U.S. patent number 3,669,093 [Application Number 04/889,128] was granted by the patent office on 1972-06-13 for apparatus for giving medical treatment by irradiation from radioactive substances.
Invention is credited to Hans Goedecke, Kurt Sauerwein.
United States Patent |
3,669,093 |
Sauerwein , et al. |
June 13, 1972 |
APPARATUS FOR GIVING MEDICAL TREATMENT BY IRRADIATION FROM
RADIOACTIVE SUBSTANCES
Abstract
Apparatus for treating human or animal patients by local
irradiation from a radioactive substance comprises a hollow probe
closed at one end for introduction into a natural or surgically
produced opening in the body of the patient and a capsule which
contains a quantity of the radioactive substance and is fixed to
the end of a flexible but longitudinal thrust-transmitting cable
which propels the capsule between the interior of a shielding block
and the interior of the probe which is fixed to the block by a
delivery tube through which the cable extends. The cable passes
through a passage in the block and when the capsule is situated in
the interior of the block the cable extends from the block through
an opening in the end of the block remote from the delivery tube,
around the greater part of the periphery of a driving wheel which
is situated in the housing containing the shielding block, through
a storage tube to a terminal stop. The cable is pressed against the
driving wheel by spring-loaded rollers so that it is moved when the
driving wheel rotates and the storage tube extends between the
housings of two photo-electric assemblies which detect the movement
of the end of the cable remote from the capsule and respond by
controlling the movements of the driving wheel. The effective
length of the storage tube, measured between the two photo-electric
cell assemblies is equal to the distance traveled by the radiation
capsule between the interior of the block and the end of the probe
so that the two photo-electric cell assemblies stop the driving
wheel when the capsule is either in its position at the closed end
of the probe or in its position within the block.
Inventors: |
Sauerwein; Kurt (Dusseldorf,
DT), Goedecke; Hans (Mettmann Rhineland,
DT) |
Family
ID: |
5744663 |
Appl.
No.: |
04/889,128 |
Filed: |
December 30, 1969 |
Foreign Application Priority Data
|
|
|
|
|
Sep 5, 1969 [DT] |
|
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P 19 45 015.8 |
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Current U.S.
Class: |
600/7;
250/497.1 |
Current CPC
Class: |
A61M
25/0113 (20130101); A61M 31/00 (20130101); A61N
5/1007 (20130101); A61N 2005/1008 (20130101) |
Current International
Class: |
A61M
31/00 (20060101); A61M 25/01 (20060101); A61N
5/10 (20060101); A61j 001/00 (); A61n 005/10 ();
G21f 005/00 () |
Field of
Search: |
;128/1.1,1.2
;250/106,108 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Pace; Channing L.
Claims
We claim:
1. In apparatus for providing medical treatment for patients by
local irradiation from a radioactive substance, said apparatus
including a hollow probe for introduction into an opening in the
body of said patient, means closing one end of said probe, a
radiation capsule, a quantity of radioactive substance in said
capsule, a radiation shielding block, means defining a passage
through said block, a delivery tube fixing said probe to said
block, a flexible and longitudinal thrust transmitting cable fixed
to said capsule and extending through said delivery tube and said
passage and means for moving said cable to move said capsule
between a first position in the interior of said block and a second
position at the closed end of said probe, the improvement wherein
said means for moving said cable includes a driving wheel, means
rotatably mounting said driving wheel on the side of said block
remote from said delivery tube, means for rotating said driving
wheel and spring-loaded roller means for pressing said cable
against said driving wheel around the greater part of the periphery
thereof, and further comprising a storage tube for said cable
extending from said driving wheel on the side thereof remote from
said block, terminal stop means at the end of said storage tube
remote from said driving wheel and two photo-electric detecting
means for detecting movement of the end of said cable remote from
said capsule, said cable extending from said capsule when said
capsule is in said first position out of said block through an
opening, around said driving wheel and through said storage tube,
the effective length of said storage tube measured between said two
photo-electric detecting means being equal to the distance traveled
by said radiation capsule between said first position and said
second position and said photo-electric detecting means being
operative to control said means for rotating said driving wheel
whereby said rotating means is stopped by one of said
photo-electric detecting means when said capsule reaches said first
position from said second position and said rotating means is
stopped by the other of said photo-electric detecting means when
said capsule reaches said second position from said first
position.
