DE19506363A1 - Non-invasive thermometry in organs under hyperthermia and coagulation conditions - Google Patents

Non-invasive thermometry in organs under hyperthermia and coagulation conditions

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Publication number
DE19506363A1
DE19506363A1 DE19506363A DE19506363A DE19506363A1 DE 19506363 A1 DE19506363 A1 DE 19506363A1 DE 19506363 A DE19506363 A DE 19506363A DE 19506363 A DE19506363 A DE 19506363A DE 19506363 A1 DE19506363 A1 DE 19506363A1
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procedure
organs
coagulation conditions
coagulation
ultrasonic
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DE19506363A
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Inventor
Dietrich Prof Dr Frost
Klaus Dieter Prof Dr Kramer
Bernhard Dr Kleffner
Klaus Thomas Dr Bende
Benedikt Prof Dr Jean
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BENDE, THOMAS, DR.HABIL., 72116 MOESSINGEN, DE JEA
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BENDE THOMAS DR HABIL
FROST LORE GEB HAUPT
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/008Methods or devices for eye surgery using laser
    • A61F9/00821Methods or devices for eye surgery using laser for coagulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/008Methods or devices for eye surgery using laser
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00Ultrasound therapy
    • A61N7/02Localised ultrasound hyperthermia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00084Temperature
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/008Methods or devices for eye surgery using laser
    • A61F2009/00844Feedback systems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/008Methods or devices for eye surgery using laser
    • A61F2009/00853Laser thermal keratoplasty or radial keratotomy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/008Methods or devices for eye surgery using laser
    • A61F2009/00861Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/00863Retina
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/008Methods or devices for eye surgery using laser
    • A61F2009/00861Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/00868Ciliary muscles or trabecular meshwork
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/008Methods or devices for eye surgery using laser
    • A61F2009/00885Methods or devices for eye surgery using laser for treating a particular disease
    • A61F2009/00891Glaucoma

Abstract

The ultrasonic reflectometry is used for monitoring or controlling thermally induced, biological effects. Also using ultrasonic reflectometry with laser radiation, temp. gradients, coagulated or denatured vols. are determined also are used for therapy control or for control of the laser. The medical method of the diagnostic ultrasonic A-scan is used, yet these specific electronic detector units are replaced or supplemented by an integrator technology, e.g. according to the box car principle. The specific detector units are supplemented by a synchronising unit for identifying the patient movements.

Description

Die gezielte Überwärmung begrenzter Gewebevolumina wird als nichtchirurgische Zusatztherapie zur Unterstützung der Chemo- und Radiotherapie eingesetzt. Darüberhinaus finden laserinduzierte Koagulationsprozesse in der Onkologie (bspw. endoskopische Chirurgie in der Gastroenterologie und minimalinvasiven Chirurgie) sowie der Ophthalmologie (bspw. Glaukombehandlung) ihre Anwendung. Die klinische Durchsetzbarkeit dieser Therapieformen ist mit der Verfügbarkeit eines Verfahrens zu deren Kontrolle eng verknüpft.The targeted overheating of limited tissue volumes is called non-surgical additional therapy to support the chemo- and Radiotherapy used. In addition, find laser-induced Coagulation processes in oncology (e.g. endoscopic Surgery in gastroenterology and minimally invasive surgery) and ophthalmology (e.g. glaucoma treatment) their application. The clinical feasibility of these forms of therapy is with the Availability of a process for their control closely linked.

