Methods and systems for treating tumors using electroporation
A system is provided for treating tumor tissue sites of a patient. At least first and second mono-polar electrodes are configured to be introduced at or near the tumor tissue site of the patient. A voltage pulse generator is coupled to the first and second mono-polar electrodes. The voltage pulse generator is configured to apply sufficient electrical pulses between the first and second mono-polar electrodes to induce electroporation of cells in the tumor tissue site, to create necrosis of cells of the tumor tissue site, but insufficient to create a thermal damaging effect to a majority of the tumor tissue site.
1 . A system for treating a tumor of a patient, comprising:
at least first and second mono-polar electrodes configured to be introduced at or near a tumor tissue site of the patient;
a voltage pulse generator coupled to the first and second mono-polar electrodes and configured to applying electrical pulses between the first and second mono-polar electrodes in an amount to induce electroporation of cells in the tumor tissue site to create cell necrosis of tumor cells without creating a thermal damage effect to a majority of the tumor tissue site.
2 . The system of claim 1 , further comprising:
a monitoring electrode configured to measure a test voltage delivered to cells in the tumor tissue site.
3 . The system of claim 1 , wherein the test voltage is insufficient to create irreversible electroporation.
4 . The system of claim 1 , further comprising:
at least a third mono-polar electrode, the at least first, second and third mono-polar electrodes forming an array of mono-polar electrodes.
5 . The system of claim 4 , wherein the array is configured to be positioned in a surrounding relationship relative to the tumor tissue site.
6 . The system of claim 1 , wherein the electroporation is performed in a controlled manner with real time monitoring.
7 . The system of claim 1 , wherein the electroporation is performed in a controlled manner to provide for controlled pore formation in cell membranes.
8 . The system of claim 1 , wherein the electroporation is performed in a controlled manner to create a tissue effect in the cells at the tumor tissue site while preserving surrounding tissue.
9 . The system of claim 1 , wherein the electroporation is performed in a controlled manner with monitoring of electrical impedance,
10 . The system of claim 1 , further comprising:
detecting an onset of electroporation of cells at the tumor tissue site.
11 . The system of claim 1 , wherein the electroporation is performed in a controlled manner with controlled intensity and duration of voltage.
12 . The system of claim 1 , wherein the electroporation is performed in a controlled manner with real time control.
13 . The system of claim 1 , wherein the electroporation is performed in a manner for modification and control of mass transfer across cell membranes.
14 . The system of claim 1 , wherein the electroporation is performed in a controlled manner with a proper selection of voltage magnitude.
15 . The system of claim 1 , wherein the electroporation is performed in a controlled manner with a proper selection of voltage application time.
16 . The system of claim 15 , wherein voltage pulse generator is configured to provide that each pulse is applied for a duration of about 5 microseconds to about 62 seconds.
17 . The system of claim 1 , wherein the voltage pulse generator is configured to provide that each pulse is applied for a duration of about 90 to 110 microseconds.
18 . The system of claim 1 , wherein the voltage pulse generator is configured to provide that each pulse is applied for a duration of about 100 microseconds.
19 . The system of claim 17 , wherein the voltage pulse generator is configured to apply from about 1 to 15 pulses.
20 . The system of claim 17 , wherein the voltage pulse generator is configured to apply about eight pulses of about 100 microseconds each in duration.
21 . The system of claim 1 , wherein the voltage pulse generator is configured to provide for pulse application to produce a voltage gradient at the tumor tissue site in a range of from about 50 volt/cm to about 8000 volt/cm.
22 . The system of claim 1 , wherein a temperature of the tumor tissue site is monitored and the pulses are adjusted to maintain a temperature of 100 degrees C. or less at the tumor tissue site.
23 . The system of claim 1 , wherein a temperature of the tumor tissue site is monitored and the pulses are adjusted to maintain a temperature of 75 degrees C. or less at the tumor tissue site.
24 . The system of claim 1 , wherein a temperature of the tumor tissue site is monitored and the pulses are adjusted to maintain a temperature of 60 degrees C. or less at the tumor tissue site.
25 . The system of claim 22 , wherein the temperature is maintained at 50 degrees C. or less.
26 . The system of claim 1 , wherein a current-to-voltage ratio is adjusted based on temperature to maintain the tumor tissue site temperature at 100 degrees C. or less.
