JP5094132B2 - RF wave irradiation element for subject lesion - Google Patents

Description

  The present invention relates to an RF wave irradiation element for a lesion of a subject to be used for treatment of a lesion such as a tumor by irradiating an RF (radio frequency) wave.

The removal of a lesion such as a cancer tumor from a subject includes various energy irradiation methods such as X-rays, radio waves, and ultrasonic waves, and a freezing method in which necrosis is caused by freezing and thawing.
Known documents using the freezing method include the following.
The magazine “Ayumi of Medicine” (Vol. 206 No. 3, 2003. 7.19). Kawamura et al., “Freeze-thaw necrosis therapy for lung cancer” (P229-P231). Magazine "Cryogenic Medicine" (30, 2004). Nakatsuka, Kawamura et al., “Percutaneous cryotherapy for lung malignant tumor using CT fluoroscopy” (P9-P15).

  In RF irradiation, the lesion is irradiated with a high frequency of several hundreds KHz, and necrosis of a tumor or the like is attempted. The supplied power at this time is several tens of watts.

The supply power of several tens of watts is extremely large for the human body, for example, the lung part of lung cancer, and it is necessary to ensure sufficient safety for irradiation.
However, external noise such as a surge current due to lightning may be mixed in the irradiation path, and it is necessary to ensure pure RF wave irradiation and prevent noise from being mixed in the irradiation path. Further, as external noise, there are various high-frequency noises in regenerative power according to inverter specifications. It is necessary to remove such noise and to irradiate a stable RF wave.
An object of the present invention is to provide an RF wave irradiation element that prevents the mixing of noise and enables safe and reliable irradiation of an RF wave.

The present invention comprises an RF source;
A transformer which is provided on the output side of the RF oscillation source, the RF oscillation signal is applied to the primary side, and the midpoint of the secondary side is grounded;
A transmission electrical path leading to both ends of the secondary side of the transformer;
First and second irradiation terminals for irradiating the subject lesion with an RF wave at the output end of the electrical transmission path;
A grounding conductor portion that shields the periphery of the electrical transmission path excluding the first and second irradiation terminals, and an outer peripheral insulating portion that covers the periphery of the grounding conductor portion;
An RF wave irradiation element for a subject lesion comprising the above is disclosed.

The present invention further includes an RF oscillation source;
A transformer which is provided on the output side of the RF transmission source, the RF oscillation signal is applied to the primary side, and the midpoint of the secondary side is grounded;
An irradiation unit for irradiating the subject lesion site with RF waves, connected to the first and second output terminals at both ends of the secondary side of the transformer;
With
The irradiation part
It consists of a puncture part that punctures the lesion site and a non-puncture part,
The non-puncture unit includes first and second transmission electrical paths for transmitting RF signals from the first and second output terminals, which are both ends on the secondary side of the transformer, and the first and second transmission electrical paths. A grounding conductor portion that is provided so as to surround the ground shield,
The puncture part is connected to the first delivery electrical path of the non-puncture part, and the second delivery path is connected to the hollow first conductor in a non-contact manner and protrudes from the tip of the first conductor. Disclosed is an RF wave irradiation element for a subject lesion that includes a second conductor that can be freely radiated and emits an RF wave between the first conductor and the respective distal ends of the second conductor.

  Further, according to the present invention, the second conductor has an openable / closable antenna at the tip, closed inside the hollow first conductor, and opened outside the hollow first conductor. An RF wave irradiation element for a subject lesion is disclosed.

  Furthermore, the present invention discloses an RF wave irradiation element for a subject lesion having an open antenna with the second conductor projecting to the outside at the tip of the hollow first conductor.

  Furthermore, the present invention discloses an RF wave irradiation element for a subject lesion in which the antenna is an umbrella-shaped antenna.

  According to the present invention, it is possible to realize a safe and reliable treatment using RF waves.

  A circuit configuration example of the RF wave irradiation element of the present invention is shown in FIG. The RF oscillation source (output source) 1 is an RF wave, for example, a high frequency oscillation source of 300 KHz, and its output is, for example, about 50 W. Reference numeral 6 denotes an internal impedance of the oscillation source 1. Since some RF waves are actually used as radio wave bands, it is preferable to select a frequency that does not interfere with them.

