MR GUIDED FOCUSED ULTRASOUND SURGERY FOR PROSTATE CANCER

MR 引导聚焦超声手术治疗前列腺癌

• 批准号: 7960874
• 负责人: CLARE M TEMPANY
• 金额: $ 5.48万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7960874
• 关键词: Ablation; Adverse effects; Anatomic structures; Blood Vessels; Breast; Clinical Treatment; Clinical Trials; Collaborations; Computer Retrieval of Information on Scientific Projects Database; Data; Data Set; Detection; Development; Devices; Disease; Dose; Focused Ultrasound Therapy; Funding; Funding Opportunities; Gland; Goals; Grant; Healthcare Systems; Human; Image; Imagery; Institution; Integrated Delivery Systems; Intervention; Lesion; Magnetic Resonance Imaging; Malignant neoplasm of prostate; Measurement; Medicine; Methods; Modeling; Necrosis; Operative Surgical Procedures; Phase; Prostate; Public Health; Radical Prostatectomy; Research; Research Personnel; Resources; Safety; Source; Structure; System; Temperature; Testing; Thermal Ablation Therapy; Time; Tissues; United States National Institutes of Health; Urethra; Uterine Fibroids; Validation; Work; adenoma; base; cancer imaging; design; direct application; image guided intervention; image guided therapy; image processing; intraoperative imaging; prevent; targeted delivery; tumor; Ablation; Adverse effects; Anatomic structures; Blood Vessels; Breast; Clinical Treatment; Clinical Trials; Collaborations; Computer Retrieval of Information on Scientific Projects Database; Data; Data Set; Detection; Development; Devices; Disease; Dose; Focused Ultrasound Therapy; Funding; Funding Opportunities; Gland; Goals; Grant; Healthcare Systems; Human; Image; Imagery; Institution; Integrated Delivery Systems; Intervention; Lesion; Magnetic Resonance Imaging; Malignant neoplasm of prostate; Measurement; Medicine; Methods; Modeling; Necrosis; Operative Surgical Procedures; Phase; Prostate; Public Health; Radical Prostatectomy; Research; Research Personnel; Resources; Safety; Source; Structure; System; Temperature; Testing; Thermal Ablation Therapy; Time; Tissues; United States National Institutes of Health; Urethra; Uterine Fibroids; Validation; Work; adenoma; base; cancer imaging; design; direct application; image guided intervention; image guided therapy; image processing; intraoperative imaging; prevent; targeted delivery; tumor

