US 20050159636 A1
A semi-automatic brachytherapy loading assembly is disclosed that includes a setting group for positioning at least one of any isotope seed and a spacer, a loading group operatively engaging the setting group for depositing the least one of an isotope seed and a spacer, a viewing member for visualizing the at least one of an isotope seed and a spacer, and a seed receiving device holding group positioned to pass the at least one of an isotope seed and a spacer to a seed receiving device.
1. A brachytherapy loading assembly, constructed and arranged to help load seed receiving devices, comprising:
a brachytherapy loading device having a seed receiving device fitting at a distal location where implantable seeds can be loaded into a seed receiving device positioned at the seed receiving device fitting, the brachytherapy loading device comprising a seed receiving conduit constructed to receive seeds and other implantation materials in a line, prior to loading into seed receiving device;
the brachytherapy loading device also including a push rod that is slidable within the seed receiving conduit; and
a stop block member constructed and arranged to selectively limit motion of the push rod within the conduit, so that when the stop block is in a first position, the push rod can extend far enough to push the seeds down the conduit but not far enough to reach the seed receiving device fitting, and when the stop block is in a second position, the stop block permits the push rod to extend to the seed receiving device fitting to eject seeds from the conduit to a seed receiving device mounted at the fitting.
2. The assembly of
3. The assembly of
4. The assembly of
5. A brachytherapy loading assembly, comprising:
a seed holder having a seed guide path in which a seed can be received and travel between a proximal and a distal direction;
a loading block positioned in the guide path conduit;
at least a first and a second cartridge mounted on the loading block, the loading block disposable between at least a first and a second position, wherein material from the first cartridge is in the guide path when the loading block is in the first position and material from the second cartridge is in the guide path when the loading block is in the second position.
6. The assembly of
7. The assembly of
8. The assembly of
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11. The assembly of
12. A brachytherapy loading assembly, comprising:
a seed guide path having a groove at the distal end formed in a guide member thereof, sized to discharge brachytherapy seeds into a seed receiving device at the distal end thereof;
a viewing member comprising a visualization plate over a distal section of the guide path groove, sufficiently transparent to permit viewing the seeds in the order in which they will be loaded out the distal end.
13. The assembly of
14. The assembly of
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This application claims the benefit under § 119(e) of Provisional Patent Application Ser. No. 60/309,720, filed on Aug. 2, 2001 the contents of which are incorporated herein by reference, and is a continuation under 35 U.S.C. § 120 of pending U.S. patent application Ser. No. 10/161,239, filed on May 31, 2002, the contents of which is incorporated herein by reference.
Brachytherapy is a form of cancer treatment in which a radioactive energy source is placed into or adjacent to a malignant tumor. Generally, brachytherapy can be divided into two categories: high dose rate (HDR); and low dose rate (LDR). In HDR brachytherapy, a radioactive energy source with high activity is placed into or adjacent to the malignant tumor for a predefined period of time. Conversely, LDR brachytherapy entails the placement of a low activity radioactive energy source into or adjacent to the malignant tumor for an indeterminate period of time.
In LDR brachytherapy, radioactive isotopes are used as the radioactive energy sources. Some of the more common radioactive isotopes used in LDR brachytherapy include Iodine-125, Palladium-103, Gold-198, Ytterbium-169, and Iridium-192. These isotopes are typically packaged in a housing constructed of a lightweight and durable material, such as titanium, and are commonly referred to as isotope seeds. The dimensions of the isotope seeds can be extremely variable both in diameter and in length. The radioactive isotopes commonly used in LDR brachytherapy are selected for their low energy and relatively short half-life. Low energy sources provide for a limited tissue penetration by the emitted radiation, so that the radiation's effects are limited to the tumor without substantially affecting adjacent normal tissue. A short half-life is advantageous in that the dose of radiation that is delivered depletes in a reasonably short period of time.
The area of therapeutic effect for Iodine-125 and Palladium-103 is limited to a sphere approximately 1 cm in diameter around the isotope seed. As a result, a three-dimensional array of isotope seeds is commonly used to treat a tumor. In LDR brachytherapy of prostate cancer, a multitude of isotope seeds is typically used. Since solid tumors, like those found in prostate cancer, are perceived to be diffuse, the entire organ is targeted for therapy.
