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Laser-induced interstitial thermotherapy of liver tumors using real-time MR-monitoring sequence: fundamental and clinical examinations

使用实时 MR 监测序列对肝脏肿瘤进行激光诱导间质热疗：基础和临床检查

基本信息

批准号：
12670882
负责人：
IRIE Hiroyuki
金额：
$ 2.24万
依托单位：
Kyushu University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2002
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12670882/
关键词：
Laser Local thermotherapy MR monitoring

项目摘要

As a fundamental experiment, laser irradiation was applied to both in-vivo and in-vitro animal livers, using various parameters under various parameters of laser application. The equipment used is Dornier Medilas Fibertom 5100 (Dornier Medizintechnik, Germany) which generates Nd:YAG laser with a wavelength of 1064nm. Size of thermoablative lesions were evaluated both macroscopically and microscopically. We evaluated a relationship between laser output (W) and lesion size, a relationship between irradiation time and lesion size, and a difference of lesion size between in-vitro and in-vivo liver.Consequently, it became clear that size of thermoablative lesion was the maximum at the output of 25W (maximum output) and increased in proportion to laser irradiation time. Moreover, lesion size of in-vivo liver turned out to be smaller than that of in-vitro liver by about 1/9 under same parameters. Therefore, in actual clinical application, in order to treat liver tumors effectively, a laser ou … More tput should be set as high as possible.Using 0.2T MAGNETOM OPEN VIVA (Siemens, Germany) of the open magnetic field, several MR sequences, including 2D-FLASH and True FISP, were evaluated for online monitoring of LITT of animal liver. Laser irradiation were applied through laser tip in 25W and 10W output. Serial MR images were obtained approximately every 30 second during procedure. Comparing signal changes of all MR images and actual thermal changes of animal liver, 2D-FLASH was superior to True FISP for real-time monitoring of LITT.For clinical application of LITT, laser fiber was placed into liver tumors using special applicator. Applicator is not approved for clinical use by Ministry of Health, Labor and Welfare. Therefore, enforcement to the patient to the actual example of metastatic liver tumors was not completed and will be a future subject. However, the safety of LITT procedure was being checked through our animal experiment. LITT is expected to be a useful therapeutic option for metastatic liver tumors, especially in view of the real-time monitor of the thermoablative change by MR. Less

作为基础实验，在各种激光应用参数下使用各种参数将激光照射应用于体内和体外动物肝脏。所用设备为Dornier Medilas Fibertom 5100（Dornier Medizintechnik，德国），可产生波长为1064 nm的Nd：YAG激光。通过肉眼和显微镜评价热消融病变的大小。我们评估了激光输出（W）和损伤尺寸之间的关系、照射时间和损伤尺寸之间的关系以及体外和体内肝脏之间损伤尺寸的差异。结果表明，热消融损伤的尺寸在25 W（最大输出）时最大，并与激光照射时间成比例地增加。在相同的参数下，体内肝脏的损伤尺寸比体外肝脏的损伤尺寸小约1/9。因此，在实际临床应用中，为了有效治疗肝脏肿瘤，需要使用激光。 ...更多信息使用0.2T开放磁场的磁共振成像仪（Siemens，德国），对2D-FLASH和True FISP等几种MR序列进行了动物肝脏LITT的在线监测。通过激光头以25 W和10 W输出施加激光照射。在手术过程中，大约每30秒获得一次序列MR图像。通过比较所有MR图像的信号变化和动物肝脏的实际热变化，2D-FLASH在实时监测LITT方面上级True FISP。施用器未经厚生劳动省批准用于临床。因此，尚未完成对患者实施转移性肝肿瘤的实际病例，将作为未来的主题。然而，LITT手术的安全性正在通过我们的动物实验进行验证。LITT有望成为转移性肝肿瘤的一种有用的治疗选择，特别是考虑到MR对热消融变化的实时监测。