2. Apparatus as claimed in claim 1, wherein said photo-electric
detecting means at the end of said storage tube nearer said driving
wheel measured along the path of said cable, is situated at a
predetermined distance from said closed end of said probe measured
along the path of said cable around said driving wheel, through
said block and through said delivery tube and said cable has a
length slightly longer than said predetermined distance, and means
defining a lateral clearance between said cable and said delivery
tube and said storage tube, said lateral clearance being sufficient
to allow said cable to flex elastically under longitudinal
compression whereby said cable adopts a wavy shape within aid
tubes.
3. Apparatus as claimed in claim 1, further comprising means
defining a delivery opening at the junction between said passage
through said block and said delivery tube, the part of said passage
extending between said first position and said delivery opening
having a plurality of changes in direction, and means defining
enlargements in diameter of said passage at said changes in
direction to allow free movement of said capsule and said cable
through said part of said passage.
4. Apparatus as claimed in claim 1, further comprising a layer of
frictional material and means fixing said layer of frictional
material around the periphery of said driving wheel.
5. Apparatus as claimed in claim 4, wherein said means fixing said
layer of frictional material to said periphery of said driving
wheel includes electrical insulating means whereby said cable is
electrically insulated from said driving wheel.
6. Apparatus as claimed in claim 1, wherein said capsule and said
cable have the same diameters and cross sections as each other.
7. Apparatus as claimed in claim 1, further comprising means
forming an enlargement in said passage through said block and in
said delivery and storage tubes at transitions between said passage
and said tubes.
8. Apparatus as claimed in claim 1, wherein said radiation capsule
comprises a hollow cylinder, means closing one end of said
cylinder, partition means extending across said cylinder adjacent
said one end, said partition means and said means closing said one
end defining a space containing said radioactive substance and the
other end of said cylinder being open, said end of said cable which
is fixed to said capsule being of reduced diameter and being
received in said open end of said cylinder.
9. Apparatus as claimed in claim 8, wherein said cable comprises a
plurality of intercoiled wires forming a core and a coil of wire
surrounding said core, an end portion of said coil of wire being
removed to bare said core to form said reduced diameter portion of
said cable and said bared core being received in said open end of
said cylinder, and means securing said bared end in said
cylinder.
10. Apparatus as claimed in claim 1, wherein each of said
photo-electric detection means includes a plurality of light
sources and a plurality of photo-electric cells, said light sources
being adapted to produce beams of light shining on said cells and
said beams crossing each other in a common transverse plane in the
path of movement of said cable.
Description
This invention relates to apparatus for treating human or animal
patients by local irradiation from a radioactive substance. It is
particularly concerned with apparatus for this purpose of the kind
comprising a hollow probe closed at one end for introduction into a
natural or surgically produced opening in the body of the patient,
and a capsule which contains a quantity of a radioactive substance
(the radiator) and is fixed to the end of a flexible but
longitudinal thrust-transmitting cable which moves the capsule from
the interior of a shielding block, through a delivery tube into the
interior of the probe which is fixed to the end of the tube.
Apparatus of this kind must be capable of producing the highest
possible irradiation intensity in the smallest possible space
during the shortest possible period, particularly when using
radioactive sources of high and very high specific activity. It is
therefore important to ensure that the capsule, containing the
radioactive substance, is propelled with the utmost reliability and
precision from its position of rest in the middle of the shielding
block to the location of treatment, that is to say the location
where the closed end of the probe has been positioned by the
surgeon before the capsule is introduced into the probe. It is
equally important to ensure that on the expiry of the period of
time specified by the surgeon, that is to say at the end of the
precisely timed treatment period, the capsule containing the
radioactive substance is returned precisely to its initial position
of rest in the shielding block. This movement of the radiation
capsule, from the shielding block out to the closed end of the
probe and back again into the shielding block, must take place
automatically and by remote control, because nobody except the
patient can be allowed to remain within the effective range of the
radiation capsule when it is outside its shielding block. The
operator of the apparatus therefore cannot observe the movements of
the capsule.
