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WO2004019774A1 - Procede et dispositif pour determiner la temperature d'un tissu biologique de maniere non invasive - Google Patents

Procede et dispositif pour determiner la temperature d'un tissu biologique de maniere non invasive Download PDF

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Publication number
WO2004019774A1
WO2004019774A1 PCT/DE2003/002800 DE0302800W WO2004019774A1 WO 2004019774 A1 WO2004019774 A1 WO 2004019774A1 DE 0302800 W DE0302800 W DE 0302800W WO 2004019774 A1 WO2004019774 A1 WO 2004019774A1
Authority
WO
WIPO (PCT)
Prior art keywords
radiation
fluorescence
treatment
temperature
biological tissue
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
Application number
PCT/DE2003/002800
Other languages
German (de)
English (en)
Inventor
Georg Schuele
Carsten Framme
Ralf Brinkmann
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Medizinisches Laserzentrum Luebeck GmbH
Original Assignee
Medizinisches Laserzentrum Luebeck GmbH
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Medizinisches Laserzentrum Luebeck GmbH filed Critical Medizinisches Laserzentrum Luebeck GmbH
Priority to AU2003263142A priority Critical patent/AU2003263142A1/en
Publication of WO2004019774A1 publication Critical patent/WO2004019774A1/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
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F9/00821—Methods or devices for eye surgery using laser for coagulation
    • 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
    • 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
    • A61B5/0062—Arrangements for scanning
    • A61B5/0068—Confocal scanning
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00844—Feedback systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/00872—Cornea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F9/00802—Methods or devices for eye surgery using laser for photoablation
    • A61F9/00814—Laser features or special beam parameters therefor

