Ultrasonic applicator with laser

Abstract

An ultrasonic applicator includes: a shaft having a proximal end, an end end, and a length measured between the proximal end and the end end with respect to an axis; a plurality of channels defined in the shaft and extending from the proximal end of the shaft along at least a portion of the length of the shaft, the plurality of channels including an ultrasonic channel and an optical energy channel; one or more ultrasonic transducers disposed in the ultrasonic channels, the ultrasonic transducers being configured to generate ultrasonic energy along a first direction; and one or more optical fibers disposed in the optical energy channel, the optical fibers having a first end configured for optical coupling with a laser source and a second end configured for guiding laser energy at a predetermined angle relative to the first direction.

Description

Cross-reference to related applications

[0001] This application claims priority to U.S. Provisional Application No. 63 / 632,703, filed April 11, 2024, entitled “Ultrasound Probe With Laser,” which is incorporated herein by reference. Technical Field

[0002] This application generally relates to ultrasound therapy devices. Background Technology

[0003] Ultrasound therapy devices are used to treat a variety of conditions, including benign prostatic hyperplasia (BHP), calcifications such as bladder and kidney stones, and tumors. For some conditions, an ultrasound applicator is inserted into the body to position the ultrasound transducer close to the target area. Obstructions (such as calcifications) may exist between the ultrasound therapy device and the target area, preventing at least some of the ultrasound energy from reaching that area. Summary of the Invention

[0004] The exemplary embodiments described herein have innovative features, but no single feature is indispensable to or solely responsible for their ideal properties. The following description and accompanying drawings detail certain illustrative embodiments of this disclosure, illustrating several exemplary ways in which various principles of this disclosure are implemented. However, these illustrative examples do not exhaustively list the many possible embodiments of this disclosure. Some beneficial features will now be outlined without limiting the scope of the claims. Other objects, advantages, and novel features of this disclosure will be set forth in the following detailed description of the disclosure taken in conjunction with the accompanying drawings, which are intended to illustrate and not limit the invention.

[0005] One aspect of the invention relates to an ultrasonic applicator comprising: a shaft having a proximal end, an end end, and a length measured between the proximal end and the end end with respect to an axis; a plurality of channels defined in the shaft and extending from the proximal end of the shaft along at least a portion of the length of the shaft, the plurality of channels including an ultrasonic channel and an optical energy channel; one or more ultrasonic transducers disposed in the ultrasonic channels, the ultrasonic transducers being configured to generate ultrasonic energy along a first direction; and one or more optical fibers disposed in the optical energy channel, the optical fibers having a first end configured for optical coupling with a laser source and a second end configured for guiding laser energy at a predetermined angle relative to the first direction.

[0006] In one or more embodiments, the predetermined angle ranges from about 120 degrees to about 240 degrees, whereby ultrasonic energy is directed toward a first side of the shaft, and laser energy is directed toward a second side of the shaft. In one or more embodiments, the predetermined angle is about 180 degrees. In one or more embodiments, the ultrasonic applicator further includes an optical window defined in the shaft, aligned with a second end of the optical fiber such that laser energy passes through the optical window, and the optical window is optically transparent to one or more wavelengths of the laser energy.

[0007] In one or more embodiments, the predetermined angle is a first predetermined angle, and the ultrasonic applicator further includes a reflector configured to reflect laser energy at a second predetermined angle relative to the first direction. In one or more embodiments, the reflector is disposed in the optical energy channel. In one or more embodiments, the reflector is electromechanically actuated such that the second predetermined angle is variable.

[0008] In one or more embodiments, the predetermined angle ranges from about +60 degrees to about -60 degrees, thereby directing ultrasonic energy and laser energy toward the same side of the shaft.

[0009] In one or more embodiments, the ultrasonic applicator further includes a laser disposed in the optical energy channel and optically coupled to a first end of the optical fiber.

[0010] Another aspect of the present invention relates to a medical device comprising: an ultrasonic applicator; a laser optically coupled to a first end of an optical fiber; and a power supply electrically coupled to the ultrasonic transducer.

