Image guided laser therapy

Abstract

Systems, devices, and methods for treating a skin of a patient with therapeutic laser light via imaging a first skin area of the patient to obtain at least a first image, processing the at least a first image of the first skin area with at least one processor to identify within the first skin area at least one or more target skin areas and a non-target skin area, generating a treatment map of the first skin area based on the identified one or more target skin areas and the non-target skin area, and treating at least a portion of the one or more target skin areas with therapeutic laser light based on the generated treatment map.

What is claimed is: 
     
         1 . A method of treating the skin of a patient with therapeutic laser light, the method comprising:
 a) imaging a first skin area of the patient to obtain at least a first image;   b) processing the at least a first image of the first skin area, wherein the processing comprises
 1) identifying at least one target skin area and at least one non-target skin area in the at least a first image; and 
 2) generating a treatment map of the first skin area based on the identified at least one target skin area and the at least one non-target skin area; 
   c) displaying the treatment map to a user on a user interface;   d) receiving a user input from the user in response to displaying the treatment map; and   e) treating at least a portion of the at least one skin area with therapeutic laser light by using a scanner to direct therapeutic laser light pulses to the identified at least one target skin area, and not direct therapeutic laser light pulses to the identified at least one non-target skin area, based on the treatment map and the user input.   
     
     
         2 . The method of  claim 1 , wherein imaging the first skin area comprises
 1) using a camera, obtaining at least one of an image under ultraviolet lighting, an image under infrared lighting, and an image under visual lighting.   
     
     
         3 . The method of  claim 1 , wherein identifying at least one target skin area further comprises using a processor to
 A) identify one or more of the at least one target skin area as at least one lesion area; and   B) classify the at least one lesion area by lesion type.   
     
     
         4 . The method of  claim 3 , wherein using a processor to identify at least one lesion area comprises using a processor to identify one or more lesion areas within the first skin area based on at least one of
 1) a different skin color or shading compared to the at least one non-target skin area; and   2) a shape of the target skin area.   
     
     
         5 . The method of  claim 3 , wherein processing the at least a first image further comprises
 3) using a processor to determine at least one laser treatment parameter for treating the at least one lesion area, wherein the at least one laser treatment parameter is selected from a fluence, a pulse duration, a beam spot size, a beam diameter; and a fraction of the total area of the at least one lesion area to receive therapeutic laser light.   
     
     
         6 . The method of  claim 5 , wherein generating a treatment map of the first skin area comprises using a processor to generate a treatment map identifying
 A) at least one of a geographic location and a boundary of the at least one lesion area within the first skin area; and   B) at least one laser treatment parameter for treating the at least one lesion area.   
     
     
         7 . The method of  claim 6 , wherein displaying the treatment map on a user interface comprises displaying one or more of:
 1) an interactive image of the first skin area that allows the user to provide the user input;   2) an image of at least one lesion area within at least a portion of the first skin area;   3) a visual indication of the lesion type, based on the classifying of the at least one lesion area;   4) a visual indication of where laser pulses would be applied relative to the at least one lesion area; and   5) a visual indication of the at least one laser treatment parameter for one or more laser pulses to be applied to the at least one lesion area.   
     
     
         8 . The method of  claim 7 , wherein receiving a user input comprises receiving an input to perform one or more operation selected from:
 1) zooming in to the interactive image of the first skin area;   2) zooming out from the interactive image of the first skin area;   3) confirming a classifying of the lesion type of the at least one lesion area;   4) overriding a classifying of the lesion type of the at least one lesion area;   5) changing a classifying of the lesion type of the at least one lesion area;   6) confirming one or more laser treatment parameters for treating the at least one lesion area;   7) changing one or more laser treatment parameters for treating the at least one lesion area; and   8) initiating the automatic delivery of laser pulses to the at least one lesion area.   
     
     
         9 . The method of  claim 1 , wherein processing the at least a first image further comprises
 3) using a processor to determine at least one laser treatment parameter for treating the at least one target skin area within the first skin area, wherein the at least one laser treatment parameter is selected from a fluence, a pulse duration, a beam spot size, a beam diameter, and a fraction of the total area of the at least one target skin area to receive therapeutic laser light.   
     
     
         10 . The method of  claim 9 , wherein generating a treatment map of the first skin area comprises using a processor to generate a treatment map identifying
 A) at least one of a geographic location and a boundary of the at least one target skin area within the first skin area; and   B) at least one laser treatment parameter for treating the at least one target skin area.   
     
