CA2033670C - Apparatus for irradiating the bronchi of a patient for the purpose of photodyanamic therapy - Google Patents

Apparatus for irradiating the bronchi of a patient for the purpose of photodyanamic therapy Download PDF

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Publication number
CA2033670C
CA2033670C CA002033670A CA2033670A CA2033670C CA 2033670 C CA2033670 C CA 2033670C CA 002033670 A CA002033670 A CA 002033670A CA 2033670 A CA2033670 A CA 2033670A CA 2033670 C CA2033670 C CA 2033670C
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CA
Canada
Prior art keywords
light
guide tube
fibre
silicone composition
cylinder
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Fee Related
Application number
CA002033670A
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French (fr)
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CA2033670A1 (en
Inventor
Georges Wagnieres
Hubert Van Den Bergh
Philippe Monnier
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Novartis AG
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Novartis AG
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Publication of CA2033670A1 publication Critical patent/CA2033670A1/en
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Publication of CA2033670C publication Critical patent/CA2033670C/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00Radiation therapy
    • A61N5/06Radiation therapy using light
    • A61N5/0613Apparatus adapted for a specific treatment
    • A61N5/062Photodynamic therapy, i.e. excitation of an agent
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00Radiation therapy
    • A61N5/06Radiation therapy using light
    • A61N5/0601Apparatus for use inside the body
    • 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
    • A61B18/22Surgical 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 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B2018/2255Optical elements at the distal end of probe tips
    • A61B2018/2261Optical elements at the distal end of probe tips with scattering, diffusion or dispersion of light
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00Radiation therapy
    • A61N5/06Radiation therapy using light
    • A61N5/0601Apparatus for use inside the body
    • A61N5/0603Apparatus for use inside the body for treatment of body cavities
    • A61N2005/0604Lungs and/or airways

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  • Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Biophysics (AREA)
  • Radiation-Therapy Devices (AREA)
  • Laser Surgery Devices (AREA)

Abstract

An apparatus for irradiating the bronchi of a patient for the purpose of photodynamic therapy has an optical fibre (11) that feeds the light of a laser into a bronchoscope and is surrounded by a light-guide tube (8) and an outer tube (2). The distal end (13) of the optical fibre (11) is embedded in a silicone composition (17) containing 7 parts per thousand of TiO2 particles having a particle size of 0.2 µm. The silicone composition (17) fills the front end of the light-guide tube (8) as far as the end face (6) of an aluminium cylinder (5) which acts as a mirror. The light dispersed by the TiO2 particles is emitted radially through the light-guide tube (8) and the front portion of the outer tube (2) and acts on the patient's bronchi.