Unter Hyperthermie versteht man die Überwärmung eines im Körper­ inneren gelegenen Volumens durch Einstrahlung von hochfrequenten Feldern von außen. Als Signifikanzgröße dient die Temperatur­ erhöhung im Zielvolumen gegenüber der physiologischen Körper­ temperatur des Gesamtorganismus. Nach dem gegenwärtig geübten Stand der medizinischen Anwendung werden nadelartige Sonden mit einem temperaturempfindlichen Halbleiterelement an ihrer Spitze in den Patienten eingestochen und bis zum Zielvolumen vorgeschoben
Es sind Versuche unternommen worden, die erreichte Überwärmung nicht-invasiv nachzuweisen (bspw. Messung der NMR-Relaxations­ zeiten der Protonen des Zielvolumens, aktive und passive Mikro­ wellentomografie; einen Überblick bietet [I]). Aufgrund der teilweise sich widersprechenden Anforderungen (im wesentlichen: ausreichende Nachweistiefe und -empfindlichkeit, Darstellung der Kontrollparameter in Echtzeit, Kompensation von Störeinflüssen, verursacht durch Patientenbewegungen sowie die Kompatibilität mit dem Hyperthermiesystem) ist bis heute noch kein handhabbares und universell einsetzbares Kontrollsystem bekannt geworden. Es sind auch Versuche publiziert worden, die Änderung der Schallgeschwin­ digkeit bei Einstrahlung von Ultraschall als Signifikanzgröße zur Temperaturbestimmung heranzuziehen [II]. Da sich aber die Schall­ geschwindigkeit in Abhängigkeit von der Temperatur des biologi­ schen Materials nur sehr gering und monoton ändert, hat sich daraus kein technisches Meßverfahren ableiten lassen.
Hyperthermia is the overheating of a volume inside the body through the radiation of high-frequency fields from the outside. The increase in temperature in the target volume compared to the physiological body temperature of the whole organism serves as a significant parameter. According to the currently practiced state of medical application, needle-like probes with a temperature-sensitive semiconductor element at their tip are inserted into the patient and advanced to the target volume
Attempts have been made to detect the overheating achieved non-invasively (e.g. measurement of the NMR relaxation times of the protons of the target volume, active and passive microwell tomography; an overview offers [I]). Due to the partially contradicting requirements (essentially: sufficient detection depth and sensitivity, display of the control parameters in real time, compensation of interference caused by patient movements and compatibility with the hyperthermia system), no manageable and universally applicable control system has become known to date. Attempts have also been published to use the change in the speed of sound when ultrasound is irradiated as a significant parameter for temperature determination [II]. However, since the speed of sound changes only very slightly and monotonously as a function of the temperature of the biological material, no technical measurement method can be derived from this.

Erfindungsgemäße LösungSolution according to the invention

Die Erfindung geht von dem Grundgedanken aus, daß an der Grenz­ fläche zwischen biologisch - physiologischem Gewebe und erwärmtem Volumen eine Ultraschallreflexion auftritt. Der Amplituden­ reflexionsfaktor ist als Signal meßtechnisch erfaßbar. Größe und Änderung des Signals im Nachweispfad hängen eindeutig von der Temperaturdifferenz und deren zeitliche Änderung während der Überwärmung ab. Im Bereich der beginnenden irreversiblen Änderung des biologischen Zielvolumens gestattet das erfindungsgemäße Verfahren ein Temperaturauflösungsvermögen von ΔT 0.25 grd. Das Verfahren nach der Erfindung benutzt als Nachweis die Methode des A-Scans diagnostischer Ultraschallgeräte, jedoch wird zur Sicherstellung der geforderten strengen Linearität der Reflexions- Signalamplitude die Ultraschall-Hochfrequenz direkt abgegriffen, von der eingestrahlten Hyperthermie-Hochfrequenz gesäubert und durch eine Elektronik nach dem Prinzip des Box Car-Integrators verarbeitet und dargestellt.The invention is based on the basic idea that at the border area between biological - physiological tissue and heated Volume of ultrasound reflection occurs. The amplitudes The reflection factor can be measured as a signal. Size and Changes in the signal in the detection path clearly depend on the Temperature difference and its change over time during the Overheating. In the area of the beginning irreversible change of the biological target volume allows the invention Process a temperature resolution of ΔT 0.25 grd. The The method according to the invention uses the method of detection as evidence A scans of diagnostic ultrasound equipment, however, becomes Ensuring the required strict linearity of the reflection Signal amplitude directly picked up the ultrasonic radio frequency, cleaned of the irradiated hyperthermia high frequency and through electronics based on the principle of the box car integrator processed and presented.

Um eine quantitative Auswertung auch unter dem Einfluß von Patientenbewegungen zu ermöglichen, darf der Triggerzeitpunkt für die die Darstellung regierenden Größen wie Verzögerungszeit und Fensterbreite nicht am Sendesignal festgemacht, sondern muß am interessierenden Echo selbst verankert werden. Eine Synchronisier­ einheit verschafft sich aus Flankenwert und -steigung des n-ten Echos den Triggerzeitpunkt des darauffolgenden Echos. Die Eindeu­ tigkeit des Triggerzeitpunktes wird durch eine Komparatorschaltung sichergestellt.For a quantitative evaluation also under the influence of To enable patient movement, the trigger time for the governing variables such as delay time and Window width is not fixed to the transmission signal, but must be on of interest to the echo itself. A synchronizer unity is obtained from the flank value and slope of the nth Echoes the trigger time of the subsequent echo. The Eindeu The trigger time is determined by a comparator circuit ensured.

