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

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.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目和 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 项目概要 授权号：R01-CA109246 项目启动：2005 年 5 月 11 日 项目结束：2010 年 3 月 31 日 图像引导干预的基本原则是肿瘤检测、导航、干预的传递和控制。聚焦超声 (FUS) 和磁共振成像 (MRI) 或 MR 引导的 FUS 的强大结合可以准确检测疾病、测量组织温度变化并确认热诱导的组织变化。这种集成的递送系统可以为许多肿瘤提供非侵入性的治疗方法。我们设计、开发和测试了使用 FUS 的集成系统，该系统目前正在进行由同一研究团队领导的治疗乳腺纤维腺瘤和子宫肌瘤的临床试验。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领域最重大的挑战之一。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。它是一个离散的肿瘤，易于接近，并且具有适当的大小，可以进行局部治疗的靶向治疗。 MR 特别适合前列腺成像，因为它可以对腺体、其下部结构和所有周围组织进行良好的可视化。 MRI 引导可以提供有针对性的、受控的热能传递，并有助于防止对周围关键解剖结构的损害。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 FUS 系统，用于治疗局限性前列腺癌。我们的具体目标是 1) 测试用于前列腺 MR 引导热疗的经直肠装置。 2）在多参数MR图像数据集的基础上，使用MRI来定义目标前列腺病变。这些图像将通过配准和分割进行分析，以进行目标定义和导航，然后集成到在线热剂量规划系统中。 3) 进行I期人体试验，测试MRgFUS治疗前列腺癌的可行性、安全性和有效性。这些将在根治性前列腺切除术之前完成，并对热坏死进行病理验证。面临的挑战是通过使用多模态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时特征。当这一点能够实现时，FUS 的精确输送以最大限度地消除肿瘤并最大限度地减少副作用将成为可能。因此，在该项目结束时，我们将准备开始更大规模的 II/III 期临床试验，并与工业合作伙伴一起进行进一步试验的设备的商业开发。 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做出贡献并受益。具体目标需要开发集成的多模态图像显示系统，以便能够准确定位 MR 引导 FUS 的局灶性前列腺病变。不仅在焦点处，而且在关键的正常相邻结构（例如尿道和神经血管束）处都需要快速且空间精确的热成像。 对项目的效益 R01 直接受益于 FUS 和前列腺核心的专业知识。目前在开孔环境（前列腺核心）中完成的大部分工作将进行调整和修改，以用于闭孔高场强系统，如 R01 特定目标中所述。 U41 内开发的成像和图像处理先进技术（例如配准和分割）也将直接应用于 R01。