27 . The system of claim 1 , wherein a current-to-voltage ratio is adjusted based on temperature to maintain the tumor tissue site temperature at 75 degrees C. or less.
28 . The system of claim 1 , wherein a current-to-voltage ratio is adjusted based on temperature to maintain the tumor tissue site temperature at 60 degrees C. or less.
29 . The system of claim 1 , wherein a current-to-voltage ratio is adjusted based on temperature to maintain the tumor tissue site temperature at 50 degrees C. or less.
30 . The system of claim 1 , wherein the first electrode is placed at about 5 mm to 10 cm from the second electrode.
31 . The system of claim 1 , wherein the first and second mono-polar electrodes are circular in shape.
32 . The system of claim 1 , wherein the voltage pulse generator is configured to provide for pulse application of sufficient duration and magnitude to permanently disrupt cell membranes of cells at the tumor tissue site.
33 . The system of claim 1 , wherein a ratio of electric current through cells at the tumor tissue site to voltage across the cells is detected and a magnitude of applied voltage to the tumor tissue site is adjusted in accordance with changes in the ratio of current to voltage.
34 . A system for treating a tumor of a patient, comprising:
a bi-polar electrode configured to be introduced at or near a tumor tissue site of the patient; and
a voltage pulse generator coupled to the bi-polar electrode and configured to applying electrical pulses in an amount to induce electroporation of cells in the tumor tissue site to create cell necrosis of tumor cells without creating a thermal effect to a majority of the tumor tissue site.
35 . The system of claim 34 , wherein the electroporation is performed in a controlled manner with real time monitoring.
36 . The system of claim 34 , further comprising:
a monitoring electrode configured to measure a test voltage delivered to cells in the tumor tissue site.
37 . The system of claim 34 , wherein the test voltage is insufficient to create irreversible electroporation.
38 . The system of claim 34 , further comprising:
at least a second and a third bipolar electrodes, the at least first, second and third bipolar electrodes forming an array of electrodes.
39 . The system of claim 38 , wherein the array is configured to be positioned in a surrounding relationship relative to the tumor tissue site.
40 . The system of claim 34 , wherein the electroporation is performed in a controlled manner to provide for controlled pore formation in cell membranes.
41 . The system of claim 34 , wherein the electroporation is performed in a controlled manner to create a tissue effect in the cells at the tumor tissue site while preserving surrounding tissue.
42 . The system of claim 34 , wherein the electroporation is performed in a controlled manner with monitoring of electrical impedance;
43 . The system of claim 34 , further comprising:
detecting an onset of electroporation of cells at the tumor tissue site.
44 . The system of claim 34 , wherein the electroporation is performed in a controlled manner with controlled intensity and duration of voltage.
45 . The system of claim 34 , wherein the electroporation is performed in a controlled manner with real time control.
46 . The system of claim 34 , wherein the electroporation is performed in a manner to for modification and control of mass transfer across cell membranes.
47 . The system of claim 34 , wherein the electroporation is performed in a controlled manner with a proper selection of voltage magnitude.
48 . The system of claim 34 , wherein the electroporation is performed in a controlled manner with a proper selection of voltage application time.
49 . The system of claim 34 , wherein the voltage pulse generator is configured to provide that each pulse is applied for a duration of about 5 microseconds to about 62 seconds.
50 . The system of claim 34 , wherein the voltage pulse generator is configured to provide that each pulse is applied for a duration of about 90 to 110 microseconds.
51 . The system of claim 34 , wherein the voltage pulse generator is configured to provide that each pulse is applied for a duration of about 100 microseconds.
52 . The system of claim 50 , wherein the voltage pulse generator is configured to apply from about 1 to 15 pulses.
53 . The system of claim 50 , wherein the voltage pulse generator is configured to apply about eight pulses of about 100 microseconds each in duration.
54 . The system of claim 34 , wherein the voltage pulse generator is configured to provide for pulse application to produce a voltage gradient at the tumor tissue site in a range of from about 50 volt/cm to about 8000 volt/cm.
55 . The system of claim 34 , wherein a temperature of the tumor tissue site is monitored and the pulses are adjusted to maintain a temperature of 100 degrees C. or less at the tumor tissue site.
