Bubble cloud dispersion during thermal ablation

Abstract

An electrosurgical system suitable for use during thermal ablation procedures, comprising an ultrasonic-delivery device including a housing. An ultrasound transducer array disposed within the housing and configured to generate, transmit, and receive ultrasound waves, wherein ultrasound imaging is generated based on the received ultrasound waves. A pulse transducer configured to emit one or more dispersive pulses, wherein the one or more dispersive pulses are configured to burst bubbles accumulated during a thermal ablation procedure.

Description

BUBBLE CLOUD DISPERSION DURING THERMAL ABLATIONCROSS REFERENCE

[0001] This application claims the benefit of U.S. Provisional Patent Application Serial No. 63 / 520,082 filed 16 August 2023, the entire content of which is incorporated herein by reference.FIELD

[0002] The present technology is generally related to instruments or tools used in performing surgery on a patient and, more particularly, to thermal ablation and ultrasonic devices, systems and methods that provide for the destruction of tissue and the imaging thereof.BACKGROUND

[0003] This disclosure relates generally to the field of medical devices, systems, and methods for use in surgical procedures. More specifically, this disclosure relates to the use of ultrasonic imaging during thermal ablation procedures. 0004] Thermal ablation involves is a type of medical procedure that uses heat, cold, microwave and electrical currents to destroy (i.e., ablate) abnormal tissue. Several methods of thermal ablation have been developed to ablate various forms of abnormal tissue, such as tumors or cancerous cells (e.g., among the liver, kidney, lung, etc.). Such methods can include introducing focused localized ablation to produce coagulation in a target volume area. Generally, thermal ablation can be performed by placing an electrode near the desired tissue for ablation and applying a radiofrequency (RF) energy to the electrode.

[0005] Ultrasound diagnostic apparatuses using ultrasound images can be put to practical use during these medical procedures, for example, during thermal ablation procedures. In general, an ultrasound diagnostic apparatus includes an ultrasound probe (hereinafter referred to as “probe”) and a diagnostic apparatus body. The probe can be inserted directly onto tissue. Ultrasound or computed tomography (CT) guidance can be used prior to and during ablation treatments for aiding probe placement and thermal ablation procedures. Multiple ablation electrodes or antennas can be used to synergistically create a large ablation or to ablate separate sites simultaneously. The probe transmits ultrasonicwaves toward a subject and receives ultrasonic echoes from the subject, and the diagnostic apparatus body electrically processes reception signals to generate an ultrasound image.

[0006] However, during thermal ablation, the heating of the tissue can cause water vapor or nitrogen bubbles to generate at or around the target tissue area. These bubbles create problems when ultrasound imaging is used to monitor and assess the ablation as the bubbles can scatter the incident ultrasound energy, which can cause disruption and false or inaccurate ultrasound imaging. Waiting for all or a majority of these bubbles to dissipate on their own is time consuming and can result in delayed or prolonged treatment.

[0007] Thus, a need therefore exists for improved ultrasound imaging devices or tools, particularly those that can effectively reduce or otherwise eliminate the bubbles during thermal ablation procedures, which can improve monitoring and expedite assessments and procedures.SUMMARY

[0008] The techniques of this disclosure generally relate to instruments or tools used in performing surgery on a patient and, more particularly, to thermal ablation and ultrasonic devices, systems and methods that provide for the destruction of tissue and the imaging thereof.

[0009] Non-limiting examples of the present disclosure provide an electrosurgical system suitable for use during thermal ablation procedures, comprising an ultrasonicdelivery device including a housing. An ultrasound transducer array can be disposed within the housing and configured to generate, transmit, and receive ultrasound waves, wherein ultrasound imaging is generated based on the received ultrasound waves. A pulse transducer configured to emit one or more dispersive pulses, wherein the one or more dispersive pulses are configured to burst bubbles accumulated during a thermal ablation procedure.

[0010] Non-limiting examples of the present disclosure provide a method for bursting accumulated bubbles during thermal ablation procedures, comprising generating ultrasonic imaging with an ultrasound transducer array disposed within an ultrasonic delivery device, wherein the ultrasound transducer array generates, transmits, and receives ultrasonic waves for producing ultrasonic imaging and, periodically, emitting one or more dispersive pulses from a pulse transducer, wherein the one or more dispersive pulses are configured for bursting bubbles accumulated during a thermal ablation procedure.

[0011] The details of one or more aspects of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the techniques described in this disclosure will be apparent from the description and drawings, and from the claims.BRIEF DESCRIPTION OF DRAWINGS

[0012] FIG. 1 is a perspective view of an ultrasonic-delivery device including a pulse transducer according to embodiments.

[0013] FIG. 2 is an example ultrasonic-delivery system in use, according to embodiments.

[0014] FIG. 3 is an example of ultrasound imaging, according to embodiments.

[0015] FIG. 4 is an example of ultrasound imaging during or proceeding thermal ablation, according to embodiments.

[0016] FIG. 5 is an alternative example ultrasonic-delivery system in use, according to embodiments.

