Tumor characterization and treatment monitoring of postsurgical human breast specimens using harmonic motion imaging (HMI).
Tumor characterization and treatment monitoring of postsurgical human breast specimens using harmonic motion imaging (HMI).
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DOI：
10.1186/s13058-016-0707-3
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发表时间：
2016-05-09
期刊：
影响因子：
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通讯作者：
Konofagou E
中科院分区：
文献类型：
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作者：
Han Y;Wang S;Hibshoosh H;Taback B;Konofagou E
高强度聚焦超声（HIFU）是一种用于治疗早期乳腺癌和良性肿瘤的非侵入性技术。为了便于将其转化为临床，需要一种能够可靠地监测HIFU治疗的简单、具有成本效益的设备。我们开发了谐波运动成像（HMI），可与HIFU无缝结合用于肿瘤消融监测，即聚焦超声谐波运动成像（HMIFU）。本研究的总体目标是开发一种全超声系统，用于人体乳腺活体实时成像和消融监测。36例标本（19例正常、15例浸润性导管癌和2例纤维腺瘤）在手术切除后立即进行HMI。将标本牢固地包埋在组织模拟琼脂凝胶基质中，并浸没在脱气磷酸盐缓冲盐水中以模拟体内环境。HMI装置由与成像换能器共焦对准的HIFU换能器组成，以诱导振荡辐射力并估计产生的位移。重建3D HMI位移图以表示3D中的相对组织刚度。发现正常乳腺组织和浸润性导管癌之间的平均峰间位移存在显著差异（p = 0.003）。在正常组织和浸润性导管癌组织中，HMIFU消融前后的差异也有统计学意义（分别为53.84%和44.69%）。HMI可用于映射和区分手术后正常和病理乳腺组织中的相对硬度。高强度聚焦超声还可以成功地监测正常和病理人类乳腺标本中的热消融。这种HMI技术可能会导致乳腺肿瘤成像和HIFU治疗监测的一种新的临床工具。
High-intensity focused ultrasound (HIFU) is a noninvasive technique used in the treatment of early-stage breast cancer and benign tumors. To facilitate its translation to the clinic, there is a need for a simple, cost-effective device that can reliably monitor HIFU treatment. We have developed harmonic motion imaging (HMI), which can be used seamlessly in conjunction with HIFU for tumor ablation monitoring, namely harmonic motion imaging for focused ultrasound (HMIFU). The overall objective of this study was to develop an all ultrasound-based system for real-time imaging and ablation monitoring in the human breast in vivo. HMI was performed in 36 specimens (19 normal, 15 invasive ductal carcinomas, and 2 fibroadenomas) immediately after surgical removal. The specimens were securely embedded in a tissue-mimicking agar gel matrix and submerged in degassed phosphate-buffered saline to mimic in vivo environment. The HMI setup consisted of a HIFU transducer confocally aligned with an imaging transducer to induce an oscillatory radiation force and estimate the resulting displacement. 3D HMI displacement maps were reconstructed to represent the relative tissue stiffness in 3D. The average peak-to-peak displacement was found to be significantly different (p = 0.003) between normal breast tissue and invasive ductal carcinoma. There were also significant differences before and after HMIFU ablation in both the normal (53.84 % decrease) and invasive ductal carcinoma (44.69 % decrease) specimens. HMI can be used to map and differentiate relative stiffness in postsurgical normal and pathological breast tissues. HMIFU can also successfully monitor thermal ablations in normal and pathological human breast specimens. This HMI technique may lead to a new clinical tool for breast tumor imaging and HIFU treatment monitoring.