Temperature monitoring in moving organs during thermal ablation

热消融期间运动器官的温度监测

• 批准号: 8040155
• 负责人: Bruno Madore
• 金额: $ 39.66万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-16 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8040155
• 关键词: Ablation; Address; Algorithms; Back; Benign; Blood Vessels; Brain; Breathing; Clinical; Cryosurgery; Data; Data Set; Detection; Devices; Dimensions; Dose; Feedback; Focused Ultrasound Therapy; Freezing; Goals; Heating; High temperature of physical object; Image; In Situ; Lasers; Lateral; Lead; Length of Stay; Lesion; Literature; Liver; Location; Magnetic Resonance; Magnetic Resonance Imaging; Malignant - descriptor; Measurement; Measures; Monitor; Motion; Nature; Needles; Noise; Operative Surgical Procedures; Organ; Pain; Palliative Care; Patients; Pattern; Phase; Physiologic pulse; Predisposition; Price; Procedures; Process; Resolution; Respiration; Signal Transduction; Site; Slice; Speed; Spottings; Temperature; Thermal Ablation Therapy; Thermometry; Time; Tissues; Trauma; Treatment Cost; Trees; Ultrasonic Transducer; Uterus; Variant; Work; base; cost; design; end of life; falls; flexibility; healthy volunteer; imaging modality; improved; minimally invasive; novel; reconstruction; stem; tool; tumor; vascular bed

DESCRIPTION (provided by applicant): Thermal ablation therapy can potentially offer several advantages over traditional surgery in the treatment of both benign and malignant lesions. Compared to surgery, thermal ablation can reduce the length of hospital stays and significantly reduce overall treatment cost, and may prove superior for treating deep-seated or otherwise difficult-to-reach tumors. Furthermore, the minimally-invasive nature of most thermal ablation treatments may reduce trauma and pain for patients, a particularly attractive advantage in the context of end-of-life palliative care. Heat may be delivered with lasers, RF antennas, or ultrasound transducers, and magnetic resonance (MR) thermometry has been used to monitor thermal ablations. The imaging data must help confirm whether heat is being delivered accurately at the targeted location, help determine when a lethal thermal dose has been reached at the target, and make sure that non-targeted locations are not inadvertently damaged. Demands on the imaging method are especially challenging, as good resolution is required along spatial, temporal and temperature dimensions simultaneously. While MR thermometry has been successfully used during thermal ablations of lesions seated in organs that are fairly easily immobilized, such as the brain and uterus, MR monitoring in more mobile organs such as the liver still remains a significant challenge. Especially in the context of focused ultrasound ablation, where there may not be any device or needle inserted into the body, the task of detecting and resolving motion may fall back entirely onto the imaging method. MR monitoring must then provide, in addition to good thermometry measurements, a temporal resolution sufficient to resolve the motion that occurs in free-breathing patients during treatment. The proposed work is aimed at developing an acquisition, reconstruction and display package for the MR monitoring of thermal ablations in mobile organs such as the liver, capable of providing limited 3D coverage with a temporal resolution of about 1/2 second or better. A novel pulse sequence design and reconstruction strategy is proposed, which is specifically targeted toward tackling the motion problem in MR thermometry imaging. The proposed approach can provide distortion-free 3D anatomical data with good signal-to-noise ratio as well as flexible contrast for motion tracking, while also simultaneously providing accurate temperature measurements. By exploiting the flexibility in the obtained contrast, one may preferentially highlight given internal features such as the vascular bed, thus improving the ability of registration algorithms to detect and track motion. PUBLIC HEALTH RELEVANCE: Thermal ablation therapy can allow the destruction of tumors in situ rather than removing them surgically, thus helping to reduce pain and suffering of patients, as well as reducing overall costs. MRI is often employed to monitor such procedures, to make sure that targeted diseased tissues are being treated properly and that no healthy tissues are being damaged. The treatment of organs such as the liver that are especially mobile during respiration has proved to be challenging. The present project aims at solving this motion problem by providing robust MRI monitoring as an effective guidance tool.

描述（由申请人提供）：在治疗良性和恶性病变方面，热消融疗法可能具有与传统手术相比的几个优势。与手术相比，热消融可以减少住院时间的长度并显着降低总体治疗成本，并且可以证明对治疗深处或其他难以到达的肿瘤的治疗可能优越。此外，大多数热消融治疗的最小侵入性可能会减轻患者的创伤和疼痛，这是在临终姑息治疗的背景下特别有吸引力的优势。热量可以用激光，RF天线或超声传感器传递，并且已使用磁共振（MR）温度法来监测热消融。成像数据必须有助于确认是否在目标位置准确地输送热量，帮助确定何时在目标处达到致命的热剂量，并确保不会无意中损坏非目标的位置。对成像方法的需求特别具有挑战性，因为同时沿空间，时间和温度尺寸需要良好的分辨率。虽然在坐在相当容易固定的器官中（例如大脑和子宫）的病变的热消融中，MR温度计已成功使用，但在肝脏等更多移动器官中进行MR监测仍然是一个重大挑战。尤其是在聚焦超声消融的背景下，可能没有任何设备或针头插入到体内的情况下，检测和解决运动的任务可能完全落在成像方法上。然后，MR监测必须提供，除了良好的温度测量外，还必须提供足以解决治疗过程中自由呼吸患者发生的运动的时间分辨率。拟议的工作旨在为MR监视移动器官（例如肝脏）的热消融的MR监测开发收购，重建和显示包，该肝脏（例如肝脏）能够提供有限的3D覆盖范围，其时间分辨率约为1/2秒或更高。提出了一种新型的脉冲序列设计和重建策略，该策略是针对MR温度计成像中的运动问题的专门针对的。所提出的方法可以提供具有良好信噪比的无失真解剖数据以及运动跟踪的灵活对比度，同时还提供准确的温度测量值。通过利用在获得的对比度中的灵活性，可以优先突出显示内部特征（例如血管床），从而提高了注册算法检测和跟踪运动的能力。 公共卫生相关性：热消融疗法可以使肿瘤原位破坏，而不是通过手术去除肿瘤，从而有助于减轻患者的疼痛和痛苦，并降低整体成本。 MRI通常被用来监测此类程序，以确保对靶向患病组织进行适当治疗，并且没有健康的组织受损。事实证明，在呼吸过程中特别流动的器官（例如肝脏）的治疗被证明是具有挑战性的。本项目旨在通过提供强大的MRI监控作为有效的指导工具来解决此运动问题。