[0011] Another aspect of the invention relates to an ultrasonic applicator comprising: a shaft having a proximal end, an end end, and a length measured between the proximal end and the end end with respect to an axis; a plurality of channels defined in the shaft and extending from the proximal end of the shaft along at least a portion of the length of the shaft, the plurality of channels including an ultrasonic channel and an optical energy channel; one or more ultrasonic transducers disposed in the ultrasonic channels, the ultrasonic transducers being configured to generate ultrasonic energy along a first direction; and a laser disposed in the optical energy channel, the laser being configured to guide laser energy at a predetermined angle relative to the first direction.

[0012] In one or more embodiments, the predetermined angle ranges from about 120 degrees to about 240 degrees, thereby directing ultrasonic energy toward a first side of the shaft and laser energy toward a second side of the shaft. In one or more embodiments, the ultrasonic applicator further includes an optical window defined in the shaft, aligned with the laser such that laser energy passes through the optical window, and the optical window is optically transparent to one or more wavelengths of the laser energy.

[0013] In one or more embodiments, the predetermined angle is a first predetermined angle, and the ultrasonic applicator further includes a mirror configured to reflect the laser energy at a second predetermined angle relative to the first direction. In one or more embodiments, the predetermined angle ranges from about +60 degrees to about -60 degrees, thereby directing the ultrasonic energy and laser energy toward the same side of the shaft.

[0014] Another aspect of the invention relates to a method for performing hyperthermia, comprising: positioning an ultrasonic applicator relative to a target volume within a mammalian body; directing laser energy toward an obstruction located between the ultrasonic applicator and the target volume, the laser energy being emitted by one or more optical fibers and / or lasers disposed in an optical energy channel defined in a shaft of the ultrasonic applicator; reducing the size of the obstruction; and, after the size of the obstruction has been reduced, directing ultrasonic energy toward the target volume, the ultrasonic energy being generated by one or more ultrasonic transducers disposed in an ultrasonic channel defined in the shaft of the ultrasonic applicator.

[0015] In one or more embodiments, the obstruction comprises a calcified lesion. In one or more embodiments, laser energy is directed toward a first side of the shaft, ultrasonic energy is directed toward a second side of the shaft, and the method further includes: after the size of the obstruction is reduced, rotating the shaft to align the ultrasonic transducer with the target volume.

[0016] In one or more embodiments, the optical fiber and / or laser is configured to guide laser energy along a first direction, and the method further includes using a mirror to reflect the laser energy toward the obstruction along a second direction. In one or more embodiments, the method further includes electromechanically pivoting the mirror to adjust the second direction. Attached Figure Description

[0017] To gain a more comprehensive understanding of the nature and advantages of the concepts disclosed herein, reference is made to the detailed description and accompanying drawings of preferred embodiments.

[0018] Figure 1 It is a block diagram of a medical system according to one or more embodiments.

[0019] Figure 2 This is a simplified and partially transparent illustration of an ultrasonic applicator according to one or more embodiments.

[0020] Figure 3 This is a simplified and partially transparent illustration of an ultrasonic applicator according to one or more embodiments.

[0021] Figure 4 This is a simplified and partially transparent illustration of an ultrasonic applicator according to one or more embodiments.

[0022] Figure 5 This is a simplified and partially transparent illustration of an ultrasonic applicator according to one or more embodiments.

[0023] Figure 6 This is a simplified and partially transparent illustration of an ultrasonic applicator according to one or more embodiments.

[0024] Figure 7 This is a simplified and partially transparent illustration of an ultrasonic applicator according to one or more embodiments.

[0025] Figure 8 This is a simplified and partially transparent illustration of an ultrasonic applicator according to one or more embodiments.

[0026] Figure 9 This is a simplified and partially transparent illustration of an ultrasonic applicator according to one or more embodiments.

[0027] Figure 10 This is a flowchart of a method 1000 for performing hyperthermia according to one or more embodiments.

[0028] Figure 11 This is a simplified, partially transparent illustration of an ultrasonic applicator for illustrative purposes. Figure 10 The second step of the method shown.

[0029] Figure 12 This is a simplified, partially transparent illustration of an ultrasonic applicator for illustrative purposes. Figure 10 The third step of the method shown.

