Advanced Treatment Endpoint Assessment in MR-guided Focused Ultrasound

MR 引导聚焦超声的高级治疗终点评估

• 批准号: 10115726
• 负责人: Henrik Carl Axel Odeen
• 金额: $ 7.63万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10115726
• 关键词: 3-Dimensional; Abdomen; Ablation; Acoustics; Address; Adipose tissue; Adoption; Aftercare; Area; Breast; Caring; Cellular Structures; Coagulative necrosis; Contrast Media; Dose; Environment; Evaluation; Fatty acid glycerol esters; Fiber Optics; Focused Ultrasound; Focused Ultrasound Therapy; Frequencies; Future; Goals; Heating; Image; Imaging Techniques; Lead; Lesion; Liquid substance; Long-Term Effects; Magnetic Resonance Imaging; Maps; Measurement; Measures; Medical; Methods; Modulus; Molecular Structure; Monitor; Motion; Noise; Normal tissue morphology; Oryctolagus cuniculus; Patients; Phase; Physics; Physiologic pulse; Precision therapeutics; Procedures; Property; Protons; Radiation; Recovery; Relaxation; Research; Safety; Signal Transduction; Sonication; Speed; System; Temperature; Testing; Thermometry; Time; Tissue Viability; Tissues; Treatment outcome; Ultrasonography; Universities; Utah; Work; aqueous; base; contrast enhanced; design; elastography; experience; first-in-human; image guided; imaging modality; improved; in vivo; interest; mechanical properties; necrotic tissue; novel; soft tissue; success; temporal measurement

ABSTRACT Tissue ablation during thermal therapies, such as focused ultrasound (FUS), result in tissue necrosis and irreversible changes in cell- and macromolecular-structure. The success of thermal therapies is defined in terms of adequately treating the desired target while sparing surrounding normal tissues. This demands methods for accurately determining tissue viability in real time so that treatments be efficacious, efficient and safe. Imaging methods that can detect irreversible tissue changes correlated to long-term effects are crucial for endpoint assessment and the general success and wide adoption of thermal therapies. The MR temperature imaging methods currently used are not always accurate, and the addition of other independent measurements of tissue viability are needed . In this application, we propose to develop and test a novel MRI pulse sequence to simultaneously measure four MR-derived parameters sensitive to tissue damage. Our sequence will first measure maps of the proton resonance frequency shift, from which temperature change and cumulative thermal dose can be calculated. Simultaneously, it measures the T1- relaxation time, which indicates temperature change in fat and evidence of fluid change at the point of ablation, as well as shear wave velocity, a direct measure of tissue stiffness, which often changes with ablation. T1 relaxation is measured using a novel mono flip angle approach we recently developed. The PRF shift and shear wave velocity are encoded in the MR phase images, and can be separated using novel methods we have developed. Because of the simultaneous acquisition, these properties are automatically co-registered providing substantially more information about the evolving FUS-induced tissue changes than what is currently available. The addition of T1-mapping and shear modulus measurements will enable evaluations in adipose tissues, where the PRF method does not work, allowing for more complete evaluations in areas such as the breast and abdomen. The proposed project will immediately benefit our current complementary work in performing first-in-human breast MR-guided FUS treatments with our novel hardware that enables high signal-to-noise ratio image acquisition. This work is an important step towards our long-term goal of developing comprehensive real time measurements that can accurately monitor and predict tissue viability during and following MRgFUS.

抽象的 热治疗期间的组织消融，例如聚焦超声 (FUS)，会导致组织 细胞和大分子结构的坏死和不可逆的变化。热力的成功 疗法的定义是充分治疗所需目标，同时不伤害周围环境 正常组织。这需要实时准确测定组织活力的方法，以便 治疗有效、高效且安全。可以检测不可逆的成像方法 与长期影响相关的组织变化对于终点评估和一般情况至关重要 热疗法的成功和广泛采用。目前MR温度成像方法 使用的并不总是准确的，并且添加了其他独立的组织测量 需要生存能力。在此应用中，我们建议开发和测试一种新型 MRI 脉冲 序列同时测量四个对组织损伤敏感的 MR 衍生参数。我们的 序列将首先测量质子共振频率偏移的图，从中得到温度 可以计算变化和累积热剂量。同时，它测量 T1- 弛豫时间，它表明脂肪的温度变化和液体变化的证据 消融点以及剪切波速度，组织硬度的直接测量，通常 随消融而变化。 T1 弛豫是使用一种新颖的单翻转角方法测量的，我们 最近开发的。 PRF 位移和剪切波速度被编码在 MR 相位图像中， 并且可以使用我们开发的新方法进行分离。由于同时 收购后，这些财产会自动共同注册，从而提供更多 有关不断发展的 FUS 引起的组织变化的信息比目前可用的信息要多。这 添加 T1 映射和剪切模量测量将能够对脂肪进行评估 PRF 方法不起作用的组织，可以对某些区域进行更完整的评估 比如胸部和腹部。拟议的项目将立即使我们当前受益 与我们进行首次人体乳房 MR 引导 FUS 治疗的互补工作 新颖的硬件可实现高信噪比图像采集。这项工作是一项重要的工作 朝着我们开发全面的实时测量的长期目标迈出了一步 在 MRgFUS 期间和之后准确监测和预测组织活力。