[0017] FIG. 6 illustrates an example block diagram method for bubble disbursement during thermal ablation, according to embodiments.DETAILED DESCRIPTION

[0018] FIG. 1 depicts an electrosurgical system 100, according to embodiments. The electrosurgical system 100 can include an ultrasonic-delivery device 10, including an ultrasound transducer array 20 and a pulse transducer 30. The ultrasound transducer array 20 can be any suitable device capable of generating, transmitting, and receiving ultrasound waves. The ultrasonic-delivery device 10 can include a one-dimensional or multidimensional array of transducer elements suitable for scanning, receiving and processing ultrasound signals for viewing in two-dimensions or three-dimensions. The ultrasonicdelivery device 10 may be adapted for amplifying the reflected ultrasound signal received by the ultrasonic-delivery device 10. The ultrasonic-delivery device 10 may be adapted to produce an image over a wide field of view, such as a sector scan image produced by repeatedly transmitting and receiving ultrasound energy in radial directions from the ultrasonic-delivery device 10. Ultrasound imaging, produced from receiving an analyzing the return signals, may allow the clinician to observe the relationship betweenabnormal tissue structures, such as tumors, and normal tissue structures, such as vessels, organs, and tissue boundaries, during treatments and aid in thermal ablation procedures in real-time.

[0019] The pulse transducer 30 may be any suitable device capable of generating and transmitting ultrasonic pressure waves. In embodiments, a focused ultrasound (e.g., pulse focused ultrasound) wave may be one or more short acoustic pulses delivered at a low duty cycle and moderate intensity to noninvasively apply mechanical stress or introduce disruption to tissue or corresponding obstructions at or near the tissue area, such as bubbles being generated at or around the tissue area during thermal ablation. In embodiments, the one or more pulses (also known herein as a “dispersive pulse”) may be emitted, periodically, between thermal ablation procedures to disrupt and eliminate bubbles being generated during thermal ablation.

[0020] In embodiments, the one or more pulses may be emitted for a short duration, at a high amplitude in an attempt to disrupt or reduce as many bubbles generated at or near the tissue area as quickly as possible prior to proceeding with or during the processes of thermal ablation procedures. In embodiments, the more bubbles generated or are present at or near the tissue area the higher the amplitude may be preferred and emitted. In embodiments, the more bubbles generated or are present at or near the tissue site additional pulses or cycles may be preferred and emitted. In embodiments, the pulse transducer 30 may be configured to, when activated, emit a predetermined set of one or more pulses at a predetermined frequency and amplitude. In embodiments, the pulse transducer 30 may be configured to, when activated, emit a predetermined set of one or more pulses at varying frequencies and amplitudes (e.g., as a “sweep” function). Enabling a “sweep” function allows a single activation of the pulse transducer to cover a variety of different circumstances, including a plurality of varying frequencies, amplitudes, target area sizes, etc. In embodiments, the “sweep” function may allow the reduction or elimination of instances ranging from where only a few bubbles have been generated in a localized target tissue area to many bubbles scattered across a larger targeted tissue area.

[0021] It should be understood that the pulse transducer 30 may be coupled, integrated with, or other otherwise operable with any variety of ultrasound delivery devices, configurations, shapes, etc., for example, with a curvilinear transducer, a linear transducer, a phased array transducer, or the like.

[0022] It should be understood that the ultrasound transducer array 20 and the pulse transducer 30 may be implemented in separate devices (e.g., a separated device for producing ultrasonic imaging and a separate device for emitting pulse waves to eliminate or reduce bubble accumulation). For example, an external / independent pulse transducer can be incorporated with an electro surgical system, similar to that of FIG. 1, as an additional or alternative device. For ease of illustration, the ultrasonic-delivery device may be configured to perform some or all of the functions as illustrated by the ultrasonic-delivery device 10. However, in an alternative example embodiment, the alternative ultrasonic-delivery device may not include components and functionality to operate and control a pulse transducer. Instead, an external pulse transducer may be provided. As such, a duplicate description regarding the components and functionality has not been made for simplicity.

[0023] In embodiments, the tissue contacting surface 16 may include one or more regions defining one or more areas in which electromagnetic signals may be transmitted and received during operation. In embodiments, the tissue contacting surface 16 may include one or more regions defining one or more areas in which one or more dispersi ve pulses may be transmitted during the thermal ablation procedure and / or in between thermal ablation executions. The operations of ultrasound transducer array 20 may include directing ultrasound energy through the area in which electromagnetic signals are transmitted and received and process the received signals to produce ultrasonic imaging. The operations of the pulse transducer 30 may include directing pressure waves, via one or more pulses, through an area of the tissue contact surface to collapse, clear or otherwise eliminate any formed bubbles at or near the target tissue area during thermal ablation procedures.

[0024] In embodiments, the electrosurgical system 100 may include a power source 120, a user interface 46 associated with the ultrasonic-delivery device 10, and a processor 150 communicatively coupled with the ultrasound transducer array 20. The user interface 46 may be communicatively coupled with the processor 150 and / or an alternative or additional processor (not shown). The electrosurgical system 100 may include an ultrasonic imaging system 140 communicatively coupled with the ultrasound transducer array 20. The ultrasonic imaging system 140 may be connected to one or more display devices and / or screens 148 (e.g., LCD (liquid crystal display), plasma, OLED (organic light emitting diode), holographic, flat, augmented reality / virtual reality lens, and the like) for displaying output, such as ultrasonic imaging, from the ultrasonic imagingsystem 140, which may allow clinicians to visualize the ablative process in real-time and / or near real-time.

