Imaging Feedback to Guide Ultrasonic Tissue Fractionation for Cancer Therapy

成像反馈指导超声组织分割用于癌症治疗

• 批准号: 7668510
• 负责人: Charles Alan Cain
• 金额: $ 53.78万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-04 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7668510
• 关键词: Ablation; Abscess; Acoustics; Affect; Aftercare; Anatomy; Animals; Arrhythmia; Benign Prostatic Hypertrophy; Cardiac ablation; Cell Death; Cell Survival; Cells; Chronic; Clinical; Development; Effectiveness; Electron Microscopy; Extinction (Psychology); Feedback; Fractionation; Image; Imaging Techniques; Individual; Kidney; Laboratories; Liquid substance; Liver; Local Therapy; Lung; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of brain; Malignant neoplasm of liver; Malignant neoplasm of prostate; Mechanics; Methods; Metric; Molecular; Neoplasm Metastasis; Organelles; Outcome; Physiologic pulse; Process; Prostate; Renal carcinoma; Research; Resolution; Scanning; Scheme; Structure; Techniques; Technology; Therapeutic procedure; Time; Tissues; Ultrasonics; Ultrasonography; Uterine Fibroids; base; breast fibroadenoma; cancer therapy; capsule; clinical application; malignant breast neoplasm; organ capsule; particle; soft tissue; sound; therapy outcome; thrombolysis

DESCRIPTION (provided by applicant): Histotripsy is the controlled use of ultrasound cavitation to mechanically fractionate tissue volumes noninvasively under image guidance. With an appropriate understanding of the dynamics of bubble cloud initiation and extinction, a precise volume of tissue can be fractionated with very narrow boundaries between normal and affected tissue. Since the fractionation occurs at the tissue, cellular, and molecular levels, the results are easily seen by both ultrasound and MR imaging. Moreover, the degree of fractionation is correlated with survival of cells in the treated volume. As fractionation (or liquefaction) progresses, the amount of backscattered sound decreases as well a cell survival. Eventually, when the tissue is highly fractionated, no recognizable cellular organelles can be observed, even with electron microscopy, and the homogenized tissue looks like a fluid with few remaining ultrasound scattering particles. Since the effects of histotripsy are apparent in standard images both during and after treatment, the opportunity to develop image based feedback schemes correlating image parameters with eventual clinical outcomes is obvious. Unlike many other ablation techniques, the imaging based feedback approaches proposed herein can now be developed on a rational basis since the tissue effects can be easily seen and characterized by histological analysis and chronic animal studies where some clinical "outcome" can be determined. Thus, we will develop methods to predict clinical outcome from image parameters available both during and after treatment. This will provide an answer to the critical question for most noninvasive ablative technologies, i.e., when should the treatment be stopped and what will be the spatial extent of the desired treatment? Development of these image guidance techniques could result in a significant transformation in the effectiveness of ablative therapies in a wide range of clinical applications, e.g., prostate cancer, benign prostatic hyperplasia (BPH), breast cancer, fibroadenomas of the breast, liver cancer and metastases, kidney cancer, uterine fibroids, thrombolysis, cardiac ablations for arrhythmia control, lung and brain cancer (under certain conditions), treatment of infected wounds and abscesses, etc.

描述（由申请人提供）：组织肌肉是在图像指导下无创机械分馏的超声消失的受控使用。有了适当地了解气泡云开始和灭绝的动力学，可以通过正常组织和受影响的组织之间的狭窄边界来分离精确的组织。由于分馏发生在组织，细胞和分子水平上，因此超声和MR成像都很容易看到结果。此外，分馏程度与处理体积中细胞的存活相关。随着分馏（或液化）的进展，反向散射声音的量也减少了细胞的存活。最终，当组织高度分馏时，即使使用电子显微镜，也无法观察到可识别的细胞细胞器，并且均质组织看起来像一种流体，几乎没有剩余的超声散射颗粒。由于在治疗期间和之后的标准图像中都显而易见，因此，开发基于图像的反馈方案将图像参数与最终的临床结果相关联的机会很明显。与许多其他消融技术不同，基于成像的反馈方法现在可以在合理的基础上开发出基于成像的反馈方法，因为可以通过组织学分析和慢性动物研究轻松地看到组织效应，并确定一些临床“结果”。因此，我们将开发方法来预测在治疗期间和之后可用的图像参数中的临床结果。这将为大多数非侵入性烧蚀技术的关键问题提供答案，即何时应停止治疗，以及所需治疗的空间范围是多少？这些图像引导技术的开发可能会导致在广泛的临床应用中消融疗法的有效性显着转变（在某些条件下），治疗感染的伤口和脓肿等。