Description

Apparatus for irradiating the bronchi of a~atient for the purpose of photodmamic therapy The invention relates to an apparatus for irradiating the bronchi of a patient for the purpose of photodynamic therapy, which apparatus has an optical fibre that feeds the light of a laser into a bronchoscope.
A bronchoscope of that type is described in Chemistry in Britain, Vol. 22, No.
5, May 1986, Hubert van den Bergh, "Light and porphyrins in cancer therapy" and permits the detection and treatment of malignant lung tumours, especially on the furcate branches of the bronchi. Such treatment involves injecting a patient with porphyrin. After several days, the tumour tissue has absorbed considerably more of the dyestuff than has the healthy tissue. If the suspicious site is then irradiated, for example with a UV krypton laser at approximately 410 nm, which laser is connected to a quartz-fibre optical system, the cancer tissue is recognised by the red light emanating therefrom. In addition to this effect, which permits the detection of tumours, porphyrin has yet another advantageous property which is that it absorbs red light strongly, there being triggered in the diseased tissue a series of photochemical reactions which kill the tumour tissue, which contains the higher levels of porphyrin. The red light required for that purpose can be conveyed to the tumour likewise by way of a quartz-fibre optical system, thereby selectively destroying the cancer in the course of such photodynamic therapy. The apparatus described in connection with Figure 3 of the above-mentioned publication makes it possible to irradiate only a tumour lying in front of the end of the fibre. Figures 8 and 9 show an apparatus for irradiating the oesophagus, which apparatus permits the radial diffusion of the axially rM
incident light A Teflon tube filled with an epoxy resin is used for that purpose, the face of the end of the fibre being arranged at an axial distance from the epoxy resin composition, which contains Ti02 particles.
Another apparatus for irradiating the oesophagus is known from US-A-4,660,925.
In that apparatus, the fibre core, which is bared at the light-emitting end, is embedded in a dispersing medium which is itself surrounded by a tube-like transparent protective sheath:
The light-emitting end of the fibre core, however, projects by a great distance into the dispersing medium surrounded by the protective sheath so that the radial radiation of the 20336'0 light is restricted to a small area in relation to the dimensions of the tube-like protective sheath. In addition, the diameter of this protective sheath is considerably greater than the diameter of the fibre so that, when the apparatus is passed through the biopsy channel of a bronchoscope, difficulties may occur that are caused by the geometrical dimensions of this apparatus.
Proceeding from that prior art, the problem of the invention is to provide an apparatus of the type mentioned at the beginning that is sufficiently small to be introduced into the bronchi, and that diffuses radially the light fed in by way of the fibre, with .the smallest possible losses, even after a relatively long period of use.
This.problem is solved according to the invention in that the fibre is surrounded by a light-guide tube which projects beyond the light-emitting face of the end of the fibre by many times the fibre's diameter, and the end of the fibre is embedded in a silicone composition that contains Ti02 powder and that extends from the end of the fibre to the end of the light-guide tube.
Such an arrangement provides not only the possibility of miniaturisation but also, by reason of the high degree of transparency of silicone, a high degree of efficiency, as well as a high degree of ageing stability since the silicone retains its good optical properties for a very long period.
Tn a preferred embodiment, the end of the fibre is fixed in position in the light-guide tube by a centring cylinder. Between the centring cylinder and the silicone composition and in the vicinity of the end face there is arranged an annular gap which extends round the optical fibre and is delimited radially by the light-guide tube. The light-guide tube consists preferably of PTFE and is preferably surrounded by an outer tube that is immovable in the axial direction with respect thereto and that projects beyond the distal end of the light-guide tube, there being arranged in the projecting portion an aluminium cylinder which acts as a mirror and a PTFE cylinder which acts as a closing plug.
There is an open annular space between the light-guide tube and the outer tube. The light-guide tube projects by approximately 3 cm beyond the end of the fibre and forms a diffuser in that portion. For that purpose, the silicone composition is preferably mixed with 7 parts per thousand of Ti02 powder having a particle size of 0.2 micrometre.
In one embodiment of the invention, the light-guide tube has an inside diameter of only 0.8 mm and an outside diameter of approximately 1.1 mm. The outer tube then has an inside diameter of 1.4 mm and an outside diameter of 1.9 mm.
An embodiment of the invention is described in detail hereinafter with reference to the drawing. The single Figure shows the front end of an apparatus according to the invention that can be introduced into the biopsy channel of a bronchoscope.
According to one aspect of the present invention, there is provided an apparatus for irradiating the bronchi of a patient for the purpose of photodynamic therapy, which apparatus has an optical fibre that feeds the light of a laser into a bronchoscope, wherein the fibre (11) is surrounded by a light-guide tube (8) which projects beyond the light-emitting face (6) of the end (15) of the fibre by many times the fibre's diameter, and the end (15) of the fibre is embedded in a silicone composition (17) that contains Ti02 powder and that extends from the end (15) of the fibre to the end (7) of the light-guide tube.
The drawing shows a bronchial light diffuser indicated generally by the reference numeral 1. The bronchial light diffuser 1 has such a small diameter that it fits through the biopsy channel of a bronchoscope.
The bronchial light diffuser 1 comprises an outer tube 2 of PTFE (Teflon)TM having an inside diameter of 1.4 mm and a wall thickness of 0.25 mm. The outer tube 2 extends from the distal end 3, shown at the foot of the drawing, to a distance that is greater by a suitable length than the length of the bronchoscope to be used. The outer tube 2 is closed at 3a the distal end 3 by a Teflon plug 4 which is connected sealingly and securely by way of its outer surface to the inner surface of the outer tube 2.
An aluminium cylinder 5, of which the end face 6 facing away from the distal end 3 is in the form of a mirror, rests against the end face, facing away from the distal end 3, of the Teflon plug 4.
Resting against the end face 6 is the distal end 7 of a light-guide tube 8 of PTFE which extends through the outer tube 2, an annular gap being present between the outer surface 9 of the light-guide tube 8 and the inner surface 10 of the outer tube 2. The light-guide tube 8 has an outside diameter of approximately 1.1 mm while the outer tube 2 has an inside diameter of 1.4 mm and an outside diameter of 1.9 mm.
As shown in the upper portion of the drawing, an optical fibre 11 surrounded by a cladding 12 projects into the light-guide tube 8. The optical fibre 11 has a core diameter of 200 ~m and a cladding diameter of 280 Vim. The numerical aperture of the optical fibre is preferably 0.21.
The distal end 13 of the optical fibre 11 is secured inside a brass centring cylinder 14 which is in turn adhesively bonded in the light-guide tube 8 so that is cannot be moved in 2p336'~~
the axial direction. The fibre end 15 in the immediate vicinity of the light-emitting face 16 projects slightly out of the centring cylinder 14 and is embedded in a silicone composition 17 in such a manner that an annular gap 18 filled with air is present between the centring cylinder 14 and the silicone composition 17.
The silicone composition 17 fills the.space between the end face 6 of the aluminium cylinder 5 and the annular gap 18. It is distinguished by a high degree of transparency and does not turn yellow in the course of time. In order that the light emitted substantially axially from the end face 16 of the optical fibre 11 can be deflected in the radial direction onto the bronchial walls, the silicone composition contains dispersing particles. These particles consist of a titanium oxide powder, which is mixed in with the silicone composition 17. The silicone preferably contains 7 parts per thousand of Ti02 having a particle size of 0.2 wm.
In a preferred embodiment, the concentration of the TiOz parkicles in the silicone composition 17 is greater in the region of the axial ends of the silicone composition 17 filling the light-guide tube 8 than it is in the central region. That brings about a greater intensity of the light dispersed radially in the vicinity of the face 16 of the fibre end 15 and in the vicinity of the end face 6 of the aluminium cylinder 5.
A bronchial light diffuser emitting light radially over 360 degrees and having a length of approximately 3 cm is thus formed, which diffuser, owing to its very small diameter, can be introduced even into very narrow bronchi.
If, instead of light emission over 360 degrees, an angle of irradiation of, for example, 180 degrees is desired, the inside of the outer tube 2 can be provided with a reflective metal coating that extends in the shape of a trough over half the circumference of the surface.