[0025] The user interface 46 may be adapted to cooperatively operate with the processor unit 150 and / or other processor(s) (not shown) to enable the user to selectively control one or more parameters of electromagnetic energy delivery and / or pressure pulse delivery into tissue by the ultrasonic-delivery device 10. The user interface 46 may be configured to cooperatively operate with the processor 150 to allow the user to selectively control operations of the ultrasound transducer array 20 and the pulse transducer 30. One or more electrical signals outputted from the user interface 46 may be used to determine, initialize, and emit one or more ultrasound signals or pulses of predetermined duration, frequency, and amplitude.

[0026] The user interface 46 may be disposed on, or otherwise associated with, the ultrasonic-delivery device 10. In embodiments, the user interface 46 may include a power button or switch 44 to turn on and turn off the ultrasonic-delivery device 10. In embodiments, turning on and off the ultrasonic-delivery device 10 may include activating and deactivating the ultrasound transducer array 20, which may send and receive wave pulses to ultimately produce an ultrasonic imaging display onto the screens 148. The power button 44 may be any suitable configuration, e.g., rotatable knobs, depressible buttons, toggle switches, slide switches, voice or sound actuated switches, or any other suitable device capable of turning off power to the ultrasonic-delivery device 10. In embodiments, the power button 44 may be implemented as a remotely operable device, such as a footswitch, a hand switch, or a verbally activated switch. The user interface 46 may additionally, or alternatively, include an indicator (not shown), such as an audible and / or visual indicator, e.g., an illuminated indicator (e.g., a single- or variably colored LED indicator), to alert or signal the user that power is turned on / off.

[0027] The user interface 46 may additionally, or alternatively, include one or more user interface input mechanisms 45, as similarly described by the power button 44. The user interface input mechanisms 45 may be configured to control functions of the pulse transducer 30, such as turning the pulse transducer 30 on / off, adjusting frequency levels, adjusting amplitude levels, duration of a transmitted pulse, the number of emitted pules per each activation, etc. In embodiments, user input mechanisms 45 may be disposed on, or otherwise associated with the ultrasonic-delivery device 10 and may have any suitableconfiguration, e.g., rotatable knobs, depressible buttons, toggle switches, slide switches, voice or sound actuated switches, or any other suitable device. The user input mechanisms 45 may be implemented as a remotely operable device, such as a footswitch, a hand switch, or a verbally activated switch. In embodiments, the user input mechanisms 45 may be a pointing device, e.g., a joystick, directional arrow pad, trackball, rotatable knob, or the like, communicatively coupled to the processor 150. A user may affect movement of the pointing device (e.g., forward, backward, left, right, etc.), which may transmit signals to the processor 150 correlating to one or more operating parameters of the pulse transducer 30. For example, preconfigured parameters to emit pressure waves may be programmed for each user input mechanisms 45. In embodiments, variations on duration, frequencies, amplitude, etc. may be implemented to individual orientations or individual input mechanisms for each user input mechanisms 45.

[0028] In embodiments, data may be acquired from the ultrasound transducer array 20 and outputted from the ultrasonic-delivery device 10 to the ultrasound imaging system 140, e.g., for processing to provide an image format suitable for display and may be outputted from the imaging system 140 to one or more display devices 146. The displayed data (i.e., processed ultrasound imaging) may be used by the clinician to visualize the targeted region in real-time or near real-time during a procedure, such as a thermal ablation procedure. During activation of the ultrasound transducer array 20, a field or cloud view may be generated (with additional reference to FIG. 2) illustrating a real-time or near real-time view of the targeted region. This view may be visibly observable within the ultrasound imaging, which may be viewed on or more displays 146. Observation of the targeted region may allow clinicians to better visualize and understand how to achieve more optimized results during thermal ablation and to recognize when an excess amount of bubbles are being generated during the procedure, which may obstruct the ultrasound imaging.

[0029] FIG. 2 depicts an example ultrasonic-delivery system in use, according to embodiments. In embodiments, thermal ablation procedures may be performed, via a thermal ablation device 40, for example, an electrosurgical device. The thermal ablation procedure may be performed around the target area 230 on or within patient 42. In embodiments, ultrasonic imaging, as described herein, may be performed in real-time or near rea-time by the ultrasonic delivery device 10. As the thermal ablation procedure progresses to different locations in the patient, e.g., the target area 230 moves as theprocedure continues, the clinician may move, rotate, or otherwise relocate the ultrasonicdelivery device 10 such that the target area 230 for thermal ablation remains in the visibility zone 202 for the ultrasound transducer array 20. In embodiments, based on the ultrasound imaging displayed on displays 146, a clinician may determine how the procedure is progressing. In embodiments, noticing an accumulation of bubbles (described in greater detail in FIGS. 3 and 4), the thermal ablation procedure and / or the ultrasound transducer array 20 may be paused, temporarily. Once paused, the pulse transducer 30 may be activated, thus sending out one or more pulse waves in an attempt to eliminate or disperse the accumulated bubbles. Once visibility has been fully restored or restored to an acceptable level, the thermal ablation procedure and / or the ultrasound imaging may be restored. This process may be repeated until the thermal ablation procedure is complete and all or the majority of the treatment area 230 is free from abnormal or undesirable tissue.