[0030] Figure 13 This is a simplified, partially transparent illustration of an ultrasonic applicator for illustrative purposes. Figure 10 The fourth step of the method shown. Detailed Implementation

[0031] An ultrasonic applicator includes an optical energy channel with an optical fiber disposed therein. The optical fiber is optically coupled to a laser to transmit laser energy from the laser. The laser may be located within the optical energy channel or external to the ultrasonic applicator. The distal end of the optical fiber may be configured to direct the laser energy at a predetermined angular direction relative to an ultrasonic transducer and / or ultrasonic window in the ultrasonic applicator. The shaft of the ultrasonic applicator may be optically transparent to the laser energy. Alternatively, an optical window may be defined in the shaft to allow the laser energy to pass through. In some embodiments, the distal end of the optical fiber may be aligned with a mirror that reflects the laser energy at a predetermined angle. In some embodiments, the mirror may be electromechanically actuated to adjust the reflection angle.

[0032] In one or more embodiments, an ultrasonic applicator includes an optical energy channel provided with a laser. The laser is configured to direct the laser energy at a predetermined angular direction relative to an ultrasonic transducer and / or ultrasonic window in the ultrasonic applicator. In some embodiments, the laser may be aligned with a reflector and / or an optical window.

[0033] Laser energy can be used in combination with ultrasound energy to treat a therapeutic volume (e.g., a calcification in a mammal, such as a human). Using a combination of ultrasound and laser energy to treat the volume may be more efficient and / or more effective than using ultrasound energy alone. In this embodiment, one or more laser fibers may be used in the device to accelerate the treatment.

[0034] In addition, or as an alternative, laser energy can be used to ablate and / or break up obstructions (such as calcifications) that may prevent or limit the reach of ultrasound energy to the treatment volume.

[0035] Figure 1 This is a schematic diagram of a medical system 100, in which at least some of the devices, systems, and / or methods disclosed herein according to at least some embodiments are employed. System 100 includes a patient support 106 (on which a patient 108 is shown), a magnetic resonance imaging (MRI) system 102, and an image-guided power delivery system 104.

[0036] The magnetic resonance imaging system 102 includes a magnet 110 arranged around an opening 112, an imaging zone 114 in which the magnetic field is sufficiently strong and homogeneous for MRI, a set of magnetic field gradient coils 116 for rapidly changing the magnetic field to achieve spatial encoding of the MRI signal, a magnetic field gradient coil power supply 118 for powering the magnetic field gradient coils 116 and controlled over time, a transmit / receive coil 120 (also referred to as a "body" coil) for manipulating the orientation of magnetic spins within the imaging zone 114, a radio frequency transceiver 122 connected to the transmit / receive coils 120, and a computer 124 that performs tasks (by executing instructions and / or otherwise) to assist the operation of the MRI system 102 and is coupled to the radio frequency transceiver 122, the magnetic field gradient coil power supply 118, and an image-guided power delivery system 104. The image-guided power delivery system 104 includes a treatment applicator (e.g., an ultrasound applicator) for performing image-guided therapy (e.g., hyperthermia) to treat a treatment volume within a patient 108.

[0037] In some embodiments, the MRI computer 124 may include more than one computer, at least one of which may be dedicated to the MRI system 102. In at least some embodiments, the MRI computer 124 and / or one or more other computing devices (not shown) located in and / or coupled to the system 100 may also perform one or more tasks (by executing instructions and / or otherwise) such as controlling the drive or operating frequency of ultrasound elements in the treatment applicator, for example, at the center frequency (f0) and / or at a higher harmonic (3f0) of the center frequency.

[0038] One or more computers (including computer 124) may include a treatment plan for patient 108 and / or program instructions for (e.g., in real time) determining the treatment plan, which includes a target treatment volume and a required or minimum energy (e.g., thermal) dose for the target treatment volume. The treatment plan may also include the required operating or driving frequencies of ultrasound elements, such as f0 and / or 3f0. The computers may use images from MRI system 102 to image-guide the rotational and insertion / retraction positions of the treatment applicator. In some embodiments, one or more dedicated computers control the image-guided energy delivery system 104. Some or all of the aforementioned computers may communicate with each other (e.g., via a local area network, wide area network, cellular network, WiFi network, or other networks), for example, via a software-controlled link connected to a communication network.

[0039] In some embodiments, the treatment plan includes a set of initial parameters for driving each ultrasound element, such as its initial frequency, initial phase, and initial amplitude. These parameters can be updated in real time based on a measured temperature of the target volume, determined, for example, by magnetic resonance thermometry.

[0040] In other embodiments, the image-guided energy delivery system 104 may be guided using ultrasonic energy generated by an ultrasonic imaging device.

