A system for treating unwanted tissue

Abstract

This technology provides a device for selectively heating one or more lesional areas of the lung. [Solution] Selective heating of diseased tissue is achieved by exposing the lung to an electromagnetic field to produce dielectric heating or eddy current heating. In one embodiment, the frequency of electromagnetic radiation is selected to satisfy specific resonance conditions of the device, the electromagnetic radiation is applied to a coil, and the shape parameters of the coil are selected to create a maximum electric field in the area to be heated. The electromagnetic radiation is applied by a pair of electromagnetic energy signal applicators positioned around the patient's torso, one of which is positioned cranially from the area to be treated and the other caudally from the area to be treated, and these electromagnetic energy signal applicators are shaped to wrap around or partially wrap around the torso.

Description

Technical Field

[0001] (Cross - Reference to Related Applications) This application claims priority to U.S. Application No. 63 / 030879, filed May 27, 2020, entitled SYSTEM FOR TREATING UNWANTED TISSUE, which is hereby incorporated herein by reference for all purposes. In the United States, this application claims the benefit under 35 U.S.C. § 119 of U.S. Application No. 63 / 030879, filed May 27, 2020, entitled SYSTEM FOR TREATING UNWANTED TISSUE.

[0002] The present invention relates to medical devices and methods for treating unwanted tissue. The present invention has exemplary uses in the treatment of lung diseases such as chronic obstructive pulmonary disease (COPD), an example of a lung disease being emphysema.

Background Art

[0003] There are various medical conditions that may include, as part of their treatment, destroying or affecting unwanted tissue. Such treatment should ideally not damage normal tissue adjacent to the unwanted tissue. For example, some lung diseases can benefit from treatment involving the destruction of or affecting diseased lung tissue. Some of these treatments involve heating of the lung tissue. Background information on lung diseases can be found in medical books such as "Pulmonary Pathophysiology" by Dr. John B. West (ISBN 0 - 683 - 08934 - X).

[0004] Emphysema is a disease that damages the alveoli (air sacs) in a patient's lungs.

[0005] Emphysema can cause alveoli to form and rupture in a patient's lungs. This alters the distribution of air spaces in the lungs, reducing the surface area available for oxygen intake. Lung damage caused by emphysema can trap stagnant air in the lungs and / or reduce the amount of oxygen-rich fresh air flowing into the lungs. In patients with emphysema, the affected areas of the lungs are not effectively ventilated through the bronchi and trachea, thus preventing the complete contraction and expansion of the lungs. The trapped air inside the lungs may prevent the diaphragm from moving naturally up and down. This condition can cause dyspnea and reduce overall health and quality of life.

[0006] Prior art techniques for heating diseased tissue within the lungs involve inserting an ablation device into the diseased area through the trachea and bronchi (see, for example, Brannan et al. US2016 / 0184013). This technique has several drawbacks: only a small portion of the lung is accessible, precise mapping of the diseased area is required, and the ablation device must be precisely guided to its location. Furthermore, during treatment, incidental damage occurs to tissues located along the device's path from the insertion point to the treatment point.

[0007] Some prior references in the general field of this invention are as follows: a) Lichtenstein et al., U.S. Patent No. 8,444,635, incorporated herein by reference, discloses a system for exposing undesirable tissue to a scanning focused microwave beam. b) Palti, US8019414 discloses combining chemotherapy with a low-intensity, intermediate-frequency alternating electric field tuned to a specific type of target cell. c) Armitage, US4269199 discloses a method for inducing local hyperthermia by shortwave diathermia in the treatment of tumors. This method involves moving a coil over a part of the body containing the tumor so that the axis of the induction coil constantly traverses different parts of the tumor. d) Turner, US4798215, discloses a combination of thermotherapy treatment and a non-invasive thermometer. e) Leveen, US5010897, discloses a device for deep hyperthermia of cancer. This device uses two single-winding coaxial coils, which rotate synchronously in a plane parallel to each other, with the central axes of each coil aligned on the exact same line perpendicular to the plane of the coils. The magnetic field of the combined rotating coils continuously heats the tumor. f) Evans, US5503150 discloses an apparatus and method for non-invasively locating and heating a volume of tissue, which includes the ability to detect temperature changes in that volume of tissue. g) Kasevich, US6181970 discloses a medical system and device that utilizes microwave energy to provide tissue heating therapy and diagnostic imaging. h) Barry et al., US8585645, discloses the use of high-temperature steam delivered through the lumen of a catheter to treat a location in the patient's lung. i) Turnquist et al., US2011 / 0054431 discloses a device and method for non-invasively heating body tissues and fluids using emitted energy for the detection and / or treatment of various bodily conditions, such as vesicoureteral reflux, and for non-invasively measuring the resulting temperature changes in the target and surrounding body fluids and tissues. j) Lichtenstein et al., WO2017 / 201625, describes methods and apparatus available for treating emphysema by heating tissue with energy delivered through an external electrode or coil. k) Vertikov et al., US8467858, describes devices and techniques for thermotherapy based on optical imaging. l) Ruggera et al., CA1212424A, describes a helical coil for a diathermy apparatus driven by a frequency corresponding to an integer multiple of half the fundamental wavelength, for achieving uniform heating in the transverse direction and allowing the heating focal volume to be shifted along the coil axis from the usual central position along the axis produced by full-wave excitation.

[0008] There is a general need for systems that can automatically heat tissue in diseased areas. There is also a general need for systems that can heat tissue in diseased areas without the need to precisely locate the diseased area. In particular, there is a need for novel, practical methods and devices to heat the entire diseased portion of the lung without overheating healthy parts of the lung or surrounding healthy tissue. [Overview of the project]

[0009] The present invention has numerous embodiments. These embodiments include, without limitation, the following: - A device useful for selectively heating tissue within a patient. - Control system for tissue heating device - A method for controlling a device for selectively heating tissue within a patient. - Methods for treating patients, including selective heating of tissues within the patient. - Use of the apparatus for the treatment of COPD and other lung diseases: Exemplary and non-limiting uses of the methods and apparatus described herein are for the treatment of diseased lung tissue, e.g., lung tissue affected by emphysema or other forms of COPD. Some embodiments provide methods and / or apparatus specifically adapted to selectively heat lung tissue for the treatment of COPD and / or other lung diseases.

[0010] One aspect of the present invention provides an apparatus for treating emphysema or COPD by selectively heating diseased lung tissue of a patient to a therapeutic temperature sufficient to produce a therapeutic effect in the diseased lung tissue, comprising: at least one signal applicator having a conductor sized to extend circumferentially around or substantially around the torso of the patient; a power supply connected to the at least one applicator to deliver a radio frequency (RF) signal, wherein the power supply has an impedance matching network that can be operated to match the output impedance of the power supply to the input impedance of the signal applicator; and a controller operably associated with the power supply and configured to control the power supply to apply the RF signal to the applicator, wherein the applicator, when energized by the RF signal, is operable to couple an electromagnetic energy signal to the patient's tissue, thereby heating the patient's tissue by the electromagnetic energy signal, and the diseased tissue is selectively heated to a higher temperature than healthy tissue due to relatively low blood circulation to the diseased tissue.

[0011] In some embodiments, the power supply has a maximum RF signal output power of at least 500 watts. In some embodiments, the RF signal generates a localized axial electric field or alternating magnetic field within the patient's lungs. The localized field may serve as the primary heating (dielectric) source for the patient's tissues.

[0012] In some embodiments, a temperature monitor is operable to monitor temperature at one or more locations within the patient's tissue, a controller is connected to receive temperature signals from the temperature monitor indicating the temperature at the one or more locations, and the controller is configured to apply feedback control to the power supply to adjust the electromagnetic energy signal delivered to the patient at least partially based on the temperature signals.

[0013] In some embodiments, the temperature monitor is a non-invasive temperature monitor.

[0014] In some embodiments, the temperature monitor includes a magnetic resonance imaging (MRI) system and a processor configured to process MRI signals provided by the MRI system to determine the temperature corresponding to each of the one or more positions.

[0015] In some embodiments, the temperature monitor includes an ultrasonic (US) diagnostic imaging system and a processor configured to process ultrasonic signals provided by the US diagnostic imaging system to determine the temperature corresponding to each of the one or more positions.

[0016] In some embodiments, the controller is configured to control one or more parameters of the RF signal until the temperature at the position is at least equal to the treatment temperature.

