Claims for Patent: 8,185,176

Summary for Patent: 8,185,176

Title:	Method and apparatus for vasculature visualization with applications in neurosurgery and neurology
Abstract:	The invention provides methods and systems for neurovascular imaging (150).
Inventor(s):	Mangat; Gurpreet (Markham, CA), Brzozowski; Lukasz (Toronto, CA), Croft; Richard L. (Oakville, CA)
Assignee:	Novadaq Technologies, Inc. (Mississauga, CA)
Application Number:	11/912,878
Patent Claims:	1. A computer implemented method of intra-operatively confirming the removal of at least one vessel comprising an arteriovenous malformation in a subject, comprising: a. administering a fluorescent dye to a recipient subject; b. applying a sufficient amount of energy to a vessel in the subject such that the fluorescent dye fluoresces; c. detecting pixel data in a detection area to be imaged; d. transmitting the pixel data to a processor; e. obtaining a fluorescing image of the vessel; f. observing the fluorescing image to identify a location of an arteriovenous malformation; g. surgically removing the vessel including the arteriovenous malformation; h. intraoperatively confirming the removal of the vessel including the arteriovenous malformation by observing the fluorescing image to determine if a fluorescent signal stops at a point of removal of the vessel, wherein a lack of a fluorescent signal downstream of the point of removal indicates the arteriovenous malformation has been removed; and i. calculating on the processor a relative maximum fluorescent intensity in an area of fluorescence, the area of fluorescence indicated by a number of pixels associated with the fluorescing dye in a pre treatment image and a post treatment image corresponding to the detection area, wherein a fewer number of pixels and less fluorescent intensity at the detector area indicates a removal of the arteriovenous malformation, and a greater number of pixels and greater fluorescent intensity at the detection area indicates a non-removal of the arteriovenous malformation. 2. The method of claim 1, wherein the recipient subject is an animal. 3. The method of claim 1, wherein the animal is a human. 4. The method of claim 1, wherein the fluorescent dye is a tricarbocyanine dye or an analog thereof. 5. The method of claim 4, wherein the tricarbocyanine dye is indocyanine green. 6. The method of claim 1, wherein the fluorescent dye comprises a mixture or combination of multiple fluorescent dyes or analogs thereof. 7. The method of claim 1, wherein the dye is administered intravenously. 8. The method of claim 1, wherein the dye is administered by catheter or cannula. 9. The method of claim 1, wherein the dye is administered as a bolus injection. 10. The method of claim 1, wherein the dye is administered less than an hour before confirming removal of the arteriovenous malformation. 11. The method of claim 1, wherein the dye is administered more than 30 seconds confirming removal of the arteriovenous malformation. 12. The method of claim 1, wherein the energy is light energy. 13. The method of claim 12, wherein the light energy is provided by a laser. 14. The method of claim 13, wherein the laser power output is about 2.5 watts. 15. The method of claim 14, wherein the laser power output lasts for about 30 seconds. 16. The method of claim 14, wherein the output is a continuous wave. 17. The method of claim 12, wherein the light energy is provided by an incandescent light and a filter. 18. The method of claim 12, wherein the wavelength of the light energy is in the infra-red spectrum. 19. The method of claim 12, wherein the wavelength of the light energy is about 805 nanometers. 20. The method of claim 1, wherein the image is obtained by a camera. 21. The method of claim 20, wherein the camera is a charge coupled device. 22. The method of claim 20, wherein the camera is a video recorder. 23. The method of claim 1, wherein the vessel is a blood vessel. 24. The method of claim 1, wherein the vessel is an artery. 25. The method of claim 1, wherein the vessel is a vein. 26. The method of claim 1, wherein the vessel is a nidus associated with AVM. 27. The method of claim 1, wherein the vessel is surgically exposed. 