Definitions

  • the invention relates to a method and a device for the non-invasive determination of the temperature of biological tissue treated with radiation, in particular laser radiation, by means of fluorescence detection.
  • the temperature of the treated biological tissue in particular the back of the eye, can increase, which leads to unintended damage to the retinal areas.
  • a non-invasive real-time temperature determination has not yet been possible with such eye treatments, but would be extremely desirable for the safety of the radiation and to optimize the treatment.
  • the temperature control should be based on the area of the target structure or the area to be protected.
  • the object of the invention is therefore to create a method and a device for the non-invasive determination of the temperature on the treated biological tissue, in particular in ophthalmology, in which electromagnetic radiation sources are used for the treatment radiation.
  • the invention creates a fluorescence-based method and a corresponding device, wherein During the respective irradiation time of the treatment radiation, additional radiation pulses, which are used for fluorescence excitation, are preferably directed at the treated biological tissue with a shorter pulse duration and less energy than with the treatment radiation.
  • the additional radiation pulses can occur essentially at the same time intervals.
  • the excited fluorescence is detected by optical measurement.
  • the temperature increase is determined from a change in the fluorescence, in particular the respective absolute values of the temperature are determined.
  • treatment radiation itself can also be used for fluorescence excitation.
  • the natural fluorophores contained in the irradiated, biological tissue are stimulated. When used on the back of the eye, this can be the autofluorescence of lipofuscin, which accumulates as an old pigment in the retinal pigment epithelium, or also of flavins. In other biological tissues, this is typically the autofluorescence of the natural fluorophores, in particular NADH (nicotinamide-adenine-dinncleotide, reduced) and tryptophan.
  • NADH nicotinamide-adenine-dinncleotide, reduced
  • a fluorescent dye to be injected can also be used for temperature determination.
  • the African already for cli ⁇ diagnosis fluorophores used fluorescein and indocyanine green (ICG) are mainly used.
  • the fluorescence properties of the fluorophores change, in particular the fluorescence intensity, as a function of the temperature increase.
  • the absolute temperature increase can then be determined from this change in fluorescence with the aid of calibration data.
  • a fluorescence measurement signal which is normalized to the normal body temperature, for example the human body temperature of 37 ° C., is preferably obtained shortly before, when, or immediately after the treatment radiation is switched on by an additional short-term radiation pulse.
  • the pulse energy or pulse power of the treatment beam can be controlled in order to obtain the desired temperature at the radiation site.
  • the target tissue can be determined by a suitable choice of the dye, in particular by specific attachment of the dye, if exogenous dyes are used.
  • the suitable wavelength natural tissue-specific chromophores can be excited, which means that their temperature increase can be recorded selectively.
  • a confocal fluorescence excitation a temporal and depth resolution and thus a 3-D temperature distribution during irradiation can be achieved in addition to the temporal resolution.
  • It shows 1 shows a first exemplary embodiment of a device for carrying out the invention in which the treatment beam source is used for fluorescence excitation;
  • FIG. 2 shows a second exemplary embodiment of a device with which the invention can be carried out
  • Fig. 4 shows a temperature-dependent change in fluorescence
  • A2E (1 ⁇ M dissolved in DMSO), the main constituent of the fluorophore lipofuscin, which occurs naturally in the retinal pigment epithelium, the fluorescence intensity changing linearly with the sample temperature;
  • the device shown partially in block diagram in FIGS. 1 and 2 includes a treatment beam source 1, for example a laser beam source, in particular a cw laser.
  • the treatment radiation used for the treatment of the fundus of the eye is generated with the treatment beam source 1.
  • the treatment radiation is processed and via an applicator 9, in particular a slit lamp, via a further optic 8, which preferably An ophthalmic contact glass can be directed onto the fundus, in particular the retina of an eye 5.
  • the treatment beam source 1 is controlled by a system controller 3.
  • the system control 3 can in particular control the radiation energy and the time period with which the treatment radiation is directed onto the fundus.
  • the signals measured by a fluorescence detector 2 are also evaluated in the system controller 3 and converted into temperature values.
  • the fluorescence of the fundus can be excited on the one hand with the treatment beam source 1.
  • the fluorescence excitation can be carried out with an additionally coupled beam source ⁇ .
  • the device shown in FIG. 2 has the additional beam source 6 used for fluorescence excitation in the form of a pulsed electromagnetic beam source, in particular a pulsed LED or a pulsed laser.
  • the radiation from the additional beam source 6 can be coupled into the beam path of the treatment radiation with the aid of a beam splitter 4. In the exemplary embodiment shown, this coupling takes place after the applicator 9. However, coupling into the treatment radiation can also take place inside or in front of the applicator 9.
  • the fluorescent light emitted from the background of the eye is directed to a fluorescence detector 2 with the aid of a beam splitter 7. Its signals are passed on to the system control 3 for evaluation and conversion into absolute temperature values.
  • the absolute values of the temperature can be displayed or for Control or actuation of the treatment beam source 1 can be used.
  • the fluorescence detector can be designed as a photodiode.
  • a CCD camera or a PMT (photomultiplier) is also suitable for fluorescence measurement.
  • a confocal arrangement with a scanner such as is known for 3-D fluorescence measurement, for example from DE 198 50 149 AI, can be used.
  • the fluorescence measurement can be spectrally resolved.
  • FIG. 3 shows that the temperature profile calculated as a function of the irradiation time corresponds to the fluorescence data measured at the fundus of the patient during irradiation.
  • A2E is a pyridium bisretenoid that is formed by a Schiff base reaction. It is a main component of retinal lipofuscin and can be produced synthetically.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Physics & Mathematics (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biophysics (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Ophthalmology & Optometry (AREA)
  • Radiology & Medical Imaging (AREA)
  • Optics & Photonics (AREA)
  • Vascular Medicine (AREA)
  • Investigating, Analyzing Materials By Fluorescence Or Luminescence (AREA)
  • Laser Surgery Devices (AREA)
  • Eye Examination Apparatus (AREA)

Abstract

L'invention concerne un procédé et un dispositif pour déterminer de manière non invasive la température d'un tissu biologique traité par rayonnement, notamment par rayon laser, en particulier d'un fond d'oeil. Selon l'invention, la variation de fluorescence du tissu irradié est saisie par mesure optique, puis les valeurs de température absolues sont déterminées sur la base des signaux de mesure, en fonction de quoi le traitement par rayonnement est éventuellement régulé. La fluorescence peut être la fluorescence propre au tissu ou la fluorescence d'un colorant injecté.
PCT/DE2003/002800 2002-08-30 2003-08-20 Procede et dispositif pour determiner la temperature d'un tissu biologique de maniere non invasive Ceased WO2004019774A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2003263142A AU2003263142A1 (en) 2002-08-30 2003-08-20 Method and device for the non-invasive determination of the temperature in biological tissue