[0017] In some embodiments, the controller has a thermal model of at least a portion of the patient that correlates the temperature at the one or more positions to the temperature of the target position. The controller is configured to apply the thermal model using the temperature signal as an input and adjust the heating energy based at least in part on the output of the thermal model.

[0018] In some embodiments, the thermal model includes one or more of the electrical and thermal properties of different tissue types of the patient, the distribution of the different tissue types of the patient, the shape of the one or more electromagnetic energy applicators, the resulting predicted electromagnetic field distribution, and the perfusion of the patient.

[0019] In some embodiments, the at least one signal applicator has a coil.

[0020] In some embodiments, the coil includes turns in the range of 5 to 100.

[0021] In some embodiments, the coil includes turns in the range of 10 to 60.

[0022] In some embodiments, the turns of the coil are uniformly spaced by a pitch distance along the longitudinal axis of the coil.

[0023] In some embodiments, the turns of the coil are non-uniformly spaced along the longitudinal axis of the coil.

[0024] In some embodiments, the cross-section of the coil is not circular.

[0025] In some embodiments, the spacing between the turns of the coil along the longitudinal axis of the coil is adjustable.

[0026] In some embodiments, the cross-section of the coil is adjustable along the longitudinal axis of the coil.

[0027] In some embodiments, the coil has a length of at least 70 centimeters.

[0028] In some embodiments, the coil has a length of at least 1 meter.

[0029] In some embodiments, the coil has an inner diameter of at least 30 cm.

[0030] In some embodiments, the length of the coil is greater than or equal to the width of the coil.

[0031] In some embodiments, the length of the coil is greater than or equal to 4 times the width of the coil.

[0032] In some embodiments, the coil includes multilayer windings.

[0033] In some embodiments, the coil is configured to open like a bivalve shell to accommodate the patient.

[0034] In some embodiments, the device comprises a patient support configured to support the patient in a supine position, the patient support having a head support located outside the coil.

[0035] In some embodiments, the RF signal has a frequency in the range of about 5 kHz to about 100 MHz.

[0036] In some embodiments, the RF signal has a frequency in the range of about 500 kHz to about 10 MHz.

[0037] In some embodiments, the controller is configured to set the frequency of the RF signal such that the maximum electric field value of the electromagnetic energy signal is at a desired position for the at least one applicator.

[0038] In some embodiments, the controller is configured to set the frequency of the RF signal so as to generate a standing wave in the at least one applicator.

[0039] In some embodiments, the controller is configured to set the frequency of the RF signal to generate a standing wave in the at least one applicator, the standing wave having a maximum electric field at a desired location (e.g., at or near the location of a volume of lesional tissue in a patient's lung).

[0040] In some embodiments, the controller is configured to set the frequency of the RF signal to be the same as, or close to, the resonant frequency between the applicator and the patient.

[0041] In some embodiments, the controller is configured to set the frequency of the RF signal to an integer multiple of, or close to, the resonant frequency of the applicator when the patient is present.

[0042] In some embodiments, the RF signal has a power in the range of about 500 watts to about 5 kilowatts.

[0043] In some embodiments, the controller is configured to apply time-domain modulation to the RF signal.

[0044] In some embodiments, the controller is configured to control the power supply so as to generate the RF signal as a pulsed signal and to control the pulse width in the pulsed signal.

[0045] In some embodiments, the one or more signal applicators have two signal applicators connected to the power supply and capable of operating to deliver the electromagnetic energy signal to the patient's tissue.

[0046] In some embodiments, the two signal applicators include a first signal applicator positioned cranially to the volume to be treated and a second signal applicator positioned caudally to the volume to be treated.

[0047] In some embodiments, each of the two signal applicators is shaped to wrap around or partially wrap around the patient's torso.

[0048] In some embodiments, the signal applicator is adjustable to conform to the contours of the patient being treated.

[0049] In some embodiments, the device includes cooling means for cooling the patient.

[0050] In some embodiments, the cooling means includes a source of the cooling fluid, which is arranged to bring the cooling fluid into thermal contact with an area of ​​the patient's skin.

[0051] In some embodiments, the cooling means includes a patient support that includes a passage that has thermal contact with a surface for supporting the patient and is connected to transport the cooling fluid.

[0052] In some embodiments, the cooling means is configured to cool the patient's chest and back.

[0053] In some embodiments, the cooling means is configured to cool the patient's groin area.

[0054] In some embodiments, the cooling means includes a source of cooled air.

[0055] In some embodiments, the device is used for the treatment of emphysema or COPD.

[0056] One aspect of the present invention provides a method for treating emphysema or COPD by selectively heating diseased lung tissue of a patient to a therapeutic temperature sufficient to produce a therapeutic effect in the diseased lung tissue, comprising the steps of: providing at least one signal applicator having a conductor extending circumferentially around or substantially around the torso of the patient; delivering a radio frequency (RF) signal to the at least one applicator, enabling the RF signal to be absorbed by both the healthier tissue and the diseased tissue of the patient's lung, thereby heating the tissue of the patient's lung, wherein the heating raises the temperature of the diseased tissue to a temperature above a therapeutic threshold temperature, while the temperature of the healthier tissue is kept below a safety threshold temperature, which is lower than the therapeutic threshold temperature, by blood circulation through the healthier tissue; and maintaining the temperature of the diseased tissue above the therapeutic threshold temperature for a cumulative time sufficient to provide a therapeutic effect.

[0057] In some embodiments, the RF signal has an output power of at least 500 watts.

[0058] In some embodiments, the therapeutic effect is the ablation of the lesional tissue.

[0059] In some embodiments, the therapeutic effect is necrosis of the diseased tissue.

[0060] In some embodiments, the therapeutic effect is the induction of inflammation in the lesional tissue.

[0061] In some embodiments, the RF signal generates a localized, axially extending alternating electric or magnetic field within the patient's lungs.

[0062] In some embodiments, the applicator has at least one coil, and the patient's lung is located within the coil.

[0063] In some embodiments, the RF signal generates an alternating magnetic field that extends substantially parallel to the vertical direction of the patient.

[0064] In some embodiments, the method has a substantially uniform intensity of the alternating magnetic field within the coil.

[0065] In some embodiments, the at least one applicator has a pair of conductive members spaced apart along the patient's torso.

[0066] In some embodiments, the RF signal generates a local alternating electric field that extends in an axial direction substantially parallel to the vertical direction of the patient.

[0067] In some embodiments, the method comprises the steps of monitoring the temperature of tissue within the patient and controlling the RF signal based on the monitored temperature. For example, the step of controlling the RF signal may include one or more of the steps of setting the frequency of the RF signal and setting the amplitude or power of the RF signal. In some embodiments, the method comprises the step of setting the frequency of the RF signal so as to generate an electromagnetic standing wave in the patient (for example, in the patient's lungs).

[0068] Further aspects and exemplary embodiments are shown in the accompanying drawings and / or described below.

[0069] The present invention has embodiments expressed as methods and embodiments expressed as apparatus. Where an apparatus is described herein, all described features of the apparatus and the use of such apparatus are also intended to describe the corresponding methods, and where a method is described herein, the disclosure of such method is also intended to provide apparatus configured to implement such method.

[0070] It is emphasized that the present invention relates to any combination of the above features, even if these features are described in different claims. [Brief explanation of the drawing]

[0071] The attached drawings illustrate non-limiting exemplary embodiments of the present invention.

[0072] [Figure 1] This figure shows an apparatus according to an exemplary embodiment.

[0073] [Figure 1A] This is a schematic graph showing differential heating of diseased and healthy tissue.

[0074] [Figure 1B] An example control system for the apparatus described herein is shown in block diagram.

[0075] [Figure 1C] This is a schematic cross-sectional view of a coil, illustrating one method for adjusting the cross-sectional shape of the coil.

[0076] [Figure 2] This is a side elevation view of a device according to an exemplary embodiment including a multilayer coil.

[0077] [Figure 3] This is a side elevation view of another exemplary device including a pair of spaced-out applicators extending circumferentially or partially circumferentially around a patient. [Modes for carrying out the invention]

[0078] To provide a more complete understanding of the present invention, specific details are described throughout this description. However, the invention may be carried out without these specific details. In other instances, well-known elements are not shown or described in detail to avoid unnecessarily obscuring the invention. Accordingly, this specification and the drawings should be taken as illustrative rather than restrictive.