[0030] FIG. 3 depicts an example of ultrasound imaging, according to embodiments. Ultrasound imaging 200 may be an example real-time or near real-time image transmission of a target or partial target area 230 of a patient (whether before, during, or after a procedure). In the example ultrasound imaging 200, a liver 210, a kidney 212 and a spine 214 have been depicted and outlined for illustrative purposes. The ultrasonic imaging may be displayed and viewed within a visibility zone 202. In embodiments, the ultrasound imaging 200 may allow the clinician to observe the relationship between abnormal tissue structures 220, such as tumors, and normal tissue structures 222, such as vessels and tissue boundaries, during treatments and aid in thermal ablation procedures in real-time or near real-time. In embodiments, normal tissue structures 222 can be observed by the clinician within healthy or normal portions of the organs, for example, at or near a location of the liver 210, in addition to the observed abnormal tissue 220. It will be understood, while abnormal tissue structures may be readily or easily identifiable by a user, such as a clinician, the abnormal tissue structure 220 has been more clearly distinguished for a clearer depiction.

[0031] FIG. 4 depicts an example of ultrasound imaging during or proceeding thermal ablation, according to embodiments. Ultrasound imaging 300 may be an example real-time or near real-time image transmission of a target or partial target area of a patient during, partially or wholly, a thermal ablation procedure to the target area 230. For example, thermal ablation may be performed at or near the location or target area 230 in which any abnormal tissue 220 may be identified, e.g., a tumor. In embodiments, one or moreelongated needles, which can be visible in the ultrasound imaging 300, may be inserted into the patient and directed to the target area 230, e.g., a liver 210. The one or more elongated needles may be heated by microwave, RF, or other applicable energy, thus performing thermal ablation to destroy abnormal tissue 220. During this process, the heating of the one or more needles may cause the tissue at or near the target area 230 to bubble. In embodiments, these bubbles 232 may be created from water vapor or nitrogen that may be bubbling out of the tissue. As illustrated in FIG. 4, these bubbles 232 can create difficulties when ultrasound imaging is used to monitor and assess the ablation. The bubbles 232, being of a low-density material, may bounce the ultrasonic waves back to the ultrasonic-delivery device 10, which may become incident ultrasound energy. The incident ultrasound energy may prevent visibility to the back of the heated, target zone 230. Thus, view of a full, three- dimensional image is prevented. In embodiments, the incident ultrasound energy may cause disruption to the imaging, such as false or inaccurate ultrasound images.

[0032] In embodiments, to more effectively remove or disperse these bubbles 232 from the target area 230, the pulse transducer 30 may be effectively utilized, emitting one or more dispersive pulses. In embodiments, one or more pulses may be emitted, having a predetermined or set duration, frequency, amplitude, etc. to effectively eliminate or disperse the bubbles 232. In embodiments, to ensure or confirm that use of the pulse transducer 30 is effective, real-time or near real-time imaging may be viewed, in which a user may see a clearer and clearer image forming at or near the target area 230, as the bubbles 232 are reduced.

[0033] Because the pulses generated by the pulse transducer 30 may interfere with the ultrasound imaging performed by the ultrasound transducer array 20, the pulse transducer 30 may be activated such that the duration of the process to remove or reduce the number / size of bubbles 232 is short enough not to cause significant tissue heating or create meaningful additional cavitation outside the target area 230. In embodiments, the duration of the bubble removing process may be minimal as to not meaningfully impact the ultrasound imaging. In embodiments, once a threshold level of bubbles 232 has been cleared, the thermal ablation process may continue with the ultrasound image visibility being completely restored or restored to an acceptable level determined by the clinician. In embodiments, once a threshold amount of imaging is restored, such that all or a minimumamount of the ultrasound imaging is restored to an acceptable level, the thermal ablation process may continue, including reactivating the ultrasound imaging.

[0034] In embodiments, emitting one or more dispersive pulses may impact the use of the ultrasound transducer array 20 to create ultrasound imaging. As such, techniques may be implemented to prevent the dispersive pulses from interfering with the ultrasound imaging. In embodiments, the ultrasound transducer array 20 may be paused periodically to allow emission of one or more dispersive pulses. While this may lead to potential reductions to the ultrasound imaging frame rate, depending on the rate of the dispersive pulsing, no risk of interference to the ultrasonic imaging would occur. In embodiments, activation / deactivation of the ultrasound transducer array 20 and / or the pulse transducer 30 may be accomplished either manually (e.g., by stopping the imaging, applying one or more dispersive pulses with same or separate probe, and reactivating imaging) or automatically (e.g., the ultrasound transducer array 20 and / or the pulse transducer 30 being electronically control to be activated and deactivated such that one does not interfere with the other).

[0035] In embodiments, alternatively or in addition to the technique described above, a dispersive pulse frequency that is outside the bandwidth of the imaging probe may be implemented to reduce sensitivity to the one or more dispersive pulse signals. In embodiments, the one or more dispersive pulses may either be focused or plane wave transmissions. Focused transmissions may assist in ensuring that the highest amplitudes are only achieved within the target area 230, which may reduce the energy impacting surrounding tissues. Plane wave transmissions may apply energy to larger volumes in a shorter duration of time and, therefore, may have a lower impact on the frame rate of the ultrasound imaging. In embodiments, it should be understood that dispersive pulses, as described herein, may vary in frequency (and therefore wavelength) in order to either penetrate to deeper tissues more effectively or to improve interaction with variable bubble quantity / size distribution and utilize one or more of the described features for eliminating or dispersing bubbles 232. For example, should a large number of bubbles be present, or the thermal ablation procedure is being performed deeper within the tissue of a patient, the pulse transducer 30 may be configured such that, upon activation by one or more user input mechanisms, a pressure pulse of a considerably high amplitude or frequency may be emitted.