In order to place isotope seeds into the aforementioned three-dimensional array, needles, using a two-dimensional grid pattern in conjunction with longitudinal spacing, can deliver isotope seeds. The two dimensional grid is frequently defined by a needle guide, called a template. The template is provided with a plurality of holes that provide guidance for the longitudinal progression of the needles, thus insuring their desired two-dimensional position within the tumor. After the two-dimensional needle array is positioned within the tumor, the isotope seeds are deposited along the longitudinal axis of each needle.
Proper spacing of the isotope seeds along the longitudinal axis of the needle is accomplished through the use of biocompatible spacers further deposited between the isotope seeds. The use of spacers also serves to maintain the low energy effect on the prostate by maintaining a distance between the isotope seeds. The spacers and isotope seeds are alternately loaded into the needle prior to placement of the needle into the tumor. Upon placing the needle into the tumor, a cannula is engaged to maintain the position of the line of isotope seeds and spacers as the needle is withdrawn. This yields a line of isotope seeds in their proper longitudinal position. This process is repeated at the other two-dimensional grid coordinates, thus forming the desired three-dimensional array of isotope seeds.
An improved version of this procedure, as disclosed in U.S. Pat. No. 6,213,932, includes transparent plastic seed cartridges, detachably connected to the applicator, for holding a plurality of radioactive isotope seeds. This version enabled a surgeon to visually ascertain the number of spacers within a cartridge, thereby eliminating the guesswork previously involved in determining the number of remaining isotope seeds, greatly reducing the time required to load a needle.
A device that includes a cartridge having a plurality of individual isotope seeds, known as the Mick™ applicator system, registered to Mick Radio-Nuclear Instruments, Inc., is currently in widespread use. The cartridge retains a large number of individual isotope seeds that have been loaded therein at a separate facility. Additionally, isotope seeds can also be loaded into the cartridge at the hospital or at a nuclear pharmacy, thereby eliminating the time and cost requirements of loading individual isotope seeds in an operating room.
In the prior art, a seed-containing cartridge is attached to an applicator in a manner substantially similar to the way a magazine is attached to a firearm. The cartridge is spring-loaded to force one isotope seed at a time into a seed discharge chamber that further retains a single isotope seed for insertion into a needle. A special hollow needle is connected to the needle holder of a distal end of the applicator. A push rod is inserted into a distal end of the applicator and pushed directionally in a proximal-to-distal direction. The distal end of the push rod engages an isotope seed in the seed discharge chamber and drives the isotope seed into the hollow interior of the special needle and then out of the distal end of the needle into the prostate. The surgeon then extracts the needle to a predetermined distance, withdraws the plunger rod to a position on the proximal end of the seed discharge chamber so that an additional isotope seed can enter the chamber from the cartridge. Subsequent isotope seeds are then introduced into the needle, and then prostate, in an identical manner.
Although the Mick™ applicator system eliminates the risk of dropping individual isotope seeds in an operating room, it increases the amount of time required to implant a multitude of isotope seeds into the prostate because of the inability to inject more than one seed at a time. Further advances in this technique have additionally resulted in a reduction of the guesswork required by the surgical staff to determine the number of isotope seeds in a cartridge. However, these systems do not provide for either an identical loading system for spacers or for a system for visualizing the order of isotope seeds and spacers to be loaded into a needle.
Thus, there is a need for an improved applicator system that semi-automatically and sequentially loads radioactive isotope seeds and biocompatible spacers and that enables a surgeon to visually ascertain the number and sequence of isotope seeds and spacers within a cartridge.
The present invention eliminates the above-mentioned needs for an improved version of the brachytherapy procedure for cancer treatment by providing a device and method for the semi-automatic and sequential loading of at least one isotope seed followed by at least one biocompatible spacers and that further enables a surgeon to visually ascertain the number and sequence of isotope seeds and spacers within a cartridge.