56 . The system of claim 34 , wherein a temperature of the tumor tissue site is monitored and the pulses are adjusted to maintain a temperature of 75 degrees C. or less at the tumor tissue site.
57 . The system of claim 34 , wherein a temperature of the tumor tissue site is monitored and the pulses are adjusted to maintain a temperature of 60 degrees C. or less at the tumor tissue site.
58 . The system of claim 55 , wherein the temperature is maintained at 50 degrees C. or less.
59 . The system of claim 34 , wherein a current-to-voltage ratio is adjusted based on temperature to maintain the tumor tissue site temperature at 100 degrees C. or less.
60 . The system of claim 34 , wherein a current-to-voltage ratio is adjusted based on temperature to maintain the tumor tissue site temperature at 75 degrees C. or less.
61 . The system of claim 34 , wherein a current-to-voltage ratio is adjusted based on temperature to maintain the tumor tissue site temperature at 60 degrees C. or less.
62 . The system of claim 34 , wherein a current-to-voltage ratio is adjusted based on temperature to maintain the tumor tissue site temperature at 50 degrees C. or less.
63 . The system of claim 34 , wherein the voltage pulse generator is configured to provide for pulse application of sufficient duration and magnitude to permanently disrupt cell membranes of cells at the tumor tissue site.
64 . The system of claim 34 , wherein a ratio of electric current through cells at the tumor tissue site to voltage across the cells is detected and a magnitude of applied voltage to the tumor tissue site is adjusted in accordance with changes in the ratio of current to voltage.
65 . A method for treating a tumor of a patient, comprising:
introducing at least first and second mono-polar electrodes to a tumor tissue site of the patient;
positioning the at least first and second mono-polar electrodes at or near the tumor tissue site;
applying an electric field in a controlled manner to the tumor tissue site in an amount sufficient to produce electroporation of cells at the tumor tissue site and below an amount that causes thermal damage to a majority of the tumor tissue site.
66 . The method of claim 65 , further comprising:
using a monitoring electrode to measure a test voltage delivered to cells in the tumor tissue site.
67 . The method of claim 66 , wherein the test voltage is insufficient to create irreversible electroporation.
68 . The method of claim 65 , further comprising:
introducing at least a third mono-polar electrode to the tumor tissue site, the first, second and third mono-polar electrodes forming an array of electrodes.
69 . The system of claim 68 , wherein the array is positioned in a surrounding relationship relative to the tumor tissue site.
70 . The method of claim 65 , further comprising:
performing the electroporation in a controlled manner with real time monitoring.
71 . The method of claim 65 , further comprising:
performing the electroporation in a controlled manner to provide for controlled pore formation in cell membranes.
72 . The method of claim 65 , further comprising:
performing the electroporation in a controlled manner to create a tissue? effect of cells at the tumor tissue site while preserving surrounding tissue.
73 . The method of claim 65 , further comprising:
performing the electroporation in a controlled manner with monitoring of electrical impedance;
74 . The method of claim 65 , further comprising:
detecting an onset of electroporation of cells at the tumor tissue site.
75 . The method of claim 65 , further comprising:
performing the electroporation in a controlled manner with controlled intensity and duration of voltage.
76 . The method of claim 65 , further comprising:
performing the electroporation in a controlled manner with real time control.
77 . The method of claim 65 , further comprising:
performing the electroporation in a manner for modification and control of mass transfer across cell membranes.
78 . The method of claim 65 , further comprising:
performing the electroporation in a controlled manner with a proper selection of voltage magnitude.
79 . The method of claim 65 , wherein the electroporation is performed in a controlled manner with a proper selection of voltage magnitude.
80 . The method of claim 65 , wherein the electroporation is performed in a controlled manner with a proper selection of voltage application time.
81 . The method of claim 65 , wherein the duration of each pulse is about 5 microseconds to about 62 seconds.
82 . The method of claim 65 , wherein the duration of each pulse is about 90 to 110 microseconds.
83 . The method of claim 65 , wherein pulses are applied for a period of about 100 microseconds.
84 . The method of claim 82 , wherein about 1 to 15 pulses are applied.
85 . The method of claim 82 , wherein about eight pulses of about 100 microseconds each in duration are applied.
