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 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.
2 . The method of claim 1 further comprising:
using a monitoring electrode to measure a test voltage delivered to cells in the tumor tissue site.
3 . The method of claim 2 wherein the test voltage is insufficient to create irreversible electroporation.
4 . The method of claim 1 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.
5 . The system of claim 4 herein the array is positioned in a surrounding relationship relative to the tumor tissue site.
6 . The method of claim 1 further comprising:
performing the electroporation in a controlled manner with real time monitoring.
7 . The method of claim 1 further comprising:
performing the electroporation in a controlled manner to provide for controlled pore formation in cell membranes.
8 . The method of claim 1 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.
9 . The method of claim 1 further comprising:
performing the electroporation in a controlled manner with monitoring of electrical impedance;
10 . The method of claim 1 further comprising:
detecting an onset of electroporation of cells at the tumor tissue site.
11 . The method of claim 1 further comprising:
performing the electroporation in a controlled manner with controlled intensity and duration of voltage.
12 . The method of claim 1 further comprising:
performing the electroporation in a controlled manner with real time control.
13 . The method of claim 1 further comprising:
performing the electroporation in a manner for modification and control of mass transfer across cell membranes.
14 . The method of claim 1 further comprising:
performing the electroporation in a controlled manner with a proper selection of voltage magnitude.
15 . The method of claim 1 wherein the electroporation is performed in a controlled manner with a proper selection of voltage magnitude.
16 . The method of claim 1 wherein the electroporation is performed in a controlled manner with a proper selection of voltage application time.
17 . The method of claim 1 wherein the duration of each pulse is about 5 microseconds to about 62 seconds.
18 . The method of claim 1 wherein the duration of each pulse is about 90 to 110 microseconds.
19 . The method of claim 1 wherein pulses are applied for a period of about 100 microseconds.
20 . The method of claim 18 , wherein about 1 to 15 pulses are applied.
21 . The method of claim 18 , wherein about eight pulses of about 100 microseconds each in duration are applied.
22 . The method of claim 1 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.
23 . The method of claim 1 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.
24 . The method of claim 1 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.
25 . The method of claim 1 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.
26 . The method of claim 1 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.
27 . The method of claim 1 further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 100 degrees C. or less.
28 . The method of claim 1 further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 75 degrees C. or less.
29 . The method of claim 1 further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 60 degrees C. or less.
30 . The method of claim 1 further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 50 degrees C. or less.
31 . The method of claim 1 wherein the pulses applied are of sufficient duration and magnitude to permanently disrupt cell membranes of cells at the tumor tissue site.
32 . The method 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.
33 . The method of claim 1 wherein the tumor is a prostate tumor.
34 . The method of claim 1 wherein the tumor is a breast tumor.
35 . The method of claim 1 wherein the tumor is a kidney tumor.
36 . The method of claim 1 wherein the tumor is a colo-rectal tumor.
37 . The method of claim 1 wherein the tumor is a brain tumor.
38 . The method of claim 1 wherein the tumor is a lung tumor.
39 . The method of claim 1 wherein the tumor is a liver tumor.
40 . The method of claim 1 wherein the tumor is a adrenal gland tumor.
41 . The method of claim 1 wherein the tumor is a skin tumor.
42 . The method of claim 1 wherein the tumor is a pancreas tumor.
43 . The method of claim 1 wherein the tumor is a uterine fibroid.
44 . The method of claim 1 wherein the tumor is a breast fibroid.
45 . 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.
46 . The method of claim 45 , wherein a monitoring electrode is provided.
47 . The method of claim 46 , wherein the monitoring electrode is placed distal or proximal to the bipolar electrode.
48 . The method of claim 46 , wherein the monitoring electrode is placed at a fixed distance form the bipolar electrode.
49 . The method of claim 46 , wherein the monitoring electrode is mounted on a sheath through which the bipolar electrode is placed.
50 . The method of claim 49 , 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.
51 . The method of claim 46 , wherein the monitoring electrode is positioned at a biopsy guide coupled to the RF electrode.