Alle Komponenten der Synchronisiereinheit sind analog aufgebaut, wodurch diese zentrale Steuereinheit wie das gesamte Nachweis­ systems in Echtzeit arbeitet. All components of the synchronization unit are constructed analogously, making this central control unit like the whole proof systems works in real time.  

Weitere AnwendungenMore applications

Unter medizinischen Hyperthermiebedingungen sind auch diejenigen therapeutischen Verfahren zusammenzufassen, denen Koagulations­ prozesse zugrunde liegen. Die Kongruenz der Anforderungen an ein Kontroll- oder Steuerungssystem bei diesen Behandlungsformen resultiert daraus, daß auch hier Therapierisiko und -wirkung nach den erzeugten Temperaturgradienten sowie der räumlichen Ausdehnung der erzeugten Herde zu bewerten ist. Zur on line-Messung und geeigneten Darstellung dieser beiden Kriterien am Patienten sind alle Komponenten des erfindungsgemäßen Verfahrens notwendig, wobei die Ultraschall-Arbeitsfrequenz der jeweiligen Aufgabenstellung anzupassen ist.Medical hyperthermia conditions include those to summarize therapeutic procedures involving coagulation underlying processes. The congruence of the requirements for a Control system for these types of treatment results from the fact that here too the therapy risk and effect the generated temperature gradient and the spatial expansion the herd produced is to be assessed. For online measurement and appropriate presentation of these two criteria to the patient all components of the method according to the invention are necessary, wherein the ultrasound working frequency of the respective task is to be adjusted.

In der endoskopischen und minimal-invasiven Chirurgie werden Laser- und Plasmasysteme zur Koagulation maligner Gewebevolumina eingesetzt. Mit der Festlegung des koagulierten Volumens ist die Frage der örtlichen Abtötung des Tumors sowie die Frage möglicher Tumorabsiedelungen eng verknüpft. Da weder tatsächlich erreichte Temperaturen noch tatsächlich erreichte Eindringtiefen sicher nachweisbar sind, sind beide Verfahren zur curativen Behandlung (bspw. in der gastroenterologischen Chirurgie und der Gynäkologie) bislang nicht anwendbar.In endoscopic and minimally invasive surgery Laser and plasma systems for the coagulation of malignant tissue volumes used. With the determination of the coagulated volume, the Question of local killing of the tumor as well as the question of possible Tumor settlements closely linked. Since neither actually reached Temperatures still reached penetration depths safely are demonstrable, both methods are used for curative treatment (e.g. in gastroenterological surgery and gynecology) not yet applicable.

Durch Einsatz des erfindungsgemäßen Thermometrieverfahrens hat der Laserchirurg die Möglichkeit, Temperaturgradienten und koagulierte Volumenbereiche on line zu überwachen. Daraus resultieren ganz erhebliche Fortschritte für die Therapie kleiner Tumoren im Hinblick auf ambulante Operationsmöglichkeiten ohne ausräumende Exzision und eine Verbreiterung des Anwendungsspektrums.By using the thermometry method according to the invention Laser surgeon the possibility of temperature gradients and coagulated Monitor volume ranges online. This results entirely considerable progress for the therapy of small tumors in the Regarding outpatient surgery options without clearing out Excision and a broadening of the range of applications.

In der Ophthalmologie wird die Laserkoagulation u. a. bei der Glaukombehandlung (transskerale Cyclophotokoagulation TSCPC) und zu Fehlsichtigkeitskorrekturen (Thermokeratoplastik) eingesetzt. Alleiniger Steuerparameter während der TSCPC sind bislang bei vorgewählter Laserleistung die vorab geschätzte Bestrahlungsdauer. Darüberhinaus kann nicht beurteilt werden ob der Ziliarkörper oder angrenzende Strukturen getroffen werden. Die Effektivität dieses Eingriffs wird durch die Therapiekontrolle mit dem on line- Thermometrieverfahren deutlich verbessert. In ophthalmology, laser coagulation is used. a. in the Glaucoma treatment (transsceral cyclophotocoagulation TSCPC) and used to correct ametropia (thermokeratoplasty). The only control parameters during the TSCPC are so far preselected laser power the previously estimated irradiation time. Furthermore, it cannot be assessed whether the ciliary body or adjacent structures are hit. The effectiveness of this Intervention is controlled by the therapy with the on-line Thermometry significantly improved.  

