Simultaneous MRI/US for real-time liver ablation guidance and confirmation

同步 MRI/US 用于实时肝脏消融指导和确认

• 批准号: 10677721
• 负责人: James H Holmes
• 金额: $ 76.67万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677721
• 关键词: 3-Dimensional; 3D ultrasound; Ablation; Acoustics; Adoption; Advanced Development; Algorithms; Anatomy; Animal Model; Animals; Breathing; Cattle; Cirrhosis; Clinical; Collaborations; Compensation; Diffusion; Diffusion Magnetic Resonance Imaging; Elements; Equipment; Etiology; Family suidae; Feedback; Fluoroscopy; Freedom; Goals; Hand; Human; Image; Institution; Intervention; Interventional Ultrasonography; Intestines; Iowa; Lesion; Liver; Location; Lung; Magnetic Resonance Imaging; Methods; Modality; Modeling; Monitor; Motion; Navigation System; Needles; Operative Surgical Procedures; Organ; Pathology; Patient-Focused Outcomes; Patients; Performance; Perfusion; Positioning Attribute; Procedures; Recurrence; Research; Roentgen Rays; Safety; Scientist; Site; Sum; System; Techniques; Technology; Temperature; Thermometry; Time; Tissue Model; Tissues; Translating; Ultrasonography; United States National Institutes of Health; Universities; Validation; Wisconsin; Work; X-Ray Computed Tomography; clinical practice; comparative; contrast enhanced; curative treatments; deep learning; experimental study; flexibility; image guided; image guided intervention; image guided radiation therapy; image registration; improved; in vivo imaging system; industry partner; innovation; liver ablation; liver tumor ablation; microwave ablation; microwave electromagnetic radiation; minimally invasive; multidisciplinary; novel; operation; pre-clinical; real-time images; respiratory; skills; soft tissue; success; technology validation; temporal measurement; treatment response; tumor; ultrasound; user-friendly; virtual

Project Summary: Percutaneous liver tumor ablation procedures are performed with ultrasound (US), computed tomography (CT) and CT-fluoroscopy guidance. Each image guidance modality has strengths and weakness. US provides superior tissue contrast and real-time guidance; however, suboptimal or absent acoustic windows, motion (respiratory, bulk), and poor applicator conspicuity compromise precise tumor targeting and a widening skill gap limit widespread adoption. The larger field-of-view (FOV) provided by CT is critical for evaluating proximity of non-target anatomy; however, poor tissue contrast, limited access along the X-Y-Z axis, motion, and non- real-time guidance limit accurate tumor targeting. Magnetic resonance imaging (MRI) provides superior soft tissue contrast but presents challenges with the comparatively long acquisition times for real-time guidance and limited access within the scanner bore. Image fusion technologies attempt to harness the strengths of each modality. Unfortunately, current image fusion technologies are unable to sufficiently account for liver deformation, bulk respiratory and patient motion which compromise targeting. Further, they do not address challenges associated with US. An Academic Industrial Partnership is proposed to develop and validate a solution comprised of two primary elements. The first is a combined platform with a novel MRI compatible hands-free US and fast 3D deformable image registration for optimized simultaneous US and virtual MR image guidance in the ablation setting. The second element will be development of advanced MRI methods for real- time treatment monitoring through MR Thermometry in combination with near-real-time assessment of ablation zone margins using advanced diffusion and perfusion MRI. This solution will improve primary efficacy and reduce local recurrence after ablation of liver tumors. This proposal will focus on microwave ablation however the solution is applicable for a wide variety of thermal therapies.

项目概要： 经皮肝脏肿瘤消融手术通过超声（US）、计算机断层扫描（CT）进行 和 CT 透视指导。每种图像引导方式都有优点和缺点。美国提供 卓越的组织对比度和实时引导；然而，次优或没有声学窗口、运动 （呼吸、散装）和较差的施药器显着性会影响精确的肿瘤靶向和扩大技能 差距限制了广泛采用。 CT 提供的更大视野 (FOV) 对于评估接近度至关重要 非目标解剖结构；然而，组织对比度差、沿 X-Y-Z 轴的访问有限、运动和非 实时引导限制了肿瘤靶向的精确性。磁共振成像 (MRI) 提供卓越的软 组织对比度，但对实时引导的采集时间相对较长提出了挑战 扫描仪孔内的访问受到限制。图像融合技术试图利用 每种方式。不幸的是，当前的图像融合技术无法充分解释肝脏 变形、大量呼吸和患者运动都会影响瞄准。此外，他们没有解决 与美国相关的挑战。建议建立学术工业合作伙伴关系来开发和验证 解决方案由两个主要元素组成。第一个是具有新型 MRI 兼容的组合平台 免提超声和快速 3D 变形图像配准，可优化同步超声和虚拟 MR 图像 消融设置中的指导。第二个要素将是开发先进的 MRI 方法，以实现真实的 通过 MR 测温法结合近实时消融评估进行治疗时间监控 使用先进的扩散和灌注 MRI 确定区域边缘。该解决方案将提高主要功效和 减少肝脏肿瘤消融后的局部复发。然而，该提案将重点关注微波消融 该解决方案适用于多种热疗法。