To this end, according to this invention in an apparatus of the
kind described the cable extends from the radiation capsule when
this is situated in the interior of the shielding block, out of the
shielding block through an opening in the end of the shielding
block remote from the delivery tube around the greater part of the
periphery of a driving wheel which is situated in a housing
containing the shielding block, the cable being pressed against the
driving wheel by spring loaded rollers distributed around the
periphery of the driving wheel, through a storage tube to a
terminal stop, the storage tube extending between the housings of
two photo-electric cell assemblies which detect the movement of the
end of the cable remote from the capsule and respond by controlling
the movements of the driving wheel, the effective length of the
storage tube, measured between the two photo-electric cell
assemblies being equal to the distance traveled by the radiation
capsule between the interior of the block and the end of the
probe.
The driving wheel which drives the cable is itself preferably
driven, in a manner which is conventional in apparatus of this
kind, by a reversible motor which is switched off as soon as the
radiation capsule reaches the end of the probe whereupon the motor
has its polarity reversed so that when it is switched on again it
rotates in the opposite direction. By means of the arrangement in
accordance with the invention when the apparatus is put into
operation by switching on the motor, the radiation capsule is
propelled from a location precisely in the middle of the shielding
block out to a location precisely at the closed end of the probe.
The motor is then stopped automatically. When it is started again,
the capsule moves back again equally precisely.
This precision in the movement of the radiation capsule can be
still further improved, for the purpose of compensating any
inaccuracies or changes in the lengths of the cable or tubes, by
making the cable slightly longer than the distance between the
closed end of the probe and the beam of the photo-electric cell
assembly nearest to the driving wheel, and by providing the cable
with a lateral clearance in the delivery tube and in the storage
sufficient to allow the cable to flex elastically in the tubes, to
a certain extent, adopting a slightly wavy shape. The effect
obtained is that when the cable has been driven outwards the
capsule is thrust firmly and accurately against the closed end of
the probe, the cable adopting a slightly wavy shape in the delivery
tube, and similarly when the cable is fully retracted its rear end
is thrust firmly against the terminal stop, the cable adopting a
slightly wavy shape in the storage tube. The end thrusts are
applied by the elastic resiliency of the cable.
For the same purpose the duct which guides the cable passages in
the part of the shielding block extending between the position of
the capsule in the interior of the block and the delivery opening
changes direction a number of times and is enlarged in diameter at
least at the bends, to allow a free passage for the capsule and
cable.
According to a further preferred feature of the invention, in order
to ensure that a reliable, slip-free drive is obtained under all
circumstances between the driving wheel and the cable the diameter
of which may be only 2 mm the periphery of the driving wheel is
covered with a layer of frictional material, for example the kind
of material usually used for brakes and clutches. It should however
be observed that these materials are often electrically conductive.
In order to prevent the cable itself, or other parts which might
come into contact with the cable, from acquiring electric
potential, the frictional material is electrically insulated from
the driving wheel, which is itself electrically connected through
its driving shaft to the shaft of the electric motor.
The radiation capsule preferably has the same diameter as the
cable, to ensure that both these parts can move easily through the
guiding passages. A further precaution to ensure easy movement is
that wherever one end or the other of the cable passes from one
part of the apparatus to another the guiding passage is enlarged in
diameter to form a double cone.
Reliable and easy movement is ensured not only by giving the
capsule and the cable the same diameter but also by joining the two
together in such a way that a smooth transition is obtained. For
this purpose the radiation capsule consists of a hollow cylinder
with a closed bottom and containing the radioactive substance
interposed between the bottom and a partition and the open end of
the capsule receives the end of the cable which is locally reduced
in diameter to allow insertion. This can be done, for example in
the case of a cable consisting in a conventional way of a core made
of one or more coiled steel wires, surrounded by an outer coil, by
cutting off from the end of the cable a short length of the outer
coil and inserting the projecting length of core into the open end
of the capsule, the joint being made secure by brazing.
As a safety precaution, to ensure that the control system which
controls the drive cannot fail, each photocell assembly preferably
contains a number of light sources and a number of photo-electric
cells, the light beams crossing each other in the same transverse
plane in the path of movement of the cable.
An example of an apparatus constructed in accordance with the
invention is illustrated diagrammatically in the accompanying
drawings in which:
FIG. 1 is a longitudinal section through the complete apparatus,
constructional details and parts which do not form part of the
present invention having been omitted for greater clarity;
FIG. 1a is a longitudinal section through a delivery tube and
through the probe, showing the radiation capsule in its terminal
operative position;
FIG. 2 is a cross section through a driving mechanism for the
cable;
FIG. 3 is a longitudinal section through the driving mechanism for
the cable;
FIG. 4 is a longitudinal section through a housing forming a rear
end stop for the cable;
FIG. 5 is a half cross section through the housing forming the rear
end stop for the cable;
FIG. 6 is a longitudinal section through a housing for a
photo-electric cell assembly;
FIG. 7 is a half cross section through the housing for the
photo-electric cell assembly;
FIG. 8 is a longitudinal section through a part of the radiation
shielding block; and,
FIG. 9 is a cross section through the part of the radiation
shielding block .