The transformer 2 is provided on the output side of the oscillation source 1, the primary side 2A is connected, and the secondary side 2B is the high frequency output side to the lesion. The midpoint 3 of the secondary side 2B is grounded (E). A dotted line portion 4 is a portion that is punctured into the subject lesion, and has an irradiation end 5 for irradiating the lesion with an RF wave. The electrical path from the secondary side of the transformer 2 to immediately before the irradiation end 5 that is a load (the tip of the part that does not enter the body) is shielded by the ground shield part 7 around the periphery. This shield part 7 is connected to the ground line, and makes the circuit part in the shield completely floated from the ground. Assuming that the two ends of the secondary side 2B are point K and point M, RF waves are transmitted to the irradiation end 5 as a load through the following two paths.
(1) E → 2B1 → K → irradiation end 5
(2) E ← 2B2 ← M ← Irradiation end 5
The two paths (1) and (2) are paths based on the balanced transmission method from the ground E in terms of electric circuit.

Noise removal by balanced transmission in FIG. 1 will be described with reference to FIG. FIG. 2 is an equivalent circuit for explaining noise removal, and reference numerals 30 and 31 denote a positive-side equivalent power source and a negative-side equivalent power source of the center point grounding of the transformer 2. The power source 32 is an equivalent power source for external noise, the paths 33 and 34 are transmission paths through the K point and M point from both ends on the secondary side of the transformer 2, and the load 5 is an irradiation end for the lesion. Furthermore, the ground path 35 shows the pathway by shield 7 for ground shield around the path from the secondary output side of the secondary side central grounding point and trans 2 of the transformer 2 to the load immediately before.

When the secondary output voltage of the transformer 2 is V _s , the voltages V1 and V2 of the positive and negative equivalent power sources 30 and 31 are
V ₁ = + V _s / 2
V ₂ = −V _s / 2
The current i flowing through the two paths and the load 5 is
i = (i _s / 2) + (i _s / 2)
It is. However, (i _s / 2) is a current determined by V ₁ and V ₂ and the load 5. For such a two-line balanced circuit, the external noise source 32 may be virtually considered to be connected in series to the transformer center ground point. As a result, the same polarity and the same polarity toward the load through the power supplies 30 and 31 are obtained. flow noise current i _n value, the load 5, so that both are canceled. By this cancellation, the noise current from the external noise source 32 does not flow to the load 5 and does not affect it.

  FIG. 3 is an example of a circuit in which the ground shield is applied to the whole including the oscillation part. This circuit includes an RF oscillating unit 36, an RF bandpass filter (for example, composed of a capacitor and reactance) 38A, a low-pass filter 38B (for example, composed of a capacitor and reactance), a DC power source 37, and a low-pass filter (for example, composed of a capacitor and reactance). ) 39 and the transformer 2, the secondary output path 40 formed as a cable from the output end, and the load 5. The filter 38A passes only the RF wave, and the filter 38B and the filter 39 pass only the direct current, thereby eliminating noise on the path related to each. The secondary output path 40 is composed of two paths, that is, an output path 40A from the K end and an output path 40B from the M end. The filters 38 and 39 have various circuit modes.

  The ground shield portions are 7, 7A, 7B, and 7C. Reference numeral 7 denotes a ground shield part (to be precise, a shield to the tip of the non-puncture part before the puncture part) of the path connecting the cabled transformer output path and the load 5, and 7A denotes the entire ground of the transformer 2 The shield part 7B is a ground shield part for the entire filter 38, and 7C is a ground shield part for the entire filter 39. These shield portions are made of, for example, metal conductors (annular or box-shaped) that cover the entire circuits. Of course, the ground shield portions 7A, 7B, and 7C also have a configuration in which the periphery is covered with an insulator portion as shown in FIGS.

  According to the configuration of FIG. 3, the entire path from the oscillation source to immediately before the load is grounded, and there is an advantage that mixing of external noise can be completely prevented.

  In addition, although the shield part 7 grade | etc., Was used as the ground shield, if the electromagnetic shielding function is given or the function is added, the shielding of the electromagnetic wave from the outside can be achieved.

For reference, FIG. 4 shows a circuit configuration of a conventionally used RF wave irradiation element. This circuit has an internal impedance 6 in series with the RF oscillation source 1 and provides an RF wave to the irradiation end 5 in one loop. The contact E has a one-end grounding configuration with an impedance 6.
The circuit shown in FIG. 4 has a path based on the unbalanced transmission method in terms of electrical circuit.

  According to the circuit employing the balanced transmission method of the present invention, the same current i flows in a balanced manner in the directions (1) and (2), and noise is less likely to be canceled (can be canceled). On the other hand, the unbalanced transmission method in the circuit of FIG. 4 has a one-loop configuration, and noise is easy to ride on and is difficult to remove. Since the circuit of the present invention is less susceptible to noise, there is an advantage that an RF wave with a desired power can be applied as designed. On the other hand, according to FIG. 4, it is difficult to irradiate RF waves with power as designed because it is easy for noise to ride. Furthermore, power fluctuation due to noise is inevitable.