[0036] FIG. 5 depicts another, alternative example of an ultrasonic-delivery system in use, according to embodiments. In embodiments, a thermal ablation device 302 can have a body 304, including a user input (UI) 306 and an antenna 308. UI 306 can be similarly described as user interface 46 of FIG. 1, wherein the user input can include a plurality of user input mechanisms to control operations of the thermal ablation device 302. For example, one or more user input mechanisms can include buttons, dials, switches, etc. to turn the thermal ablation device 302 on / off, control the amount of power used, positioning of the device, etc. In embodiments, one or more user mechanisms can be configured to control activation and deactivation of a pulse transducer 310. In embodiments, the antenna 308 can extend distally from the body 304 and into the patient. In embodiments, thermal ablation procedures can be performed, via a thermal ablation device 302, for example, an electrosurgical device. In embodiments, one or more electrical components 312 (e.g., electrodes) can be positioned at or near the distal end of antenna 308. In embodiments, one or more electrical components 312 can be positioned throughout the length of antenna 308. In embodiments, the one or more electrical components 312 can be configured to provide electrical currents for thermal ablation, which can destroy abnormal tissue, e.g., tumor tissue 320.

[0037] In embodiments, pulse transducer 310 can include one or more transducer elements (e.g., piezoelectric transducers, capacitive micromachined ultrasonic transducers (CMUT), etc.) that can be coupled to the distal end of antenna 308. In embodiments, the one or more transducer elements can be configured to provide a pressure wave to target area 330, which can eliminate or disperse the accumulated bubbles. In embodiments, because the transducer elements are incorporated with the antenna 308 and, during ablation procedures, can be within patient 342, more simplified transducer elements can be implemented, compared to alternative embodiments described herein. These less complex transducer elements, while they may provide less focused or direct pulses, can reduce complexity of the system and reduce costs. Moreover, even though less focused or direct pulses may occur, due to the pulse transducer being in such close quarters to the accumulating bubbles, effective bubble reduction can be achieved due to the transducer elements already being localized within the tissue of interest.

[0038] In embodiments, the thermal ablation procedure may be performed around the target area 330 on or within patient 342. In embodiments, ultrasonic imaging, as previouslydescribed, may be performed in real-time or near real-time by the ultrasonic delivery device 314. As the thermal ablation procedure progresses to different locations in the patient, e.g., as target area 330 moves during the ablation procedure, the clinician can relocate the ultrasonic-delivery device 314 such that the target area 330 for thermal ablation remains in the visibility zone 309 for an ultrasound transducer array. In embodiments, based on the ultrasound imaging displayed, a clinician may determine how the procedure is progressing. In embodiments, noticing an accumulation of bubbles, the thermal ablation procedure or the ultrasound transducer array may be paused, temporarily. Once paused, pulse transducer 310, while the antenna 308 remains within patient 342, can be activated, thus sending out one or more pulse waves in an attempt eliminate or disperse accumulated bubbles. In embodiments, because the transducer elements are already in the patient, antenna 308 does not have to be removed in order to provide transmitted pulses from pulse transducer 310. Transitioning between thermal ablation procedures and pulse transmissions can be more effectively achieved because the same device (i.e., thermal ablation device 302 / antenna 308) can be used for both thermal ablation and pulse transmission, while remaining in patient 342. Once visibility has been fully restored or restored to an acceptable level, the thermal ablation procedure or the ultrasound imaging can be restored. This process can be repeated until the thermal ablation procedure is complete and all or the majority of the treatment area 330 is free from abnormal or undesirable tissue.

[0039] In embodiments, a clinician can use higher amplitudes, compared to other embodiments, as the provided pulse(s) can be projected directly into ablated (e.g., dead or destroyed) tissue rather than through healthy tissue, which is desired to be preserved. In embodiments, a clinician can also use higher localized energy delivery, compared to other embodiments, for the same or similar reasons as using higher amplitudes. In embodiments, utilizing transducer elements at the distal end of the antenna 308 can allow a clinician to use higher frequencies, compared to other embodiments, that, potentially, have poor penetration qualities.

[0040] FIG. 6 illustrates an example block diagram method for bubble disbursement during thermal ablation, according to embodiments. In embodiments, the ultrasonicdelivery device 10 can be available and used during a thermal ablation procedure. At 400, the ultrasound transducer array can be activated to send and receive ultrasound waves to a patient and generate an ultrasound imaging. In embodiments, the ultrasound imaging canbe continuous imaging of the patient in real-time or near real time. The ultrasound imaging can be conducted prior to the thermal ablation procedure and continue (at least periodically) during the thermal ablation procedure.

[0041] At 402, the clinician can begin the thermal ablation procedure. In embodiments, ultrasound imaging can be viable in real-time or near real-time during thermal ablation procedures.