The forward end of a housing 1 contains a radiation shielding block
2 which, for manufacturing reasons, consists of two parts 2a and
2b. The part 2a of the shielding block contains an axial bore 2d.
When the apparatus is not being used a capsule 3 containing the
radioactive substance rests in this bore, in the middle of the
shielding block, shielded in all directions by the radiation
absorbing mass of the shielding block. When a patient is to be
given treatment, the capsule is propelled from the middle of the
shielding block 2, through a delivery tube 4 into a hollow
closed-ended probe 5, connected to the other end of the delivery
tube. The capsule 3 is moved as far as the closed end of the probe,
which has been inserted by the surgeon in position with its closed
end at the location of treatment. The bore 2d is connected at its
forward end to a passage 2c passing through the part 2b of the
shielding block, with several changes in direction an outlet end 1b
of the passage 2c being located in a cover plate 1a which forms the
forward closure of the housing 1. The outlet 1b can be closed by a
cover 6 mounted rotatably on the closure plate 1a, the cover 6
being lockable in two positions by means of a lock 6a. When the
cover 6 is in the position shown in FIG. 1, the outlet opening 1b
is open, ready to receive a terminal coupling 4a of the delivery
tube 4, whereas by rotating the cover 6 through 180.degree. the
opening 1b can be closed. The radiation capsule 3 is attached to
the forward end of a cable 7 which extends backwards, from the
middle of the shielding block 2a, 2b, through the axial bore 2d
into the interior of the rear part of the housing 1, passing
through a storage tube 8 as far as stationary stop plate 9. Between
the shielding block 2 and the storage tube 8 the cable 7 passes
around most of the periphery of a driving wheel 10, the cable being
thrust firmly against the peripheral surface of the driving wheel
by several spring loaded thrust rollers 11, as shown in FIG. 2. The
storage tube 8 extends between the housings of two photo-electric
cell assemblies 12, 13 which sense the movements of the rear end 7a
of the cable 7 and respond by controlling the driving wheel 10, the
forward cell assembly 12 stopping the driving wheel as soon as the
cable end 7a, during the delivery of the capsule 3, ceases to
interrupt the beam path of the cell assembly 12. The photo-electric
cell assembly 13, on the other hand, stops the driving wheel 10,
during the return movement of the capsule 3 into the shielding
block 2 as soon as the rear end 7a of the cable interrupts the beam
path of the cell assembly 13. The effective distance between the
two cell assemblies 12 and 13, measured along the storage tube 8,
is exactly equal to the length of the path followed by the capsule
3 between its position of seat in the middle of the shielding block
and its terminal position at the closed end of the probe 5, the
capsule advancing through this distance during its forward stroke
and returning through the same distance on its return stroke.
The thrust rollers 11 consist of the outer rings of ball bearings,
the inner rings of which are mounted on axle pins 14. One end of
each axle pin 14 is radially movable with respect to the axis of
the driving wheel 10 in the interior of a driving wheel housing 15.
The outer end of each axle pin 14 projects outwards from the
housing 15 and supports a pulley wheel 16. An endless elastic cord
16a, for example a rubber band or an endless helical spring passes
around the outside of all the pulley wheels 16. The cord 16a
applies an inward thrust to all the pulley wheels 16, thrusting
them radially inwards towards the axis of the driving wheel 10 and
so thrusting the rollers 11 inwards against the outer surface of
the cable 7, to the effect that the cable 7 is thrust firmly
against the peripheral surface of the driving wheel 10.
In order to increase the frictional grip between the cable and the
driving wheel 10, so as to ensure a slip-free drive for the cable,
the peripheral surface of the driving wheel 10 carries a frictional
layer 10a which has a groove in its outer surface to accommodate
the cable, the depth of the groove being approximately half the
cable diameter. The driving wheel 10 is mounted on the driving
shaft 17a of a gear box 17, the outer end of the driving shaft 17a
being supported by an auxiliary ball bearing 18 mounted on the
driving wheel housing 15. The layer 10a is electrically insulated
from the wheel and this insulates the cable from the shaft 17a.