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE10240109A DE10240109A1 (de) 2002-08-30 2002-08-30 Verfahren und Vorrichtung zur nichtinvasiven Bestimmung der Temperatur an mit einer Strahlung, insbesondere Laserstrahlung behandeltem biologischem Gewebe mittels Fluoreszenz
DE10240109.8 2002-08-30

Publications (1)

Publication Number Publication Date
WO2004019774A1 true WO2004019774A1 (fr) 2004-03-11

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE2003/002800 Ceased WO2004019774A1 (fr) 2002-08-30 2003-08-20 Procede et dispositif pour determiner la temperature d'un tissu biologique de maniere non invasive

Country Status (3)

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AU (1) AU2003263142A1 (fr)
DE (1) DE10240109A1 (fr)
WO (1) WO2004019774A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102009016184A1 (de) * 2009-04-03 2010-10-14 Carl Zeiss Meditec Ag Verfahren und Vorrichtung zur nichtinvasiven Temperaturbestimmung an mit einer Behandlungsstrahlung behandeltem biologischen Gewebe
WO2024188870A1 (fr) * 2023-03-10 2024-09-19 Carl Zeiss Meditec Ag Agencement de mesure de température et dispositif de commande pour un système à base de laser uv pour correction d'erreur de réfraction ou pour un système à base de laser femtoseconde, système de ce type, procédé de fourniture de données de commande, et procédé pour correction d'erreur de réfraction ou pour réticulation ou changement d'indice de réfraction induit par laser

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102007052103A1 (de) 2007-10-31 2009-05-07 Medizinisches Laserzentrum Lübeck GmbH Vorrichtung zur schonenden Lasertherapie der Retina

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5762609A (en) * 1992-09-14 1998-06-09 Sextant Medical Corporation Device and method for analysis of surgical tissue interventions
WO2000009003A1 (fr) * 1998-08-13 2000-02-24 Dornier Medtech Holding International Gmbh Dispositif et procede pour representer des modifications tissulaires
DE19916653A1 (de) * 1999-04-14 2000-10-19 Holger Lubatschowski Optoakustische Gewebsdifferentierung zur patientenspezifischen Dosierung der Laserstrahlung bei der Zyklophotokoagulation des Auges

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5762609A (en) * 1992-09-14 1998-06-09 Sextant Medical Corporation Device and method for analysis of surgical tissue interventions
WO2000009003A1 (fr) * 1998-08-13 2000-02-24 Dornier Medtech Holding International Gmbh Dispositif et procede pour representer des modifications tissulaires
DE19916653A1 (de) * 1999-04-14 2000-10-19 Holger Lubatschowski Optoakustische Gewebsdifferentierung zur patientenspezifischen Dosierung der Laserstrahlung bei der Zyklophotokoagulation des Auges

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
DESMETTRE T J ET AL: "DIODE LASER-INDUCED THERMAL DAMAGE EVALUATION ON THE RETINA WITH A LIPOSOME DYE SYSTEM", LASERS IN SURGERY AND MEDICINE, WILEY- LISS, NEW YORK, US, vol. 24, no. 1, 1999, pages 61 - 68, XP000955451, ISSN: 0196-8092 *

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102009016184A1 (de) * 2009-04-03 2010-10-14 Carl Zeiss Meditec Ag Verfahren und Vorrichtung zur nichtinvasiven Temperaturbestimmung an mit einer Behandlungsstrahlung behandeltem biologischen Gewebe
US9180052B2 (en) 2009-04-03 2015-11-10 Carl Zeiss Meditec Ag Method and device for non-invasive temperature determination in biological tissue treated with treatment radiation
WO2024188870A1 (fr) * 2023-03-10 2024-09-19 Carl Zeiss Meditec Ag Agencement de mesure de température et dispositif de commande pour un système à base de laser uv pour correction d'erreur de réfraction ou pour un système à base de laser femtoseconde, système de ce type, procédé de fourniture de données de commande, et procédé pour correction d'erreur de réfraction ou pour réticulation ou changement d'indice de réfraction induit par laser

Also Published As

Publication number Publication date
DE10240109A1 (de) 2004-03-11
AU2003263142A1 (en) 2004-03-19

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