[0042] At 404, during the thermal ablation procedure, abnormal tissue at or near the target tissue area can be destroyed, ablated, or otherwise become dissipated. In embodiments, while the abnormal tissue is ablated, bubbles can begin to generate at or around the target tissue area from the heating of the abnormal tissue. In embodiments, the bubbles can be formed of water vapor or nitrogen bubbles to generate at or around the target tissue.

[0043] At 406, an accumulation of bubbles can be accumulated, such that obstruction of the ultrasound imaging is or has occurred. In embodiments, a threshold level of obstruction can have occurred, for example, an excessive amount of accumulation based on the observation of the clinician. In embodiments, the amount of bubble accumulation can have occurred such that the target tissue area is partially or completely obstructed.

[0044] At 408, the pulse transducer can be activated, as described herein, in which a pressure pulse is emitted at or near the target tissue area. In embodiments, the target tissue area can be emitted at a predetermined frequency, amplitude, duration, etc. in embodiments, the pressure pulse can be emitted as a sweep function transmitting a variety of various frequencies, amplitudes, durations, etc. In embodiments, the pulse transducer can be activated following temporary deactivation of the ultrasound transducer array, such that the pressure pulse does not interfere with the produced ultrasound imaging. In embodiments, the pulse transducer can be activated while the ultrasound transducer array is activated and producing ultrasound imaging, such that the pressure pulse has a frequency, amplitude, duration, etc. that does not interfere, or minimally interferes, with the produced ultrasound imaging. Activation of the pulse transducer can be repeated until all or a majority of the bubbles have been dissipated. In examples, the clinician can determine that a threshold level of bubbles have been dissipated such that the thermal ablation procedure can continue (e.g., the accumulated bubbles no longer obstruct the ultrasound imaging or a sufficient amount of bubbles have been dissipated to enable sufficient view of the target tissue area).

[0045] This process, the repetition of 404, 406 and 408 can be repeated until the thermal ablation procedure has been completed. In embodiments all or a sufficient amount of abnormal tissue has been ablated. At 410 the ultrasonic-delivery device 10 can be deactivated.

[0046] In examples, an electrosurgical system suitable for use during thermal ablation procedures, comprising an ultrasonic-delivery device including a housing. An ultrasound transducer array disposed within the housing and configured to generate, transmit, and receive ultrasound waves, wherein ultrasound imaging is generated based on the received ultrasound waves and a pulse transducer configured to emit one or more dispersive pulses, wherein the one or more dispersive pulses are configured to burst bubbles accumulated during a thermal ablation procedure.

[0047] In examples, an electrosurgical system suitable for use during thermal ablation procedures, comprising an ultrasonic-delivery device including a housing. An ultrasound transducer array disposed within the housing and configured to generate, transmit, and receive ultrasound waves, wherein ultrasound imaging is generated based on the received ultrasound waves and a pulse transducer configured to emit one or more dispersive pulses, wherein the one or more dispersive pulses are configured to burst bubbles accumulated during a thermal ablation procedure.

[0048] In examples, the pulse transducer is also disposed within the housing of the ultrasonic-delivery device.

[0049] In examples the pulse transducer is disposed on an antenna of a thermal ablation device.

[0050] In examples, the duration of the emitted one or more dispersive pulses has a duration short enough such that the one or more dispersive pulses do not cause harmful tissue heating to a patient.

[0051] In examples, the duration of the emitted one or more dispersive pulses has a duration short enough such that the one or more dispersive pulses do not create additional cavitation outside a target area for thermal ablation.

[0052] In examples, the duration of the emitted one or more dispersive pulses has a duration short enough such that the one or more dispersive pulses do not affect ultrasonic imaging.

[0053] In examples, the pulse transducer emits the one or more dispersive pulses automatically during the thermal ablation process, wherein ultrasonic imaging is automatically paused while the one or more dispersive pulses are emitted.

[0054] In examples, the one or more dispersive pulses are at least one of focused wave transmissions or plane wave transmissions.

[0055] In examples, the one or more dispersive pulses have a frequency that is outside the bandwidth of the ultrasound transducer array.

[0056] In examples, activation of the pulse transducer performs a sweep function, wherein a single activation of the pulse transducer emits a variety of dispersive pulses of varying frequencies or amplitudes and reaches varying target area sizes.

[0057] In examples, a method for bursting accumulated bubbles during thermal ablation procedures, comprising generating ultrasonic imaging with an ultrasound transducer array disposed within an ultrasonic delivery device, wherein the ultrasound transducer array generates, transmits, and receives ultrasonic waves for producing ultrasonic imaging and periodically, emitting one or more dispersive pulses from a pulse transducer, coupled with the ultrasonic delivery device, wherein the one or more dispersive pulses are configured for bursting bubbles accumulated during a thermal ablation procedure.

[0058] In examples, disposing the pulse transducer on an antenna of a thermal ablation device that performs the thermal ablation procedure.

[0059] In examples, limiting the duration of the emitted one or more dispersive pulses to a duration short enough such that the one or more dispersive pulses do not cause harmful tissue heating to a patient.

[0060] In examples, limiting the duration of the emitted one or more dispersive pulses to a duration short enough such that the one or more dispersive pulses do not create additional cavitation outside a target area for thermal ablation.

[0061] In examples, limiting the duration of the emitted one or more dispersive pulses to a duration short enough such that the one or more dispersive pulses do not affect ultrasonic imaging.

