Real-time Ultrasonic Monitoring of Tumor Ablation

肿瘤消融实时超声监测

• 批准号: 7914959
• 负责人: TOMY VARGHESE
• 金额: $ 20.79万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7914959
• 关键词: Ablation; Aftercare; Animal Model; Animals; Area; Characteristics; Chest; Clinical; Complex; Devices; Electrodes; Elements; Evaluation; Family suidae; Finite Element Analysis; Frequencies; Goals; Gold; Hepatic; Histology; Histopathology; Image; Imagery; In Situ; In Vitro; Kidney; Lesion; Liver; Liver neoplasms; Malignant Neoplasms; Maps; Measurement; Measures; Mechanics; Metastatic Neoplasm to the Liver; Methodology; Methods; Modality; Modeling; Monitor; Necrosis; Neoplasm Metastasis; Normal tissue morphology; Oryctolagus cuniculus; Outcome; Patients; Performance; Pilot Projects; Primary carcinoma of the liver cells; Procedures; Process; Property; Prostatic; Radio; Radiofrequency Interstitial Ablation; Recurrence; Research; Shapes; Signal Transduction; Simulate; Specimen; System; Task Performances; Techniques; Testing; Time; Tissue Model; Tissues; Tumor Volume; Ultrasonics; Ultrasonography; Wood material; Woodchuck; base; cancer cell; cancer therapy; clinical application; effective therapy; in vivo; information display; interstitial; light microscopy; microwave electromagnetic radiation; minimally invasive; novel strategies; radiofrequency; reconstruction; tool; tumor

DESCRIPTION (provided by applicant): Radiofrequency (RF) and microwave ablation techniques are interstitial, focal ablative therapies that can be used in a percutaneous fashion. They permit in situ destruction of hepatic, renal and prostatic tumors. However, local recurrence rates after RF ablative therapy are as high as 34-55%, due in part to the inability to visualize the zone of necrosis (thermal lesion) after treatment under conventional ultrasound guidance. Elastography is a promising tool for visualizing the zone of necrosis in tissue resulting from RF ablation. The goal of this research is to develop and evaluate techniques for ultrasound-based in-vivo elastography for visualizing ablated regions during and after thermal therapy, and to determine whether elastographic images provide clinical information on the extent and viability of the treated region. The research plan develops and evaluates "RF electrode displacement" elastography. Basic elastic modulus properties of normal liver, liver neoplasms and metastases, and ablated liver wjll first be measured using a precision mechanical testing device. Elastography phantoms using the Young's Modulus measured in liver tissue will also be used to determine the reliability of mapping out ablated regions. Special phantoms, including those that have complex shapes, will challenge electrode displacement elastography under realistic conditions. Finite element analysis (FEA) will be utilized to model tissue displacements induced by RF electrode displacements and to extrapolate and understand phantom results. In-vivo studies will be conducted to test electrode displacement elastography for in-vivo elastographic imaging both on a wood- chuck HCC cancer and Rabbit VX2 metastases model to evaluate the elastographic depiction of cancers before and after ablation therapy. Comparisons of the elastograms with histopathology using light microscopy of ablated tissue will be performed to determine if elastograms are able to differentiate ablated (necrotic) from unablated (regions with viable cancer cells) and normal tissue regions. Real-time implementation of electrode displacement elastography along with 2-D cross-correlation processing will be implemented on the Siemens Antares scanner. Finally, a pilot study will be performed using the real-time elastographic modality developed on the Siemens Antares scanner on both a larger porcine animal model and tumor model (both the primary HCC and metastases model) to evaluate the ability to monitor percutaneous RF ablation using elastography under actual imaging conditions Clinical application of in-vivo elastography to monitor the progression and outcome of ablative cancer treatments during the minimally invasive RF ablation procedure could benefit a large group of patients.

描述（由申请人提供）：射频（RF）和微波炉消融技术是可以用经皮的方式使用的间隙，局灶性消融疗法。它们允许原位破坏肝，肾脏和前列腺肿瘤。但是，RF消融治疗后的局部复发率高达34-55％，部分原因是在常规超声指导下治疗后无法可视化坏死区（热病变）。弹性图是可视化RF消融导致组织中坏死区的有前途的工具。这项研究的目的是开发和评估基于超声的体内弹性弹力图，以可视化热疗法期间和之后的消融区域，并确定弹性图像是否提供了有关处理区域的程度和生存能力的临床信息。该研究计划制定并评估“ RF电极位移”弹性图。正常肝脏，肝脏肿瘤和转移和消融的肝脏WJLL的基本弹性模量性质首先使用精确的机械测试装置进行测量。使用在肝组织中测得的杨氏模量的弹性幻象也将用于确定映射消融区域的可靠性。特殊的幻影，包括具有复杂形状的幻影，将在逼真的条件下挑战电极位移弹性。有限元分析（FEA）将用于模拟由RF电极位移引起的组织位移，并推断和理解幻象结果。将进行体内研究，以测试电极位移弹性图，以在木质HCC癌和兔VX2转移酶模型上进行体内弹性成像，以评估消融治疗前后的癌症的弹性描述。将对弹性图与组织病理学的比较，使用消融组织的光学显微镜进行组织病理学的比较，以确定弹性图是否能够将消融的（坏死）与未层化的（具有可行癌细胞）和正常组织区域区分开。电极位移弹性图的实时实现以及2D互相关处理将在西门子的安塔雷斯扫描仪上实施。最后，将使用在较大的猪动物模型和肿瘤模型（主要的HCC和转移酶模型）上使用的实时弹性模态进行试验研究，以评估使用经皮RF使用经皮RF消融的能力。在实际成像条件下的弹性图在微创RF消融手术过程中监测烧蚀性癌症治疗的进展和结果的临床应用可以使大量患者受益。