[0041] Figure 2 This is a simplified and partially transparent illustration of an ultrasonic applicator 20 according to one or more embodiments. The ultrasonic applicator 20 may be used in an image-guided power delivery system 104 (…). Figure 1 The ultrasonic applicator 20 includes a shaft 200 attached to or comprising an end 202. Multiple channels 210 may be defined in the shaft 200. Each channel 210 extends from or to a proximal end 262 of the shaft 200 toward a distal end 264. Both the shaft 200 and each channel 210 may extend parallel to a first axis 271, such that the respective lengths of the shaft 200 and each channel 210 can be measured about the first axis 271.

[0042] Channel 210 includes an ultrasound channel 211 configured to receive or accommodate one or more ultrasound transducers 220. The ultrasound transducers 220 may include an array of ultrasound transducers, such as a linear array or a focused array of ultrasound transducers. The ultrasound transducers 220 may be mounted on and / or electrically connected to an elongated circuit board 222. The elongated circuit board 222 may be electrically coupled (e.g., via wire 224) to a controller 226 that selectively provides electrical energy generated by a power source 228 at a specific frequency, relative phase, and / or amplitude, according to a treatment plan, to treat a target volume 230 within the patient's body. In some embodiments, the controller 226 and the power source 228 may be combined together. The ultrasound energy 232 generated by the ultrasound transducers 220 is directed along a first direction toward a first side 214 of the shaft 200. In some embodiments, the ultrasound energy 232 may pass through an ultrasound window 204 defined or formed on the first side 214 of the shaft 200. Ultrasonic energy 232 can be focused geometrically and / or electronically onto the target volume 230.

[0043] Channel 210 may include a cooling channel 212 configured to receive a cooling fluid (e.g., a cooling fluid such as water) that can be used to cool the ultrasound applicator 20 and / or surrounding volume (e.g., surrounding tissue) during ultrasound therapy. The cooling fluid may be supplied from a cooling fluid reservoir 240. The cooling fluid may be recirculated between the cooling fluid reservoir 240 and the cooling channel 212. Cooler (e.g., room temperature) cooling fluid may flow from the cooling fluid reservoir 240 to the cooling channel 212 through an inlet conduit 242. After flowing through at least a portion of the cooling channel 212 and receiving heat from the ultrasound applicator 20, warmer cooling fluid may flow from the cooling channel 212 to the cooling fluid reservoir 240 through an outlet conduit 244. A pump 252 may be fluidly coupled to the inlet conduit 242, and / or a pump 254 may be fluidly coupled to the outlet conduit 244. Alternatively, pump 252 or 254 may be fluid-coupled to inlet line 242 and fluid-coupled to outlet line 244.

[0044] Channel 210 includes an optical energy channel 213. The optical energy channel 213 is configured to receive one or more optical fibers 280 having a proximal end 282 configured for optical coupling with a laser 290 (e.g., a laser source) to receive and transmit laser energy 286 generated by the laser 290. The laser 290 may be controlled by a controller 292. In some embodiments, the controller 292 and the laser 290 may be combined.

[0045] The distal end 284 of the optical fiber 280 can be configured to guide laser energy 286 toward a second side 216 of the shaft 200. The first side 214 and the second side 216 can be opposite sides of the shaft 200. Alternatively, the distal end 284 of the optical fiber 280 can be oriented and / or configured to guide the laser energy 286 at a predetermined angle relative to a first direction of the ultrasonic energy 232. For example, in Figure 2 In this configuration, ultrasonic energy 232 is typically guided along or parallel to a second axis 272, which is orthogonal to the first axis 271. The width or diameter of the shaft 200 can be measured about the second axis 272. Figure 2 In this embodiment, the predetermined angle of the laser energy 286 is approximately 180 degrees from the first direction of the ultrasonic energy 232 (e.g., where the ultrasonic energy 232 is guided at 0 degrees or about 0 degrees and substantially parallel to the second axis 272). In one or more embodiments, the predetermined angle 275 of the laser energy 286 may be approximately 120 degrees to approximately 240 degrees from the first direction of the ultrasonic energy 232 (e.g., where the ultrasonic energy 232 is guided at 0 degrees or about 0 degrees and substantially parallel to the second axis 272), the angle including approximately 150 degrees, approximately 180 degrees, approximately 210 degrees, and any value or range between any two of the foregoing values.