[0062] In examples, emitting the one or more dispersive pulses automatically during the thermal ablation process, wherein ultrasonic imaging is automatically paused while the one or more dispersive pulses are emitted.

[0063] In examples, emitting at least one of focused wave transmissions or plane wave transmissions from the pulse transducer.

[0064] In examples, emitting one or more dispersive pulses having a frequency that is outside the bandwidth of the ultrasound transducer array.

[0065] In examples, performing a sweep function when activating the pulse transducer, wherein a single activation of the pulse transducer emits a variety of dispersive pulses of varying frequencies or amplitudes and reaches varying target area sizes.

[0066] In examples, a method for bursting accumulated bubbles during thermal ablation procedures, comprising periodically emitting one or more dispersive pulses from a pulse transducer, wherein the one or more dispersive pulses are configured for bursting bubbles accumulated during a thermal ablation procedure.

[0067] It should be understood that various aspects disclosed herein can be combined in different combinations than the combinations specifically presented in the description and accompanying drawings. It should also be understood that, depending on the example, certain acts or events of any of the processes or methods described herein can be performed in a different sequence, can be added, merged, or left out altogether (e.g., all described acts or events cannot be necessary to carry out the techniques). In addition, while certain aspects of this disclosure are described as being performed by a single module or unit for purposes of clarity, it should be understood that the techniques of this disclosure can be performed by a combination of units or modules associated with, for example, a medical device.

[0068] In one or more examples, the described techniques can be implemented in hardware, software, firmware, or any combination thereof. If implemented in software, the functions can be stored as one or more instructions or code on a computer-readable medium and executed by a hardware-based processing unit. Computer-readable media can include non-transitory computer-readable media, which corresponds to a tangible medium such as data storage media (e.g., RAM, ROM, EEPROM, flash memory, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer).

[0069] Instructions can be executed by one or more processors, such as one or more digital signal processors (DSPs), general purpose microprocessors, application specific integrated circuits (ASICs), field programmable logic arrays (FPGAs), or other equivalent integrated or discrete logic circuitry. Accordingly, the term “processor” as used herein can refer to anyof the foregoing structure or any other physical structure suitable for implementation of the described techniques. Also, the techniques could be fully implemented in one or more circuits or logic elements.

[0070] Example 1. An electrosurgical system suitable for use during thermal ablation procedures, comprising: an ultrasonic-delivery device including a housing; an ultrasound transducer array disposed within the housing and configured to generate, transmit, and receive ultrasound waves, wherein ultrasound imaging is generated based on the received ultrasound waves; and a pulse transducer configured to emit one or more dispersive pulses, wherein the one or more dispersive pulses are configured to burst bubbles accumulated during a thermal ablation procedure.

[0071] Example 2. The electrosurgical system of example 1, wherein the pulse transducer is also disposed within the housing of the ultrasonic-delivery device.

[0072] Example 3, The electrosurgical system of example 1. wherein the pulse transducer is disposed on an antenna of a thermal ablation device.

[0073] Example 4. The electrosurgical system of example 1, wherein the duration of the emitted one or more dispersive pulses has a duration short enough such that the one or more dispersive pulses do not cause harmful tissue heating to a patient.

[0074] Example 5. The electrosurgical system of example 1, wherein the duration of the emitted one or more dispersive pulses has a duration short enough such that the one or more dispersive pulses do not create additional cavitation outside a target area for thermal ablation.

[0075] Example 6. The electrosurgical system of example 1, wherein the duration of the emitted one or more dispersive pulses has a duration short enough such that the one or more dispersive pulses do not affect ultrasonic imaging.

[0076] Example 7. The electrosurgical system of example 1, wherein the pulse transducer emits the one or more dispersive pulses automatically during the thermal ablation process, wherein ultrasonic imaging is automatically paused while the one or more dispersive pulses are emitted.

[0077] Example 8. The electrosurgical system of example 1, wherein the one or more dispersive pulses are at least one of focused wave transmissions or plane wave transmissions.

[0078] Example 9. The electrosurgical system of example 1, wherein the one or more dispersive pulses have a frequency that is outside the bandwidth of the ultrasound transducer array

[0079] Example 10. The electrosurgical system of example 1, wherein activation of the pulse transducer performs a sweep function, wherein a single activation of the pulse transducer emits a variety of dispersive pulses of varying frequencies or amplitudes and reaches varying target area sizes.

[0080] Example 11. A method for bursting accumulated bubbles during thermal ablation procedures, comprising: generating ultrasonic imaging with an ultrasound transducer array disposed within an ultrasonic delivery device, wherein the ultrasound transducer array generates, transmits, and receives ultrasonic waves for producing ultrasonic imaging; and periodically, emitting one or more dispersive pulses from a pulse transducer, coupled with the ultrasonic delivery device, wherein the one or more dispersive pulses are configured for bursting bubbles accumulated during a thermal ablation procedure.

[0081] Example 12. The method for bursting accumulated bubbles of example 11, further comprising disposing the pulse transducer on an antenna of a thermal ablation device that performs the thermal ablation procedure.

[0082] Example 13. The method for bursting accumulated bubbles of example 11, further comprising limiting the duration of the emitted one or more dispersive pulses to a duration short enough such that the one or more dispersive pulses do not cause harmful tissue heating to a patient.