28. A computer implemented method of intra-operatively locating at least one vessel comprising an arteriovenous malformation in a subject, comprising: a. administering a fluorescent dye to a recipient subject; b. applying a sufficient amount of energy to at least one vessel to the subject such that the fluorescent dye fluoresces; c. detecting pixel datain a detection area to be imaged; d. transmitting the pixel data to a processor; e. obtaining a fluorescing image of the at least one vessel; f. intraoperatively locating a suspect vessel of said at least one vessel, the suspect vessel having an arteriovenous malformation; g. observing the image to determine if the fluorescent signal leaks from the suspected vessel, wherein a leak of a fluorescent signal from the suspected vessel indicates an arteriovenous malformation; and h. calculating on the processor a relative maximum fluorescent intensity in an area of fluorescence, the area of fluorescence indicated by a number of pixels associated with the fluorescing dye in a pre treatment image and a post treatment image corresponding to the detection area, wherein a fewer number of pixels and less fluorescent intensity at the detector area indicates a removal of the arteriovenous malformation, and a greater number of pixels and greater fluorescent intensity at the detection area indicates a non-removal of the arteriovenous malformation. 29. The method of claim 28, wherein the recipient subject is an animal. 30. The method of claim 29, wherein the animal is a human. 31. The method of claim 28, wherein the fluorescent dye is a tricarbocyanine dye or an analog thereof. 32. The method of claim 31, wherein the fluorescent dye comprises a mixture or combination of a first fluorescent dye or analogs thereof and a second fluorescent dye or analog thereof. 33. The method of claim 31, wherein the tricarbocyanine dye is indocyanine green. 34. The method of claim 28, wherein the dye is administered intravenously. 35. The method of claim 28, wherein the dye is administered as a bolus injection. 36. The method of claim 28, wherein the dye is administered by catheter or annula. 37. The method of claim 28, wherein the dye is administered less than an hour before confirming removal of the arteriovenous malformation. 38. The method of claim 28, wherein the dye is administered more than 30 seconds confirming removal of the arteriovenous malformation. 39. The method of claim 28, wherein the energy is light energy. 40. The method of claim 39, wherein the light energy is provided by a laser. 41. The method of claim 40, wherein the laser power output is about 2.5 watts. 42. The method of claim 41, wherein output is a continuous wave. 43. The method of claim 40, wherein the laser power output lasts for about 30 seconds. 44. The method of claim 39, wherein the light energy is provided by an incandescent light and a filter. 45. The method of claim 39, wherein the wavelength of the light energy is in the infra-red spectrum. 46. The method of claim 39, wherein the wavelength of the light energy is about 805 nanometers. 47. The method of claim 28, wherein the image is obtained by a camera. 48. The method of claim 47, wherein the camera is a charge coupled device. 49. The method of claim 47, wherein the camera is a video recorder. 50. The method of claim 28, wherein the vessel is a blood vessel. 51. The method of claim 28, wherein the vessel is an artery. 52. The method of claim 28, wherein the vessel is a vein. 53. The method of claim 28, wherein the vessel is a nidus associated with AVM. 54. The method of claim 28, wherein the vessel is surgically exposed. 55. A portable system comprising: a) a device for administering fluorescent dye to a subject; b) an energy source capable of emitting two laser beams of sufficient energy such that the fluorescent dye fluoresces; c) an imaging head for imaging at least one vessel; and d) a processor coupled to perform the method of claim 1 or claim 28. 56. The system of claim 55, comprising a field of view having a first dimension of about 0.5 to 1.5 inches and a second dimension of about 0.5 to about 1.5 inches. 57. The system of claim 55, wherein the first and second dimension are approximately 1 inch. 58. The system of claim 55, wherein the system has an irradiance in the range of about 15-25 mW/cm.sup.2. 59. The system of claim 55, wherein the two laser beams converge at a common focal point. 60. The system of claim 55, wherein the two laser beams comprise green light. 61. The system of claim 55, wherein the two laser beams comprise radiation in the infrared spectrum. 62. The system of claim 55, said system comprising a second energy source capable of emitting sufficient energy to excite a second fluorescent dye such that said second fluorescent dye fluoresces. 63. The system of claim 55, wherein the imaging head is contained in an endoscope. 64. The system of claim 55, wherein the imaging head is contained in a surgical microscope.