasm Diseases 0.000 description 1
- 229920003171 Poly (ethylene oxide) Polymers 0.000 description 1
- 229920000954 Polyglycolide Polymers 0.000 description 1
- 230000002411 adverse Effects 0.000 description 1
- 125000002947 alkylene group Chemical group 0.000 description 1
- 150000001408 amides Chemical class 0.000 description 1
- 125000003118 aryl group Chemical group 0.000 description 1
- 239000011324 bead Substances 0.000 description 1
- 201000011510 cancer Diseases 0.000 description 1
- 239000011248 coating agent Substances 0.000 description 1
- 238000000576 coating method Methods 0.000 description 1
- 239000002131 composite material Substances 0.000 description 1
- 150000001875 compounds Chemical class 0.000 description 1
- 230000001010 compromised effect Effects 0.000 description 1
- 238000000354 decomposition reaction Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 125000001033 ether group Chemical group 0.000 description 1
- XUCNUKMRBVNAPB-UHFFFAOYSA-N fluoroethene Chemical group FC=C XUCNUKMRBVNAPB-UHFFFAOYSA-N 0.000 description 1
- 239000008240 homogeneous mixture Substances 0.000 description 1
- 230000001678 irradiating effect Effects 0.000 description 1
- 150000002576 ketones Chemical class 0.000 description 1
- 235000014655 lactic acid Nutrition 0.000 description 1
- 239000004310 lactic acid Substances 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 239000011159 matrix material Substances 0.000 description 1
- 239000000155 melt Substances 0.000 description 1
- 238000002844 melting Methods 0.000 description 1
- 230000008018 melting Effects 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 231100000252 nontoxic Toxicity 0.000 description 1
- 230000003000 nontoxic effect Effects 0.000 description 1
- 229920000747 poly(lactic acid) Polymers 0.000 description 1
- 229920003229 poly(methyl methacrylate) Polymers 0.000 description 1
- 229920001707 polybutylene terephthalate Polymers 0.000 description 1
- 239000004633 polyglycolic acid Substances 0.000 description 1
- 239000004626 polylactic acid Substances 0.000 description 1
- 239000002861 polymer material Substances 0.000 description 1
- 239000004926 polymethyl methacrylate Substances 0.000 description 1
- 239000004810 polytetrafluoroethylene Substances 0.000 description 1
- 229920001343 polytetrafluoroethylene Polymers 0.000 description 1
- QQONPFPTGQHPMA-UHFFFAOYSA-N propylene Natural products CC=C QQONPFPTGQHPMA-UHFFFAOYSA-N 0.000 description 1
- 125000004805 propylene group Chemical group [H]C([H])([H])C([H])([*:1])C([H])([H])[*:2] 0.000 description 1
- 238000000518 rheometry Methods 0.000 description 1
- UONOETXJSWQNOL-UHFFFAOYSA-N tungsten carbide Chemical compound [W+]#[C-] UONOETXJSWQNOL-UHFFFAOYSA-N 0.000 description 1
- 150000003755 zirconium compounds Chemical class 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L31/18—Materials at least partially X-ray or laser opaque
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/04—Macromolecular materials
- A61L31/06—Macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
Definitions
- This invention relates to fiducial markers.
- CT computer tomographic
- MRI magnetic resonance imaging
- CT computer tomographic
- MRI magnetic resonance imaging
- the body may be subjected to focused treatment to remove or destroy the abnormality, for example using chemotherapy, radiation therapy and/or surgery.
- images of the abnormality are used by a radiologist to adjust the irradiating device and to direct radiation solely at the abnormality while minimizing or eliminating adverse effects to surrounding healthy tissue.
- visualization techniques are used to follow the progress of the treatment.
- the images of the lesion in the patient can guide the surgeon during the operation. By reviewing the images prior to surgery, the surgeon can decide the best strategy for reaching and biopsying, excising, or otherwise manipulating the abnormality. After surgery has been performed, further scanning is utilized to evaluate the success of the surgery and the subsequent progress of the patient.