Next, the irradiation element made into a probe of the present invention will be described.
FIG. 5 shows an external view of a probed irradiation element. The element body 10 includes a puncture unit 11 and a non-puncture unit 12, and the non-puncture unit 12 is a part that connects the puncture unit 11 and the transformer 2 on the RF oscillation source 1 side. Specifically, electrical connection is achieved by inserting the connector portion 13 connected to the secondary output ends K and M of the transformer 2 into the end portion 14 of the support portion 12.

The non-puncture portion 12 has two electrical paths k and m passing through the K point and the M point from the connector 13 and a ground conductor portion, and external insulators thereof, which are omitted in FIG. Describe.
The puncture part 11 is a member to be punctured into the subject, or the tip side of the puncture part 11 is formed into a needle shape so that the tip 11a of the minute opening can be punctured, and a path on the way to the tip has a hollow part 11b. 11A of 1st conductor parts and the 2nd conductor wire 11B which penetrates the hollow inside of this conductor part 11A are comprised. The conductor portion 11A is electrically connected to the point M from the connector 13 in the member of the non-puncture portion 12, and penetrates through this hollow. The second conductor wire 11 </ b> B is made of a sharp and hard metal wire, and is connected to the K point from the connector B in the member of the non-puncture portion 12. The tip 11a of the conductor portion 11A has a minute opening connected to the inside hollow, and the tip of the second conductor wire 11B can project to the outside through this opening. The opening tip 11a of the first conductor portion 11A is the first irradiation end, and the tip of the second conductor wire 11B is the second irradiation end. Naturally, the first conductor portion 11A and the second conductor portion 11B are electrically non-contact, for example, separated by an insulator layer.

  FIG. 6 shows a state of the second conductor portion 11B in a state of protruding from the first conductor portion 11A. Here, the tip 11b of the second conductor portion 11B includes an umbrella-shaped antenna 11c for securing the RF wave radiation area and directionality. The antenna 11c is bundled like a closed umbrella in the inner hollow portion of the first conductor portion 11A, and the tip opening is projected and then opened to become an umbrella bone shape. The forward movement of the second conductor wire 11B in the hollow portion in the direction of the distal end opening and the return and retraction movement from the opening to the inside can be performed manually by the user or automatically by a manipulator. Here, the treatment site is interposed between the opened umbrella-shaped antenna 11c and the tip 11a of the first conductor portion 11B. That is, the first irradiation end 11a of the puncture unit 11 is punctured by forward movement and stopped just before the treatment site. In this stopped state, the second conductor wire 11B is advanced along the hollow of the first conductor portion 11A, protrudes through the opening of the tip, and penetrates the treatment site. After confirming the penetration, the umbrella-bone antenna 11c is opened. Thus, the opened umbrella-bone antenna 11c and the first irradiation end 11a face each other across the treatment site, and in this state, an RF wave is oscillated. Thus, RF waves are radiated from the opposed umbrella-shaped antenna 11c and the first irradiation end 11a, and treatment such as necrosis of the cancer tissue at the treatment site is performed.

FIG. 7 shows a configuration example as a probe. The probe includes a non-puncture portion 12 and a puncture portion 11, and the non-puncture portion 12 has k and m ends as RF feed terminals, and the periphery thereof is an insulator layer 21, which forms a kind of cable configuration. The periphery of the insulator layer 21 is an annular metal conductor layer 20, and further has an insulator layer 23 as the outermost peripheral layer.
One-touch operation portions 25 and 26 are provided on the outer periphery of the insulator layer 23. The operation unit 25 is an operation button for moving the second irradiation end 11b forward and backward within the first conductor portion 11A, and the operation unit 26 is an opening / closing operation button for the umbrella-shaped antenna 11c. These operating mechanisms are not shown. There may be a method of directly moving the second irradiation end 11c on the front side of the feeding terminal k and a method of providing an operating system for opening and closing the umbrella-shaped antenna 11c on the front side of the insertion port. Furthermore, there is also a method of pushing the second conductor wire 11B directly by hand and pulling it forward.

The metal conductor layer 20 is a ground conductor that forms the ground shield part 7 in FIG. 3, and has a large ground area by being an annular shape. The metal conductor layer 20 is provided only on the support portion 12 and does not extend to the puncture portion 11. The reason is that the puncture part 11 is a part to be punctured in the subject, and the ground conductor and the subject are brought into contact with each other. As a result, noise from surroundings can be prevented with a large area at the place where the ground conductor is provided.
At the boundary between the puncture unit 11 and the support unit 10, the first irradiation end 11 </ b> A and the end of the ground conductor 18 are separated from each other by the insulator layer 24 so that they do not directly contact each other.