[0046] The shaft 200 may be optically transparent to one or more wavelengths of light with laser energy 286 generated by the laser 290. Alternatively, an aperture and / or optical window may be defined in the shaft 200 to allow wavelengths of light with laser energy 286 generated by the laser 290 to pass through. This optical window may be optically transparent to one or more wavelengths of light with laser energy 286 generated by the laser 290.

[0047] Figure 3 This is a simplified and partially transparent illustration of an ultrasonic applicator 30 according to one or more embodiments. The ultrasonic applicator 30 is identical to the ultrasonic applicator 20, except that in the ultrasonic applicator 30, the distal end 284 of the optical fiber 280 is aligned with an optical window 300 defined in a shaft 200. The optical window 300 is optically transparent to the wavelength of light with laser energy 286 generated by the laser 290. Therefore, the optical window 300 allows the wavelength of light with laser energy 286 generated by the laser 290 to pass through and reach the shaft 200, for example, for treating a target volume 230 and / or breaking up obstructions (e.g., calcifications) located between the ultrasonic applicator 30 and the target volume 230.

[0048] Figure 4This is a simplified and partially transparent illustration of an ultrasonic applicator 40 according to one or more embodiments. The ultrasonic applicator 40 is identical to the ultrasonic applicator 20, except that a reflector 400 is disposed in the optical energy channel 213 of the ultrasonic applicator 40. The reflector 400 is aligned with the distal end 284 of the optical fiber 280 to reflect laser energy 286 at a predetermined angle. The reflector 400 may be fixed or actuated electromechanically (e.g., via a controller electrically communicating with the reflector 400) to adjust the reflection angle of the laser energy 286.

[0049] Figure 3 and Figure 4 The illustrated embodiments can be combined. For example, reflector 400 ( Figure 4 The reflected laser energy is 286, and the reflected laser energy 286 can pass through the optical window 300. Figure 3 ).

[0050] Figure 5 This is a simplified and partially transparent illustration of an ultrasonic applicator 50 according to one or more embodiments. The ultrasonic applicator 50 is identical to the ultrasonic applicator 20, except that in the ultrasonic applicator 50, a laser 500 is disposed in the optical energy channel 213 instead of the optical fiber 2180. The laser 500 is configured to generate laser energy 286 at a predetermined angular direction relative to the ultrasonic transducer 220 and / or the ultrasonic window 204. The laser 500 can be controlled by a controller 292, which is electrically and / or wirelessly coupled to the laser 500. The electrical connection between the laser and the controller 292 can be achieved, for example, using one or more wires or cables 510.

[0051] Figure 3 , Figure 4 and / or Figure 5 The illustrated embodiments can be combined. For example, reflector 400 ( Figure 4 The laser energy 286 generated by laser 500 can be reflected. Alternatively, the laser energy 286 generated by laser 500 can pass through optical window 300. Figure 3 In addition, or as an alternative, reflector 400 ( Figure 4 The laser energy 286 generated by the laser 500 can be reflected, and the reflected laser energy 286 can pass through the optical window 300. Figure 3 Furthermore, or as an alternative, for example according to one or more embodiments in Figure 6 In the ultrasonic applicator 60 shown, the laser 500 can be optically coupled to the optical fiber 280. Figure 2 The ultrasonic applicator 60 is the same as the ultrasonic applicator 50, except that the optical fiber 280 is optically coupled to the laser 500.

[0052] Figure 7 This is a simplified and partially transparent illustration of an ultrasonic applicator 70 according to one or more embodiments. The ultrasonic applicator 70 is identical to the ultrasonic applicator 40, except that in the ultrasonic applicator 70, the optical fiber 280 is configured to guide laser energy 286 toward a first side 214 of the shaft 200 in the same direction as the ultrasonic energy 232. An optional reflector 400 may be used to guide the laser energy 286 toward the first side 214 of the shaft 200 such that the laser energy 286 is aligned with the ultrasonic energy 232 at a predetermined distance from the first side 214 of the shaft 200 (e.g., at the focal length of the ultrasonic energy 232). An optional optical window 300 through which the laser energy 286 can pass may be provided on the first side 214 of the shaft 200.

[0053] The reflector 400 can reflect the laser energy 286 at a predetermined angle 275 of about +60 degrees to about -60 degrees relative to a first direction of the ultrasonic energy 232 (e.g., where the ultrasonic energy 232 is guided at 0 degrees or about 0 degrees and generally parallel to the second axis 272). This angle includes about 150 degrees, about 180 degrees, about 210 degrees, and any value or range between any two of the aforementioned values.