- markers in the form of wire or beads made of highly radiopaque materials such as gold or tantalum.
- the gold or tantalum marker may lead to production of artefacts in the image produced, for example information may be missing and/or "starbursts" may be present, leading to difficulties in accurately interpreting the images.
- MRI techniques eddy currents may be produced in the gold or tantalum which again may result in the production of artefacts which render image interpretation more difficult. It is desirable that any fiducial marker is visible under MRI, CT and X-ray imaging so that, in any situation, one or more of the techniques may be used to visualize any marker .
- fiducial markers which are as small as possible, to minimise patients' discomfort.
- clinicians require markers to provide a strong signal which implies such markers should be as large as possible.
- a fiducial marker which comprises a radiopaque material encapsulated in a bio-compatible polymeric material, wherein said radiopaque material comprises zirconium moieties.
- Said marker suitably has a maximum dimension measured in a first direction of less than 50mm.
- a marker may be elongate, for example in the form of a string or the like.
- said marker has a maximum dimension measured in a first direction of less than 10mm, preferably less than 8mm, more preferably less than 6mm, especially less than 4mm.
- the maximum dimension may be at least lmm or at least 2mm.
- the maximum dimension in said first direction may be in the range 1.5 to 4mm.
- Said marker preferably has a dimension in a second direction perpendicular to the first direction which is less than said maximum dimension in said first direction.
- the ratio of the maximum dimension in said first direction to said dimension in said second direction may be greater than 1, preferably greater than 1.1, more preferably greater than 1.3, especially greater than 1.5.
- the ratio may be less than 5, preferably less than 4, more preferably less than 3, especially less than 2.
- the volume of the marker may be less than 20mm 3 , suitably less than 15mm 3 , preferably less than 10mm 3 , more preferably less than 8mm 3 , especially less than 6mm 3 .
- the volume may be at least 0.75mm 3 , preferably at least lmm 3 .
- the density of the marker may be at least 1.1 g/cm 3 , suitably at least 1.2 g/cm 3 , preferably at least 1.3 g/cm 3 , more preferably at least 1.5 g/cm 3 , especially at lest 1.6 g/cm 3 .
- the density may be less than 3.5 g/cm 3 , suitably less than 3.2 g/cm 3 .
- the density may be in the range 1.5 to 3 g/cm 3 .
- Said marker preferably has a substantially constant cross- section along at least 50%, suitably at least 70%, preferably at least 90%, more preferably at least 95%, especially about 100%, of its extent in one direction, for example said first direction referred to.
- Said cross- section is preferably substantially symmetrical about a first plane which bisects the cross-section in one direction; preferably also it is symmetrical about two mutually orthogonal planes which bisect the cross-section.
- Said cross-section preferably includes a substantially circular outer wall.
- Said cross-section described may be substantially annular or circular. It preferably includes substantially no void areas.
- Said cross-section preferably has an area of less than 5mm 2 , preferably less than 4mm 2 , more preferably less than 3mm 2 , especially less than 2mm 2 .
- the area may be less than 1.5mm 2 .
- the area is preferably greater than 0.5mm 2 .
- Said cross-section is preferably of substantially constant shape on moving from one side of the marker to an opposite side thereof.
- said marker may be substantially spherical.
- Said fiducial marker may be in the form of an extruded tube, coil or solid member.
- Said marker preferably includes substantially no void areas; it is preferably substantially solid throughout.
- Said radiopaque material is preferably an integral part of said marker.
- Said radiopaque material is preferably not fiowable within the marker.
- Said radiopaque material is preferably substantially immovably fixed in position in said marker so that its position relative to that of the polymeric material is substantially immovably fixed.
- Said radiopaque material is preferably covered, at least in part, by said bio-compatible polymeric material.