The driving wheel 10 is driven, in both directions, through the
gear box 17 by a reversible motor 19 which can be directed, by a
conventional remote control device which need not be described here
in detail, to an external source of electric power situated outside
the apparatus housing 1.
In front of the driving wheel housing 15, the cable 7 passes
through a tube 20 which connects the housing 15 to the radiation
shielding block 2. Rearward from the driving wheel housing 15 the
cable passes through a tube 21 which connects the housing 12 to the
housing of the photocell assembly 12. As shown in FIG. 2, the tubes
20 and 21 are attached to the driving wheel housing 15 by cap nuts
22 screwed onto externally threaded projections 15a on the housing
15.
The cable 7 runs with a small amount of lateral clearance in the
tubes 4 and 8 so as to allow the capsule 3 to be thrust firmly
against the closed end of the probe by lateral elastic deflection
of the cable, which has enough room to flex into a slightly wavy
shape in the tubes. Similarly the rear end 7a of the cable is
thrust firmly against the stop plate 9 by the resilient action of
the cable.
The passage 2c inside the part 2b of the shielding block also has
excess diameter beyond what would be necessary for practice guiding
of the cable. This is not only to allow the cable to adopt a
slightly wavy shape, but allows sufficient room for the capsule 3,
which is a rigid body, to move almost frictionessly through the
duct.
The passage 2c in the part 2b of the shielding block has ends which
expand conically in diameter. There are similar conically expanded
openings in the coupling 4a and in the shielding block 2a where the
axial bore 2d meets the passage 2c in the shielding block part 2d.
This is to ensure that wherever the capsule 3 passes, on its
journey, from one part of the apparatus into another part it is
able to travel freely and without encountering obstructions. The
same precaution to ensure easy movement is taken where the rear end
7a of the cable, in its return movement, passes through the
photocell assembly housing 12 into the storage tube 8 (FIG. 6).
As shown in FIGS. 8 and 9, the shielding block part 2b is
subdivided into two unequal parts by a separation plane extending
parallel to the axis of the part 2b but displaced away from the
axis through a distance equal to half the diameter of the passage
2c. The passage 2c is cut as a groove occupying an axial plane in
the larger of the two separated parts, the smaller of the two
separated parts having a flat separation surface and acting as a
closing cover to enclose the groove, forming a closed passage.
As shown in FIGS. 4 to 7 each of the photo-electric cell assemblies
12 and 13 contains two light sources and two photocells, the light
beams crossing each other on the same cross section of the cable
path. For this purpose each cell housing has two bores 23, 24 which
cross each other in the middle of the cable path. Each bore 23, 24
has an outward extension 23a, 24a extending from one end of the
bore and an opposite extension 23b, 24b extending from the other
end of the bore. Each of the first two extensions 23a, 24a contains
an electric lamp and each of the opposite extensions 23b, 24b
contains a photocell, so that in effect each photocell assembly
contains two independent photo-electric cell sensors the light
beams of which cross. The terminal cell assembly 13 is shown in
FIG. 4. Only one side of this assembly is connected to the storage
tube 8, the other side of the assembly forming the stationary
terminal stop plate 9 for the rear end 7a of the cable.
In order to minimize frictional resistance in the tubes and bores
and at their transition the capsule 3 has the same diameter and the
same cross section as the cable 7. For the same purpose the cable
duct is expanded in diameter conically at the transitions between
one part of the apparatus and another.
The radiation capsule 3 preferably consists of a hollow cylinder
closed at one end and containing the radioactive substance
interposed between its bottom and a second bottom forming a
partition which is brazed in place or otherwise secured. The end of
the cable 7, which is locally reduced in diameter is inserted into
the open end of the capsule 3. The cable 7 consists, in the known
way, of a core of one or more coiled wires, surround by a sheath
which is also in the form of a coiled wire. The cable is joined to
the radiation capsule 3 by cutting away a short terminal length of
the outer coil and inserting the projecting end of the core into
the open end of the capsule 3. To ensure that a perfectly reliable
joint is obtained the core is securely anchored in the capsule,
preferably by brazing . If desired however other methods for
securing the joint can be used for example welding or adhesive
bonding.
* * * * *