Endoscopic fluorescence imaging

Abstract

Systems and methods are configured for combined fluorescence imaging and white light imaging of tissue such as during surgical endoscopic procedures. A chip-on-tip type endoscope can be equipped with both white light and blue light LEDs. A single camera or dual cameras are configured with backside illuminated CMOS image sensor(s) to receive and process the white light and fluorescence images. The light sources, image sensors and image processing circuitry are configured to synchronously emit light and record pixels for visible white light and fluorescence frames alternately. Global or quasi-global shuttering can be used on the image sensor(s). A modified color filter array and other filters can be provided to enhance fluorescence imaging capabilities. Insufflating gas clears debris from the camera field of view and aids in moving he cannula distally through a body passageway.

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         26 . A self-contained endoscope comprising a single-use, disposable cannula for imaging a patient's internal organ and a reusable handle that is releasably connected to said cannula through electrical and mechanical connectors, wherein:
 said single-use cannula comprises:
 a light source at a distal portion of the cannula, configured to illuminate
 said internal organ: and 
 
 an imaging structure at said distal portion of the camera, configured to
 receive light from the internal organ and in response to produce images of the internal organ; 
 
 an input gas port for insufflating gas at a proximal portion of the cannula,
 a distal gas port for said gas at the distal portion of the cannula, and a gas conduit connecting the input and distal gas ports; 
 
 wherein said distal gas port is configured to direct a flow of said gas over
 a field of view of said imaging structure to aid in clearing debris from said field of view; and 
 
   said reusable handle comprises:
 an integral display screen configured to display images taken with said
 imaging structure. 
 
   
     
     
         27 . The endoscope of  claim 26 , in which:
 said light source is configured to illuminate said internal organ with white
 light during first time intervals and with non-white light during second time intervals that are time-interleaved with said first time intervals, and 
   said imaging structure is configured to receive both white light and non-white
 light from the internal organ and in response to produce a white light image and a non-white image of the internal organ that are spatially and temporally registered with each other. 
   
     
     
         28 . The endoscope of  claim 26 , in which said distal gas port comprises an outer shell that at least partly surrounds said imaging structure and directs said gas over a distal face of the imaging structure. 
     
     
         29 . The endoscope of  claim 26 , in which said gas conduit comprises space between the outer shell and the imaging structure. 
     
     
         30 . The endoscope of  claim 26 , in which said distal gas port is further configured to direct gas flow directed distally of said distal tip of the cannula to aid in moving said distal tip of the cannula through a patient's passageway. 
     
     
         31 . The endoscope of  claim 26 , further including a gas flow controller having an input for gas and an output feeding gas to said input gas port of the cannula. 
     
     
         32 . The endoscope of  claim 31 , in which said controller is configured to intermittently increase the pressure of gas delivered to said distal port of the cannula. 
     
     
         33 . The endoscope of  claim 31 , further including a portable gas cartridge threaded into said flow controller. 
     
     
         34 . The endoscope of  claim 26 , in which said imaging structure comprises an imaging sensor and a processor in a stacked arrangement. 
     
     
         35 . A method of imaging a patient's inner bladder wall comprising:
 illuminating said inner bladder wall;   receiving light from the bladder wall at an imaging structure that is at a tip of a
 cannula, and in response producing images of the bladder wall; and 
   supplying insufflating gas at a distal port of said cannula to create a gas flow over
 a field of view of the imaging structure that aids in clearing debris from said field of view. 
   
     
     
         36 . The method of  claim 35 , in which said supplying step further comprises creating a gas flow directed distally of said distal tip of the cannula to aid in moving said distal tip through a patient's body passageway. 
     
     
         37 . The method of  claim 35 , in which:
 said illuminating comprises illuminating the bladder wall with white light during
 first time intervals and with non-white excitation light causing fluorescence from selected tissue during second time intervals time-interleaved with said first time intervals; and 
   receiving both said fluorescence and reflections of said white light from the
 bladder wall at an imaging structure that is at a tip of a cannula, and in response producing a white light image of the bladder wall and a fluorescence image of the bladder wall that are both spatially and temporally registered with each other. 
   
     
     
         38 . An endoscope comprising:
 a cannula having a light source and an imaging structure at a distal portion of the
 cannula, said light source being configured to illuminate a field of view (FOV) in an interior space in a patient's body and said imaging structure being configured to image at least some of said FOV; 
   a source of insufflating gas;   a conduit from the source of insufflating gas to said distal portion
 of the cannula to deliver said gas to said distal portion; 
   said distal portion of the cannula being configured to direct said gas delivered
 thereto to flow over the imaging structure and thereby aid in clearing the FOV of the imaging structure of debris; and 
   an image display that is operatively coupled with said imaging structure
 to receive said images therefrom and display at least some of the received images. 
   
     
     
         39 . The endoscope of  claim 26 , in which:
 said light source is configured to illuminate said internal organ with
 white light and with non-white light in a selected wavelength range and 
   said imaging structure is configured to receive both
 white light and non-white light from the internal organ and in response produce a white light image and a non-white image of the internal organ that are spatially and temporally registered with each other. 
   
     
     
         40 . The endoscope of  claim 31 , in which said cannula is a single-use, disposable cannula that is in a sterile package before use, said source of gas is a portable cartridge that contains less than 10 grams of said gas, wherein said cannula, source of gas, and handle with said image display form a self-contained, portable endoscope. 
     
     
         41 . The endoscope of  claim 26 , further comprising a proximal liquid port at the
 proximal portion of the cannula and a distal liquid port at the distal portion of the cannula that are in fluid flow communication with each other.   
     
     
         42 . The endoscope of  claim 26 , further including a source of said insufflating gas
 coupled with said distal gas port and configured to intermittently pulse the flow of gas from the distal gas port to aid in clearing debris adjacent the imaging structure.   
     
     
         43 . The endoscope of  claim 26 , in which said imaging structure comprises an
 image sensor for white light and an image sensor for non-white light.   
     
     
         44 . The endoscope of  claim 26 , in which said imaging structure comprises a global
 filter configured to change between passing primarily white light and passing primarily non-white light in response to electronic control.