- Said radiopaque material is preferably substantially fully enclosed by said bio-compatible polymeric material.
- Radiopaque material and polymeric material are preferably contiguous. Preferably substantially all of the radiopaque material is contiguous with bio-compatible polymeric material.
- Said fiducial marker preferably includes no part which is arranged to be moved, for example pivoted, between predetermined first and second positions.
- Said marker preferably includes no moving parts. It should be appreciated however that this does not exclude the possibility of the marker being manipulated, for example bent, into any particular shape.
- Said fiducial marker preferably comprises radiopaque material and polymeric material which have been extruded.
- Said fiducial marker may have a weight of at least 3 mg, preferably at least 5 mg .
- the weight may be less than 100 mg, suitably less than 75 mg, preferably less than 50 mg, more preferably less than 25 especially less than 10 mg .
- Said marker may include at least lwt%, suitably at least 3wt%, preferably at least 10wt%, more preferably at least 20wt%, especially at least 30wt% of radiopaque material. In some embodiments said marker may include at least 35wt% or at least 40wt% of said radiopaque material. Tne amount of radiopaque material may be less tnan 80wt%, suitably less than 70wt%, preferably less than 60 wt%, more preferably 55wt% or less, especially 50wt% or less.
- Said marker may include at least 30wr%, preferably at least 40wt%, more preferably at least 45wt%, especially at least 50wt% of said bio-compatible material.
- the amount of bio-compatible polymeric material may be 97wt% or less, suitably 90wt% or less, preferably 80wt% or less, more preferably 70wt% or less, especially 65wt% or less.
- the sum of the wt% of said bio-compatible polymeric material and said radiopaque material in said fiducial marker may be at least 60wt%, suitably at least 70wt%, preferably at least 80wt%, more preferably at least 90wt%, especially at least 99wt%.
- Said bio-compatible polymeric material may be any polymeric material which is non-toxic and not otherwise harmful when introduced into the human or animal body as a fiducial marker.
- Said bio-compatible polymeric material may have a Notched Izod Impact Strength (specimen 80mm x 10mm x 4mm with a cut 0.25mm notch (Type A), tested at 23°C, in accordance with ISO180) of at least 4KJm “2 , preferably at least 5KJm "2 , more preferably at least 6KJm “2 .
- Said Notched Izod Impact Strength measured as aforesaid, may be less than 10KJm "2 , suitably less than 8KJm "2 .
- the Notched Izod Impact Strength, measured as aforesaid, of the composite material of said fiducial marker may be at least 3KJm "2 , suitably at least 4KJm "2 , preferably at least 5KJm .
- Said impact strength may be less than 50 KJm "2 , suitably less than 30KJm "2 .
- Said bio-compatible polymeric material suitably has a melt viscosity (MV) of at least 0.06 kNsrrf 2 , preferably has a MV of at least 0.09 kNs ⁇ f 2 , more preferably at least 0.12 kNsi ⁇ f 2 , especially at least 0.15 kNsrrf 2 .
- MV melt viscosity
- MV is suitably measured using capillary rheometry operating at 400°C at a shear rate of 1000s "1 using a tungsten carbide die, 0.5x3.175mm.
- Said bio-compatible polymeric material may have a MV of less than 1.00 kNsrrf 2 , preferably less than 0.5 kNsrrf 2 .
- Said bio-compatible polymeric material may have a MV in the range 0.09 to 0.5 kNsm “2 , preferably in the range 0.14 to 0.5 kNsm "2 .
- Said bio-compatible polymeric material may have a tensile strength, measured in accordance with ISO527 (specimen type Ib) tested at 23°C at a rate of 50mm/minute of at least 20 MPa, preferably at least 60 MPa, more preferably at least 80 MPa.
- the tensile strength is preferably in the range 80-110 MPa, more preferably in the range 80-100 MPa.
