An Intraoperative Guidance Platform for Radio Frequency Ablation

射频消融术中指导平台

• 批准号: 8781978
• 负责人: Andrea Borsic
• 金额: $ 21.85万
• 依托单位: NE SCIENTIFIC, LLC
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2015-08-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8781978
• 关键词: Ablation; Accounting; Affect; Anatomy; Animal Model; Animals; Blood Vessels; Blood flow; Breast; Caliber; Computer Simulation; Computer software; Contrast Media; Electrodes; Electromagnetics; Elements; Engineering; Faculty; Family suidae; Frequencies; Gases; Geometry; Goals; Health; Healthcare; Heating; Image; Imaging technology; Intervention; Interventional radiology; Kidney; Laboratories; Laparoscopy; Lesion; Liver; Location; Lung; Magnetism; Manufacturer Name; Maps; Mediating; Modeling; Musculoskeletal; Needles; Neoplasm Metastasis; Operative Surgical Procedures; Optics; Organ; Outcome; Patients; Pattern; Phase; Physicians; Physics; Positioning Attribute; Primary Neoplasm; Printing; Psyche structure; Radio; Radiofrequency Interstitial Ablation; Recurrence; Reporting; Research; Series; Shapes; Simulate; Survival Rate; System; Techniques; Time; Tissues; Ultrasonography; Uncertainty; Validation; Visual; Water; Work; X-Ray Computed Tomography; base; cancer therapy; computer science; evaporation; improved; in vivo; intraoperative imaging; minimally invasive; programs; simulation; skills; tumor

DESCRIPTION (provided by applicant): The objective of this proposed research program is to develop a platform for planning and guidance during Radio Frequency Ablation (RFA). RFA is a thermally mediated ablation technique, where an applicator carrying one electrode is inserted into tumors percutaneously (or via laparoscopy, or open surgical approaches). Radio Frequency (RF) energy is applied, denaturating and coagulating tissues in a volume of 2cm to 5cm of diameter. Some RFA electrodes are shaped as straight needles; others deploy an umbrella of tines to ablate a larger volume. RFA is attractive as it can be used percutaneously resulting minimally invasive. RFA is a widely accepted cancer treatment therapy, and is applied to primary and secondary tumors in different organs, including liver, lung, kidney, breast, and in musculoskeletal interventions. RFA is often the preferred treatment option for inoperable patients. The typical approach for RFA is percutaneous. Physicians therefore have no direct view of the location of electrodes and of tissues. CT and Ultrasound are used intraoperatively to track the location of electrodes, but both CT and Ultrasound (US) have limited ability to visualize the necrotization of tissues under RFA. It is hard therefore to assess which tissues have been treated and which not. Currently physicians rely on "mental maps" of where they have previously ablated tissues and estimate where to go next. The necrotization volume is also "mentally estimated" from lesion geometry charts provided in print by electrode manufacturers. These charts show the expected ablation geometry for a uniform tissue and do not account for the anatomy or the presence of blood vessels, which can modify and reduce the ablation volume as they transport heat away. The overarching goal of this program is to develop a platform for pre-operative planning and intraoperative RFA guidance, based on simulation of the electrical / thermal effects of RFA and real-time intraoperative prediction of necrotization patterns. Image fusion of RFA simulations onto CT intraoperative images would constitute a guidance system able to show which tissues have been treated and which not, allowing the physicians to properly repositions electrodes and achieve consistent overlap. This would improve outcomes of RFA particularly for patients with tumors greater than 4cm, for which total necrotization has been shown to be particularly hard without guidance.

描述（由申请人提供）：该建议的研究计划的目的是在射频消融（RFA）期间开发一个计划和指导平台。 RFA是一种热介导的消融技术，携带一个电极的涂抹器被经插入肿瘤（或通过腹腔镜或开放手术方法）。施用射频（RF）能量，将直径为2厘米至5厘米的体积变性和凝结组织。一些RFA电极形状为直针。其他人则部署尖齿雨伞，以消除更大的体积。 RFA很有吸引力，因为它可以经常使用，从而最小化。 RFA是一种广泛接受的癌症治疗疗法，可应用于不同器官的原发性和次要肿瘤，包括肝脏，肺，肾脏，乳房以及肌肉骨骼干预措施。 RFA通常是无法手术患者的首选治疗选择。 RFA的典型方法是经皮。因此，医师对电极和组织的位置没有直接的看法。 CT和超声术中用于跟踪电极的位置，但CT和Ultrasound（US）都具有有限的可视化能力 RFA下组织的坏死。因此，很难评估哪些组织已经接受治疗，哪些组织没有。目前，医生依靠他们以前消融组织的位置的“心理图”，并估计下一步要去哪里。坏死体积也从电极制造商印刷中提供的病变几何图表中“精神上估计”。这些图表显示了对均匀组织的预期消融几何形状，并且不考虑解剖学或血管的存在，这可以在它们运输热量时修改和减少消融体积。该计划的总体目标是基于对RFA的电气 /热效应和实时术中坏死模式的电气 /热效应的模拟，以开发一个用于术前计划和术中RFA指导的平台。 RFA模拟在CT术中图像上的图像融合将构成一个指导系统，能够显示已接受过哪些组织，哪些组织不允许医生正确重新定位电极并实现一致的重叠。这将改善RFA的预后，特别是对于大于4厘米的肿瘤患者，在没有指导的情况下，总共坏死特别困难。