An Intraoperative Guidance Platform for Radio Frequency Ablation

射频消融术中指导平台

• 批准号: 9348031
• 负责人: Andrea Borsic
• 金额: $ 74.01万
• 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 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9348031
• 关键词: Ablation; Agar; Anatomy; Award; Blood Vessels; Breast; Caliber; Certification; Clinical; Clinical Trials; Computer Simulation; Data Collection; Data Set; Decision Making; Development; Devices; Documentation; Electrodes; Ensure; Evaluation; Family suidae; Geometry; Goals; Growth; Hepatic; Image; Imaging technology; Intervention; Investigation; Kidney; Laparoscopy; Lesion; Liver; Liver Fissure; Location; Lung; Magnetic Resonance Imaging; Manufacturer Name; Maps; Mediating; Modeling; Musculoskeletal; Needles; Neoplasm Metastasis; Northern America; Northern Europe; Operating Rooms; Operative Surgical Procedures; Organ; Patients; Pattern; Phase; Physicians; Positioning Attribute; Primary Neoplasm; Procedures; Psyche structure; Radiofrequency Interstitial Ablation; Recurrence; Reporting; Research; Running; Site; Small Business Innovation Research Grant; System; Techniques; Testing; Therapeutic Effect; Time; Tissues; Ultrasonography; X-Ray Computed Tomography; animal data; base; cancer imaging; cancer therapy; follow-up; graphical user interface; image guided; imaging Segmentation; improved; improved outcome; in vivo; intraoperative imaging; killings; minimally invasive; operation; post intervention; predictive modeling; programs; radio frequency; simulation; tumor; vapor

Project Summary: 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 2cm, for which total necrotization has been shown to be particularly hard to achieve without guidance.

项目摘要： 该拟议的研究计划的目的是开发一个计划和指导的平台 射频消融（RFA）。 RFA是一种热中介的消融技术 将一种电极经常插入肿瘤（通过腹腔镜或开放手术方法）。收音机 应用频率（RF）能量，变性和凝结时间为2厘米至5厘米的时间 直径。一些RFA电极形状为直针。其他人则部署尖齿以消灭A 较大的体积。 RFA很有吸引力，因为它可以经常使用，从而最小化。 RFA是宽阔的 接受的癌症治疗疗法，并应用于不同器官的原发性和次要肿瘤， RFA通常是首选的治疗 无法手术的患者的选择。 RFA的典型方法是经皮。因此，医师对位置没有直接的看法 电极和组织。 CT和超声术中用于跟踪电子位置，但 CT和超声（US）都具有有限的可视化RFA下组织坏死的能力。很难 因此，以评估已接受了哪些组织，哪些组织未进行。目前医师依靠“心理图” 他们以前烧过的组织的位置并估计下一步去哪里。坏死卷也是 电极制造商在印刷中提供的病变几何图表的“精神估计”。这些图表 显示均匀组织的预期消融几何形状，不考虑解剖结构或存在 血管，可以在热量运输热量时修饰并减少消融体积。 该计划的总体目标是开发一个术前计划和术中的平台 RFA指导，基于对RFA和实时术中的电 /热效应的模拟 坏死模式的预测。 RFA模拟在CT术中图像上的图像融合将 构成一个能够显示已经处理过哪些组织的引导系统，哪些组织允许 医师正确重新定位电极并实现一致的重叠。这将改善 RFA特别适用于大于2厘米的肿瘤患者，对此总坏死性已被证明为 在没有指导的情况下很难实现。