- Said bio-compatible polymeric material may have a flexural strength, measured in accordance with ISO178 (80mm x 10mm x 4mm specimen, tested in three-point-bend at 23°C at a rate of 2mm/minute) of at least 50 MPa, preferably at least 100 MPa, more preferably at least 145 MPa.
- the flexural strength is preferably in the range 145-180MPa, more preferably in the range 145-164 MPa.
- Said bio-compatible polymeric material may have a flexural modulus, measured in accordance with ISO178 (80mm x 10mm x
- the flexural modulus is preferably m the range 3.5- 4.5 GPa, more preferably m the range 3.5-4.1 GPa.
- Said bio-compatible polymeric material may be amorphous or semi-crystalline. It is preferably semi-crystalline .
- the level and extent of crystallinity in a polymer is preferably measured by wide angle X-ray diffraction (also referred to as Wide Angle X-ray Scattering or WAXS), for example as described by Blundell and Osborn (Polymer 24 , 953, 1983).
- WAXS Wide Angle X-ray Scattering
- crystallinity may be assessed by Differential Scanning Calerimetry (DSC).
- the level of crystallinity of said bio-compatible polymeric material may be at least 1%, suitably at least 3%, preferably at least 5% and more preferaoly at least 10%. In especially preferred embodiments, the crystallinity may be greater than 25%.
- the main peak of the melting endotherm (Tm) of said biocompatible polymeric material (if crystalline) may be at least 300 0 C.
- Said bio-compatible polymeric material may include a polymeric moiety which is: an acrylate (e.g. it comprises or consists of methylmethacrylate moieties); a uretna n e, a vinyl chloride; a silicone; a siloxane (eg comprising dimethylsiloxane moieties); a sulphone; a carbonate; a fluoroalkylene (e.g. a fluoroethylene) ; an acid (e.g. a glycolic acid or lactic acid); an amide (e.g. comprising nylon moieties); an alkylene (e.g. ethylene or propylene); an oxyalkylene (e.g.
- polyoxymethylene polyoxymethylene
- ester e.g. polyethylene terephthalate
- ether e.g. an aryletherketone, an arylethersulphone (e.g. polyethersulphone or polyphenylenesulphone) or an ether lmide
- Said bio-compatible polymeric material may be a resorbable polymer .
- Said bio-compatible polymeric material may be selected from a polyalkylacrylate (e.g. polymethylmethacrylate), a polyfluoroalkylene (e.g. PTFE), a polyurethane, a polyalkylene (e.g. polyethylene or polypropylene), a polyoxyakylene (e.g. polyoxymethylene), a polyester (e.g. polyethylene terephthalate or polybutylene terephthalate) , a polysulphone, a polycarbonate, a polyacid (e.g. polyglycolic acid or polylactic acid) , a polyalkylene oxide ester (e.g.
- a polyalkylacrylate e.g. polymethylmethacrylate
- a polyfluoroalkylene e.g. PTFE
- a polyurethane e.g. polyethylene or polypropylene
- a polyoxyakylene e.g. polyoxymethylene
- polyester e
- polyethylene oxide terephalate a polyvmylchloride, a silicone, a polysiloxane, a nylon, , a polyaryletherketone, a polarylethersulphone, a polyether imide and any copolymer which includes any of the aforementioned .
- saj_d bio-compatible polymeric material is selected from resorbable polymers, polyethylene, polypropylene, silicone and polyetheretherkecone . More preferably, sa_i_d polymeric material is selecce ⁇ from polyethylene, polypropylene, silicone and polyetheretheketone .
- Said bio-compatible polymeric material may be a homopolymer having a repeat unit of general formula
- A, B, C and D independently represent 0 or 1
- E and E' independently represent an oxygen or a sulphur atom or a direct link
- G represents an oxygen or sulphur atom, a direct link or a -O-Ph-0- moiety
- Ph represents a phenyl group
- m, r, s, t, v, w, and z represent zero or 1
- Ar is selected from one of the following moieties (i) to (v) which is bonded via one or more of its phenyl moieties to adjacent moieties
- a phenyl moiety has 1,4-, linkages to moieties to which it is bonded .