[0054] In some embodiments, laser energy 286 and ultrasonic energy 232 may be generated simultaneously and / or periodically to ablate the target volume 230. Alternatively, laser energy 286 may be used to break up calcifications (e.g., blockage 310) before ablation of the target volume 230 (e.g., using laser energy 286 and / or ultrasonic energy 232). Figure 11-13 Laser energy 286 and ultrasonic energy 232 can be used without rotating the shaft 200.

[0055] In some embodiments, the optical fiber 280 may be bent or angled, as an alternative to or supplement to the optional reflector 400, to guide laser energy 286 toward a first side 214 of the shaft 200, and optionally to align it with ultrasonic energy 232 at a predetermined distance from the first side 214 of the shaft 200, for example as... Figure 8 As shown. The bent / angled optical fiber 280 can emit laser energy 286 at a predetermined angle 275 of about +60 degrees to about -60 degrees relative to a first direction of ultrasonic energy 232 (e.g., where ultrasonic energy 232 is guided at 0 degrees or about 0 degrees and generally parallel to the second axis 272). This angle includes about 150 degrees, about 180 degrees, about 210 degrees, and any value or range between any two of the foregoing values.

[0056] In some embodiments, a laser 500 may be included. Figure 5 , Figure 6( ), to replace or supplement fiber optic 280 and / or laser 290.

[0057] In some embodiments, the reflector 400 can be mechanically actuated to adjust the deflection angle of the laser energy 286. For example, the reflector 400 can be adjusted to have a first state or a first deflection angle 275, in which the laser energy 286 is aligned with the target volume 230, for example, as... Figure 7 As shown. Alternatively, the reflector 400 can be adjusted to have a second state or a second deflection angle 975, in which the laser energy 286 is directed toward the second side 216 of the shaft 200 (e.g., through an optional second optical window 300 located on / in the second side 216 of the shaft 200), for example as... Figure 9 As shown, for example, to apply laser energy 286 to the obstruction. The second deflection angle 975 may be about 120 degrees to about 240 degrees relative to the first direction of the ultrasonic energy 232 (e.g., where the ultrasonic energy 232 is guided at 0 degrees or about 0 degrees and generally parallel to the second axis 272), the angle including about 150 degrees, about 180 degrees, about 210 degrees, and any value or range between any two of the foregoing values.

[0058] Figure 10 This is a flowchart of a method 1000 for performing hyperthermia according to one or more embodiments.

[0059] In step 1001, the ultrasound applicator is positioned relative to a target volume (e.g., target volume 230). The target volume may represent a target site for hyperthermia. For example, the target volume may include calcifications (e.g., stones such as bladder stones or kidney stones), tumors, or other objects or features. The target volume may be located within a mammal such as a human. Imaging techniques (e.g., ultrasound imaging, MRI, and / or other imaging techniques) may be used to position the ultrasound applicator. The ultrasound applicator may be the same as ultrasound applicators 20, 30, 40, 50, 60, or 70.

[0060] In step 1002, laser energy is directed toward the obstruction located between the ultrasonic applicator and the target volume. This laser energy is emitted and / or generated by the ultrasonic applicator. For example, the laser energy may be generated by a laser located in a light energy (e.g., laser) channel defined within the ultrasonic applicator. Alternatively, the laser energy may be emitted from one or more optical fibers in the light energy channel. These optical fibers (or fibers) may be optically coupled to an internal laser in the light energy channel, or optically coupled to an external laser located outside the light energy channel and / or outside the ultrasonic applicator. The laser energy may be oriented at a predetermined angle and / or within a predetermined angular range relative to the axis along which the shaft of the ultrasonic applicator extends. In some embodiments, a reflector may reflect the laser energy at a predetermined angle and / or within a predetermined angular range.

[0061] In some embodiments, any imaging technique used in the ultrasound localization step 1001 can be used to detect obstructions. Alternatively, obstructions can be detected while applying hyperthermia to the target volume, for example, using one or more ultrasound transducers in the ultrasound applicator. For example, due to an obstruction (e.g., a calcification) located between the ultrasound applicator and the target volume and at least partially aligned with the ultrasound energy, some or all of the ultrasound energy directed to the target volume may fail to reach it. Detection can be performed automatically or (e.g., manually) by determining, for example, that the temperature of the target volume (e.g., as measured by MRI thermography) is not increasing at a rate lower than the target rate and / or the expected rate of temperature change.

