An integrated theranostic system for breast cancer

乳腺癌综合治疗诊断系统

• 批准号: 9975111
• 负责人: Elisa E. Konofagou
• 金额: $ 54.98万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-11 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9975111
• 关键词: Ablation; Address; Aftercare; Age; Anesthesia procedures; Animals; Benign; Blood; Breast; Breast Cancer Model; Breast Cancer Patient; Breast Cancer Treatment; Breast conservation; Bypass; Cancer Etiology; Cessation of life; Cicatrix; Clinic; Clinical; Coagulation Process; Detection; Diagnosis; Diagnostic; Disease; Early treatment; Elasticity; Elderly woman; Engineering; Ensure; Female Breast Carcinoma; Focused Ultrasound; Focused Ultrasound Therapy; General Anesthesia; Generations; Histology; Human; Image; In Situ; Interruption; Ions; Lesion; Local Therapy; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Neoplasms; Mammary Gland Parenchyma; Mammary Neoplasms; Mastectomy; Mechanics; Methodology; Methods; Modeling; Monitor; Morbidity - disease rate; Motion; Mus; Nonmetastatic; Normal tissue morphology; Operative Surgical Procedures; Outpatients; Patients; Performance; Population; Procedures; Radiation; Recovery; Risk; Role; Safety; Skin; Specimen; Speed; Survival Rate; System; Techniques; Technology; Testing; Therapeutic; Thermal Ablation Therapy; Thermometry; Time; Translations; Ultrasonography; Woman; base; breast imaging; breast surgery; cancer diagnosis; clinical translation; comparative; cost; cost efficient; high risk; image guided; in vivo; malignant breast neoplasm; minimally invasive; mortality risk; preservation; real time monitoring; side effect; standard care; surgical risk; theranostics; tumor; tumor growth; young woman

Breast cancer is the most frequently diagnosed cancer (excluding skin cancer) in women, and is the second leading cause of cancer death among women in the U.S. Currently, one woman in seven will develop breast cancer in her lifetime. Surgical intervention is warranted in most cases. However, as tumors are being detected at increasingly earlier stages, new methods for less invasive and more focal treatments are warranted. In sharp contrast with its premise, the translation of high-intensity focused ultrasound (HIFU) to the clinic has been comparatively anemic due to the unreliable (B-mode-based) or extremely costly and slow (MRI-based) monitoring techniques available. There has thus been an urgent need for a simple, cost- efficient technology that can reliably and efficiently monitor HIFU treatment and thereby ensure its clinical translation. In order to address both needs and maintain the low cost of HIFU while preserving all its advantages, we have developed the radiation-force-based technique of Harmonic Motion Imaging (HMI) that can be used seamlessly with HIFU for simultaneous tumor targeting and generation and monitoring of ablation, namely HMI for Focused Ultrasound (HMIgFUS). In the proposed study, we will integrate the HMIgFUS into a clinical system that will facilitate translation of HMIFU for the focal, thermal treatment of breast tumors. The underlying hypothesis is that HMIgFUS using parallel beamforming will be capable of optimally monitoring HIFU ablation in a clinical setting where speed of application is key. The team assembled encompasses ultrasound, breast imaging, breast surgery, mouse tumor models and histopathological analysis. Our group has demonstrated that motion estimation using parallel beamforming is feasible 1) at extremely high framerates (up to 5000 fps) ensuring highest quality of motion estimation including 2) high precision displacements, 3) coherent compounding for SNR increase, 4) 2D capability as well as 5) real-time implementation. Such a reliable monitoring technique could prove pivotal in rendering an entirely noninvasive treatment accessible to a wide population of breast cancer patients for the first time by propelling it into fast and reliable outpatient procedure for the focal treatment of benign or small, non-metastatic breast cancer, thus minimizing mortality and risk.

乳腺癌是女性最常诊断出的癌症（不包括皮肤癌），并且 是美国女性癌症死亡的第二大原因。目前，一名女性 七人一生中会患上乳腺癌。大多数情况下需要手术干预 案例。然而，随着肿瘤在越来越早的阶段被发现，新的方法 需要进行侵入性较小且集中的治疗。与它的前提形成鲜明对比的是， 高强度聚焦超声（HIFU）向临床的转化相对较 由于不可靠（基于 B 模式）或极其昂贵且缓慢（基于 MRI）而导致贫血 可用的监测技术。因此，迫切需要一种简单、成本低的方法。 高效的技术，可以可靠、高效地监测 HIFU 治疗，从而确保 它的临床翻译。为了满足这两种需求并保持 HIFU 的低成本，同时 保留其所有优点，我们开发了基于辐射力的技术 谐波运动成像 (HMI) 可与 HIFU 无缝使用，同时进行 肿瘤靶向以及消融的生成和监测，即聚焦的 HMI 超声波（HMIgFUS）。在拟议的研究中，我们将把 HMIgFUS 整合到临床中 该系统将有助于将 HMIFU 转化为乳腺肿瘤的局部热治疗。 基本假设是使用并行波束形成的 HMIgFUS 将能够 在应用速度至关重要的临床环境中优化监测 HIFU 消融。这 组建的团队涵盖超声、乳腺成像、乳腺手术、小鼠肿瘤 模型和组织病理学分析。我们的小组已经证明了运动估计 使用并行波束形成是可行的 1) 在极高的帧速率（高达 5000 fps） 确保最高质量的运动估计，包括 2) 高精度位移，3) 用于提高信噪比的相干复合，4) 2D 功能以及 5) 实时 执行。这种可靠的监控技术对于渲染结果至关重要 为广大乳腺癌患者提供完全无创的治疗 首次将其推向快速可靠的门诊程序，用于局部治疗 良性或小型非转移性乳腺癌，从而最大限度地降低死亡率和风险。