Implants and biodegradable fiducial markers
Implantable materials may be used in an iatrogenic site. Applications include radiopaque materials for fiducial marking. For instance, a method of treating fiducially marking a patient comprising placing a fiduciary marker in the patient at a tissue in the patient, said marker comprising a collection of pharmaceutically acceptable, covalently-crosslinked hydrolytically biodegradable hydrogel particles into the tissue of the patient, the collection comprising a plurality of the particles having a covalently attached radiopaque agent, with the radiopaque agent being present in the collection at a concentration of at least about 0.1% w/w.
1. A method of fiducially marking a patient comprising placing a fiduciary marker in the patient at a tissue in the patient that requires the fiduciary marker, said marker comprising a collection of pharmaceutically acceptable, covalently-crosslinked hydrolytically biodegradable hydrogel particles into the tissue, the collection comprising a plurality of the particles having a covalently attached radiopaque agent, with the radiopaque agent being present in the collection at a concentration of at least about 0.1% w/w.
2. The method of claim 1 wherein the collection has a Hounsfield number of more than about 50.
3. The method of claim 1 wherein the collection, as placed in the patient, has a volume between 1 and 40 ml.
4. The method of claim 1 wherein the collection is stable, having dimensions that do not appreciably change following implantation for a predetermined amount of time, and thereafter softens and biodegrades.
5. The method of claim 4 wherein the predetermined amount of time is between 30 and 90 days.
6. The method of claim 1 with the hydrogel particles comprising the covalently attached radiopaque agent being a first set of particles, and further comprising a second set of particles comprising particles free of a covalently-bound radiopaque agent.
7. The method of claim 1 with the collection further comprising a non-covalently bound radiopaque agent.
8. The method of claim 1 wherein the hydrogel particles are spheroidal with a maximum diameter of between about 20 to about 200 microns.
9. The method of claim 1 , with the hydrogel particles being biodegradable to produce only degradation products that are absorbed into the circulatory system and cleared from the body via renal filtration.
10. The method of claim 1 wherein the hydrogel particles, before hydrolysis, have a total swellability in physiological solution of no more than about 30% by volume.
11. The method of claim 1 wherein degradation products of the hydrogel particles comprise a polyethylene glycol covalently bound to the radioopaque agent, with the radioopaque agent comprising iodine.
12. The method of claim 1 wherein the hydrogel is a product of a covalent crosslinking chemical reaction between at least two precursors, with one of the precursors comprising a branched polyethylene glycol with at least four arms.
13. The method of claim 12 wherein between 25% and 90% of the arms comprise the radioopaque agent.
14. The method of claim 1 wherein the tissue is a tissue cavity.
15. The method of claim 14 wherein the tissue cavity is created by removal of cancerous tissue.
16. The method of claim 14 wherein the tissue cavity is facial or is located in a breast.
17. The method of claim 14 wherein the cavity is a iatrogenic cavity.
18. The method of claim 14 comprising substantially filling the cavity with the particles.
19. The method of claim 18 wherein the particles are dehydrated when initially placed in the site and rehydrate in the site.
20. The method of claim 18 wherein the collection of particles, upon rehydration, has a volume that is substantially equal to the removed tissue volume.
21. The method of claim 14 further comprising visualizing margins of the cavity with a machine selected from the group consisting of magnetic resonance imaging, X-ray, and computerized tomography.
22. The method of claim 1 with the collection having a lubricity and maximum diameter suitable for manual passage out of a syringe through a 30 gauge needle.
23. The method of claim 1 further comprising an osmotic agent present in a mixture with the collection, the agent comprising a hydrophilic polymer that increases an osmotic pressure in the mixture.
24. The method of claim 1 wherein the collection of particles is completely biodegradable at a time between about 30 and about 365 days.
25. The method of claim 1 wherein the crosslinked hydrogels comprise a first precursor and a second precursor covalently bonded to each other wherein the first precursor, before crosslinking, comprises a branched polyethylene glycol with at least four arms and between 25% and 90% of the arms comprising the radioopaque agent.