[0083] Example 14. The method for bursting accumulated bubbles of example 11, further comprising limiting the duration of the emitted one or more dispersive pulses to a duration short enough such that the one or more dispersive pulses do not create additional cavitation outside a target area for thermal ablation.

[0084] Example 15. The method for bursting accumulated bubbles of example 11, further comprising, limiting the duration of the emitted one or more dispersive pulses to a duration short enough such that the one or more dispersive pulses do not affect ultrasonic imaging.

[0085] Example 16. The method for bursting accumulated bubbles of example 11, further comprising emitting the one or more dispersive pulses automatically during the thermal ablation process, wherein ultrasonic imaging is automatically paused while the one or more dispersive pulses are emitted.

[0086] Example 17. The method for bursting accumulated bubbles of example 11, further comprising emitting at least one of focused wave transmissions or plane wave transmissions from the pulse transducer.

[0087] Example 18. The method for bursting accumulated bubbles of example 11, further comprising emitting one or more dispersive pulses having a frequency that is outside the bandwidth of the ultrasound transducer array.

[0088] Example 19. The method for bursting accumulated bubbles of example 11, further comprising performing a sweep function when activating the pulse transducer, wherein a single activation of the pulse transducer emits a variety of dispersive pulses of varying frequencies or amplitudes and reaches varying target area sizes.

[0089] Example 20. A method for bursting accumulated bubbles during thermal ablation procedures, comprising: periodically emitting one or more dispersive pulses from a pulse transducer, wherein the one or more dispersive pulses are configured for bursting bubbles accumulated during a thermal ablation procedure.

Claims

WHAT IS CLAIMED IS:

1. An electrosurgical system (100) suitable for use during thermal ablation procedures, characterized by, an ultrasonic-delivery device (10) including a housing (12); an ultrasound transducer array (20) disposed within the housing and configured to generate, transmit, and receive ultrasound waves, wherein ultrasound imaging is generated based on the received ultrasound waves; and a pulse transducer (30), coupled within the housing, configured to emit one or more dispersive pulses, wherein the one or more dispersive pulses are configured to burst bubbles accumulated during a thermal ablation procedure.

2. The electrosurgical system according to claims 1, wherein the pulse transducer is disposed on an antenna of a thermal ablation device.

3. The electrosurgical system according to any of claims 1 to 2, wherein the duration of the emitted one or more dispersive pulses has a duration short enough such that the one or more dispersive pulses do not cause harmful tissue heating to a patient.

4. The electrosurgical system according to any of claims 1 to 3, wherein the duration of the emitted one or more dispersive pulses has a duration short enough such that the one or more dispersive pulses do not create additional cavitation outside a target area for thermal ablation.

5. The electrosurgical system according to any of claims 1 to 4, wherein the duration of the emitted one or more dispersive pulses has a duration short enough such that the one or more dispersive pulses do not affect ultrasonic imaging.

6. The electrosurgical system according to any of claims 1 to 5, wherein the pulse transducer emits the one or more dispersive pulses automatically during the thermal ablation process, wherein ultrasonic imaging is automatically paused while the one or more dispersive pulses are emitted.

7. The electrosurgical system according to any of claims 1 to 6, wherein the one or more dispersive pulses are at least one of focused wave transmissions or plane wave transmissions.

8. The electrosurgical system according to any of claims 1 to 7, wherein the one or more dispersive pulses have a frequency that is outside the bandwidth of the ultrasound transducer array.

9. The electrosurgical system according to any of claims 1 to 8, wherein activation of the pulse transducer performs a sweep function, wherein a single activation of the pulse transducer emits a variety of dispersive pulses of varying frequencies or amplitudes and reaches varying target area sizes.

10. A method for operating a transducer for bursting accumulated bubbles during thermal ablation procedures, characterized by, generating ultrasonic imaging with an ultrasound transducer array (20) disposed within an ultrasonic delivery device (10), wherein the ultrasound transducer array generates, transmits, and receives ultrasonic waves for producing ultrasonic imaging; and periodically, emitting one or more dispersive pulses from a pulse transducer (30), coupled with the ultrasonic delivery device, wherein the one or more dispersive pulses are configured for bursting bubbles (232) accumulated during a thermal ablation procedure.

11. The method for operating a transducer for bursting accumulated bubbles according to claim 10, further characterized by disposing the pulse transducer on an antenna of a thermal ablation device that performs the thermal ablation procedure.

12. The method for operating a transducer for bursting accumulated bubbles according to any of claims 10 to 11, further characterized by limiting the duration of the emitted one or more dispersive pulses to a duration short enough such that the one or more dispersive pulses do not affect ultrasonic imaging.

13. The method for operating a transducer for bursting accumulated bubbles according to any of claims 10 to 12, further characterized by emitting the one or more dispersive pulses automatically during the thermal ablation process, wherein ultrasonic imaging is automatically paused while the one or more dispersive pulses are emitted.

14. The method for operating a transducer for bursting accumulated bubbles according to any of claims 10 to 13, further characterized performing a sweep function when activating the pulse transducer, wherein a single activation of the pulse transducer emits a variety of dispersive pulses of varying frequencies or amplitudes and reaches varying target area sizes.

15. A method for bursting accumulated bubbles during thermal ablation procedures, comprising: periodically emitting one or more dispersive pulses from a pulse transducer, wherein the one or more dispersive pulses are configured for bursting bubbles accumulated during a thermal ablation procedure.

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