- biocompatible polymeric material may be a homopolymer having a repeat unit of general formula or a homopolymer having a repeat unit of general formula
- A, B, C, and D independently represent 0 or 1 and E, E 1 , G, Ar, m, r, s, t, v, w and z are as described in any statement herein.
- said bio-compatible polymeric material is a homopolymer having a repeat unit of general formula IV.
- Ar is selected from the following moieties (vi) to (x)
- the middle phenyl may be 1,4- or 1, 3-substituted. It is preferably 1 , 4-substituted.
- Suitable moieties Ar are moieties (ii) , (in), (iv) and (v) and, of these, moieties, (ii), (in) and (v) are preferred.
- Other preferred moieties Ar are moieties (vii) , (viii) , (ix) and (x) and, of these, moieties (vii), (viii) and (x) are especially preferred.
- An especially preferred class of bio-compatible polymeric materials are polymers (or copolymers) which consist essentially of phenyl moieties in conjunction with ketone and/or ether moieties. That is, in the preferred class, the first polymer material does not include repeat units which include -S-, -SO 2 - or aromatic groups other than phenyl.
- Preferred bio-compatible polymeric materials of the type described include:
- B represents 0 (i.e. polyetherketone) ;
- e a polymer consisting essentially of units of formula IV, wherein Ar represents moiety (v) , E and E 1 represents oxygen atoms, G represents a direct link, m represents 0, w represents 0, s, r, A and B represent 1 (i.e. polyetheretherketoneketone) .
- Said bio-compatible polymeric material may consist essentially of one of units (a) to (f) defined above.
- said polymeric material may comprise a copolymer comprising at least two units selected from (a) to (f) defined above.
- Preferred copolymers include units
- a copolymer may comprise units (a) and
- (f) may comprise units (a) and (e) .
- Said bio-compatible polymeric material preferably comprises, more preferably consists essentially of, a repeat unit of formula (XX)
- said bio-compatible polymeric material is selected from polyetheretherketone, polyetherketone, polyetherketoneetherketoneketone and polyetherketoneketone .
- said polymeric material is selected from polyetherketone and polyetheretherketone.
- said polymeric material is polyetheretherketone.
- Said radiopaque material is suitably such that when added to the bio-compatible polymeric material the radiopacity of the combination is increased.
- Said radiopaque material preferably improves the imageability of the bio-compatible polymeric material when imaged using both CT and MRI techniques .
- Said radiopaque material may comprise a compound, for example a salt incorporating zirconium moieties.
- Said radiopaque material preferably includes oxygen moieties .
- Said radiopaque material may be a ceramic. It may be a zirconium ceramic salt. Said radiopaque material preferably includes zirconium moieties and oxygen moieties. Said material is preferably an oxide which comprises zirconium moieties. Said material is preferably zirconium dioxide.
- Said radiopaque material preferably has a decomposition temperature which is greater than 300 0 C, suitably greater than 325°C, preferably greater than 350 0 C, more preferably greater than 500 0 C, especially greater than 700 0 C, suitably so it can be melt-processed with the preferred bio-compatible polymeric materials.
- Said fiducial marker may include one or a plurality of bio-compatible polymeric materials. Where said marker includes a second or subsequent bio-compatible polymeric material, the second or subsequent material may have any feature of said bio-compatible polymeric material described herein.
- said fiducial marker in said fiducial marker is preferably in the range 50 to 80wt%, more preferably 55-75wt%.
- Said fiducial marker may include one or a plurality of radiopaque materials.
- the sum of the wt% of all radiopaque materials in said fiducial marker may be in the range 20 to 80wt%, suitably 20 to 70wt%, preferably 20 to 55wt%, more preferably in the range 20 to 50wt%, especially 25 to 50wt%.