86 . The method of claim 65 , wherein pulses are applied to produce a voltage gradient at the tumor tissue site in a range of from about 50 volt/cm to about 8000 volt/cm.
87 . The method of claim 65 , further comprising:
monitoring a temperature of the tumor tissue site; and
adjusting the pulses to maintain a temperature of 100 degrees C. or less at the tumor tissue site.
88 . The method of claim 65 , further comprising:
monitoring a temperature of the tumor tissue site; and
adjusting the pulses to maintain a temperature of 75 degrees C. or less at the tumor tissue site.
89 . The method of claim 65 , further comprising:
monitoring a temperature of the tumor tissue site; and
adjusting the pulses to maintain a temperature of 60 degrees C. or less at the tumor tissue site.
90 . The method of claim 65 , further comprising:
monitoring a temperature of the tumor tissue site; and
adjusting the pulses to maintain a temperature of 50 degrees C. or less at the tumor tissue site.
91 . The method of claim 65 , further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 100 degrees C. or less.
92 . The method of claim 65 , further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 75 degrees C. or less.
93 . The method of claim 65 , further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 60 degrees C. or less.
94 . The method of claim 65 , further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 50 degrees C. or less.
95 . The method of claim 65 , wherein the pulses applied are of sufficient duration and magnitude to permanently disrupt cell membranes of cells at the tumor tissue site.
96 . The method of claim 65 , wherein a ratio of electric current through cells at the tumor tissue site to voltage across the cells is detected and a magnitude of applied voltage to the tumor tissue site is adjusted in accordance with changes in the ratio of current to voltage.
97 . The method of claim 65 , wherein the tumor is a prostate tumor.
98 . The method of claim 65 , wherein the tumor is a breast tumor.
99 . The method of claim 65 , wherein the tumor is a kidney tumor.
100 . The method of claim 65 , wherein the tumor is a colo-rectal tumor.
101 . The method of claim 65 , wherein the tumor is a brain tumor.
102 . The method of claim 65 , wherein the tumor is a lung tumor.
103 . The method of claim 65 , wherein the tumor is a liver tumor.
104 . The method of claim 65 , wherein the tumor is a adrenal gland tumor.
105 . The method of claim 65 , wherein the tumor is a skin tumor.
106 . The method of claim 65 , wherein the tumor is a pancreas tumor.
107 . The method of claim 65 , wherein the tumor is a uterine fibroid.
108 . The method of claim 65 , wherein the tumor is a breast fibroid.
109 . A method for treating a tumor of a patient, comprising:
introducing a bi-polar electrode to a tumor tissue site of the patient;
positioning the bi-polar electrode at or near the tumor tissue site;
applying an electric field in a controlled manner to the tumor tissue site in an amount sufficient to produce electroporation of cells at the tumor tissue site and below an amount that causes thermal damage to a majority of the tumor tissue site.
110 . The method of claim 109 , wherein a monitoring electrode is provided.
111 . The method of claim 110 , wherein the monitoring electrode is placed distal or proximal to the bipolar electrode.
112 . The method of claim 110 , wherein the monitoring electrode is placed at a fixed distance form the bipolar electrode.
113 . The method of claim 110 , wherein the monitoring electrode is mounted on a sheath through which the bipolar electrode is placed.
114 . The method of claim 113 , wherein a distance of the monitoring electrode from the bipolar electrode is varied and positioned in response to an imaging of a monitored tissue site.
115 . The method of claim 110 , wherein the monitoring electrode is positioned at a biopsy guide coupled to the RF electrode.
116 . The method of claim 115 , wherein the RF electrode is configured to be placed through the biopsy guide.
117 . The method of claim 116 , wherein the monitoring electrode is placed at a tip of the biopsy guide and rests against tissue when the bipolar electrode is placed.
118 . The method of claim 109 , further comprising:
using a monitoring electrode to measure a test voltage delivered to cells in the tumor tissue site.
119 . The method of claim 108 , wherein the test voltage is insufficient to create irreversible electroporation.
120 . The method of claim 109 , further comprising:
introducing at least a second and a third bipolar electrode to the tumor tissue site, the first, second and third bipolar electrodes forming an array of electrodes.
121 . The system of claim 120 , wherein the array is positioned in a surrounding relationship relative to the tumor tissue site.
