Advancing Methods for MR-guided Focused Ultrasound Hyperthermia for Head and Neck Cancer

推进 MR 引导聚焦超声热疗治疗头颈癌的方法

• 批准号: 10738459
• 负责人: Kisoo Kim
• 金额: $ 15.49万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 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 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10738459
• 关键词: Acoustics; Acute; Adopted; Aftercare; Algorithms; Anatomy; Area; Award; Blood flow; Brain; Breathing; Canada; Chemotherapy and/or radiation; Clinical; Clinical Trials; Complex; Dedications; Deglutition; Development; Dose; Drug Delivery Systems; Drug Sensitization; Evaluation; Excision; Feedback; Focused Ultrasound; Focused Ultrasound Therapy; Goals; Head and Neck Cancer; Head and neck structure; Health; Heating; Hyperthermia; Image; Immunotherapy; Knowledge; Location; Magnetic Resonance Imaging; Malignant Neoplasms; Measurement; Mediating; Mentors; Metastatic Neoplasm to Lymph Nodes; Metastatic Neoplasm to the Bone; Methods; Monitor; Morphologic artifacts; Motion; Movement; Neck; Oncology; Outcome Study; Pancreas; Patients; Perfusion; Phase; Phase I Clinical Trials; Physiological; Predisposition; Prostate; Public Health; Radiation; Radiation therapy; Research; Research Project Grants; Safety; Shapes; Site; Soft tissue sarcoma; Sonication; Spottings; Squamous cell carcinoma; System; Techniques; Technology; Temperature; Therapeutic; Thermal Ablation Therapy; Thermometry; Time; Tissues; Toxic effect; Training; Transducers; United States; Uterine Fibroids; blood perfusion; cancer therapy; cancer type; chemoradiation; chemotherapy; cost; experience; experimental study; high risk; hyperthermia treatment; image guided; imaging modality; improved; in silico; interest; magnetic resonance imaging biomarker; melanoma; new technology; predictive modeling; prevent; reconstruction; response; safety and feasibility; simulation; standard of care; success; translational scientist; treatment response; tumor; ultrasound

PROJECT SUMMARY/ABSTRACT Head and Neck Cancer is a public health concern in the United States and a major challenge in oncology. Chemoradiotherapy has been mainly adopted to improve survival for patients with head and neck cancers. However, the benefit remains limited to patients with a high risk of complications, and the burden of toxicity in surviving patients with head and neck cancers is severe. Hyperthermia combined with other treatments, such as radiation, chemotherapy, and immunotherapy, has been shown in clinical trials to increase response for head and neck cancers, but success is highly dependent upon the delivered thermal dose distributions. Hence, this technology requires spatially controllable heat delivery and adequate temperature monitoring. MR-guided focused ultrasound (MRgFUS) can potentially be used to deliver hyperthermia. The focused ultrasound technique has been received much interest due to its completely non-invasive heat delivery with a high degree of spatial selectivity and dynamic control. With these inherent advantages, clinical MRgFUS systems have been developed and approved for thermal ablation treatments of various sites, such as the brain, uterine fibroids, prostate, pancreas, and bone metastases. However, the major technical challenges remain for MRgFUS hyperthermia delivery to head and neck cancers: There is a need for 1) optimizing sonication strategies for enhancing temperature distributions and delivering conformal hyperthermia to HNC, and 2) advanced MR imaging methods for accurate temperature imaging with significantly reduced artifacts and rapid MR imaging to evaluate tissue response. The proposed project will develop methods for more effective hyperthermia delivery under magnetic resonance imaging control to increase response rate and survival for patients with superficial and deep tumors in the head and neck, such as squamous cell carcinoma, melanoma, and soft tissue sarcoma. In this project, the specific aims are 1) to develop practical and optimal sonication strategies for conformal delivery of hyperthermia to target head and neck cancer, 2) develop robust real-time MR thermometry methods for temperature imaging with a minimal artifact in the complex anatomy of the head and neck, and 3) develop real-time simultaneous MR imaging of temperature and tissue response during hyperthermia (R00 Phase). These technical developments will advance MRgFUS-mediated hyperthermia delivery to head and neck cancers and the training plan includes opportunities to apply the new knowledge. I have assembled an outstanding team of renowned mentors (Drs. Diederich, Larson, and Payne) and specialized advisors (Drs. Ozhinsky, Bucknor, and Chan) with expertise in MR-guided Focused Ultrasound therapy, clinical head and neck cancer treatment, quantitative MRI, and MR thermometry. The proposed award will provide me with the necessary experiences to become an independent, transdisciplinary, and translational scientist dedicated to image-guided thermal therapy and therapeutic ultrasound.

项目概要/摘要 头颈癌是美国的一个公共卫生问题，也是肿瘤学的一项重大挑战。 放化疗主要用于提高头颈癌患者的生存率。 然而，益处仍然仅限于并发症风险高且毒性负担高的患者 对于幸存的头颈癌患者来说，这种情况非常严重。热疗结合其他治疗， 临床试验已证明放疗、化疗和免疫疗法等可提高疗效 对于头颈癌，但成功很大程度上取决于所传递的热剂量分布。 因此，该技术需要空间可控的热量传递和充分的温度监控。 MR 引导聚焦超声 (MRgFUS) 可能用于提供热疗。重点关注的 超声技术因其完全非侵入性的热传递而受到广泛关注 高度的空间选择性和动态控制。凭借这些固有的优势，临床MRgFUS 已开发并批准了用于各种部位热消融治疗的系统，例如 脑、子宫肌瘤、前列腺、胰腺和骨转移。然而，主要的技术挑战 MRgFUS 热疗治疗头颈癌的效果仍然存在：需要 1) 优化 用于增强温度分布并向 HNC 提供适形热疗的超声处理策略， 2) 先进的 MR 成像方法可实现精确的温度成像，并显着减少伪影 和快速磁共振成像来评估组织反应。拟议的项目将开发更多方法 在磁共振成像控制下进行有效的热疗，以提高反应率和 头颈部浅表和深层肿瘤患者的生存率，例如鳞状细胞癌， 黑色素瘤和软组织肉瘤。在这个项目中，具体目标是1）开发实用且优化的 用于针对头颈癌进行适形热疗的超声处理策略，2) 开发 强大的实时 MR 测温方法，可在复杂环境中实现最小伪影的温度成像 头部和颈部的解剖结构，3) 开发温度和组织的实时同步 MR 成像 热疗期间的反应（R00 阶段）。这些技术发展将推动 MRgFUS 介导的 热疗治疗头颈癌，培训计划包括应用热疗的机会 新知识。我组建了一支由著名导师组成的优秀团队（迪德里奇博士、拉尔森博士和 Payne）和具有 MR 引导聚焦方面专业知识的专业顾问（Ozhinsky、Bucknor 和 Chan 博士） 超声治疗、临床头颈癌治疗、定量 MRI 和 MR 测温。这 拟议的奖项将为我提供必要的经验，使我成为一个独立的、跨学科的、 致力于图像引导热疗和治疗超声的转化科学家。