- the sum of the wt% of all organic polymeric materials and all radiopaque materials in same fiducial marker is suitably at least 80wt%, preferably at least 90wt%, more preferably at least 95wt%, especially at least 99wt%.
- said fiducial marker may comprise a radiopaque material in particulate form dispersed within, preferably throughout, said bio-compatible polymeric material.
- Said fiducial marker preferably has a substantially constant density throughout.
- Said marker is preferably substantially homogenous.
- said polymeric material defines a matrix in which particles of radiopaque material are substantially uniformly dispersed and embedded.
- the total wt% of all particulate radiopaque materials in said marker may be at least 14wt%, suitably at least 20wt%, preferably at least 25wt%, more preferably at least 30wt%, especially at least 35wt%.
- the total may be 70wt% or less, suitably less than 60wt%, preferably less than 55wt% . If too much radiopaque material is included the integrity and/or strength of the marker may be compromised; if there is too little, the marker may not be satisfactorily visible in for example CT or MRI imaging techniques.
- the total wt% of all bio-compatible polymeric materials in said marker may be at least 40wt%, preferably at least 50wt% .
- the total may be less than 85wt%, preferably less than 70wt%, more preferably less than 65wt%.
- the sum of the wt% of all particulate radiopaque materials and all bio-compatible polymeric materials in said marker may be at least 80wt%, preferably at least 90wt%, more preferably at least 95wt%, especially at least 99wt%.
- said fiducial marker includes 40 to 75wt% of bio-compatible polymeric material (preferably of formula [XX] above, especially polyetheretherketone) and 25 to 60wt% of radiopaque material (especially particulate material, for example zirconium dioxide) .
- a fiducial marker includes 45 to 70wt% of polyetheretherketone and 30 to 55wt% of a particulate radiopaque material, especially zirconium dioxide.
- said fiducial marker includes 60 to 85wt% of biocompatible polymeric material (preferably of formula [xx] above, especially polyetheretherketone) and 15 to 40wt% of a radiopaque material (especially particulate material, for example a zirconium oxide) .
- said fiducial marker includes 15-30wt% of a zirconium compound as aforesaid and 70-85wt% of a polyaryletherketone, especially polyetheretherketone.
- a wire for example a metal wire may be encapsulated in said bio-compatible polymeric material.
- the wire may have a diameter in the range 10 to 200 ⁇ m, suitably 20 to lOO ⁇ m, more preferably 25 to 75 ⁇ m, especially about 50 ⁇ m.
- the wire may be metal, for example selected from tantalum or another radiopaque wire.
- the wire is selected from stainless steel, tungsten and tantalum. Because the wire is very fine and is encapsulated in an inert and strong biocompatible polymeric material, the level of underdesirable artefacts noticeable on imaging may be significantly less than when thicker wire is used; and the bio-compatible polymeric material maintains the integrity of the marker.
- a metal wire having a diameter in the range 0.1mm to 0.4mm (preferably in the range 0.1mm to 0.3mm) and preferably being selected from stainless steel, tungsten and tantalum defines a core which is encapsulated m a bio-compatible polymeric material as described herein (preferably one of formula [xx] and especially poletheretherketone) , wherein the bio-compatible polymeric material is filled with said radiopaque material, especially a zirconium oxide.
- the layer which encapsulates the wire may include 40 to 85wt% of said bio-compatible polymeric material and 15 to 60wt% of filler (e.g. one or more radiopaque fillers as described) . When a zirconium oxide is included, the layer may include 40 to 70wt% (preferably 45 to 60wt%) of said oxide with the balance being said bio-compatible polymer.
- a fiducial marker may comprise first and second fillers encapsulated in said biocompatible polymeric material, which may be of formula [xx] and is preferably polyetheretherketone .
- a first filler may be a metal, suitably in powderous form, which may be selected from stainless steel, tantalum and titanium.
- a second filler suitably comprises said radiopaque material.