Aufstellung der verwendeten Bezugszeichen und BegriffeList of the reference symbols and terms used

Bild 1 : Ausführungsbeispiel Therapiekontrolle
1 Zielvolumen
2 Laser, laserübertragender Wellenleiter oder (hochfrequenzübertragende Dipolanordnung)
3 Ein oder mehrere Schallwandler
4 Akustischer Nachweispfad
Figure 1: Example of therapy control
1 target volume
2 lasers, laser-transmitting waveguide or (high-frequency transmitting dipole arrangement)
3 One or more transducers
4 Acoustic detection path

Literaturliterature

I) M. GAUTHERIE (Hrsg.)
Methods of Hyperthermia Control Springer Berlin Heidelberg (1990)
II) R.L. NASONI, T. BOWEN
Ultrasonic Speed as a Parameter for Non-Invasive Thermometry In: MIZUSHINA (Hrsg.): Non-Invasive Temperature Measurement Gordon & Breach Publishers 1 (1989), 101-107.
I) M. GAUTHERIE (ed.)
Methods of Hyperthermia Control Springer Berlin Heidelberg (1990)
II) RL NASONI, T. BOWEN
Ultrasonic Speed as a Parameter for Non-Invasive Thermometry In: MIZUSHINA (ed.): Non-Invasive Temperature Measurement Gordon & Breach Publishers 1 (1989), 101-107.

Claims (10)