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Project Summary Grant Number: R01-CA109246 Project Start: 11-MAY-2005 Project End: 31-MAR-2010 The fundamental principles of image-guided interventions are tumor detection, navigation, delivery and control of the intervention. The powerful union of focused ultrasound (FUS) and magnetic resonance imaging (MRI) or MR-guided FUS allows for accurate detection of the disease, measurement of tissue temperature changes and confirmation of thermally induced tissue changes. Such an integrated delivery system can provide a non-invasive treatment method for many tumors. We have designed, developed and tested integrated systems for use of FUS, which are currently in clinical trials for treatment of breast fibro-adenomas and uterine leiomyomas, led by this same team of investigators. Prostate cancer represents one of the most significant challenges in medicine and public health, facing the US healthcare system today. It presents an ideal model for this non-invasive thermal ablation method or FUS surgery. It is a discrete tumor, which is accessible, and of an appropriate size for targeted delivery of a focal treatment. MR is uniquely suited to imaging the prostate as it allows excellent visualization of the gland, its substructure and all surrounding tissues. MRI guidance can provide targeting, controlled delivery of the thermal energy and help prevent damage to the surrounding critical anatomic structures. In the proposed research, our goal is to develop an interactive comprehensive MR image-guided FUS system for treatment of localized prostate cancer. Our specific aims are 1) To test transrectal device for MR guided thermal therapy in the prostate. 2) To use MRI to define the target prostate lesions, on the basis of multi-parametric MR image data sets. These images will be analyzed, by registration and segmentation, for target definition and navigation, and then integrated into an on-line thermal dose planning system. 3) To perform phase I human trials to test the feasibility, safety and efficacy of MRgFUS for prostate cancer. These will be done prior to radical prostatectomy, with resulting pathological validation of thermal necrosis. The challenge is to increase the information content of intraoperative image data by using multimodal features, while at the same time preserving the interactivity and the near-real time features of intraoperative imaging. When this can be achieved, the precise delivery of FUS to maximize tumor ablation, and minimize side effects will be possible. Thus, at the conclusion of this project we will be poised to begin larger phase II/III clinical trials, with an industrial partner leading to commercial development of a device for further trials. Benefit to NCIGT Both the Prostate and FUS cores contribute and benefit from this collaboration by means of new scientific opportunities and funding. The Specific Aims require the development of an integrated multi-modal image display system to allow accurate targeting of focal prostate lesions for MR guided FUS. Rapid and spatially accurate thermal imaging will be required, not only at the focal point but at the critical normal, adjacent structures, such as the urethra and neuro-vascular bundles. Benefit to the Project The R01 benefits directly from the expertise within the FUS and Prostate cores. Much of the work now being done in the open-bore setting (Prostate Core) will be adapted and modified for use in the closed bore, high field strength system as outlined in the R01 Specific Aims. Imaging and image-processing advances, such as registration and segmentation, developed within the U41 will also have direct application to this R01.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 项目摘要 赠款编号：R01-CA109246 项目开始：2005年5月11日 项目结束：2010年3月31日 图像引导干预措施的基本原理是肿瘤检测，导航，输送和控制干预措施。聚焦超声（FUS）和磁共振成像（MRI）或MR引导FUS的强大结合允许准确检测疾病，测量组织温度变化以及确认热诱导的组织变化。这种综合递送系统可以为许多肿瘤提供一种非侵入性治疗方法。我们已经设计，开发和测试了用于使用FUS的集成系统，这些系统目前正在临床试验中，用于治疗由同一批研究人员领导的乳腺纤维 - 腺瘤和子宫平滑肌瘤。前列腺癌是当今美国医疗保健系统面临的医学和公共卫生中最重要的挑战之一。它为这种非侵入性热消融方法或FUS手术提供了理想的模型。它是一种离散的肿瘤，可访问，适合靶向焦点治疗的尺寸适当。 MR非常适合对前列腺进行成像，因为它可以很好地可视化腺体，其子结构和所有周围的组织。 MRI指导可以提供靶向，控制的热能输送，并有助于防止对周围临界解剖结构的损害。在拟议的研究中，我们的目标是开发一种交互式综合MR图像引导系统，用于治疗局部前列腺癌。我们的具体目的是1）测试前列腺中MR引导热疗法的转直肠装置。 2）使用MRI根据多参数MR图像数据集来定义目标前列腺病变。这些图像将通过注册和分割分析目标定义和导航，然后集成到在线热剂量计划系统中。 3）进行I期人类试验以测试MRGFUS前列腺癌的可行性，安全性和功效。这些将在根治性前列腺切除术之前进行，从而导致热坏死的病理验证。面临的挑战是通过使用多模式特征来增加术中图像数据的信息内容，同时保留术中成像的交互性和近实的时间特征。如果可以实现这一目标，则可以确切的FUS递送以最大程度地消融，并最大程度地减少副作用。因此，在该项目的结论结束时，我们将有望开始进行更大的II/III期临床试验，并通过工业合作伙伴为商业开发提供了用于进一步试验的设备。 对NCIGT的好处 前列腺和FUS核心都通过新的科学机会和资金从这种合作中贡献和受益。具体目的需要开发集成的多模式图像显示系统，以使MR引导FUS的局灶性前列腺病变准确靶向。不仅在焦点，而且在临界正常的相邻结构（例如尿道和神经血管束）上，不仅需要快速和空间准确的热成像。 对项目的好处 R01直接从FUS和前列腺内部的专业知识中受益。如R01特定目的中所述，现在将在开放孔环境（前列腺芯）中完成的大部分工作（前列腺芯）进行调整和修改。 U41中开发的成像和图像处理的进步（例如注册和分割）也将直接应用于此R01。