[0062] In some embodiments, after detecting the obstruction 310 and / or before applying the laser energy 286 in step 1002, the ultrasonic applicator 20 may be rotated (e.g., rotated 180 degrees) to align the laser energy 286 with the obstruction 310, for example as... Figure 11 As shown. With Figure 2 Compared to the ultrasonic applicator 20 shown, Figure 11 The ultrasonic applicator 20 shown is rotated 180 degrees, so that the second side 216 of the shaft 200 is positioned closer to the obstruction 310 and the target volume 300 than the first side 214 of the shaft 200. Figure 11 In this context, ultrasonic applicator 20 can be replaced by ultrasonic applicator 30, 40, 50, 60 or 70.

[0063] In step 1003, the size and / or volume of the obstruction 310 is reduced, for example, as... Figure 12 As shown. For example, the blockage can be crushed, broken, and / or disintegrated.

[0064] In step 1004, following the reduction of the size and / or volume of the obstruction in step 1003, ultrasonic energy is directed toward the target volume. After the size and / or volume of the obstruction is reduced, some or all of the ultrasonic energy can reach the target volume. Imaging techniques (e.g., ultrasound, MRI, and / or other imaging techniques) can be used to monitor the size and / or volume of the obstruction.

[0065] In some embodiments, after reducing the size and / or volume of the obstruction in step 1003 and / or before step 1004, the ultrasonic applicator 20 may be rotated (e.g., rotated 180 degrees) to align the ultrasonic energy 232 with the target volume 230, for example, as Figure 13 As shown, with Figure 11 and Figure 12 In contrast, the ultrasonic applicator 20 was rotated 180 degrees.

[0066] In some embodiments, laser energy and ultrasonic energy can be used simultaneously and / or sequentially (e.g., alternately) to heat-treat the target volume. This may include one or more cycles: rotating the ultrasonic applicator (e.g., rotating it about 180 degrees) alternately between a first ultrasonic energy treatment and a second laser energy treatment, for example, using ultrasonic applicators 20, 30, 40, 50, or 60. Alternatively, when using ultrasonic applicator 70, it is not necessary to rotate the ultrasonic applicator, so that laser energy and ultrasonic energy can be applied simultaneously and / or sequentially while maintaining the same rotational orientation.

[0067] Laser energy can increase the rate and / or efficiency of treatment of a target volume. For example, when a target volume is blocked by calcifications or other objects, at least part (or all) of the ultrasound energy cannot reach that volume. Laser energy can be used to break up the calcifications (or other obstructions), thereby enabling the effective and / or more efficient use of ultrasound energy on the target volume. Alternatively, laser energy can be used to ablate the target volume, as a supplement to or replacement of ultrasound energy.

[0068] This invention should not be considered limited to the specific embodiments described above, but should be understood to cover all aspects of the invention as expressly set forth in the appended claims. By reading this disclosure, those skilled in the art will be able to understand various modifications, equivalent processes, and numerous structures to which the invention is applicable. These claims are intended to cover such modifications and equivalents.

[0069] Furthermore, as previously stated, certain aspects may be embodied in one or more methods. Actions performed as part of this method may be ordered in any applicable manner. Therefore, embodiments can be constructed in which the order of action execution differs from the order shown, and may include the simultaneous execution of certain actions, even if they are shown as sequential actions in the illustrative embodiments.

Claims

1. An ultrasonic applicator, comprising: A shaft having a proximal end, an end end, and a length measured about an axis between the proximal end and the end end; Multiple channels are defined in the shaft and extend from the proximal end of the shaft along at least a portion of the length of the shaft, the multiple channels including an ultrasonic channel and a light energy channel; One or more ultrasonic transducers are disposed in the ultrasonic channel, the ultrasonic transducers being configured to generate ultrasonic energy along a first direction; as well as One or more optical fibers are disposed in the optical energy channel, the optical fibers having a first end configured for optical coupling with a laser source and a second end configured for guiding laser energy at a predetermined angle relative to the first direction.

2. The ultrasonic applicator as claimed in claim 1, wherein, The predetermined angle ranges from approximately 120 degrees to approximately 240 degrees, thereby directing the ultrasonic energy toward a first side of the shaft and the laser energy toward a second side of the shaft.