- Said fiducial marker may include 5- 20wt% of said first filler, 15-60wt% of said second filler and 20-80wt% of said bio-compatible polymeric material.
- tnere is provided the use of a member which comprises a said radiopaque material encapsulated in a bio-compatible polymeric material as a fiducial marker.
- the member may be a fiducial marker as described in said first aspect.
- a said radiopaque material encapsulated in a bio-compatible polymeric material in the manufacture of a fiducial marker for use in marking a position on a human or animal body.
- the fiducial marker may be as described according to said first aspect.
- a method of marking a position in the human or animal body comprising positioning, preferably securing, within the body a fiducial marker as described according to the first aspect.
- the method may include positioning a plurality, preferably at least four, markers in the body.
- a method of obtaining images of predetermined positions of a human or animal body comprising imaging a human or animal body in which has been positioned one or a plurality (preferably a plurality) of fiducial markers according to said first aspect.
- the method may include imaging the body by CT or MRI scanning techniques.
- the method involves imaging by both CT and MRI scanning techniques .
- the method may involve X-ray imaging.
- the fiducial markers are visible to X-ray imaging and compatible with CT and MRI methods.
- the method may include the step of positioning one or a plurality of said fiducial markers in position within the body prior to said imaging.
- a method of making a fiducial marker comprising encapsulating a said radiopaque material in a bio-compatible material.
- the method preferably includes the step of extrusion to encapsulate said radiopaque material.
- a mixture comprising radiopaque and polymeric materials may be extruded suitably to define a filament.
- a wire may be coated with extruded polymeric material.
- the method may include chopping extruded material to define fiducial markers of appropriate dimensions.
- the invention extends to a pack comprising a fiducial marker according to said first aspect contained in a packaging material.
- the packaging material could be sterile .
- fiducial markers described herein are for use and/or use in relation to human bodies.
- a fiducial marker may be prepared by selection of a polyetheretherketone (PEEK OPTIMA LT3 polymer obtained from Invibio Limited, UK) and a highly pure grade of zirconium dioxide of suitable particle size. The combination may then be introduced into a twin screw melt extrusion compounder and a lace produced having a diameter of 2 to 3 mm. The lace may then be passed to a conveyer, cooled and chopped into granules. The granules may be introduced into an extruder and monofilaments produced which may then be chopped to produce fiducial markers of predetermined lengths comprising polyetheretherketone polymer with zirconium dioxide substantially homogenously dispersed throughout the polymer.
- PEEK OPTIMA LT3 polymer obtained from Invibio Limited, UK
- markers described can be imaged using CT, MRI and X- ray techniques. In each case, images include less distortion and/or starburst and/or other artefacts compared to other known markers.
- Markers as described may be provided in a range of dimensions as shown in the table below. Furthermore, spherical markers, having diameters in the range 1 to 5 mm may be provided.
- a standard wire coating technique may be used to coat a 0.12mm diameter stainless steel wire with a homogenous mixture comprising PEEK OPTIMA LT3 polymer (50wt%) and zirconium dioxide (50wt%).
- the coated wire may be cut to size to define a fiducial marker comprising a wire core and an outer homogenous sheaf of PEEK OPTIMA LT3 polymer and zirconium dioxide.
- the inclusion of the wire core improves visibility of the marker under MRI conditions, whilst the zirconium dioxide improves the visibility of the marker in other imagining techniques .
- the stainless steel wire core may be replaced with tantalum or titanium; or the amount of zirconium dioxide may be adjusted (e.g. in the range 30-70wt%) .
- the metal wire may be replaced with metal powder, for example of stainless steel, tungsten or tantalum, at up to 20wt% of the entire marker.
- metal powder for example of stainless steel, tungsten or tantalum
- An example of such a marker may include up to 20wt% of metal powder, 30 to 70wt% of zirconium dioxide and the balance being PEEK OPTIMA LT3. The materials are mixed to define a homogenous mass and extruded to define an elongate marker having a diameter of 1mm.