[0079] Figure 1 shows an apparatus 10 according to an exemplary embodiment. Patient P has a volume V of tissue to be treated by heating. Volume V may include, for example, alveoli in the lungs L of a patient affected by emphysema.

[0080] Volume V may have relatively lower blood circulation compared to healthier tissue in other parts of the lung L, thereby delivering energy to the tissue within volume V at a given power density (i.e., for example, cm 3In a measurable volume V, if energy is delivered to the tissue within volume V at a given rate measurable, for example, in watts per unit volume, this results in a higher temperature rise than would occur if the same power density of energy were delivered to healthier tissue in other parts of the lung L. The higher temperature rise within volume V may, at least in a significant portion, be due to reduced blood circulation in volume V compared to blood circulation in healthier tissue. Circulating blood acts as a coolant, removing energy more quickly from healthier tissue than from volume V. This effect may be applied to heat the tissue in volume V to a temperature high enough to achieve a desired result (e.g., tissue ablation, tissue necrosis, or induction of tissue inflammation of volume V) while ensuring that the temperature of the surrounding healthier tissue remains below a safe threshold temperature so as not to harm the surrounding healthier tissue.

[0081] For example, if the same amount of power per unit volume can be dissipated to each volume of tissue in a portion of lung L that includes one or more volumes V of diseased tissue, then the power level can be selected such that one or more volumes of diseased tissue in lung L with poor blood circulation are heated to at least the therapeutic temperature threshold, while the temperature of the healthier tissue volumes in lung L with better blood circulation remains below the safety temperature threshold.

[0082] Figure 1A is a schematic graph illustrating the principle described above. Initially, the temperature T of the diseased tissue volume V is... V and the temperature of healthy tissue volume T H Both are, Body temperature T B It is equal to: At time t=0, energy with the selected power density is added to volume V and the volume of healthy tissue. This results in temperature T V and T H The temperature rises. As this occurs, the temperature T V This is due to poor blood circulation with low volume V, and temperature T HThe power density of the energy applied, and the time required to deliver the applied energy to patient P, are selected such that the temperature of healthy tissue does not exceed the safety threshold temperature T1, while the temperature of volume V reaches at least the therapeutic temperature threshold T2.

[0083] The device 10 delivers energy to the patient's tissue via a signal applicator, which in the device 10 has the form of a coil 20 extending around a portion of the patient P's body containing the lesional tissue to be heated.

[0084] Coil 20 is driven by a power supply 25 to generate an electromagnetic field that delivers energy into the tissues of patient P. In the apparatus 10, the power supply 25 has output terminals 26A and 26B, which are connected by signal conductors 27A and 27B to apply signals to the corresponding terminals of coil 20. In some embodiments, the power supply 25 is connected to coil 20 at its ends (e.g., terminals 28A and 28B). In some embodiments, the power supply 25 is connected to coil 20 at terminals located away from its ends (e.g., terminals 28C and 28D).

[0085] The controller 24 controls the power supply 25 to deliver energy to the patient P's tissues to produce the desired therapeutic outcome. In some embodiments, the controller 24 is connected to receive feedback from a temperature monitor 23 that monitors the temperature at one or more points 23A within and / or near volume V.

[0086] The controller 24 may be configured to adjust the signal delivered to the coil 20 to produce a desired temperature distribution in the patient P's tissue. For example, it may be desirable to heat the volume of lesional tissue to at least the therapeutic temperature threshold T2 temperature over a desired period of time, while maintaining the temperature of healthier tissue below the safety temperature threshold T1.

[0087] The controller 24 may include a feedback controller having one or more inputs. One or more inputs may include temperature measurements of the patient P's tissue. The device 10 includes a temperature monitor 23 that acquires temperature measurements. Temperature measurements may be performed with one or more temperature sensors of any suitable type.

[0088] The coil 20 has several windings 20A. In a typical and non-limiting embodiment, the number of windings is in the range of 5 to 100. In some embodiments, the coil 20 has windings 20A in the range of 10 to 60. It is not essential that the coil 20 has an integer number of windings.

[0089] The winding 20A may comprise, for example, a conductive wire, tube, bar, etc. The winding 20A may have a cross-section such as round, elliptical, or other. The cross-section may vary along the length of the coil 20. In some embodiments, the winding 20A has a tubular structure.

[0090] The coil 20 is positioned to receive at least a portion of the patient P's body, including volume V. For example, if volume V is in the lungs, the coil 20 may be sized to receive the patient P's torso such that volume V is inside the coil 20. For example, if patient P is an adult and the coil 20 receives the patient P's torso as shown in Figure 1, the coil 20 may have a diameter D20 of, for example, about 30–90 cm (for some larger patients, a diameter closer to the upper end of this range, or even larger, may be required). The winding 20A may be tightly wound around patient P, or it may be sized to have a gap between the winding 20A and patient P. If patient P is a child or other small person, the coil 20 may have a smaller diameter, but large enough to extend around patient P's torso.

[0091] Figure 1B is a block diagram showing a control system that may be applied to apparatus 10 or other apparatus described herein. In this example, the power supply 25 includes a signal generator 25A that delivers an output signal 22-1 to an amplifier 25B. The signal generator 25A is operable to generate a signal, which is amplified by the amplifier 25B to produce an amplified signal 22-2. The amplified signal 22-2 is applied to drive the coil 20.

[0092] The amplified signal 22-2 may comprise a sine wave signal having a frequency in the range of approximately 5 kHz to approximately 100 MHz. In some embodiments, the signal 22-2 has a frequency in the range of approximately 500 kHz to approximately 10 MHz. In some embodiments, the amplified signal 22-2 has a power in the range of approximately 500 watts to 5 kilowatts.

[0093] In the embodiment shown in Figure 1B, the power supply 25 includes an impedance matching network 25C. The impedance matching network 25C is connected between the output of the amplifier 25B and the coil 20 and is adjustable to provide optimal power delivery to the patient P. As is known to those skilled in the art of RF systems, the matching network comprises a combination of circuit elements such as capacitors, resistors, and / or inductors that can be connected in various topologies to match the output impedance of the amplifier 25B to the input impedance of the system including the coil 20 and the patient P. The input impedances of the coil 20 and the patient P vary depending on the characteristics of the coil 20 and the patient P, as well as the characteristics of the channel that delivers the RF energy of the signal 22-2 to the coil 20. The matching network 25C is adjustable to maximize power delivery to the patient P and minimize back reflection of power to the amplifier 25B.

[0094] In the embodiment shown in Figure 1B, a reflectance detector 25D is provided to measure the RF power reflected from the coil 20 and the patient P. The reflectance detector 25D may include, for example, a circulator configured to guide the RF power reflected from the coil 20 to an output port, at which any suitable type of RF power meter is provided to measure the reflected power. A matching network 25C may be tuned to minimize the reflected power detected by the reflectance detector 25D with respect to a particular patient P and coil 20.

[0095] Signal 22-2 causes an alternating current to flow through the winding 20A of coil 20. This current generates an alternating magnetic field inside coil 20. The alternating magnetic field generates an alternating electric field, which induces eddy currents in the conductive material (e.g., patient P's tissue) located inside coil 20. The combination of coil 20 and the signal provided by power supply 25 may be selected such that the maximum value of the electric field lies in a plane perpendicular to the axis of coil 20 and is located at a desired position (e.g., at the location of the treatment volume V).

[0096] In the shown embodiment, the coil 20 has a solenoid shape, and the magnetic field within the coil 20, generated by passing current through the winding 20A, is oriented generally parallel to the longitudinal axis of the coil 20. In the shown embodiment, the coil 20 is oriented such that the magnetic field lines extend in the superior / inferior direction (i.e., parallel to the longitudinal centerline of the patient's body). Advantageously, the magnetic field strength is generally uniform in a cross-section of the coil 20 cut perpendicular to the longitudinal axis of the coil 20.

[0097] Figure 1B shows the output and input sections of an exemplary controller 24. Some embodiments may include all of these output and input sections. Other embodiments may lack some of these input and output sections. The same hardware may optionally provide two or more, or all, different input and / or output sections of the controller 24. Control signals and / or data signals may include any suitable form of analog or digital signals.