Claims (10)

1. An apparatus for irradiating the bronchi of a patient for the purpose of photodynamic therapy, which apparatus has an optical fibre that feeds the light of a laser into a bronchoscope, wherein the fibre (11) is surrounded by a light-guide tube (8) which projects beyond the light-emitting face (6) of the end (15) of the fibre by many times the fibre's diameter, and the end (15) of the fibre is embedded in a silicone composition (17) that contains TiO2 powder and that extends from the end (15) of the fibre to the end (7) of the light-guide tube.
2. An apparatus according to claim 1, wherein the end (13,15) of the fibre is fixed in position in the light-guide tube (8) by a centring cylinder (14), and an annular gap (18) that extends round the optical fibre (11) in the vicinity of the end face (16) and is delimited radially by the light-guide tube (8) is provided between the centring cylinder (14) and the silicone composition (17).
3. An apparatus according to claim 1 or claim 2, wherein the light-guide tube (8) consists of PTFE.
4. An apparatus according to any one of claims 1 to 3, wherein the light-guide tube (8) is surrounded by an outer tube (2) that is immovable in the axial direction and that projects beyond the distal end (7) of the light-guide tube (8), and an aluminium cylinder (5) which acts as a mirror and a PTFE
cylinder (4) which acts as a closing plug are arranged in the projecting portion.
5. An apparatus according to claim 4, wherein an open annular space is present between the light-guide tube (8) and the outer tube (2).
6 6. An apparatus according to any one of claims 1 to 5, wherein the light-guide tube (8) projects by approximately 3 cm beyond the end (13,15,16) of the fibre.
7. An apparatus according to any one of claims 1 to 6, wherein the silicone composition (17) contains seven parts per thousand of TiO2 powder having a particle size of 0.2 µm.
8. An apparatus according to any one of claims 1 to 7, wherein the light-guide tube (8) has an inside diameter of 0.8 mm and an outside diameter of approximately 1.1 mm.
9. An apparatus according to claim 8, wherein the outer tube (2) consists of PTFE and has an inside diameter of 1.4 mm and an outside diameter of 1.9 mm.
10. An apparatus according to claim 4, wherein the concentration of the TiO2 powder is lower in the axially central region than it is in the vicinity of the end faces (6,16) of the optical fibre (11) and the aluminium cylinder (5).
CA002033670A 1990-01-09 1991-01-07 Apparatus for irradiating the bronchi of a patient for the purpose of photodyanamic therapy Expired - Fee Related CA2033670C (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CH5890 1990-01-09
CH58/90-5 1990-01-09

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CA2033670A1 CA2033670A1 (en) 1991-07-10
CA2033670C true CA2033670C (en) 2001-11-20

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US (1) US5054867A (en)
EP (1) EP0437181B1 (en)
JP (1) JP2913215B2 (en)
AT (1) ATE117213T1 (en)
CA (1) CA2033670C (en)
DE (1) DE59008307D1 (en)
DK (1) DK0437181T3 (en)
ES (1) ES2067013T3 (en)
RU (1) RU2013098C1 (en)
UA (1) UA26254A (en)

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Also Published As

Publication number Publication date
CA2033670A1 (en) 1991-07-10
DE59008307D1 (en) 1995-03-02
ATE117213T1 (en) 1995-02-15
JPH04297280A (en) 1992-10-21
JP2913215B2 (en) 1999-06-28
US5054867A (en) 1991-10-08
EP0437181A1 (en) 1991-07-17
EP0437181B1 (en) 1995-01-18
RU2013098C1 (en) 1994-05-30
DK0437181T3 (en) 1995-03-20
UA26254A (en) 1999-07-19
ES2067013T3 (en) 1995-03-16

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