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- Animal Behavior & Ethology (AREA)
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- Heart & Thoracic Surgery (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Vascular Medicine (AREA)
- Epidemiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Optics & Photonics (AREA)
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Abstract
La présente invention concerne un marqueur de position visible par une vaste gamme de techniques d'imagerie, qui comprend un matériau radio-opaque, comprenant des fractions zirconium, encapsulé dans un matériau polymère biocompatible, par exemple une polyaryléthercétone telle qu'une polyétheréthercétone.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| GBGB0707671.4A GB0707671D0 (en) | 2007-04-20 | 2007-04-20 | Fiducial marker |
| PCT/GB2008/001347 WO2008129249A2 (fr) | 2007-04-20 | 2008-04-17 | Marqueur de position |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| EP2139420A2 true EP2139420A2 (fr) | 2010-01-06 |
Family
ID=38135153
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| EP08737008A Withdrawn EP2139420A2 (fr) | 2007-04-20 | 2008-04-17 | Marqueur de position |
Country Status (4)
| Country | Link |
|---|---|
| EP (1) | EP2139420A2 (fr) |
| CA (1) | CA2684564A1 (fr) |
| GB (1) | GB0707671D0 (fr) |
| WO (1) | WO2008129249A2 (fr) |
Families Citing this family (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB2471508A (en) * | 2009-07-02 | 2011-01-05 | Invibio Ltd | Composite enclosure with specific WVTR and impact strength, used in an implantable device |
| WO2013191510A1 (fr) * | 2012-06-22 | 2013-12-27 | 서울대학교 산학협력단 | Matériau métallique médical pour insertion in vivo, comprenant un moyen permettant d'éviter les mouvements in vivo |
| KR101544490B1 (ko) * | 2013-09-05 | 2015-08-13 | 서울대학교산학협력단 | 체내 이동방지 수단이 구비된 체내삽입용 의료용구 |
Family Cites Families (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6174330B1 (en) * | 1997-08-01 | 2001-01-16 | Schneider (Usa) Inc | Bioabsorbable marker having radiopaque constituents |
| US6520952B1 (en) * | 2000-03-23 | 2003-02-18 | Neich Medical Co., Ltd. | Ceramic reinforced catheter |
| PT1444993E (pt) * | 2003-02-10 | 2007-01-31 | Heraeus Gmbh W C | Liga metálica melhorada para dispositivos médicos e implantes |
| US7761138B2 (en) * | 2004-03-12 | 2010-07-20 | Boston Scientific Scimed, Inc. | MRI and X-ray visualization |
| US20050283226A1 (en) * | 2004-06-18 | 2005-12-22 | Scimed Life Systems, Inc. | Medical devices |
| US20060204445A1 (en) * | 2005-03-11 | 2006-09-14 | Anthony Atala | Cell scaffold matrices with image contrast agents |
| GB0521536D0 (en) * | 2005-10-22 | 2005-11-30 | Invibio Ltd | Fiducial marker |
-
2007
- 2007-04-20 GB GBGB0707671.4A patent/GB0707671D0/en not_active Ceased
-
2008
- 2008-04-17 EP EP08737008A patent/EP2139420A2/fr not_active Withdrawn
- 2008-04-17 CA CA002684564A patent/CA2684564A1/fr not_active Abandoned
- 2008-04-17 WO PCT/GB2008/001347 patent/WO2008129249A2/fr not_active Ceased
Non-Patent Citations (1)
| Title |
|---|
| See references of WO2008129249A3 * |
Also Published As
| Publication number | Publication date |
|---|---|
| CA2684564A1 (fr) | 2008-10-30 |
| WO2008129249A2 (fr) | 2008-10-30 |
| WO2008129249A3 (fr) | 2008-12-24 |
| GB0707671D0 (en) | 2007-05-30 |
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