[0098] The controller 24 acquires patient data 30 as input 30-1. Patient data 30 may include one or more of the following: - One or more of the specified characteristics of the amplifier's output signal 22-2, such as the power or power density to be delivered to a specific patient P, the frequency or frequency spectrum of the signal 22-2, etc. - A prescribed sequence for delivering power to a specific patient P. - Treatment temperature and / or temperature threshold - Location of one or more volumes containing lesional tissue to be treated - Physical characteristics of a specific patient P (e.g., height, weight, body fat content, waist circumference, pulmonary circulation measurements, lung volume, pre-treatment imaging data (e.g., from MRI, CT scans, etc.) which can be used as a basis for determining the dimensions and / or tissue characteristics of patient P). The input unit 30-1 may receive input from one or more of the following: a graphical user interface, discrete control, wired or wireless data interface, data store, data server, etc.

[0099] Depending on the nature of the patient data 30 and the capabilities of the controller 24, the controller 24 may directly receive specified characteristics for signal 22-2, or may derive characteristics for signal 22-2 based on information about patient P (e.g., one or more of the types described above). Also, depending on the nature of the patient data 30 and the capabilities of the controller 24, the controller 24 may receive and apply specific parameters for controlling the power supply 25 within the patient data 30, apply built-in control parameters, or derive control parameters by processing the patient data 30.

[0100] The controller 24 may receive an input signal 31 at an input unit 31-1 that indicates one or both of the RF power reflected from the coil 20 and the RF power delivered to the coil 20. The controller 24 may output a signal 33 at an output unit 33-1 connected to a matching network 25C. The controller 24 may be configured to adjust the matching network 25C with the signal 33 to minimize the reflected RF power from the coil 20 / patient P. This adjustment may be performed once before treatment and / or automatically on a continuous or periodic basis.

[0101] If signal 31 includes the measured power level of signal 22-2, the controller 24 may use this measured power level of signal 22-2 as feedback for controlling signal 22-2.

[0102] The controller 24 may receive a signal 32 from the temperature monitor 23 at the input unit 32-1. Based on the signal 32, the controller 24 may be configured to control the power of signal 22-2, control the modulation of signal 22-2, and / or stop treatment if the measured temperature exceeds a high temperature threshold.

[0103] Figure 1B shows an output unit 34-1 that sends the control signal 34 to the control signal generator 25A. The signal 34 may control one or more of the following: the frequency of signal 22-1, the frequency spectrum of signal 22-1, the pulsation of signal 22-1, and the amplitude of signal 22-1.

[0104] Figure 1B shows an output unit 35-1 that delivers a control signal 35 for controlling amplifier 25B. The control signal 35 may, for example, control the gain of amplifier 25B.

[0105] The controller 24 may adjust the power delivered to the patient P's tissue in response to a temperature measurement (e.g., in signal 32) (e.g., by signals 34 and / or 35). For example, the controller 24 may control the power supply 25 to do one or more of the following: - For example, the power level of signal 22-2 is adjusted to match the cooling effect of perfusion in healthy tissue so that healthy tissue does not overheat while diseased tissue is being heated to the required temperature. - For example, time-domain modulation of signal 22-2 is performed to enable intermittent power delivery, which allows the diseased tissue to be kept at the required temperature while perfusion in healthy areas cools the tissue to below the required temperature. - For example, adjust the frequency of signal 22-1 so that it reaches the resonant frequency described below.

[0106] In some embodiments, the controller 24 includes a thermal model of at least a portion of the patient being treated. The thermal model correlates the temperatures at one or more locations within the patient P where temperature measurement is available to the temperatures at one or more target locations where temperature measurement may not be available. The controller 24 may be configured to apply the thermal model using the measured temperatures as input to the thermal model and to adjust the signal 22-2 based at least partially on the output of the thermal model.

[0107] The thermal model may include, for example, one or more of the following: the electrical and thermal properties of different tissue types of patient P being treated, the distribution of different tissue types of patient P being treated, the shape of the coil 20 and the resulting expected field distribution, and the perfusion flow rate of patient P being treated.

[0108] In some embodiments, the controller 24 is configured to deliver power to patient P at power-on intervals separated by periods during which no RF power is delivered to patient P or reduced RF power is delivered. For example, the controller 24 may apply signal 22-2 over power-on intervals having a length ranging from a few seconds to several minutes, separated by pauses ranging from a few seconds to several minutes. The controller 24 may be configured to control the duration of the power-on intervals and / or pauses.

[0109] In some embodiments, the controller 24 may be configured to discontinue treatment when a completion criterion is met (for example, when a certain number of power-on intervals are completed, when a certain temperature is achieved in the patient P's lesion tissue, when a certain temperature function is achieved in the patient P's lesion tissue, for example, when the temperature has been above a threshold for a certain amount of time).

[0110] In some embodiments, the frequency of signal 22-1 (and 22-2) is selected to generate a standing wave within the coil 20. The frequency selection is typically determined by the characteristics of the coil 20 (e.g., shape, number of windings W) and the impedance of patient P. In some embodiments, the standing wave has a single electric field maximum. The coil 20 may be positioned relative to patient P such that the electric field maximum is located in or near the lesion tissue to be treated in patient P.

[0111] In some embodiments, the frequency of signal 22-2 is adjusted to be or approximately the resonant frequency of coil 20 (including patient P). In some embodiments, the frequency of the signal is adjusted to be or approximately an integer multiple of the resonant frequency of coil 20 including patient P. The choice of frequency is typically determined by the characteristics of the coil (e.g., shape, number of windings 20A) and the impedance of patient P. The frequency can be calculated in advance using these parameters (e.g., by controller 24 or in calculations outside controller 24) and then fine-tuned by measuring the electric field in coil 20 using an electric field meter.

[0112] The power of the signal 22-2 applied to drive coil 20 may be selected to deliver a specified amount of heating to the patient P's tissue (for example, by controlling the gain of amplifier 25B and / or adjusting the amplitude of signal 22-1). The power of the signal 22-2 applied to coil 20 may be selected based on factors such as one or more of the following: - Patient P's weight - Estimated weight of a portion of patient P (e.g., patient P's lungs) - Patient P's height and / or waist circumference - RF absorption in patient P's tissue within coil 20 (this varies mainly depending on the percentage of fat in patient P's body). - RF coupling between coil 20 and patient P's tissue (this varies depending on the signal frequency and the dimensions and shape of coil 20) - Measurements of pulmonary circulation in patient P

[0113] In some embodiments, the temperature monitor 23 is of a type that can operate to perform non-invasive temperature detection. For example, tissue temperature may be measured by processing an ultrasound signal or a magnetic resonance imaging (MRI) signal.

[0114] In some embodiments, temperature measurement is performed using a non-contact temperature sensing system (e.g., one used for processing MRI data). In some such embodiments, the coil 20 is located inside the MRI system. The controller 24 may be configured to interrupt the delivery of signals 22-2 to the coil 20 so that temperature measurement can be performed.

[0115] In some embodiments, temperature measurement is performed using an invasive temperature sensor that is inserted into the patient P (e.g., through a needle or catheter).

[0116] In some embodiments, the apparatus described herein is combined with an imaging system (e.g., an ultrasound imaging system or an MRI system). The imaging system may be used for temperature monitoring and / or for imaging a patient P.

[0117] When the device 10 is applied to treat diseased tissue in the lungs of patient P, the coil 20 is preferably long enough to receive at least the lungs L of patient P within the coil 20. It is generally desirable that the head of patient P is shielded from high-frequency radiation and / or outside the coil 20.

[0118] Figure 1 shows a non-limiting and exemplary embodiment in which the length L20 of the coil 20 is close to the height of the patient P. In Figure 1, the windings of the coil 20 extend around a volume V including the body and lungs L of the patient P. Other configurations are possible. For example, the coil 20 may have a shorter length so that the torso of the patient P is contained within the coil 20. The length L20 may be selected based on the characteristics of the patient P.

[0119] The coil 20 may have a circular cross-section, but this is not required. In some embodiments, the coil 20 is flat. For example, the coil 20 may have an oval or elliptical cross-sectional shape.

[0120] In some embodiments, the cross-sectional shape of the coil 20 is adjustable. For example, the material of the coil 20 may be elastically deformable so that the coil 20 can be deformed to a configuration that stretches the holes in the coil 20 and reduces the height of the coil 20. This may be done, for example, by expanding the coil 20. Figure 1C schematically shows the expansion of the coil 20 by pulling apart the non-conductive bars 29.