FIG. 8 is a configuration example characterized by the first irradiation end 11a. The second conductor wire 11B is provided with an umbrella-shaped antenna 11c for ensuring the irradiation area and directionality of the second irradiation end 11b. FIG. 8 shows a second umbrella bone at the tip of the first irradiation end 11a. 11d was provided. The umbrella bone-shaped antenna 11d can be freely opened and closed, and the umbrella is opened after the second irradiation end 11a protrudes from the distal end opening and penetrates the treatment site 50. Having an operation button for opening and closing the antenna 11d is the same as in FIG.
Without the umbrella-bone antenna 11d, the tip radiation end area of the first irradiation end is small, and sufficient radiation energy and radiation width may not be ensured. However, the provision of the umbrella-bone antenna 11d is sufficient. There is an advantage that radiation energy and radiation width can be secured.
The antenna shape and structure of the umbrella antennas 11c and 11d are not limited in principle as long as they can maximize the efficiency of irradiation of the radiation beam to the irradiation site, but other antenna shapes and structures may be used depending on the spread and state of the irradiation site. Adopting a shape or structure is not denied.

A specific example of the irradiation element probe that can be exchanged is shown in FIG. The irradiation element probe 30 can be inserted into the cable path 31 formed as a cable connected to the K and M ends by one-touch operation, and is so-called disposable. The insertion is realized by inserting the end portion 35 on the probe 30 side into the connector 32 provided at the end portion of the cable path 31, and the removal is realized by removing the end portion 35 from the connector 32.
The probe 30 includes a non-puncture part 33 and a puncture part 34. The non-puncture part 33 has slide-type operation parts 36 and 37 outside the circumference, and the puncture part 34 has a hollow conductor part 34A and a needle-like conductor part 34B penetrating through the hollow conductor part 34A and projecting outside from the tip opening. . The operation part 36 is an antenna opening / closing operation part at the tip of the hollow conductor part 34A. By moving the slide 36A as indicated by an arrow, the antenna connected to the operation part 36A opens in an umbrella shape and moves in the opposite direction. By doing so, the umbrella-shaped antenna is closed. The operation unit 37 is an opening / closing operation unit for the antenna at the tip of the needle-shaped conductor 34B. By moving the slide 37A as shown by an arrow, the antenna connected to the operation unit 36B opens like an umbrella and moves in the opposite direction. By doing so, the umbrella-bone shaped antenna is closed. Here, the umbrella-bone antenna is as shown in FIG.
Furthermore, the hollow conductor portion 34A is gradually narrowed toward the tip opening, and has a structure that is easy to puncture. Such a structure can also be applied to the elements shown in FIGS.
The internal structure of the non-puncture part 33 is similar to the case of FIG. That is, the two conductors connected to the h and m ends are cabled, and the periphery of the conductor is an insulator layer, the periphery of the insulator layer is a ground conductor layer, and the periphery of the ground conductor layer is insulated. A body layer was formed.

FIG. 9 is an embodiment diagram as an irradiation apparatus. The irradiation apparatus includes an RF wave irradiation element 100, an RF power unit 101 that supplies RF power thereto, an RF generation source 102, an output control unit 103, a doctor operation table 104, and a processing unit 105.
The doctor operation table 104 is an operation unit for performing a puncture operation, and the processing unit 105 is an apparatus that performs various processes for the operation. The output control unit 103 performs instructions for oscillation and stop of the RF source 102, control of the oscillation energy, power control (for example, AGC) in the RF power unit 101, opening / closing control of the antenna of the irradiation element 100, and movement control. Do. These controls are based on a doctor command from the doctor console 104 and / or a control command based on a treatment plan from the processing unit 105. The output control unit 103 sends the state of the RF generation source 102, the RF power unit 101, and the state of the irradiation element 100 to the processing unit 105.

The above embodiment is an example in which one probe is provided in one balanced transmission circuit, but two probes can be provided in one balanced transmission circuit. Two probes are provided at each of the two output terminals on the secondary side of the high-frequency transformer. In the above embodiment, one of the two output terminals is connected to the puncture needle, the other is connected to the cylindrical conductor around the puncture needle, and both are incorporated as a probe.
In the new embodiment, an independent probe (that is, a total of two probes) is provided for each of the output terminals on the secondary side of the high-frequency transformer, and the cancer lesion is sandwiched between the two probes. It was decided to irradiate with high frequency. In this case, each of the two probes has one puncture needle at the tip, and no umbrella-bone antenna exists. In one of the previous embodiments, the umbrella-bone antenna was opened to improve the radio wave radiation efficiency. However, this new embodiment simplifies the mechanism by removing the umbrella-bone antenna and uses two probes. It has the aim of enabling safe and reliable irradiation by pinching the lesion.

