MR Guided Focused Ultrasound Surgery near Metal Implants

金属植入物附近的 MR 引导聚焦超声手术

• 批准号: 8934112
• 负责人: PEJMAN GHANOUNI
• 金额: $ 24.08万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-26 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8934112
• 关键词: Ablation; Address; Aftercare; Agar; Animals; Area; Bone neoplasms; Clinical; Clinical Research; Clinical Treatment; Conventional Surgery; Development; Devices; Diagnostic; Environment; Evaluation; Failure; Family suidae; Fatty acid glycerol esters; Focused Ultrasound; Focused Ultrasound Therapy; Fracture; Frequencies; Future; Goals; Health; Heating; Human; Image; Imaging Techniques; Implant; Knee; Magnetic Resonance Imaging; Malignant Bone Neoplasm; Maps; Measures; Metals; Metastatic Neoplasm to the Bone; Methods; Monitor; Morphologic artifacts; Nerve; Noise; Operative Surgical Procedures; Orthopedics; Pain; Patients; Performance; Predisposition; Procedures; Protons; Recovery; Replacement Arthroplasty; Research; Research Subjects; Resolution; Scanning; Signal Transduction; Site; Slice; Spinal Fusion; System; Techniques; Temperature; Testing; Thermometry; Three-Dimensional Imaging; Time; Tissues; Total Hip Replacement; Treatment Protocols; Validation; Variant; Weight; Work; bone; cancer site; contrast enhanced; experience; flexibility; hip replacement arthroplasty; human subject; image guided; imaging modality; in vivo; innovation; novel; novel strategies; spectrograph; targeted imaging; treatment planning; tumor

DESCRIPTION (provided by applicant): This project aims to develop and validate magnetic resonance imaging (MRI) techniques to enable MR-guided focused ultrasound surgery (MRgFUS) treatment of subjects in the presence of implanted metal devices. Relevance: High-intensity focused ultrasound is one of the most promising new non-invasive ablation methods, and was recently clinically approved for the treatment of painful bone metastases. MRI offers excellent tissue contrast for planning treatments and for assessing the results of an ablation as well as for non- invasive real-time monitoring of the ablation using MR thermometry. Unfortunately, some patients with painful bone metastases treatments have previously had metallic implants inserted for stabilization of their bones, or have other devices such as a total hip replacement, which prohibits the use of MRI guidance due to severe image artifacts. Our group, together with others, has made substantial improvements to MRI near orthopedic implants such as spinal fusions and joint replacements. However, these 3D techniques are volumetric, slow, and inappropriate for interactive imaging applications such as MRgFUS. Approach: The proposed research seeks to overcome these limitations by developing a completely new class of rapid, interactive 2D MRI techniques with almost complete image artifact correction near metal. We will apply these specifically to MRgFUS in two specific aims: (1) to develop rapid, interactive T2 and T1 weighted scans that can be used for pre-treatment planning and for post-treatment evaluation using contrast enhancement, and (2) to develop MR thermometry techniques for real-time MRgFUS treatment monitoring in the presence of metal implants. We will validate the metal artifact correction in ex vivo animal and in vivo human studies, and verify appropriate imaging performance (contrast and SNR) in MRgFUS patients without metal who are being treated for periosteal ablations of painful bone cancers. Summary: We will develop rapid MRI approaches to image in the presence of metal with minimal artifacts, and tailor these to the interactive planning, real-time temperature monitoring, and post-treatment evaluation of MRgFUS procedures. Following our initial validation in MRgFUS subjects, this research will enable a larger clinical study to demonstrate efficacy of these methods for routine treatment of patients with metallic implants.

描述（由申请人提供）：该项目旨在开发和验证磁共振成像 (MRI) 技术，以便在存在植入金属装置的情况下对受试者进行 MR 引导聚焦超声手术 (MRgFUS) 治疗。相关性：高强度聚焦超声是最有前途的新型非侵入性消融方法之一，最近被临床批准用于治疗疼痛性骨转移。 MRI 提供出色的组织对比度，可用于规划治疗和评估消融结果，以及使用 MR 测温法对消融进行无创实时监测。不幸的是，一些接受痛苦的骨转移治疗的患者之前曾植入金属植入物以稳定骨骼，或者使用其他装置，例如全髋关节置换术，但由于严重的图像伪影而无法使用 MRI 引导。我们的团队与其他团队一起，对脊柱融合和关节置换等骨科植入物附近的 MRI 进行了重大改进。然而，这些 3D 技术是体积测量的、速度慢且不适合 MRgFUS 等交互式成像应用。方法：拟议的研究旨在通过开发一种全新的快速、交互式 2D MRI 技术来克服这些限制，该技术可以在金属附近实现几乎完整的图像伪影校正。我们将这些专门应用于 MRgFUS 的两个具体目标：(1) 开发快速、交互式 T2 和 T1 加权扫描，可用于治疗前计划和使用对比增强进行治疗后评估，以及 (2) 开发MR 测温技术用于在存在金属植入物的情况下实时监测 MRgFUS 治疗。我们将在离体动物和体内人类研究中验证金属伪影校正，并验证正在接受疼痛性骨癌骨膜消融治疗的无金属 MRgFUS 患者的适当成像性能（对比度和信噪比）。摘要：我们将开发快速 MRI 方法，在存在金属的情况下以最小的伪影进行成像，并根据 MRgFUS 程序的交互式计划、实时温度监测和治疗后评估进行定制。继我们在 MRgFUS 受试者中进行初步验证后，这项研究将开展更大规模的临床研究，以证明这些方法对金属植入物患者常规治疗的有效性。