[0121] In some embodiments, the cross-sectional shape of the coil 20 is independently adjustable along the longitudinal axis of the coil 20. Such adjustments can be made according to the patient's characteristics. The adjustment of the cross-sectional shape of the coil 20 may be achieved by creating the coil 20 from a flexible conductive material (e.g., flexible wire, flexible bar) and deforming the coil by moving the windings of the coil 20 to a desired shape.

[0122] In some embodiments, the shape of the coil 20 varies along its length. For example, the windings of the coil 20 may be more densely wound (the pitch distance PD between adjacent windings is smaller). For example, it may be beneficial to wind the coil 20 more densely (with a smaller PD) around a particular region to obtain best results. In some embodiments, the end portions of the coil 20 are wound more densely than the intermediate portions of the coil 20 between the end portions.

[0123] The windings 20A are spaced apart along length L20. The windings 20A may be spaced uniformly or unevenly apart from each other (i.e., the pitch distance PD may be uniform or uneven).

[0124] In some embodiments, the spacing of the windings 20A along the longitudinal axis of the coil 20 is adjustable. In such embodiments, the spacing of the windings 20A may be adjusted according to the patient's characteristics. This can be achieved by using a flexible element, such as a coaxial network cable or other flexible wire, as the windings of the coil 20 and supporting the windings with an adjustable frame made of a material that does not absorb radio frequency (RF) radiation.

[0125] In some embodiments, the diameter of the coil 20 varies along the length of the coil 20.

[0126] In some embodiments, the coil 20 has multilayer windings, as shown in Figure 2, for example.

[0127] The techniques described herein may be modified. For example, instead of a single coil 20, the apparatus described herein may include two or more applicators working together to deliver energy to the tissues of patient P. For example, Figure 3 shows an exemplary apparatus 40 similar to apparatus 10, except that it includes two spaced-apart applicators A1 and A2. Each of applicators A1 and A2 is configured to wrap around or partially wrap around the torso of patient P. Applicators A1 and A2 may be ring-shaped. Applicators A1 and A2 may have, for example, circular, elliptical, or round cross-sections.

[0128] In some embodiments, applicators A1 and A2 extend completely (360 degrees) around the torso of patient P. In some embodiments, one or both of applicators A1 and / or A2 extend over angles of at least 180 degrees, or at least 230 degrees, or at least 250 degrees, or at least 270 degrees, or at least 300 degrees, or at least 330 degrees, with respect to the left-right and top-down center points inside the applicator in the plane of the applicator. In some embodiments, applicators A1 and A2 extend circumferentially around patient P. In this disclosure, “approximately around” when applied to an applicator means that the applicator extends over angles ranging from 180 degrees to 360 degrees with respect to the left-right and top-down center points inside the applicator in the plane of the applicator.

[0129] For example, applicators A1 and A2 may be made from a thin conductive sheet (e.g., copper foil) formed to extend around the body of patient P.

[0130] When the output signal 22-2 of the power supply 25 is delivered to applicators A1 and A2, the fluctuating electric field between applicators A1 and A2 delivers energy to the tissue of patient P, where it is then dissipated.

[0131] In the apparatus 40, one or both of the applicators A1 and A2 overlap with the volume V containing the tissue to be treated. In another exemplary embodiment, the applicators A1 and A2 are arranged symmetrically with respect to the volume V containing the tissue to be treated. For example, applicator A1 may be positioned cranially with respect to the treatment volume V, and applicator A2 may be positioned caudally with respect to the treatment volume V.

[0132] In another exemplary embodiment, applicators A1 and / or A2 may be configured to form an open section of the ring. The applicators may be connected to terminals of the power supply 25. For example, one of the applicators may be grounded, and the other applicator may be connected to a terminal of the power supply 25 carrying signal 22-1 (e.g., a fluctuating voltage signal).

[0133] The techniques described herein may be further modified. For example, the devices 10 and 40 may be positioned vertically rather than horizontally so that the patient P stands or sits inside the coil 20 or inside the applicators A1 and A2. This eliminates the need for a table for the patient P to lie on, which may offer further advantages.

[0134] Further variations of the disclosed technology are also possible. For example, the coil 20 and / or applicators A1, A2 may be configured to open like a bivalve to receive patient P. The windings of the coil 20 or the applicators A1, A2 may be divided along the opening of the bivalve and may make electrical contact when the bivalve closes.

[0135] In some embodiments, the coil 20 is wound around the patient P when the patient P is lying down on the table, sitting, or standing.

[0136] In some embodiments, a shield is provided to shield a specific part of a patient from RF radiation. The shield may be provided by a shield made of, for example, a mesh, grid, or continuous sheet of conductive material. The shield is optionally transparent so that the shielded area can be seen.

[0137] In some embodiments, the entire apparatus, including patient P, is housed within a shielding structure such as a Faraday cage or any other enclosure made of conductive material. Such a structure can prevent high-frequency radiation from the apparatus from interfering with other systems. The shielding structure may be continuous or made of wire mesh. In some embodiments, the walls of the room in which the apparatus is located are either incorporated into or supported by appropriate RF shielding.

[0138] Some embodiments include means for locally cooling the patient P's skin (e.g., by a flow of air, water, or another liquid through a pouch placed in direct contact with the skin or in contact with the area to be cooled). Such cooling can help protect the patient P's skin and surface tissues from overheating, improve the patient P's comfort, and / or help remove heat from the patient P's blood.

[0139] In some embodiments, cooling is provided to an area of ​​patient P where significant blood circulation is present near the skin (e.g., the groin area). Figure 2 shows a fan 33 positioned to deliver a stream of cooling air to patient P. In some embodiments, patient P is supported on a cooled support (e.g., a platform or mat containing a passage for transporting cooled gas or liquid, or a mesh through which cooling gas may be delivered to remove heat from patient P's skin).

[0140] The signals described herein may be transmitted from their source to their destination by any suitable method. For example, control signals may be transmitted by conductors, optical conductors, wireless communication technology, etc. Power signals, such as the output signal 22-2 of power supply 25, may be transmitted to their destination by suitable conductors such as coaxial cables, wires, waveguides, inductive or capacitive coupling, or free-space transmission.

[0141] The controller 24 may be implemented by any suitable technology, including specially designed hardware, configurable hardware, a programmable data processor comprising software (which optionally includes "firmware") executable on a data processor, a dedicated computer, or a data processor specifically programmed, configured, or built to perform one or more stages of the methods described herein, and / or any combination of two or more of these. Examples of specially designed hardware include logic circuits, application-specific integrated circuits ("ASICs"), large-scale integrated circuits ("LSIs"), very large-scale integrated circuits ("VLSIs"). Examples of configurable hardware include one or more programmable logic devices, such as programmable array logic ("PALs"), programmable logic arrays ("PLAs"), field-programmable gate arrays ("FPGAs"), and configurable neural networks such as convolutional neural networks ("CNNs"). Examples of programmable data processors include microprocessors, digital signal processors ("DSPs"), embedded processors, graphics processors, numerical coprocessors, general-purpose computers, server computers, cloud computers, mainframe computers, and computer workstations. For example, one or more data processors in controller 24 may implement the method described herein by executing software instructions in program memory accessible from the processor. (Interpretation of Terms)

[0142] Unless the context clearly requires a different interpretation, throughout this specification and the claims - Words like "preparation" and "to prepare" should be interpreted in a comprehensive sense, as opposed to an exclusive or exhaustive sense; that is, they should be interpreted as "including but not limited to." - "Connected," "joined," or any variation thereof means any direct or indirect connection or joining between two or more elements, which may be physical, logical, or a combination thereof. - When used to describe this specification, the terms "in this specification," "above," "below," and similar terms refer to the entire specification and not to any specific part thereof. - When referring to a list of two or more items, "or" encompasses the following interpretations of this word: any of the items in this list, all of the items in this list, and any combination of the items in this list. - The singular forms "a," "an," and "the" also include the meaning of any appropriate plural form.

[0143] The terms indicating direction (if any) used in this specification and any appended claims, such as “vertical,” “transverse,” “horizontal,” “upward,” “downward,” “forward,” “backward,” “inward,” “outward,” “left,” “right,” “front,” “rear,” “upper,” “lower,” “down,” “up,” and “below,” depend on the specific orientation of the apparatus described and illustrated. The subject matter described herein may take on a variety of alternative orientations. Therefore, these terms relating to direction are not strictly defined and should not be interpreted narrowly.

