Steerable Laser Interstitial Thermotherapy (SLIT) Robot for Brain Tumor Therapy

用于脑肿瘤治疗的可操纵激光间质热疗 (SLIT) 机器人

• 批准号: 10572533
• 负责人: Jun Sheng
• 金额: $ 23.24万
• 依托单位: UNIVERSITY OF CALIFORNIA RIVERSIDE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10572533
• 关键词: Ablation; Adjuvant; Agar; Air; Algorithms; Animal Model; Animals; Applications Grants; Brain; Brain Neoplasms; Computer software; Cranial Irradiation; Custom; Development; Devices; Diagnosis; Ensure; Evaluation; FDA approved; Family suidae; Fiber; Future; Gadolinium; Glioblastoma; Goals; In Vitro; Induced Hyperthermia; Intelligence; Lasers; Lesion; Location; Magnetic Resonance; Magnetic Resonance Imaging; Malignant Neoplasms; Mechanics; Modality; Modeling; Morphology; Motion; Neoplasm Metastasis; Neurosurgical Procedures; Operative Surgical Procedures; Organ; Outcome; Patients; Peripheral; Pharmaceutical Preparations; Primary Brain Neoplasms; Procedures; Prognosis; Protocols documentation; Radiation; Radiation necrosis; Recurrence; Repeat Surgery; Research Personnel; Robot; Robotics; Safety; Shapes; Site; Structure; System; Techniques; Temperature Sense; Tendon structure; Testing; Thermometry; Tissues; Trephine hole; Tumor Tissue; United States National Institutes of Health; Work; clinically relevant; design; effective therapy; flexibility; graphical user interface; improved; in vivo; interstitial; kinematics; minimally invasive; multidisciplinary; neuropathology; neurosurgery; novel; phantom model; porcine model; pre-clinical; prevent; remote monitoring; robot control; skills; software development; technology development; tumor; tumor ablation

Project Summary/Abstract Glioblastoma (GBM) is one of the most prevalent and challenging cancers to cure. Each year, nearly 12,000 new cases of GBM are diagnosed in the US, with the overall median survival being only 12 to 18 months. GBM rarely metastasizes to other organs; however, there is no effective treatment for GBM tumors. Standard therapies with surgery combined with adjuvant radiation and FDA-approved drugs can add a few months to median survival but cannot prevent the recurrence of GBM. For recurrent GBM (rGBM), prognosis is even more dismal. Repeated surgery is often not recommended since patients have already gone through it during the treatment of initial GBM, and the efficacy of other treatment options is very limited. Laser interstitial thermotherapy (LITT) is an emerging technique for minimally invasive treatment of rGBM. By introducing a slender laser probe into a brain tumor, LITT can ablate the tumor tissue percutaneously using laser radiation. However, existing LITT devices which often set the tip of a laser probe at the core of the tumor are inadequate to achieve conformal ablation (i.e., ablation with the maximum tumor coverage and minimum collateral damage), especially when tumors are large, irregularly shaped, or multifocal. Hence, to achieve conformal ablation and improve the efficacy of LITT, we propose a novel robot to deliver thermal radiation at multiple locations inside a brain tumor. We will develop a novel steerable laser interstitial thermotherapy (SLIT) robot with a slender footprint and a custom- designed flexible laser ablation probe. We will introduce SLIT to the peripheral of a brain tumor through a small burr hole, manipulate SLIT around critical structures, and perform ablation at targets that are planned by clinicians under the guidance of magnetic resonance imaging (MRI). All aspects of new procedure will be remotely monitored and controlled by clinicians using intra-operative MRI and thermometry (MRT) to ensure precision and safety. In this project, we will 1) Design and develop an MR-compatible steerable robot with a flexible ablation probe, 2) Develop software that enables planning and control of multi-site tumor ablation, and 3) Evaluate the safety and functionality of SLIT using clinically relevant models. We have formed a multidisciplinary team with expertise in minimally invasive surgical robots, biomedical fiber lasers, neurosurgery, neurosurgical devices, neuropathology, advanced MR imaging, animal models, and neuroradiology to successfully conduct the proposed studies. LITT for rGBM therapy will serve as a model for technology development, while the outcome will generate a transformative platform with applications to many neurosurgical procedures that require dexterous minimally invasive access to brain lesions.

项目摘要/摘要 胶质母细胞瘤（GBM）是治愈最普遍，最具挑战性的癌症之一。每年，将近12,000个新 在美国诊断出GBM病例，总体生存率仅为12至18个月。 GBM很少 转移到其他器官；但是，对于GBM肿瘤没有有效的治疗方法。标准疗法 手术结合辅助辐射和FDA批准的药物可以增加几个月的中位数存活率 但无法阻止GBM的复发。对于复发性GBM（RGBM），预后更加令人沮丧。重复 通常不建议您进行手术 GBM，其他治疗方案的功效非常有限。激光间质热疗（LITT）是 RGBM微创治疗的新兴技术。通过将细长的激光探针引入大脑 肿瘤，LITT可以使用激光辐射将肿瘤组织纯化。但是，现有的LITT设备 通常将激光探针的尖端设置在肿瘤核心的尖端是不足以实现共形消融（即 消融具有最大的肿瘤覆盖范围和最小侧支损害），尤其是当肿瘤大时 不规则形状或多灶。因此，为了实现保形消融并提高了LITT的功效，我们 提出一个新型的机器人，以在脑肿瘤内的多个位置提供热辐射。我们将发展一个 新颖的可通话激光间隙热疗（SLIT）机器人，具有细长的足迹和定制 设计的柔性激光消融探针。我们将通过小的狭缝介绍脑肿瘤的外围 Burr洞，操纵临界结构周围的缝隙，并在计划的目标上进行消融 临床医生在磁共振成像（MRI）的指导下。新程序的所有方面将是 临床医生使用术中MRI和温度法（MRT）对远程监测和控制，以确保 精度和安全。在这个项目中，我们将1）设计并开发了一个MR兼容的可及可访问的机器人 柔性消融探针，2）开发软件，以计划和控制多站点肿瘤消融，并控制 3）使用临床相关模型评估缝隙的安全性和功能。我们已经形成了 多学科团队在微创手术机器人，生物医学纤维激光器中具有专业知识， 神经外科，神经外科手术，神经病理学，先进的MR成像，动物模型和 神经放射学以成功进行拟议的研究。用于RGBM治疗的LITT将作为模型 技术开发，而结果将产生一个具有应用程序的变革平台 需要轻巧的侵入性进入脑病变的神经外科手术。