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

基本信息

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
项目类别：
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

项目摘要

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.

项目概要/摘要胶质母细胞瘤 (GBM) 是最常见且最具挑战性的癌症之一。每年，近 12,000 个新在美国诊断出 GBM 病例，总体中位生存期仅为 12 至 18 个月。 GBM 很少转移至其他器官；然而，GBM 肿瘤没有有效的治疗方法。标准疗法有手术结合辅助放疗和 FDA 批准的药物可以将中位生存期延长几个月但不能阻止GBM的复发。对于复发性 GBM (rGBM)，预后更加悲观。重复通常不建议进行手术，因为患者在初始治疗期间已经经历过手术 GBM 和其他治疗方案的疗效非常有限。激光间质热疗（LITT）是一种 rGBM 微创治疗的新兴技术。通过将细长的激光探针引入大脑 LITT可以利用激光辐射经皮消融肿瘤组织。然而，现有的 LITT 设备通常将激光探针的尖端设置在肿瘤核心不足以实现适形消融（即，最大肿瘤覆盖和最小附带损害的消融），特别是当肿瘤很大时，形状不规则或多焦点。因此，为了实现适形消融并提高LITT的疗效，我们提出一种新型机器人，可以在脑肿瘤内的多个位置提供热辐射。我们将开发一个新颖的可操纵激光间质热疗（SLIT）机器人具有纤细的占地面积和定制的设计了柔性激光烧蚀探头。我们将通过一个小导管将 SLIT 引入脑肿瘤的周围钻孔，在关键结构周围操纵 SLIT，并对计划的目标进行消融临床医生在磁共振成像（MRI）的指导下。新程序的各个方面都将临床医生使用术中 MRI 和测温 (MRT) 进行远程监控和控制，以确保精度和安全性。在这个项目中，我们将 1) 设计和开发一个兼容 MR 的可转向机器人灵活的消融探针，2) 开发能够规划和控制多部位肿瘤消融的软件，以及 3) 使用临床相关模型评估 SLIT 的安全性和功能性。我们已经形成了一个多学科团队拥有微创手术机器人、生物医学光纤激光器、神经外科、神经外科设备、神经病理学、高级 MR 成像、动物模型和神经放射学成功地进行了拟议的研究。 rGBM 治疗的 LITT 将作为模型技术开发，而成果将产生一个变革性的平台，可应用于许多领域需要灵巧的微创进入脑部病变的神经外科手术。