[0144] Some aspects of the present invention may also be provided in the form of a program product. The program product may comprise any non-temporary medium that holds a set of computer-readable instructions that cause a data processor to perform the method of the present invention when executed by the data processor. For example, the program product may store computer-executable instructions that cause one or more control methods to be performed by the controller 24 when executed by one or more processors. The program product according to the present invention may be any of the many different forms. The program product may comprise, for example, a magnetic data storage medium including a floppy diskette, an optical data storage medium including a hard disk drive, a CD-ROM, a DVD, an electronic data storage medium including ROM, flash RAM, an EPROM, a chip embedded in hardware or pre-programmed (e.g., an EEPROM semiconductor chip), or a non-temporary medium such as nanotechnology memory. Computer-readable signals on the program product may optionally be compressed or encrypted.

[0145] Where components (e.g., coils, applicators, amplifiers, matching networks, power supplies, controllers, stands, assemblies, devices, circuits, etc.) are referred to above, unless otherwise indicated, references to those components (including references to “means”) should be interpreted as including any components that perform the function of the described components (i.e., are functionally equivalent), including components that are not structurally equivalent to the disclosed structures that perform the function of the illustrated exemplary embodiments of the present invention, as equivalents to those components.

[0146] For illustrative purposes, specific examples of systems, methods, and apparatus are described herein. These are merely examples. The technologies provided herein can be applied to systems other than the exemplary systems described above. Many changes, modifications, additions, omissions, and substitutions are possible within the implementation of the invention. The invention includes variations of the embodiments described which will be obvious to those skilled in the art. These variations include variations obtained by replacing features, elements, and / or actions with equivalent features, elements, and / or actions; mixing and integrating features, elements, and / or actions from different embodiments; combining features, elements, and / or actions from embodiments described herein with features, elements, and / or actions from other technologies; and / or combining features, elements, and / or actions from embodiments described herein with omissions.

[0147] For example, while various methods are presented as proceeding in a given sequence, alternative examples may proceed in a different sequence, or execute routines having stages in a different order, or use systems having blocks in a different order. Stages, actions, processes, or blocks may be deleted, moved, added, subdivided, combined, and / or modified to provide alternative forms or partial combinations. The described processes or blocks may be implemented in a variety of different ways. Also, when a process or block is sometimes shown as being executed sequentially, a particular process or block may instead be executed in parallel or at different points in time.

[0148] Various features are described herein as being present in “some embodiments.” Such features are not essential and may not be present in all embodiments. Embodiments of the present invention may not include such features, may include any one of such features, or may include any combination of two or more such features. All possible combinations of such features are contemplated in this disclosure, even if such features are shown in different drawings and / or described in different sections or paragraphs. This is limited only to the extent that a particular feature among such features is incompatible with other features of such feature, but it is not possible for a person skilled in the art to construct a practical embodiment combining such incompatible features. As a result, the statement that “some embodiments” have feature A and “some embodiments” have feature B should be interpreted as an explicit indication that the inventors also intend embodiments combining features A and B (unless otherwise stated or if features A and B are fundamentally incompatible).