52 . The method of claim 51 , wherein the RF electrode is configured to be placed through the biopsy guide.
53 . The method of claim 52 , wherein the monitoring electrode is placed at a tip of the biopsy guide and rests against tissue when the bipolar electrode is placed.
54 . The method of claim 45 , further comprising:
using a monitoring electrode to measure a test voltage delivered to cells in the tumor tissue site.
55 . The method of claim 44 , wherein the test voltage is insufficient to create irreversible electroporation.
56 . The method of claim 45 , 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.
57 . The system of claim 56 , wherein the array is positioned in a surrounding relationship relative to the tumor tissue site.
58 . The method of claim 45 , further comprising:
performing the electroporation in a controlled manner with real time monitoring.
59 . The method of claim 45 , further comprising:
performing the electroporation in a controlled manner to provide for controlled pore formation in cell membranes.
60 . The method of claim 45 , 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.
61 . The method of claim 45 , further comprising:
performing the electroporation in a controlled manner with monitoring of electrical impedance.
62 . The method of claim 45 , further comprising:
detecting an onset of electroporation of cells at the tumor tissue site.
63 . The method of claim 45 , further comprising:
performing the electroporation in a controlled manner with controlled intensity and duration of voltage.
64 . The method of claim 45 , further comprising:
performing the electroporation in a controlled manner with real time control.
65 . The method of claim 45 , further comprising:
performing the electroporation in a manner for modification and control of mass transfer across cell membranes.
66 . The method of claim 45 , further comprising:
performing the electroporation in a controlled manner with a proper selection of voltage magnitude.
67 . The method of claim 45 , wherein the electroporation is performed in a controlled manner with a proper selection of voltage magnitude.
68 . The method of claim 45 , wherein the electroporation is performed in a controlled manner with a proper selection of voltage application time.
69 . The method of claim 45 , wherein the duration of each pulse is about 5 microseconds to about 62 seconds.
70 . The method of claim 45 , wherein the duration of each pulse is about 90 to 110 microseconds.
71 . The method of claim 45 , wherein pulses are applied for a period of about 100 microseconds.
72 . The method of claim 60 , wherein about 1 to 15 pulses are applied.
73 . The method of claim 60 , wherein about eight pulses of about 100 microseconds each in duration are applied.
74 . The method of claim 45 , 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.
75 . The method of claim 45 , 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.
76 . The method of claim 45 , 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.
77 . The method of claim 45 , 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.
78 . The method of claim 45 , 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.
79 . The method of claim 45 , further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 100 degrees C. or less.
80 . The method of claim 45 , further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 75 degrees C. or less.
81 . The method of claim 45 , further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 60 degrees C. or less.
82 . The method of claim 45 , further comprising:
adjusting a current-to-voltage ratio based on temperature to maintain the tumor tissue site temperature at 50 degrees C. or less.
83 . The method of claim 45 , wherein the pulses applied are of sufficient duration and magnitude to permanently disrupt cell membranes of cells at the tumor tissue site.
84 . The method of claim 45 , 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.
85 . The method of claim 45 , wherein the tumor is a prostate tumor.
86 . The method of claim 45 , wherein the tumor is a breast tumor.
87 . The method of claim 45 , wherein the tumor is a kidney tumor.
88 . The method of claim 45 , wherein the tumor is a colo-rectal tumor.
89 . The method of claim 45 , wherein the tumor is a brain tumor.
90 . The method of claim 45 , wherein the tumor is a lung tumor.
91 . The method of claim 45 , wherein the tumor is a liver tumor.
92 . The method of claim 45 , wherein the tumor is a adrenal gland tumor.
93 . The method of claim 45 , wherein the tumor is a skin tumor.
94 . The method of claim 45 , wherein the tumor is a pancreas tumor.
95 . The method of claim 45 , wherein the tumor is a uterine fibroid.
96 . The method of claim 45 , wherein the tumor is a breast fibroid.