     
         11 . The method of  claim 10 , wherein displaying the treatment map on a user interface comprises displaying one or more of:
 1) an interactive image of the first skin area that allows the user to provide the user input;   2) an image at least a first target skin area within at least a portion of the first skin area;   3) a visual indication of where laser pulses would be applied relative to the at least a first target skin area; and   5) a visual indication of the at least one laser treatment parameter for one or more laser pulses to be applied to the at least a first target skin area.   
     
     
         12 . The method of  claim 11 , wherein receiving a user input comprises receiving a user input selected from:
 1) an input to zoom in to the interactive image of the first skin area;   2) an input to zoom out from the interactive image of the first skin area;   3) an input confirming one or more laser treatment parameters for treating the at least one target skin area;   4) an input changing one or more laser treatment parameters for treating the at least one target skin area; and   5) an input to initiate the automatic delivery of laser pulses to the at least one target skin area.   
     
     
         13 . The method of  claim 1 , wherein treating at least a portion of the at least one target skin area comprises:
 1) using a therapeutic laser light source capable of generating pulsed therapeutic laser light;   2) using at least one movable optical element optically coupled to the therapeutic laser light source for receiving and directing the pulsed therapeutic laser light to a desired portion of the at least one target skin area;   3) using at least one controller for controlling the movable optical element to direct the pulsed therapeutic laser light to the desired portion of the at least one target skin area;   4) generating pulsed therapeutic laser light using the therapeutic laser light source;   5) controlling the movable optical element using the controller to direct one or more therapeutic laser light pulses to a first desired portion of a selected one of the at least one target skin area;   6) moving the movable optical element using the controller to direct one or more therapeutic laser light pulses to a desired portion of the selected one of the at least one target skin area that is different from the first desired portion; and   7) repeating step 6 one or more times until a desired fraction of the selected one of the at least one target skin area has been treated with therapeutic laser light pulses.   
     
     
         14 . The method of  claim 13 , wherein treating at least a portion of the at least one target skin area comprises a treating at least a portion of a plurality of target skin areas, the method further comprising:
 8) repeating steps (5)-(7) one or more times, wherein each repetition of step 5 comprises applying one or more therapeutic laser light pulses to a different selected one of the plurality of target skin areas.   
     
     
         15 . The method of  claim 13 , wherein steps (5)-(7) are performed automatically by the controller, after receiving a user input authorizing the delivery of the laser pulses, to direct the generated pulsed therapeutic laser light to the desired portions of the one or more target skin areas. 
     
     
         16 . A method of treating the skin of a patient with therapeutic laser light, the method comprising:
 a) using a camera to image a first skin area of the patient to obtain a first image comprising a plurality of pixels;   b) using a processor to identify areas of the first skin area to receive therapeutic laser light by
 1) processing the first image into a plurality of sub-areas of one or more pixels based at least in part on one of colors, shadings, and shapes within the first image; 
 2) classifying each sub-area of the first image as one of a target skin area and a non-target skin area based on one of the color, the shading, and the shape of the sub-area; and 
 3) determining at least one laser treatment parameter for treating each target skin area, wherein the at least one treatment parameter is selected from a fluence, a pulse duration, a beam spot size, a beam diameter, and a fraction of the total area of the target skin area to receive therapeutic laser light; 
   c) generating a treatment map of the first skin area based on the processing, wherein the treatment map identifies at least a portion of each target skin area to receive therapeutic laser light;   d) displaying the treatment map to a user on a user interface;   e) receiving a user input from the user in response to displaying the treatment map, wherein the user input is selected from:
 1) an input to zoom in to a portion of the treatment map; 
 2) an input to zoom out from a portion of the treatment map; 
 3) an input confirming one or more of the at least one laser treatment parameter for treating at least one target skin area; 
 4) an input changing one or more of the at least one laser treatment parameter for treating at least one target skin area; 
 5) an input to initiate the delivery of laser pulses to the at least one target skin area; and 
   f) based on the treatment map and the user input, treating at least a portion of each target skin area in the first skin area with therapeutic laser light by using a scanner to direct one or more therapeutic laser light pulse to at least a portion of each target skin area, and not direct therapeutic laser light pulses to any non-target skin area.   
     
     
         17 . The method of  claim 16 , wherein each sub-area comprises one of a pixel or a group of pixels. 
     
