Feasibility and safety assessment of magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU)-mediated mild hyperthermia in pelvic targets evaluated using an in vivo porcine model.
Feasibility and safety assessment of magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU)-mediated mild hyperthermia in pelvic targets evaluated using an in vivo porcine model.
复制标题
使用体内猪模型评估磁共振引导高强度聚焦超声（MRgHIFU）介导的骨盆目标轻度热疗的可行性和安全性。
DOI：
10.1080/02656736.2019.1685684
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Altman,MichaelB
中科院分区：
文献类型：
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作者：
Zhu,Lifei;Partanen,Ari;Talcott,MichaelR;Gach,HMichael;Greco,SuellenC;Henke,LaurenE;Contreras,JessikaA;Zoberi,Imran;Hallahan,DennisE;Chen,Hong;Altman,MichaelB
目的：评价磁共振引导高强度聚焦超声(MRgHIFU)在活体猪盆腔不同靶点热疗的可行性和安全性参数。方法：使用商用高强度聚焦超声系统(Sonalleve V2，Inepend Medical Inc.，加拿大密西索加)对6头猪进行13次高强度聚焦超声热疗，治疗时间为42 °C(±1°)，30 °C(±1°)，30 (±5%)，靶径18 mm，功率100W。可行性评估使用准确性、一致性和MR-温度计性能为基础的指标。结果：靶区内平均温度(Tavg)与靶区内靶区温度(TROI)之差平均为0.51 ± 0.33 °C，TROI内温度标准差平均为1.55 ± 0.31 °C，30分钟TAVG平均变化量为0.80 ± 0.17 °C，TAVG与靶区平均TAVG之差为0.80±0.17 °C，TAVG与靶区平均TAVG之差为0.80 ± 0.17 °C，TAVG与靶区平均TAVG之差为0.33 °C。治疗前后达到≥41 °C和冷却到≤40 °C的平均时间分别为47.25 ± 27.47 S和66.37 ± 62.68 S。与未加热的对照组相比，MR图像、大体病理或组织学分析均未见明显的组织异常灌流或永久性损伤。结论：MRgHIFU介导的羟色胺在体内治疗一系列临床模拟骨盆几何形状的动物模型是可行的，安全性评估是令人满意的，这意味着该技术可能在治疗人类患者的盆腔靶点方面具有实用价值。
Purpose:To evaluate the feasibility and assess safety parameters of magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU)-mediated hyperthermia (HT; heating to 40–45 °C) in various pelvic targets in a porcine modelin vivo.Methods:Thirteen HT treatments were performed in six pigs with a commercial MRgHIFU system (Sonalleve V2, Profound Medical Inc., Mississauga, Canada) to muscle adjacent to the ventral/dorsal bladder wall and uterus to administer 42 °C (±1°) for 30 min (±5%) using an 18-mm target diameter and 100 W power. Feasibility was assessed using accuracy, uniformity, and MR-thermometry performance-based metrics. Safety parameters were assessed for tissues in the targets and beam-path by contrast-enhanced MRI, gross-pathology and histopathology.Results:Across all HT sessions, the mean difference between average temperature (Tavg) and the target temperature within the target region-of-interest (tROI, the cross-section of the heated volume at focal depth) was 0.51 ± 0.33 °C. Within the tROI, the temperature standard deviation averaged 1.55 ± 0.31 °C, the average 30-min Tavgvariation was 0.80 ± 0.17 °C, and the maximum difference between Tavgand the 10th- or 90th-percentile temperature averaged 2.01 ± 0.44 °C. The average time to reach ≥41 °C and cool to ≤40 °C within the tROI at the beginning and end of treatment was 47.25 ± 27.47 s and 66.37 ± 62.68 s, respectively. Compared to unheated controls, no abnormally-perfused tissue or permanent damage was evident in the MR images, gross pathology or histological analysis.Conclusions:MRgHIFU-mediated HT is feasible and safety assessment is satisfactory for treating an array of clinically-mimicking pelvic geometries in a porcine modelin vivo, implying the technique may have utility in treating pelvic targets in human patients.