Cryotherapy, thermal therapy, temperature modulation therapy, and probe apparatus therefor
A variable length interstitial probe apparatus includes: a probe for effecting thermal therapy and/or cryotherapy to a tissue; a flexible umbilical sheath permanently affixed to the probe, including at least one interface for supplying energy, cooling fluid, cooling gas, heating fluid, and/or heating gas to the probe; and an adjustable depth stop configured to slide along a length of a shaft region of the probe, and lock to the shaft region at a selected position. The adjustable depth stop is configured to engage a probe driver and/or a skull mount apparatus to stabilize positioning of the probe and to control a depth of entry of the probe into a patient. The probe may be configured to effect temperature modulation therapy, where processing circuitry activates a modulation pattern of thermal therapy emission and cryogenic therapy emission for applying a thermal dose to the tissue.
1. A system for performing temperature modulation therapy to a tissue with an interstitial probe, the system comprising:
an interstitial probe, comprising a shaft region, a tip region, at least one thermal therapy-generating element for thermal therapy emission via the tip region, and at least one cryotherapy-generating element for cryogenic therapy emission via the tip region;
processing circuitry; and
a memory having instructions stored thereon, wherein the instructions, when executed by the processing circuitry, cause the processing circuitry to, while the interstitial probe is positioned proximate a tissue:
determine a thermal dose for effecting thermal therapy treatment based on a present position of the interstitial probe,
identify, based at least in part upon the thermal dose, a modulation pattern comprising at least one cycle of lower thermal output interspersed between two higher thermal outputs, wherein a higher thermal output corresponds to activation of a first thermal therapy element of the at least one thermal therapy-generating element for a first time interval and the lower thermal output corresponds to activation of a first cryogenic therapy element of the at least one cryogenic therapy element for a second time interval,
activate, at the present position of the interstitial probe, temperature modulation therapy by the interstitial probe utilizing the identified modulation pattern for applying the thermal dose to the tissue,
during the application of the thermal dose via the modulation therapy, monitor at least one temperature of the tissue,
identify a difference between a goal temperature corresponding to the thermal dose and the at least one temperature of the tissue, and
responsive to identifying the difference, alter the modulation pattern, wherein altering the modulation pattern comprises altering at least one of a) a length of the first time interval, b) a length of the second time interval, c) an emission level of the first thermal therapy-generating element during the first time interval, d) an emission level of the first thermal therapy-generating element during the second time interval, e) an emission level of the first cryotherapy-generating element during the first time interval, and f) an emission level of the first cryotherapy-generating element during the second time interval.
2. The system of claim 1 , wherein altering the modulation pattern comprises selecting a new modulation pattern of a plurality of pre-set modulation patterns.
3. The system of claim 1 , wherein identifying the difference between the goal temperature and the at least one temperature of the tissue comprises identifying a measured tissue temperature differs from the goal temperature by at least a threshold amount.
4. The system of claim 1 , wherein altering the modulation pattern comprises lowering an overall tissue temperature towards the goal temperature to avoid cellular damage during thermal therapy.
5. The system of claim 1 , wherein a goal thermal dose profile comprises the goal temperature, wherein the goal thermal dose profile is related to the thermal dose.
6. The system of claim 1 , wherein the instructions, when executed, cause the processing circuitry to identify, based at least in part upon the thermal dose, the modulation pattern further comprise instructions to cause the processing circuitry to identify the modulation pattern based at least in part upon a desired effect upon the tissue, wherein the desired effect comprises at least one of altering normal biological function, altering abnormal biological function, and disrupting a blood-brain barrier.
7. The system of claim 1 , wherein the instructions, when executed, cause the processing circuitry to identify, based at least in part upon the thermal dose, the modulation pattern further comprise instructions to cause the processing circuitry to identify the modulation pattern based at least in part upon a type of secondary treatment to be applied at the region of interest, wherein the type of secondary treatment comprises at least one of a drug treatment, a chemical treatment, a biochemical treatment, and a radiation treatment.
8. The system of claim 1 , wherein monitoring the at least one temperature of the tissue comprises performing image-based thermography of the tissue.
9. The system of claim 1 , further comprising a controller remotely located to the probe, wherein the controller comprises at least a portion of the processing circuitry.
10. The system of claim 1 , further comprising a flexible umbilical sheath portion permanently affixed to the shaft region, wherein the flexible umbilical sheath portion includes at least one interface for supplying one of energy, cooling fluid, cooling gas, heating fluid, and heating gas to the shaft region.
11. The system of claim 1 , wherein the first time interval is different from the second time interval.
12. The system of claim 1 , wherein the first time interval is similar to the second time interval.
13. The system of claim 1 , wherein at least one of the two higher thermal outputs corresponds to a simultaneous activation of a cryogenic therapy element for at least part of the first time interval.
14. The system of claim 1 , wherein the thermal dose comprises at least one of the following: a goal temperature, a goal thermal dose profile, or a goal energy dose profile.