Thermochemical Ablation in Image-Guided Interventions: Initial Assessment

图像引导干预中的热化学消融：初步评估

• 批准号: 7447690
• 负责人: ERIK N CRESSMAN
• 金额: $ 16.25万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2010-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7447690
• 关键词: Ablation; Acids; Acute; Address; Animals; Appearance; Biological Markers; Blood gas; Breast; Cell Death; Coagulation Process; Colorectal Cancer; Data; Data Set; Defect; Electrolytes; Excision; Family suidae; Goals; Heating; Histologic; Human; Image; Injection of therapeutic agent; Invasive; Laboratories; Lesion; Liver; Malignant Neoplasms; Malignant neoplasm of lung; Malignant neoplasm of prostate; Measurement; Measures; Methods; Microscopic; Modality; Monitor; Necrosis; Normal tissue morphology; Osmolalities; Outcome; Pathologic; Pathology; Patients; Perfusion; Physiology; Primary carcinoma of the liver cells; Radiofrequency Interstitial Ablation; Rate; Reaction; Recording of previous events; Recurrence; Reproducibility; Research; Risk; Sampling; Serum; Shapes; Solid; Solutions; Specimen; Staining method; Stains; Sus scrofa; Techniques; Temperature; Testing; Tissues; Toxic effect; Water; X-Ray Computed Tomography; base; cost; human disease; image guided intervention; improved; in vivo; metastatic colorectal; size; tumor

DESCRIPTION (provided by applicant): The long-term research goal of this laboratory is to develop and implement new, low-cost, minimally invasive, image-guided interventions for human diseases, in particular to improve outcomes in solid malignancies amenable to this approach such as breast or prostate cancer, metastatic colorectal cancer, lung cancer, and hepatocellular carcinoma (HCC), which is the focus of this application. Current methods such as radiofrequency ablation are inadequate with regard to treatable lesion size, tumor recurrence, survival benefit, procedural risk, and cost. The objective in this application is to establish in vivo feasibility of a new ablation method recently discovered called thermochemical ablation. This technique, when narrowly defined, overcomes these shortcomings by exploiting the considerable heat energy released as water is formed in acid-base reactions. The central hypothesis of this application is that thermochemical ablation can create an evenly distributed zone of coagulation in liver tissue without systemic toxicity. To establish feasibility and test this hypothesis two aims are outlined below: Aim 1: Quantify the size, shape, reproducibility, and temperature history of acute thermochemical coagulation zones measured by multiple correlated modalities based upon the known key variables of volume and concentration, with injection rates of acid and base constant. The eventual goal is treatment in humans where excision and pathologic correlation of tissues in most patients is not feasible. To address this, perfusion defects seen on CT scans of treated, explanted pig livers will be measured and correlated with three volume data sets: gross pathology, viability staining, and microscopic pathology. This will provide initial data for a robust imaging biomarker of the zone of coagulation created using the method. Aim 2: Characterize acute effects of thermochemical ablation at both tissue and systemic levels. Tissue effects will be visualized in selected sections from treated specimens using histologic methods to image necrosis and cell death. The microscopic appearance of the ablations will be characterized and the transition zone to normal tissue will be evaluated. Systemic effects are possible due to the use of concentrated solutions of acid and base that could potentially alter the whole animal physiology. Therefore serum osmolality, arterial blood gas measurements (pO2, pCO2, pH), and electrolytes will be monitored, with serial sampling after injection to detect changes.

描述（由申请人提供）：该实验室的长期研究目标是开发和实施新的、低成本、微创、图像引导的人类疾病干预措施，特别是改善适合这种方法的实体恶性肿瘤的结果例如乳腺癌或前列腺癌、转移性结直肠癌、肺癌和肝细胞癌（HCC），这是本应用的重点。目前的方法（例如射频消融）在可治疗的病灶大小、肿瘤复发、生存获益、手术风险和成本方面都不够。本应用的目的是确定最近发现的一种新的消融方法（称为热化学消融）的体内可行性。当狭义地定义时，该技术通过利用酸碱反应中形成水时释放的大量热能来克服这些缺点。该应用的中心假设是热化学消融可以在肝组织中产生均匀分布的凝血区，而不会产生全身毒性。为了建立可行性并测试这一假设，概述了以下两个目标： 目标 1：根据已知的体积和浓度关键变量，通过注射，量化急性热化学凝固区的大小、形状、再现性和温度历史。酸和碱常数的比率。最终目标是对大多数患者的组织切除和病理相关性不可行的人类进行治疗。为了解决这个问题，将测量经过处理的移植猪肝的 CT 扫描中发现的灌注缺陷，并将其与三个体积数据集相关联：大体病理学、活力染色和显微病理学。这将为使用该方法创建的凝固区域的稳健成像生物标志物提供初始数据。目标 2：表征热化学消融在组织和全身水平上的急性效应。使用组织学方法对坏死和细胞死亡进行成像，在经过处理的标本中选定的切片中观察组织效应。将表征消融的微观外观，并评估向正常组织的过渡区域。由于使用酸和碱的浓溶液可能会改变整个动物的生理机能，因此可能会产生全身影响。因此，将监测血清渗透压、动脉血气测量（pO2、pCO2、pH）和电解质，并在注射后连续取样以检测变化。