FIG. 12 shows a basic configuration diagram of such an irradiation element. The irradiation element of FIG. 12 is connected to the tips of the two output paths 2a and 2b on the secondary side of the high-frequency transformer having the secondary-side midpoint grounding terminal 50 via the non-puncture portions 53 and 54. This is an example in which the irradiation ends 51 and 52 are provided. One feature is that the outer peripheries of the non-puncture portions 53 and 54 as relay portions are not grounded. In FIG. 1, two output paths on the secondary side of the high frequency transformer are connected to both ends of one irradiation end 5. In FIG. 12, separate irradiation ends 51 and 52 are connected to the two output paths 2a and 2b.
In terms of polarity, the two irradiation ends 51 and 52 are high-frequency AC waves, and therefore when one is positive, the other is always negative. Therefore, as a method of using the irradiation ends 51 and 52, as shown in FIG. 13, a lesion 60 is sandwiched between the two irradiation ends 51 and 52, and a high frequency signal is irradiated between the terminals. Since the polarities of the two irradiation ends 51 and 52 are different, one is (+) and the other is (−), and an efficient high frequency application to the lesion is possible.

  FIG. 14 shows another embodiment in which two sets of the apparatus of FIG. 12 are prepared and a total of four probes are provided. These four probes are used by sandwiching the periphery of the lesion 60 at, for example, 90 ° intervals (ie, 0 °, 90 °, 180 °, 270 °) and applying a high frequency. An important feature of this embodiment is that the two high-frequency sources on the primary side are completely synchronized, and a switch circuit 55 is provided to enable the four probes to irradiate the lesion 60 uniformly. It is a point. The periodization of the high-frequency source means that the phase and amplitude are completely coincident with each other on the time axis, and is for smoothing the current flow by switching by the switch circuit 55.

The switching operation of the switch circuit 55 is shown in FIG. The switch circuit 55 automatically switches between the three modes 1, 2, and 3 every time width t _{1. In} the mode 1, the terminal I ₁ -O ₁ , the terminal I ₂ -O ₂ , Terminals I ₃ -O ₃ and I ₄ -O ₄ are connected. As a result, 51A and 52A constitute a current pair, and 51B and 52B constitute another current pair. This is shown in FIG. In mode 2, as shown in FIG. 16B, the terminals I _{1 to} I ₄ and the terminal O ₁ are set such that 51A and 51B are one current pair, and 52A and 52B are another current pair. perform a combination of a -O _4. In mode 3, as shown in FIG. 16C, the terminals I ₁ -I ₄ and the terminals O ₁ -O ₄ are combined so that 51A and 52B, and 52A and 53B form current pairs, respectively.
Thus, at a certain time (0 to t ₁ ), as shown in FIG. 16 (a), at time (t ₁ -2t ₁ ), as shown in FIG. 16 (b), at time (2t ₁ -3t ₁ ), FIG. As shown in c), a current flows. By repeating these three modes a plurality of times, the lesion 60 is uniformly irradiated with high-frequency radiation and exhibits a therapeutic effect.

The case of the four irradiation end in FIG. 14 is not easy to operate by one operator. Therefore, at the 4 irradiation end, the two circuits of FIG. 14 are incorporated into one mechanism unit, and the switch circuit 55 is automatically switched, and the mechanism for operating the 4 irradiation ends in conjunction with each other, for example, a program and its interlocking mechanism. Just make it.
FIG. 17 shows a specific example of the cylindrical probe shown in FIGS. The probe 100 includes a coaxial cable 60, a gripping part 61 connected to the coaxial cable 60, a relay part 62 as a non-puncture part, and a puncture part 63. The relay part 62 is a part that connects the cable 60 and the puncture part 63, and the gripping part 61 is a part that has an outer diameter part for the operator to grip on the outer periphery of the relay part 62.
The gripping part 61 and the relay part 62 are so-called non-puncture parts, and the puncture site into the body is the puncture part 63. The tip 63A of the puncture portion 63 is needle-shaped.
FIG. 18 shows a cross-sectional example of the cylindrical probe of FIG. 17, (a) FIG. 18 shows another example of the II cross-section, (b) FIG. Show. (A) In the figure, there is a lead wire (core wire) 62A connected to the output end of the transformer 2 or the switch circuit 55 at the center, a conductor layer 62B as a ground wire around it, and a plastic layer 62C around the outer periphery. FIG. 6C shows an example in which a plastic layer 62C is provided in contact with the conductor layer 62B. (B) The figure is a cylindrical cross section of the puncture part 63, and consists of a metal conductor 63C. This cylindrical shape becomes thinner as it goes to the tip, and becomes a tip needle shape.