3. The ultrasonic applicator as described in claim 2, wherein, The predetermined angle is approximately 180 degrees.

4. The ultrasonic applicator as claimed in claim 1, wherein, The ultrasonic applicator further includes an optical window defined in the shaft, the optical window being aligned with the second end of the optical fiber such that the laser energy passes through the optical window, the optical window being optically transparent to one or more wavelengths of the laser energy.

5. The ultrasonic applicator as claimed in claim 1, wherein: The predetermined angle is a first predetermined angle, and The ultrasonic applicator also includes a reflector configured to reflect the laser energy at a second predetermined angle relative to the first direction.

6. The ultrasonic applicator as claimed in claim 5, wherein, The reflector is positioned in the light energy channel.

7. The ultrasonic applicator as claimed in claim 5, wherein, The reflector is electromechanically actuated, making the second predetermined angle variable.

8. The ultrasonic applicator as claimed in claim 1, wherein, The predetermined angle ranges from approximately +60 degrees to approximately -60 degrees, thereby directing the ultrasonic energy and the laser energy toward the same side of the shaft.

9. The ultrasonic applicator as claimed in claim 1, wherein, The ultrasonic applicator also includes a laser disposed in the optical energy channel and optically coupled to the first end of the optical fiber.

10. A medical device comprising: The ultrasonic applicator as described in claim 1; A laser optically coupled to the first end of the optical fiber; as well as A power supply electrically coupled to the ultrasonic transducer.

11. An ultrasonic applicator, comprising: A shaft having a proximal end, an end end, and a length measured about an axis between the proximal end and the end end; Multiple channels are defined in the shaft and extend from the proximal end of the shaft along at least a portion of the length of the shaft, the multiple channels including an ultrasonic channel and a light energy channel; One or more ultrasonic transducers are disposed in the ultrasonic channel, the ultrasonic transducers being configured to generate ultrasonic energy along a first direction; as well as A laser disposed in the optical energy channel is configured to guide laser energy at a predetermined angle relative to the first direction.

12. The ultrasonic applicator as claimed in claim 11, wherein, The predetermined angle ranges from approximately 120 degrees to approximately 240 degrees, thereby directing the ultrasonic energy toward a first side of the shaft and the laser energy toward a second side of the shaft.

13. The ultrasonic applicator as claimed in claim 11, wherein, The ultrasonic applicator also includes an optical window defined in the shaft, the optical window being aligned with the laser such that the laser energy passes through the optical window, the optical window being optically transparent to one or more wavelengths of the laser energy.

14. The ultrasonic applicator as claimed in claim 11, wherein: The predetermined angle is a first predetermined angle, and The ultrasonic applicator also includes a reflector configured to reflect the laser energy at a second predetermined angle relative to the first direction.

15. The ultrasonic applicator as claimed in claim 11, wherein, The predetermined angle ranges from approximately +60 degrees to approximately -60 degrees, thereby directing the ultrasonic energy and the laser energy toward the same side of the shaft.

16. A method for performing hyperthermia, comprising: A targeted ultrasound applicator positioned relative to the target volume within a mammalian body; Laser energy is directed toward an obstruction located between the ultrasonic applicator and the target volume, the laser energy being emitted by one or more optical fibers and / or lasers, the optical fibers and / or the lasers being disposed in an optical energy channel defined in the shaft of the ultrasonic applicator; Reduce the size of the obstruction; and After the size of the obstruction is reduced, ultrasonic energy is directed toward the target volume, the ultrasonic energy being generated by one or more ultrasonic transducers disposed in an ultrasonic channel defined in the shaft of the ultrasonic applicator.

17. The method of claim 16, wherein, The obstruction includes calcifications.

18. The method of claim 16, wherein: The laser energy is directed toward the first side of the shaft. The ultrasonic energy is directed toward the second side of the shaft, and The method further includes rotating the shaft after the size of the obstruction is reduced to align the ultrasonic transducer with the target volume.

19. The method of claim 16, wherein: The optical fiber and / or the laser are configured to guide the laser energy along a first direction, and The method further includes using a reflector to reflect the laser energy toward the obstruction along a second direction.

20. The method of claim 19, wherein, The method further includes: pivoting the reflector electromechanically to adjust the second direction.

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