     
         18 . The method of  claim 17 , wherein at least a first target skin area comprises a plurality of pixels, and wherein classifying each sub-area of the first image further comprises classifying the first target skin area as a type of lesion, based on at least one of the color, the shading, and the shape of the first target skin area. 
     
     
         19 . The method of  claim 16 , wherein generating a treatment map of the first skin area comprises using a processor to generate a treatment map identifying
 1) at least one of a geographic location and a boundary of each target skin area within the first skin area; and   2) at least one laser treatment parameter for treating each one target skin area.   
     
     
         20 . The method of  claim 19 , wherein displaying the treatment map on a user interface comprises displaying one or more of:
 1) an interactive image of the first skin area that allows the user to provide the user input;   2) an image of at least a first target skin area within at least a portion of the first skin area;   3) a visual indication of where laser pulses would be applied relative to the at least a first target skin area; and   4) a visual indication of the at least one laser treatment parameter for one or more laser pulses to be applied to the at least a first target skin area.   
     
     
         21 . The method of  claim 16 , wherein determining at least one laser treatment parameter for treating each target skin area comprises determining one or more laser beam diameter for laser pulses to treat each target skin area. 
     
     
         22 . The method of  claim 16 , wherein treating at least a portion of each target skin_area comprises:
 1) using a therapeutic laser light source capable of generating therapeutic laser light pulses;   2) using a scanner to direct therapeutic laser light pulses from the therapeutic laser light source to a desired location on the skin of the patient;   3) using a controller to control the operation of the scanner, wherein the controller is adapted to control the scanner to direct therapeutic laser light pulses from the therapeutic laser light source to each target skin area in the first skin area;   4) generating therapeutic laser light pulses using the therapeutic laser light source; and   5) directing the therapeutic laser light pulses to at least a portion of each target skin area in the first skin area, and not direct therapeutic laser light pulses to any non-target skin area in the first skin area.   
     
     
         23 . The method of  claim 22 , wherein
 1) using a scanner comprises using at least one movable optical element optically coupled to the therapeutic laser light source for receiving therapeutic laser light pulses from the therapeutic laser light source and directing the therapeutic laser light pulses to the at least a portion of each target skin area; and   2) directing the therapeutic laser light pulses to at least a portion of each target skin area comprises
 A) controlling the movable optical element using the controller to direct one or more therapeutic laser light pulses to a first portion of a selected target skin area; 
 B) moving the movable optical element using the controller to direct one or more therapeutic laser light pulses to a second portion of the selected target skin area that is different from the first portion; and 
 C) repeating step (B) one or more times until a desired fraction of the selected target skin area has been treated with therapeutic laser light pulses, wherein the second portion of the selected target skin area in each repetition of step (B) is different from each previous second portion. 
   
     
     
         24 . The method of  claim 23 , wherein
 2) directing the therapeutic laser light pulses to at least a portion of each target skin area further comprises:
 D) moving the movable optical element using the controller to direct one or more therapeutic laser light pulses to a first portion of a selected target skin area different from the selected target skin area treated in steps (A), (B), and (C); 
 E) moving the movable optical element using the controller to direct one or more therapeutic laser light pulses to a second portion of the selected target skin area different from the selected target skin area treated in steps (A), (B), and (C), wherein the second portion is different from the first portion treated in step (D); 
 F) repeating step (E) one or more times until a desired fraction of the selected target skin area of steps (D) and (E) has been treated with therapeutic laser light pulses; and 
 G) repeating steps D, E, and F one or more times, wherein each repetition of steps D, E, and F comprises applying one or more therapeutic laser light pulses to a selected target skin area that is different from every other preceding selected target skin area. 
   
     
     
         25 . The method of  claim 22 , wherein directing the therapeutic laser light pulses to at least a portion of each target skin area comprises directing therapeutic laser light pulses to the target skin areas at a frequency exceeding 1,000 pulses per second. 
     
     
         26 . The method of  claim 16 , wherein using a camera to image a first skin area of the patient to obtain a first image comprising a plurality of pixels comprises:
 1) using at least one light source capable of generating light in at least one of the ultraviolet, visible, and infrared wavelength ranges;   2) illuminating the first skin area with light from the light source in at least one of the ultraviolet, visible, and infrared wavelength ranges; and   3) capturing the first image using the camera during the illuminating.