1. Verfahren zur nicht-invasiven Thermometrie in Organen unter medizinischen Hyperthermie- und Koagulationsbedingungen, dadurch gekennzeichnet, daß die an der Grenzfläche des überwärmten Gewebes auftretenden Ultraschall-Reflexionssignale zur Tiefenmessung, Identifikation des Zielvolumens und Temperaturbestimmung herangezogen werden.1. A method for non-invasive thermometry in organs under medical hyperthermia and coagulation conditions, characterized in that the ultrasonic reflection signals occurring at the interface of the overheated tissue are used for depth measurement, identification of the target volume and temperature determination. 2. Verfahren zur nicht-invasiven Thermometrie in Organen unter medizinischen Hyperthermie- und Koagulationsbedingungen nach Anspruch 1), dadurch gekennzeichnet, daß die Ultraschall- Reflektometrie zur Überwachung oder Steuerung thermisch induzierter, biologischer Effekte benutzt wird.2. Procedure for non-invasive thermometry in organs under medical hyperthermia and coagulation conditions Claim 1), characterized in that the ultrasonic Reflectometry for monitoring or control thermally induced biological effects is used. 3. Verfahren zur nicht-invasiven Thermometrie in Organen unter medizinischen Hyperthermie- und Koagulationsbedingungen nach Anspruch 1-2), dadurch gekennzeichnet, daß mittels Ultraschall- Reflektometrie bei Lasereinstrahlung Temperaturgradienten, koaguliertes- oder denaturiertes Volumen ermittelt und zur Therapiekontrolle oder Steuerung des Lasers verwendet werden.3. Procedure for taking non-invasive thermometry in organs medical hyperthermia and coagulation conditions Claims 1-2), characterized in that by means of ultrasound Reflectometry with laser radiation temperature gradients, coagulated or denatured volume determined and Therapy control or control of the laser can be used. 4. Verfahren zur nicht-invasiven Thermometrie in Organen unter medizinischen Hyperthermie- und Koagulationsbedingungen nach Ansprüchen 1-3), dadurch gekennzeichnet, daß die medizinische Methode des diagnostischen Ultraschall-A-Scans verwendet wird, jedoch die diesen Geräten spezifische Nachweiselektronik durch eine Integratortechnik (z. B. nach dem Box Car-Prinzip) ersetzt oder ergänzt wird.4. Procedure for taking non-invasive thermometry in organs medical hyperthermia and coagulation conditions Claims 1-3), characterized in that the medical Method of diagnostic ultrasound A scan is used however, the detection electronics specific to these devices an integrator technology (e.g. based on the box car principle) replaced or is supplemented. 5. Verfahren zur nicht-invasiven Thermometrie in Organen unter medizinischen Hyperthermie- und Koagulationsbedingungen nach Ansprüchen 1-4), dadurch gekennzeichnet, daß die den diagnosti­ schen Ultraschallgeräten spezifische Nachweiselektronik durch eine Synchronisiereinheit zur Ausmittelung von Patientenbewegungen ergänzt wird. 5. Procedure for taking non-invasive thermometry in organs medical hyperthermia and coagulation conditions Claims 1-4), characterized in that the diagnostic ultrasound equipment specific detection electronics by a Synchronization unit for averaging patient movements is added.   6. Verfahren zur nicht-invasiven Thermometrie in Organen unter medizinischen Hyperthermie- und Koagulationsbedingungen nach Ansprüchen 1-5), dadurch gekennzeichnet, daß ein nach dem Verfahren des Ultraschall-Compoundscan oder Ultraschall-B-Scan arbeitendes Diagnosegerät so modifiziert wird, daß eine zweidimensionale Darstellung der signifikanten, temperatur­ zugeordneten Flächenumrandungen erreicht wird.6. Procedure for non-invasive thermometry in organs under medical hyperthermia and coagulation conditions Claims 1-5), characterized in that one after Ultrasonic compound scan or ultrasonic B-scan working diagnostic device is modified so that a two-dimensional representation of the significant, temperature assigned area boundaries is reached. 7. Verfahren zur nicht-invasiven Thermometrie in Organen unter medizinischen Hyperthermie- und Koagulationsbedingungen nach Ansprüchen 1-6), dadurch gekennzeichnet, daß ein nach dem Verfahren des diagnostischen Ultraschall-B-Scans arbeitendes Gerät so modifiziert wird, daß eine farbcodierte oder räumliche Darstellung der signifikanten temperaturzugeordneten oder zur Therapiekontrolle geeigneten Meßgrößen erreicht wird.7. Procedure for non-invasive thermometry in organs under medical hyperthermia and coagulation conditions Claims 1-6), characterized in that one after the Diagnostic ultrasound B-scan process in progress Device is modified so that a color-coded or spatial Representation of the significant temperature assigned or Therapy control suitable measurands is achieved. 8. Verfahren zur nicht-invasiven Thermometrie in Organen unter medizinischen Hyperthermie- und Koagulationsbedingungen nach Ansprüchen 1-7), dadurch gekennzeichnet, daß die Ultraschall- Reflektometrie zur Therapiekontrolle oder zur Therapiesteuerung von Laserkoagulationen in der Augenheilkunde benutzt wird (z. B. Thermokeratoplastik, Koagulation der Netzhaut, Trabeculoplastik, Cyclophotokoagulation oder Cyclokryokoagulation) sowie in Kombination mit anderen koagulativen Prozessen verwendet wird.8. Procedure for non-invasive thermometry in organs under medical hyperthermia and coagulation conditions Claims 1-7), characterized in that the ultrasonic Reflectometry for therapy control or for therapy control used by laser coagulation in ophthalmology (e.g. Thermokeratoplasty, retinal coagulation, trabeculoplasty, Cyclophotocoagulation or Cyclocryocoagulation) and in Combination with other coagulative processes is used. 9. Verfahren zur nicht-invasiven Thermometrie in Organen unter medizinischen Hyperthermie- und Koagulationsbedingungen nach Ansprüchen 1-8), dadurch gekennzeichnet, daß die Ultraschall- Reflektometrie zur Kontrolle der autolytischen Denaturierung (z. B. Viabilitätstest) herangezogen wird.9. Procedure for non-invasive thermometry in organs under medical hyperthermia and coagulation conditions Claims 1-8), characterized in that the ultrasonic Reflectometry to control autolytic denaturation (e.g. Viability test) is used. 10. Verfahren zur nicht-invasiven Thermometrie in Organen unter medizinischen Hyperthermie- und Koagulationsbedingungen nach Ansprüchen 1-9), dadurch gekennzeichnet, daß aus der Ultraschall-Reflektometrie im Hinblick auf Temperatur und Ausdehnungsgrößen ermittelt werden, welche eine Lasereinstrahlung rückgekoppelt beeinflussen und den Vorgang teilautomatisieren.10. Method of taking non-invasive thermometry in organs medical hyperthermia and coagulation conditions Claims 1-9), characterized in that from the Ultrasound reflectometry in terms of temperature and Expansion quantities are determined which are laser radiation influence feedback and partially automate the process.
DE19506363A 1995-02-24 1995-02-24 Non-invasive thermometry in organs under hyperthermia and coagulation conditions Ceased DE19506363A1 (en)

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