Robotically Assisted Sonic Therapy as a Noninvasive Nonthermal Ablation Modality: Proof of Concept in a Porcine Liver Model
Robotically Assisted Sonic Therapy as a Noninvasive Nonthermal Ablation Modality: Proof of Concept in a Porcine Liver Model
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DOI：
10.1148/radiol.2018171544
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发表时间：
2018-05-01
期刊：
影响因子：
19.7
通讯作者：
Lee, Fred T., Jr.
中科院分区：
文献类型：
--
作者：
Smolock, Amanda R.;Cristescu, Mircea M.;Lee, Fred T., Jr.
Purpose: To determine the feasibility of creating a clinically relevant hepatic ablation (ie, an ablation zone capable of treating a 2-cm liver tumor) by using robotically assisted sonic therapy (RAST), a noninvasive and nonthermal focused ultrasound therapy based on histotripsy. Materials andMethods: This study was approved by the institutional animal use and care committee. Ten female pigs were treated with RAST in a single session with a prescribed 3-cm spherical treatment region and immediately underwent abdominal magnetic resonance (MR) imaging. Three pigs (acute group) were sacrificed immediately following MR imaging. Seven pigs (chronic group) were survived for approximately 4 weeks and were reimaged with MR imaging immediately before sacrifice. Animals underwent necropsy and harvesting of the liver for histologic evaluation of the ablation zone. RAST ablations were performed with a 700-kHz therapy transducer. Student t tests were performed to compare prescribed versus achieved ablation diameter, difference of sphericity from 1, and change in ablation zone volume from acute to chronic imaging.Results: Ablation zones had a sphericity index of 0.99 +/- 0.01 (standard deviation) (P < .001 vs sphericity index of 1). Anteroposterior and transverse dimensions were not significantly different from prescribed (3.4 +/- 0.7; P =.08 and 3.2 +/- 0.8; P = .29, respectively). The craniocaudal dimension was significantly larger than prescribed (3.8 +/- 1.1; P = .04), likely because of respiratory motion. The central ablation zone demonstrated complete cell destruction and a zone of partial necrosis. A fibrous capsule surrounded the ablation zone by 4 weeks. On 4-week follow-up images, ablation zone volumes decreased by 64% (P < .001).Conclusion: RAST is capable of producing clinically relevant ablation zones in a noninvasive manner in a porcine model. (C) RSNA, 2018