FIG. 19 is an enlarged view of a part III of the joint between the relay unit 62 and the puncture unit 63. At this joint, the lead wire (core wire) 62A is connected to the inside of the cylindrical metal conductor layer 63C, and the plastic layer 62C is connected to both.
The probe as the irradiation element in FIG. 19 uses two or four as a pair, and the operator holds the holding part 61, pushes the puncture needle into the lesion, and is lateral to the cancer lesion. It will be in the state supported from. The other puncture needle is also pushed to the other side, the cancer lesion is sandwiched from both sides, and high frequency is irradiated.

FIG. 20 shows an embodiment of a probe having a guide needle. The guide needle guides the probe to the lesion site instead of the puncture needle when puncturing. Therefore, in this case, the tip of the probe is not formed into a needle shape as shown in FIG. 12, and the guide needle protrudes from the tip of the probe for puncturing. The probe 101 has an insertion portion 65 attached to the front side of the relay portion 62 that forms a non-puncture portion. The insertion portion 65 has a coupling portion 65A to which a coaxial cable 60 (FIG. 17) for guiding a high frequency signal is coupled, and an insertion port 65B into which the guide needle 64 is inserted. A guide needle 64 having an elongated shape and a needle shape is inserted into the insertion port 65B and used as a puncture guide. The guide needle 64 has a handle 64C, a stopper 64D, and a guide needle main body 64B. The guide needle 64 is inserted as shown by an arrow and is used, and is pulled out when not in use.

21 is a cross-sectional view taken along the line II of FIG. 20 (a), a cross-sectional view taken along the line II-II of the relay part 62, a cross-sectional view taken along the line III-III of the puncture part 63, and the puncture part 63. The IV-IV sectional view (a) of the tip is shown. FIG. 22 is an enlarged cross-sectional view of a joint portion between the relay portion 62 and the puncture portion 63.
As can be seen from FIGS. 21 and 22, the guide needle 64 is configured to pass through the center of the probe, and the high-frequency lead wire 60 </ b> A is disposed so as to be non-contact on the outer side. The tip of the puncture portion 63 is open, and the needle-like tip of the main body 64B of the guide needle 64 protrudes from the opening end.
An example of treatment when using such a guide needle is shown in FIG. When the probes are guided by the guide needles 70 and 71 so that the probes 102 and 103 reach the positions around the lesion 60 in two directions (for example, sites in an opposing relationship), when the tip of the probe reaches the lesion 60. The guide needles 70 and 71 are pulled out, and high frequency application from the cables 72 and 73 is performed.
According to this embodiment, the guide needle 64 is inserted into the probe and punctured to the lesion to guide, and then the guide needle is withdrawn (all or retracted). Thereafter, high-frequency irradiation is performed from the tip of the probe to realize treatment.

FIG. 24 is an embodiment diagram as an irradiation apparatus having four terminals as shown in FIG. The irradiation apparatus includes a switch circuit 55, RF wave irradiation elements 100-1 to 100-4, an RF power unit 101 that supplies RF power thereto, an RF generation source 102, an output control unit 103, a doctor operation table 104, a process Part 105 and a four-terminal positioning control part 110. In addition, there is an example having a drive control unit 111 for the puncture guide needle.
The doctor operation table 104 is an operation unit for performing a puncture operation, and the processing unit 105 is an apparatus that performs various processes for the operation. The output control unit 103 performs switching control of the switch circuit 55, instructions to oscillate and stop the RF source 102, control of oscillation energy, and power control (for example, AGC) in the RF power unit 101. These controls are based on a doctor command from the doctor console 104 and / or a control command based on a treatment plan from the processing unit 105. The output control unit 103 sends the state of the RF generation source 102, the RF power unit 101, and the state of the irradiation element 100 to the processing unit 105. Further, the control unit 110 is caused to perform the positioning control unit for the four terminals 51A to 52B from the operation unit 104. In addition, the puncture guide needle can be controlled to advance, retreat, and puncture.