122 . The method of claim 109 , further comprising:
performing the electroporation in a controlled manner with real time monitoring.
123 . The method of claim 109 , further comprising:
performing the electroporation in a controlled manner to provide for controlled pore formation in cell membranes.
134 . The method of claim 109 , further comprising:
performing the electroporation in a controlled manner to create a tissue effect of cells at the tumor tissue site while preserving surrounding tissue.
125 . The method of claim 109 , further comprising:
performing the electroporation in a controlled manner with monitoring of electrical impedance.
126 . The method of claim 109 , further comprising:
detecting an onset of electroporation of cells at the tumor tissue site.
127 . The method of claim 109 , further comprising:
performing the electroporation in a controlled manner with controlled intensity and duration of voltage.
128 . The method of claim 109 , further comprising:
performing the electroporation in a controlled manner with real time control.
129 . The method of claim 109 , further comprising:
performing the electroporation in a manner for modification and control of mass transfer across cell membranes.
130 . The method of claim 109 , further comprising:
performing the electroporation in a controlled manner with a proper selection of voltage magnitude.
131 . The method of claim 109 , wherein the electroporation is performed in a controlled manner with a proper selection of voltage magnitude.
132 . The method of claim 109 , wherein the electroporation is performed in a controlled manner with a proper selection of voltage application time.
133 . The method of claim 109 , wherein the duration of each pulse is about 5 microseconds to about 62 seconds.
134 . The method of claim 109 , wherein the duration of each pulse is about 90 to 110 microseconds.
135 . The method of claim 109 , wherein pulses are applied for a period of about 100 microseconds.
136 . The method of claim 134 , wherein about 1 to 15 pulses are applied.
137 . The method of claim 134 , wherein about eight pulses of about 100 microseconds each in duration are applied.
138 . The method of claim 109 , wherein pulses are applied to produce a voltage gradient at the tumor tissue site in a range of from about 50 volt/cm to about 8000 volt/cm.
139 . The method of claim 109 , further comprising:
monitoring a temperature of the tumor tissue site; and
adjusting the pulses to maintain a temperature of 100 degrees C. or less at the tumor tissue site.
140 . The method of claim 109 , further comprising:
monitoring a temperature of the tumor tissue site; and
adjusting the pulses to maintain a temperature of 75 degrees C. or less at the tumor tissue site.
141 . The method of claim 109 , further comprising:
monitoring a temperature of the tumor tissue site; and
adjusting the pulses to maintain a temperature of 60 degrees C. or less at the tumor tissue site.
142 . The method of claim 109 , further comprising:
monitoring a temperature of the tumor tissue site; and
adjusting the pulses to maintain a temperature of 50 degrees C. or less at the tumor tissue site.
143 . The method of claim 109 , further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 100 degrees C. or less.
144 . The method of claim 109 , further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 75 degrees C. or less.
145 . The method of claim 109 , further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 60 degrees C. or less.
146 . The method of claim 109 , further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 50 degrees C. or less.
147 . The method of claim 109 , wherein the pulses applied are of sufficient duration and magnitude to permanently disrupt cell membranes of cells at the tumor tissue site.
148 . The method of claim 109 , wherein a ratio of electric current through cells at the tumor tissue site to voltage across the cells is detected and a magnitude of applied voltage to the tumor tissue site is adjusted in accordance with changes in the ratio of current to voltage.
149 . The method of claim 109 , wherein the tumor is a prostate tumor.
150 . The method of claim 109 , wherein the tumor is a breast tumor.
151 . The method of claim 109 , wherein the tumor is a kidney tumor.
152 . The method of claim 109 , wherein the tumor is a colo-rectal tumor.
153 . The method of claim 109 , wherein the tumor is a brain tumor.
154 . The method of claim 109 , wherein the tumor is a lung tumor.
155 . The method of claim 109 , wherein the tumor is a liver tumor.
156 . The method of claim 109 , wherein the tumor is a adrenal gland tumor.
157 . The method of claim 109 , wherein the tumor is a skin tumor.
158 . The method of claim 109 , wherein the tumor is a pancreas tumor.
159 . The method of claim 109 , wherein the tumor is a uterine fibroid.
160 . The method of claim 109 , wherein the tumor is a breast fibroid.