[0149] Accordingly, the claims attached below and any claims introduced thereafter are intended to be interpreted as including all such modifications, substitutions, additions, omissions, and partial combinations that are reasonably foreseeable. The scope of the claims should not be limited by the preferred embodiments described in the examples, and the broadest interpretation that is consistent with the overall content should be given. (Other possible items) (Item 1) A device for treating emphysema or COPD by selectively heating the diseased lung tissue of a patient to a therapeutic temperature sufficient to produce a therapeutic effect in the diseased lung tissue, A signal applicator having a conductor sized to extend circumferentially around or substantially around the torso of the patient, A power supply connected to deliver a radio frequency (RF) signal to at least one applicator, wherein the power supply has an impedance matching network that can operate to match the output impedance of the power supply to the input impedance of the signal applicator, A controller operably associated with the power supply and configured to control the power supply so as to apply the RF signal to the applicator. Equipped with, The applicator is operable to couple an electromagnetic energy signal to the patient's tissue when energized by the RF signal, thereby heating the patient's tissue by the electromagnetic energy signal, and selectively heating the diseased tissue to a higher temperature than healthy tissue due to relatively low blood circulation to the diseased tissue. (Item 2) The apparatus according to item 1, comprising a temperature monitor operable to monitor temperature at one or more locations within the tissue of the patient, the controller connected to receive temperature signals from the temperature monitor indicating the temperature at the one or more locations, and the controller configured to apply feedback control to the power supply to adjust, at least partially, the electromagnetic energy signal delivered to the patient based on the temperature signals. (Item 3) The apparatus according to item 2 (or any other item herein), wherein the temperature monitor is a non-invasive temperature monitor. (Item 4) The apparatus according to item 2 (or any other item in this specification), wherein the temperature monitor comprises a magnetic resonance imaging (MRI) imaging system and a processor configured to process MRI signals provided by the MRI imaging system to determine the temperature corresponding to each of the one or more locations. (Item 5) The apparatus according to item 2 (or any other item in this specification), wherein the temperature monitor comprises an ultrasound imaging (US) system and a processor configured to process ultrasound signals provided by the US system to determine the temperature corresponding to each of the one or more locations. (Item 6) The apparatus according to any one of items 2 to 5 (or any other item of this specification), wherein the controller is configured to control one or more parameters of the RF signal until the temperature at the position is at least equal to the therapeutic temperature. (Item 7) The controller is a thermal model of at least a portion of the patient, and has a thermal model that correlates the temperature at one or more locations with the temperature at the target location. The apparatus according to any one of items 2 to 6 (or any other item in this specification), wherein the controller is configured to apply the thermal model using the temperature signal as an input and to adjust the heating energy based at least in part on the output of the thermal model. (Item 8) The apparatus according to item 7, wherein the thermal model includes one or more of the electrical and thermal properties of different tissue types of the patient, the distribution of the different tissue types of the patient, the shape of the one or more electromagnetic energy applicators, the resulting expected electromagnetic field distribution, and the perfusion flow rate of the patient. (Item 9) The apparatus according to any one of items 1 to 8 (or any other item herein), wherein the at least one signal applicator has a coil. (Item 10) The apparatus according to item 9, wherein the coil includes windings in the range of 5 to 100. (Item 11) The apparatus according to item 9, wherein the coil includes windings in the range of 10 to 60. (Item 12) The apparatus according to any one of items 9 to 11 (or any other item in this specification), wherein the windings of the coil are uniformly spaced apart by a pitch distance along the longitudinal axis of the coil. (Item 13) The apparatus according to any one of items 9 to 12 (or any other item in this specification), wherein the windings of the coil are unevenly spaced along the longitudinal axis of the coil. (Item 14) The apparatus according to any one of items 9 to 13 (or any other item in this specification), wherein the cross-section of the coil is not circular. (Item 15) The apparatus according to any one of items 9 to 14 (or any other item in this specification), wherein the spacing between the windings of the coil along the longitudinal axis of the coil is adjustable. (Item 16) The apparatus according to any one of items 9 to 15 (or any other item in this specification), wherein the cross-section of the coil is adjustable along the longitudinal axis of the coil. (Item 17) The apparatus according to any one of items 9 to 16 (or any other item herein) wherein the coil has a length of at least 70 centimeters. (Item 18) The apparatus according to any one of items 9 to 16 (or any other item in this specification), wherein the coil has a length of at least 1 meter. (Item 19) The apparatus according to any one of items 9 to 16 (or any other item in this specification), wherein the coil has an inner diameter of at least 30 cm. (Item 20) The apparatus according to any one of items 9 to 19 (or any other item in this specification), wherein the length of the coil is greater than or equal to the width of the coil. (Item 21) The apparatus according to any one of items 9 to 19 (or any other item in this specification), wherein the length of the coil is greater than or equal to four times the width of the coil. (Item 22) The apparatus according to any one of items 9 to 21 (or any other item in this specification), wherein the coil includes multilayer windings. (Item 23) The apparatus according to any one of items 9 to 22 (or any other item in this specification), wherein the coil is configured to open like a bivalve shell to insert the patient. (Item 24) A patient support configured to support the patient in a supine position, comprising a patient support having a head support located outside the coil, according to any one of items 9 to 23 (or any other item in this specification). (Item 25) The apparatus according to any one of items 1 to 24 (or any other item in this specification), wherein the RF signal has a frequency in the range of about 5 kHz to about 100 MHz. (Item 26) The apparatus according to any one of items 1 to 24 (or any other item in this specification), wherein the RF signal has a frequency in the range of about 500 kHz to about 10 MHz. (Item 27) The apparatus according to any one of items 1 to 26 (or any other item in this specification), wherein the controller is configured to set the frequency of the RF signal such that the maximum electric field value of the electromagnetic energy signal is at a desired position for the at least one applicator. (Item 28) The apparatus according to any one of items 1 to 27 (or any other item in this specification), wherein the controller is configured to set the frequency of the RF signal so as to generate a standing wave in the at least one applicator. (Item 29) The apparatus according to any one of items 1 to 28 (or any other item herein), wherein the controller is configured to set the frequency of the RF signal to generate a standing wave in at least one applicator, and the standing wave has a maximum electric field at a desired position. (Item 30) The apparatus according to any one of items 1 to 29 (or any other item in this specification), wherein the controller is configured to set the frequency of the RF signal to be or close to the resonant frequency between the applicator and the patient. (Item 31) The apparatus according to any one of items 1 to 29 (or any other item in this specification), wherein the controller is configured to set the frequency of the RF signal to an integer multiple of, or close to, the resonant frequency of the applicator when the patient is present. (Item 32) The apparatus according to any one of items 1 to 31 (or any other item in this specification), wherein the RF signal has a power of at least 500 watts, preferably in the range of about 500 watts to about 5 kilowatts. (Item 33) The apparatus according to any one of items 1 to 32 (or any other item in this specification), wherein the controller is configured to apply time-domain modulation to the RF signal. (Item 34) The apparatus according to any one of items 1 to 33 (or any other item in this specification), wherein the controller is configured to control the power supply so as to generate the RF signal as a pulsed signal and to control the pulse width in the pulsed signal. (Item 35) The apparatus according to any one of items 1 to 34 (or any other item in this specification), wherein the one or more signal applicators have two signal applicators connected to the power supply and capable of operating to deliver the electromagnetic energy signal to the patient's tissue. (Item 36) The apparatus according to item 30, wherein the two signal applicators include a first signal applicator positioned cranially to the volume to be treated and a second signal applicator positioned caudally to the volume to be treated. (Item 37) The apparatus according to item 36, wherein each of the two signal applicators is shaped to wrap around or partially wrap around the body of the patient. (Item 38) The apparatus according to item 36 or 37, wherein the signal applicator is adjustable to conform to the contours of the patient being treated. (Item 39) The apparatus according to any one of items 1 to 38, comprising a cooling means for cooling the patient. (Item 40) The apparatus according to item 39, wherein the cooling means has a source of the cooling fluid, which is arranged to bring the cooling fluid into thermal contact with an area of ​​the patient's skin. (Item 41) The apparatus according to item 40, wherein the cooling means has a patient support comprising a passage that is in thermal contact with a surface for supporting the patient, connected to transport the cooling fluid. (Item 42) The apparatus according to any one of items 39 to 41, wherein the cooling means is configured to cool the chest and back of the patient. (Item 43) The apparatus according to any one of items 39 to 42, wherein the cooling means is configured to cool the groin area of ​​the patient. (Item 44) The apparatus according to any one of items 39 to 42, wherein the cooling means has a source of cooled air. (Item 45) Use of any one of items 1 to 44 in the treatment of emphysema or COPD. (Item 46) A method for treating emphysema or COPD by selectively heating the diseased lung tissue of a patient to a therapeutic temperature sufficient to produce a therapeutic effect in the diseased lung tissue, The steps include providing at least one signal applicator having a conductor that extends circumferentially around or substantially around the torso of the patient, A step of delivering a radio frequency (RF) signal to at least one applicator, allowing the RF signal to be absorbed by both the healthier tissue and the diseased tissue of the patient's lung, thereby heating the tissue of the patient's lung, wherein the heating raises the temperature of the diseased tissue to a temperature above the therapeutic threshold temperature, while the temperature of the healthier tissue remains below a safety threshold temperature, which is lower than the therapeutic threshold temperature, due to blood circulation through the healthier tissue. A step of maintaining the temperature of the lesional tissue above the therapeutic threshold temperature for a cumulative time sufficient to provide a therapeutic effect. A method for providing this. (Item 47) The method according to item 46, wherein the RF signal has an output power of at least 500 watts. (Item 48) The method according to item 46 or 47, wherein the therapeutic effect is ablation of the lesional tissue. (Item 49) The method according to item 46 or 47, wherein the therapeutic effect is necrosis of the lesioned tissue. (Item 50) The method according to item 46 or 47, wherein the therapeutic effect is the induction of inflammation in the lesioned tissue. (Item 51) The method according to any one of items 46 to 50, wherein the RF signal generates a local axially extending alternating electric field or alternating magnetic field in the patient's lung. (Item 52) The method according to any one of items 46 to 51, wherein the at least one applicator has a coil and the patient's lung is inside the coil. (Item 53) The method according to item 52, wherein the RF signal generates a local alternating magnetic field extending in an axial direction substantially parallel to the vertical direction of the patient. (Item 54) The method according to item 53, wherein the intensity of the alternating magnetic field is substantially uniform within the coil. (Item 55) The method according to any one of items 46 to 52, wherein the at least one applicator has a pair of conductive members spaced apart along the torso of the patient. (Item 56) The method according to item 55, wherein the RF signal generates a local alternating electric field extending in an axial direction substantially parallel to the vertical direction of the patient. (Item 57) The method according to any one of items 46 to 56, comprising the steps of monitoring the temperature of tissue within the patient and controlling the RF signal based on the monitored temperature. (Item 58) The method according to item 57, wherein the step of controlling the RF signal includes the step of setting the frequency of the RF signal. (Item 59) The method of item 58, further comprising the step of setting the frequency of the RF signal so as to generate an electromagnetic standing wave in the patient. (Item 60) The method according to any one of items 57 to 59, wherein the step of controlling the RF signal includes a step of setting the amplitude of the RF signal. (Item 61) Apparatus comprising any novel and inventive feature, combination of features, or partial combination of features as described herein. (Item 62) A method comprising any novel and inventive step, act, combination of steps and / or acts, or partial combination of steps and / or acts as described herein.

Claims

1. A device for treating emphysema or COPD by selectively heating the diseased lung tissue of a patient to a therapeutic temperature sufficient to produce a therapeutic effect in the diseased lung tissue, wherein the device is A signal applicator having a conductor sized to extend circumferentially around or substantially around the torso of the patient, A power supply connected to deliver a radio frequency (RF) signal to at least one signal applicator, wherein the power supply has an impedance matching network that can operate to match the output impedance of the power supply to the input impedance of the signal applicator, A controller operably associated with the power supply and configured to control the power supply so as to apply the RF signal to the signal applicator. Equipped with, The signal applicator, when energized by the RF signal, is capable of coupling an electromagnetic energy signal into the patient's tissue, thereby heating the patient's tissue with the electromagnetic energy signal, and due to the relatively low blood circulation to the diseased lung tissue, the diseased lung tissue is selectively heated to a higher temperature than healthy tissue. Device.

2. The apparatus according to claim 1, wherein the apparatus comprises a temperature monitor capable of operating to monitor temperature at one or more locations within the tissue of the patient, the controller is connected to receive a temperature signal from the temperature monitor indicating the temperature at the one or more locations, and the controller is configured to apply feedback control to the power supply to adjust the electromagnetic energy signal delivered into the patient based at least in part on the temperature signal.

3. The apparatus according to claim 2, wherein the temperature monitor is a non-invasive temperature monitor.

4. The apparatus according to claim 2, wherein the temperature monitor comprises a magnetic resonance imaging (MRI) imaging system and a processor configured to process MRI signals provided by the MRI imaging system to determine the temperature corresponding to each of the one or more locations.

5. The apparatus according to claim 2, wherein the temperature monitor comprises an ultrasound (US) imaging system and a processor configured to process ultrasound signals provided by the US imaging system to determine the temperature corresponding to each of the one or more locations.

6. The apparatus according to any one of claims 2 to 5, wherein the controller is configured to control one or more parameters of the RF signal until the temperature at the position is at least equal to the treatment temperature.