FIG. 10 is a functional principle diagram of the processing unit 105 of the present invention.
The central part of the processing unit 105 is a parallel operation mechanism 114, which is a new device that performs the processing of Japanese Patent Application No. 2006-34911, which is the prior application of the present applicant.
Japanese Patent Application No. 2006-34911 forms two tomographic planes having a predetermined angle (for example, 90 °) connecting a puncture point (insertion point) and a target point that is a treatment target region, and on the two tomographic planes. The invention based on the acquisition of the pixel data in the above and the display of the acquired pixel data on the two tomographic planes as a tomographic image is disclosed. By making the angle different from the predetermined angle, the route from the puncture point to the target point can be confirmed and the presence or absence of an obstacle on the route can be checked, which is provided for the treatment plan. If there is an obstacle, the formation of two tomographic planes at different angles, acquisition of pixel data, and display are performed to confirm the route again to change the path.

  Such a prior application can also be used for puncturing operation at the stage of actual puncturing operation and real-time confirmation of the puncturing route. Real-time confirmation of an actual puncture operation is performed under so-called CT monitoring. CT monitoring is to monitor the state of puncture by performing high-speed acquisition of a CT image of the state of progress in the subject while proceeding with puncture and displaying it three-dimensionally.

FIG. 10 is a functional diagram for performing real-time monitoring of the puncturing operation under CT monitoring. The parallel computing mechanism 114 is the processing center of this real-time monitoring, and performs the following four functions.
(1) Management of subject voxel data at a predetermined pitch in the Z direction (body axis direction), for example, 0.1 mm pitch (2) Correction of coordinate axis due to subject posture variation (real time), for example, within 1 minute (3) Puncture point, Formation of two planes forming a predetermined angle passing through the target point and acquisition of the image (4) Control of antennas 11c and 11B and power control

In FIG. 10, in addition to the parallel operation mechanism 116, the CT apparatus 110, the tomographic image data capturing mechanism 111, the high-speed raid configuration 112 and 114, the display units 115 and 116, the operation control mechanism 117, the puncture probe geometric position. It has a take-in mechanism 118.
The CT apparatus 110 includes a CT apparatus control unit 110A and a tomographic image display unit 110B, and is along the body axis direction (Z direction) of the subject. For example, a tomographic image having a pitch of 0.1 mm is acquired. This tomographic image is sent to the high-speed raid configuration disk group 112 via the capturing mechanism 111 and accumulated. The high-speed raid configuration disk group 113 accumulates past CT tomograms.

First, the initial setting will be described.
In the initial setting, a tomographic image acquired in 0.1 mm pitch units of the subject imaged by the CT apparatus 110 in the past is displayed on the display unit 110B, and the puncture entrance (point) is connected to the target point that is a lesion site and the target point. Determine the route. In this determination, two orthogonal planes Q ₁ and Q ₂ passing through the puncture point and the target point, for example, are obtained, and pixel data on these two planes are obtained from adjacent CT tomographic planes, and the tomograms in the two planes are obtained. Images R1 and R2 are obtained. The tomographic images R1 and R2 are separately displayed on the display units 115 and 116. Further, a mark indicating the puncture point and the target point is put on this tomographic image. Thus, by observing both the two tomographic images R1 and R2, the path connecting the puncture point and the target point can be confirmed. If there is an obstacle, another puncture point and target point are selected. Then, determine the appropriate route for treatment without any obstacles.

  The two initially set images R1 and R2 thus obtained are displayed, and the actual puncturing operation is started. This utilizes the operation control mechanism 117. The irradiating element is punctured into the subject by the puncturing operation, and the position is captured by the capturing mechanism 118 and sent to the parallel computing mechanism 114 for use in position confirmation. Furthermore, CT tomographic images of a plurality of tomographic planes before and after the irradiation element itself are taken in real time, real-time image data is obtained on the two planes R1 and R2, and the planes R1 and R2 are obtained in accordance with the progress of the irradiation element. Display as the top image. Thereby, the puncture operation is executed even under CT monitoring.

  Note that the processing unit in FIG. 10 is an example, and it is needless to say that the processing unit can be realized by the same configuration and the same processing flow as that of Japanese Patent Application No. 2006-34911.