The present invention is directed to a semi-automatic loading assembly that includes a setting group, a loading group, a viewing member, and a seed receiving device holding group. The setting group further includes a handle, a push rod, and a stop block member. The handle is operatively engaged to the push rod, which is slidable within a push rod guide member. The push rod guide member passes through the stop block member, itself slidably mounted to a mounting plate. The stop block member can slidably select a number from a predefined series, indicating a number of radioactive isotope seeds or biocompatible spacers. Furthermore, the stop block member functions as the distal endpoint for the handle that is in operative engagement with the push rod.
The loading group of the assembly further includes a loading block and an indexing member. The loading block accommodates a slidable cartridge holder that can hold a plurality of cartridges, including at least one seed cartridge and at least one spacer cartridge. Further, the loading block includes an alignment visualizer to provide visual confirmation of a selected cartridge. The indexing member is spring-loaded and operatively engages the slidable cartridge holder to select at least one cartridge from the plurality of cartridges. The viewing member of the present invention further includes a body, a visualization plate, and a seed receiving device holder securement. The body also includes a demarcation gauge that permits identification of the number of isotope seeds and spacers to be loaded. The body further accommodates the push rod guide member and allows for the fixing of the visualization plate. The visualization plate allows for visualization of the demarcation gauge while functioning as a radiation shield. Additionally, the seed receiving device holder securement of the assembly accommodates the seed receiving device holder group that is composed of a seed receiving device holder flange, a seed receiving device holder hub, and a seed receiving device lock. The seed receiving device holder flange is affixed to the seed receiving device holder securement and accommodates the seed receiving device holder hub that further accommodates a seed receiving device. The seed receiving device lock secures the seed receiving device.
The present invention is further directed to a method for semi-automatically and sequentially loading radioactive seed units and biocompatible spacer units into a brachytherapy device where a plurality of cartridges with a plurality of aligned units is provided and is in operative engagement with a cartridge holder. A first cartridge is selected from the plurality of cartridges, and at least one first aligned unit of the first cartridge is deposited into a unit channel. The at least one first aligned unit of the first cartridge is driven along the unit channel to a first predetermined point. A second cartridge is then selected from the plurality of cartridges, with at least one second aligned unit of the second cartridge deposited into the unit channel. The at least one second aligned unit of the second cartridge is also driven along the unit channel to a second predetermined point by the push rod. The at least one first aligned unit of the first cartridge and the at least one second aligned unit of the second cartridge are subsequently inserted into a seed receiving device.
Referring now to
The loading group 30 of the assembly further includes a loading block 31 and an indexing member 32. The loading block 31 accommodates a slidable cartridge holder 33 that can hold a plurality of cartridges 34, including at least one seed cartridge and at least one spacer cartridge. Further, the loading block 31 includes an alignment visualizer 35 to provide visual confirmation of a selected cartridge. As illustrated in
The indexing member 32 is spring-loaded and operatively engages the slidable cartridge holder 33 to select at least one cartridge from the plurality of cartridges 34 a and 34 b. As illustrated in
As illustrated in
A preferred embodiment of the present invention semi-automatically and sequentially loads radioactive seed units and biocompatible spacer units into a brachytherapy device using the plurality of cartridges 34, with a plurality of aligned units contained therein, that is in operative engagement with the cartridge holder 33. A first cartridge is selected from the plurality of cartridges 34, and at least one unit of the first cartridge is deposited into a unit channel. The unit of the first cartridge is driven along the unit channel to a first predetermined point by the push rod 22, as visualized using demarcation gauge 44. A second cartridge is then selected from the plurality of cartridges 34, with at least one unit of the second cartridge also deposited into the unit channel. The unit of the second cartridge is also driven along the unit channel to a second predetermined point by the push rod 22, again as visualized using demarcation gauge 44. The unit of the first cartridge and the unit of the second cartridge are subsequently driven by the push rod 22 through seed receiving device holder hub 52 and inserted into a seed receiving device.
Once the desired number of isotope seeds and spacers are properly positioned, they can be inserted into seed receiving device assembly 80, as is illustrated in
Although only a few exemplary embodiments of the present invention have been described in detail above, those skilled in the art will readily appreciate that numerous modifications are to the exemplary embodiments are possible without materially departing from the novel teachings and advantages of this invention. Accordingly, all such modifications are intended to be included within the scope of this invention as defined in the following numbered claims.