7. The controller is a thermal model of at least a portion of the patient, and has a thermal model that correlates the temperature at one or more locations with the temperature at the target location. The apparatus according to any one of claims 2 to 6, wherein the controller is configured to apply the thermal model using the temperature signal as an input and to adjust the heating energy based at least in part on the output of the thermal model.

8. The apparatus according to claim 7, wherein the thermal model includes one or more of the electrical and thermal properties of different tissue types of the patient, the distribution of the different tissue types of the patient, the shape of one or more electromagnetic energy applicators, the resulting expected electromagnetic field distribution, and the perfusion flow rate of the patient.

9. The apparatus according to any one of claims 1 to 8, wherein the at least one signal applicator has a coil.

10. The apparatus according to claim 9, wherein the coil includes windings in the range of 5 to 100.

11. The apparatus according to claim 9, wherein the coil includes windings in the range of 10 to 60.

12. The apparatus according to any one of claims 9 to 11, wherein the windings of the coil are uniformly spaced apart by a pitch distance along the longitudinal axis of the coil.

13. The apparatus according to any one of claims 9 to 12, wherein the windings of the coil are unevenly spaced along the longitudinal axis of the coil.

14. The apparatus according to any one of claims 9 to 13, wherein the cross-section of the coil is not circular.

15. The apparatus according to any one of claims 9 to 14, wherein the spacing between windings of the coil along the longitudinal axis of the coil is adjustable.

16. The apparatus according to any one of claims 9 to 15, wherein the cross-section of the coil is adjustable along the longitudinal axis of the coil.

17. The apparatus according to any one of claims 9 to 16, wherein the coil has a length of at least 70 centimeters.

18. The apparatus according to any one of claims 9 to 16, wherein the coil has a length of at least 1 meter.

19. The apparatus according to any one of claims 9 to 16, wherein the coil has an inner diameter of at least 30 cm.

20. The apparatus according to any one of claims 9 to 19, wherein the length of the coil is greater than or equal to the width of the coil.

21. The apparatus according to any one of claims 9 to 19, wherein the length of the coil is greater than or equal to four times the width of the coil.

22. The apparatus according to any one of claims 9 to 21, wherein the coil includes a multilayer winding.

23. The apparatus according to any one of claims 9 to 22, wherein the coil is configured to open like a bivalve shell to allow the patient to be placed inside.

24. The apparatus according to any one of claims 9 to 23, comprising a patient support configured to support the patient in a supine position, the patient support having a head support located outside the coil.

25. The apparatus according to any one of claims 1 to 24, wherein the RF signal has a frequency in the range of about 5 kHz to about 100 MHz.

26. The apparatus according to any one of claims 1 to 24, wherein the RF signal has a frequency in the range of about 500 kHz to about 10 MHz.

27. The apparatus according to any one of claims 1 to 26, wherein the controller is configured to set the frequency of the RF signal such that the maximum electric field value of the electromagnetic energy signal is at a desired position for the at least one signal applicator.

28. The apparatus according to any one of claims 1 to 27, wherein the controller is configured to set the frequency of the RF signal so as to generate a standing wave in the at least one signal applicator.

29. The apparatus according to any one of claims 1 to 28, wherein the controller is configured to set the frequency of the RF signal so as to generate a standing wave in the at least one signal applicator, and the standing wave has a maximum electric field at a desired position.

30. The apparatus according to any one of claims 1 to 29, wherein the controller is configured to set the frequency of the RF signal to be the same as, or close to, the resonant frequency between the signal applicator and the patient.

31. The apparatus according to any one of claims 1 to 29, wherein the controller is configured to set the frequency of the RF signal to an integer multiple of, or close to, the resonant frequency of the signal applicator when the patient is present.

32. The apparatus according to any one of claims 1 to 31, wherein the RF signal has a power of at least 500 watts, preferably in the range of about 500 watts to about 5 kilowatts.

33. The apparatus according to any one of claims 1 to 32, wherein the controller is configured to apply time-domain modulation to the RF signal.

34. The apparatus according to any one of claims 1 to 33, wherein the controller is configured to control the power supply so as to generate the RF signal as a pulsed signal and to control the pulse width in the pulsed signal.

35. The apparatus according to any one of claims 1 to 34, wherein the one or more signal applicators have two signal applicators connected to the power supply and capable of operating to deliver the electromagnetic energy signal into the patient's tissue.

36. The apparatus according to claim 30, wherein the apparatus comprises two signal applicators, the first signal applicator positioned cranially from the volume to be treated, and the second signal applicator positioned caudally from the volume to be treated.

37. The apparatus according to claim 36, wherein each of the two signal applicators is shaped to wrap around or partially wrap around the patient's torso.

38. The apparatus according to claim 36 or 37, wherein the signal applicator is adjustable to conform to the contours of the patient being treated.

39. The apparatus according to any one of claims 1 to 38, further comprising a cooling means for cooling the patient.

40. The apparatus according to claim 39, wherein the cooling means has a source of the cooling fluid, which is arranged to bring the cooling fluid into thermal contact with an area of ​​the patient's skin.

41. The apparatus according to claim 40, wherein the cooling means includes a patient support comprising a passage that is in thermal contact with a surface for supporting the patient and is connected to transport the cooling fluid.

42. The apparatus according to any one of claims 39 to 41, wherein the cooling means is configured to cool the chest and back of the patient.

43. The apparatus according to any one of claims 39 to 42, wherein the cooling means is configured to cool the inguinal region of the patient.

44. The apparatus according to any one of claims 39 to 42, wherein the cooling means has a source of cooled air.

45. Use of the apparatus according to any one of claims 1 to 44.

46. A method for operating a device for treating emphysema or COPD by selectively heating the diseased lung tissue of a patient to a therapeutic temperature sufficient to produce a therapeutic effect in the diseased lung tissue, The steps include providing at least one signal applicator for the apparatus having a conductor extending circumferentially around or substantially around the torso of the patient, A step of delivering a radio frequency (RF) signal to at least one signal applicator, enabling the RF signal to be absorbed by both the healthier tissue and the diseased tissue of the patient's lung, thereby heating the tissue of the patient's lung, wherein the heating raises the temperature of the diseased tissue to a temperature above the therapeutic threshold temperature, while the temperature of the healthier tissue remains below a safety threshold temperature, which is lower than the therapeutic threshold temperature, due to blood circulation through the healthier tissue. A step of maintaining the temperature of the lesional tissue above the therapeutic threshold temperature for a cumulative time sufficient to provide a therapeutic effect. A method for providing this.

47. The method according to claim 46, wherein the RF signal has an output power of at least 500 watts.

48. The method according to claim 46 or 47, wherein the therapeutic effect is ablation of the lesional tissue.

49. The method according to claim 46 or 47, wherein the therapeutic effect is necrosis of the lesioned tissue.

50. The method according to claim 46 or 47, wherein the therapeutic effect is the induction of inflammation in the lesioned tissue.

51. The method according to any one of claims 46 to 50, wherein the RF signal generates a local axially extending alternating electric field or alternating magnetic field in the patient's lung.

52. The method according to any one of claims 46 to 51, wherein the at least one signal applicator includes a coil and the patient's lung is located within the coil.

53. The method according to claim 52, wherein the RF signal generates a local alternating magnetic field extending in an axial direction substantially parallel to the vertical direction of the patient.

54. The method according to claim 53, wherein the intensity of the alternating magnetic field is substantially uniform within the coil.

55. The method according to any one of claims 46 to 52, wherein the at least one signal applicator includes a pair of conductive members spaced apart along the torso of the patient.

56. The method according to claim 55, wherein the RF signal generates a local alternating electric field extending in an axial direction substantially parallel to the vertical direction of the patient.

57. The method according to any one of claims 46 to 56, comprising the steps of monitoring the temperature of tissue within the patient and controlling the RF signal based on the monitored temperature.

58. The method according to claim 57, wherein the step of controlling the RF signal includes the step of setting the frequency of the RF signal.

59. The method according to claim 58, further comprising the step of setting the frequency of the RF signal so as to generate an electromagnetic standing wave in the patient.

60. The method according to any one of claims 57 to 59, wherein the step of controlling the RF signal includes the step of setting the amplitude of the RF signal.

61. Apparatus comprising any novel and inventive feature, combination of features, or partial combination of features as described herein.

62. A method comprising any novel and inventive step, act, combination of steps and / or acts, or partial combination of steps and / or acts as described herein.

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