It is a figure which shows the electric circuit example of RF irradiation element of this invention. It is an equivalent circuit diagram for explanation of noise mixing prevention of the present invention. It is a structural example figure of the whole shield of this invention. It is a figure which shows the electric circuit of another RF irradiation element. It is a figure which shows the example of RF irradiation element made into the probe of this invention. It is a figure which shows the structural example of the 2nd irradiation end of RF irradiation element made into the probe of this invention. It is a detailed example figure of the non-puncture part of the RF irradiation element made into the probe of this invention. It is a figure which shows the structural example of the 1st irradiation end of the RF irradiation element made into the probe of this invention. It is a figure which shows the example of RF irradiation apparatus of this invention. It is a functional block diagram of the process part of this invention. It is a specific example figure of the probe of the RF wave irradiation element of this invention. It is a circuit diagram which has two irradiation terminals 51 and 52 with respect to one high frequency power supply of this invention. It is the example of arrangement | positioning to the lesion part 60 by the irradiation terminal of FIG. It is a circuit example figure with four irradiation terminals 51A-52B of this invention. It is a figure which shows the switching mode of the switch circuit 55 of FIG. FIG. 15 is a diagram illustrating various irradiation examples to the lesion part 60 in the switch circuit 55 of FIG. 14. It is a figure which shows the example of an irradiation element with this invention puncture guide needle. It is various sectional drawing of FIG. FIG. 18 is a cross-sectional view of the seam of FIG. 17. It is a specific example figure of the irradiation element with the puncture guide needle of this invention. It is various sectional drawing of FIG. It is sectional drawing of the seam of FIG. It is a figure which shows the example of arrangement | positioning to the lesion part 60 by the irradiation element of FIG. It is an Example figure of the irradiation apparatus with the irradiation element of 4 terminals of FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 RF generation source 2 Transformer 5 Irradiation end 11 Puncture part 12 Non-puncture part 11c, 11c Umbrella-shaped antenna

Claims (3)

An RF oscillation source;
A transformer which is provided on the output side of the RF oscillation source, the RF oscillation signal is applied to the primary side, and the midpoint of the secondary side is grounded;
A transmission electrical path leading to both ends of the secondary side of the transformer;
First and second irradiation terminals for irradiating the subject lesion with an RF wave at the output end of the electrical transmission path;
A grounding conductor portion that shields the periphery of the electrical transmission path excluding the RF oscillation source and the first and second irradiation terminals;
An outer peripheral insulator portion covering at least the ground conductor portion of the delivery electrical path,
The RF oscillation source includes an RF oscillation unit, a band-pass filter that is provided on the output side thereof and allows an RF signal to pass through, a DC power source, and a low-pass filter that is provided on the output side. An RF wave irradiation element for a subject lesion in which an output side and an output side of a low-pass filter are connected to both terminals on the primary side of the transformer. An RF oscillation source;
A transformer which is provided on the output side of the RF oscillation source, the RF oscillation signal is applied to the primary side, and the midpoint of the secondary side is grounded;
A first and a second irradiation unit connected to first and second output terminals, which are both ends of the secondary side of the transformer, for irradiating the subject lesion site with an RF wave;
The first irradiation unit is
It consists of a puncture part that punctures the lesion site, a non-puncture part, and a needle needle guide needle,
The non-puncture part is provided so as to surround an electrical transmission path for transmitting an RF signal including noise current of the same polarity and the same value by a balanced transmission method from a corresponding output terminal on the secondary side of the transformer, and the electrical transmission path. A grounding conductor portion for ground shielding and an outer peripheral insulator portion covering the grounding conductor portion,
The puncture unit includes a first hollow conductor having an opening at the tip connected to the delivery electrical path of the non-puncture unit,
The guide needle passes through the inside of the non-puncture part and the puncture part and can protrude from the tip opening of the puncture part, and guides to the lesion part of the puncture part,
The second irradiation unit is
It consists of a puncture part that punctures the lesion site, a non-puncture part, and a needle needle guide needle,
The non-puncture part is a transmission electrical path for transmitting an RF signal by a balanced transmission method from a corresponding output terminal on the secondary side of the transformer, a ground conductor part that is provided so as to surround the transmission electrical path and performs a ground shield, Provided with an outer peripheral insulator covering the ground conductor,
The puncture unit includes a second hollow conductor that leads to a delivery electrical path of the non-puncture unit,
The guide needle passes through the inside of the non-puncture part and the puncture part and can protrude from the tip opening of the puncture part, and guides to the lesion part of the puncture part,
An RF wave is radiated between the first hollow conductor and the respective distal end sides of the second hollow conductor; and
A first and a second RF oscillator each having two output terminals;
First, second, third and fourth irradiation terminals;
The first and second RF oscillation units are provided between the first and second output terminals and the first, second, third, and fourth irradiation terminals, respectively, and the output terminal and the irradiation terminal. An RF wave irradiation apparatus for a subject lesion, comprising: switch means for cyclically changing the combination of Each of the first and second RF oscillation units is provided on the output side of the RF oscillation source and the RF oscillation source, the RF oscillation signal is applied to the primary side, and the midpoint of the secondary side is It is grounded object foci for RF wave irradiation apparatus according to claim 2 comprising a transformer, a with two output terminals.

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