MICA: A Non-invasive Ultrasound-guided High Intensity Focused Ultrasound system for placental and fetal vascular ablation
MICA:一种用于胎盘和胎儿血管消融的非侵入性超声引导高强度聚焦超声系统
基本信息
- 批准号:MR/R015384/1
- 负责人:
- 金额:$ 204.88万
- 依托单位:
- 依托单位国家:英国
- 项目类别:Research Grant
- 财政年份:2018
- 资助国家:英国
- 起止时间:2018 至 无数据
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
Twin-Twin Transfusion Syndrome (TTTS) affects 10-15% of identical twins who share a placenta. This may need treatment that is high risk for around 400-600 babies every year in the UK. In TTTS, blood moves from one twin to the other through abnormal blood vessel connections in the placenta called anastomoses, which directly link the blood supplies of the twins. These anastomoses may cause one twin to get less blood and amniotic fluid and the other twin too much blood and amniotic fluid. TTTS is the biggest cause of premature birth, death or disability in identical twin pregnancies.TTTS can be seen with a specialist ultrasound scan. Women who have severe TTTS have the worst outcomes, and are recommended to have a treatment which can divide the twins' placenta by blocking the abnormal blood vessel connections that cause TTTS. At the moment this is done using a technique called fetoscopic laser, a surgical procedure where a 2-4 mm wide instrument is placed into the womb so it can reach the placenta. As the laser must be put inside the womb, this treatment is risky and can cause miscarriage, bleeding or infection in the womb, or leakage of fluid from the womb which can affect the twins' development. This is why fetoscopic laser is only used in serious cases; the risks are too high to for it to be used in cases that are not as serious.In the UK about 100-150 women per year have severe TTTS diagnosed before 18 weeks. Even though they need treatment, fetoscopic laser cannot be used because the risks are too high and instruments too big. This is a group of women whose babies have the worst outcomes of all those diagnosed with TTTS, but we have no good, safe treatments for them. Our research group works with High Intensity Focused Ultrasound (HIFU), which uses very powerful ultrasound waves that can block blood vessels in the placenta without needing to make a hole in the womb. As HIFU does not require invasive surgery to be done, we could use it to treat severe TTTS in pregnancies below 18 weeks. So far, we have tested this treatment in pregnant sheep, which share similarities to human pregnancies. Based on these experiments HIFU seems to be work well and is a safe way to block placental blood vessels.At Queen Charlotte's and Chelsea Hospital, London, we will work with experts in HIFU from the Institute of Cancer Research, London, international fetal medicine experts, pregnancy support groups and patient volunteers with experience of TTTS to design a clinical study. We will offer around 13 women and babies diagnosed with TTTS before 18 weeks the HIFU treatment as part of a carefully designed study. In this very early stage study look primarily at whether the technique is safe for mothers and babies and if we can stop blood flowing through the abnormal vessels connecting the two halves of the placenta. If HIFU is safe and effective, it would prevent the need for riskier laser treatment when these pregnancies reach 18 weeks and will most likely lead on to further, larger clinical trials.As part of this study, we will build a special ultrasound guided HIFU system that combines the best available ultrasound imaging of the babies and placental blood vessels with a HIFU system specially designed to direct the treatment to exactly the right area in the placenta. We will also design a special computer program to control the whole system. Fixing the abnormal placental blood vessels without harming the mother or the babies is difficult. The experiments we have done in sheep has shown us some of the problems that might happen. There are no places to buy a HIFU system that makes good enough pictures or allows accurate treatment of the abnormal blood vessels. Therefore we need to build a one to use in this study. The HIFU system we build may also be used in the future for treating other problems that can happen in pregnancy or for cancer treatment, where it could block the blood vessels that feed tumours.
双胞胎输血综合征(TTTS)影响10-15%共享胎盘的同卵双胞胎。这可能需要治疗,在英国每年约有400-600名婴儿面临高风险。在TTTS中,血液从一个双胞胎通过胎盘中的异常血管连接转移到另一个双胞胎,这种异常血管连接称为胎盘,直接连接双胞胎的血液供应。这些疾病可能会导致双胞胎中的一个获得较少的血液和羊水,而另一个获得过多的血液和羊水。TTTS是导致同卵双胞胎早产、死亡或残疾的最大原因。TTTS可以通过专家超声扫描发现。患有严重TTTS的女性结局最差,建议进行治疗,通过阻断导致TTTS的异常血管连接来分离双胞胎胎盘。目前,这是使用一种称为胎儿激光的技术来完成的,这是一种外科手术,将一个2-4毫米宽的仪器放入子宫中,使其能够到达胎盘。由于激光必须放在子宫内,这种治疗是有风险的,可能会导致流产,出血或子宫感染,或子宫液体泄漏,这可能会影响双胞胎的发育。这就是为什么胎儿镜激光仅用于严重病例;风险太高,不能用于不严重的病例。在英国,每年约有100-150名妇女在18周前被诊断为严重TTTS。即使他们需要治疗,也不能使用胎儿镜激光,因为风险太高,仪器太大。这是一组妇女,她们的孩子在所有被诊断为TTTS的人中有最糟糕的结果,但我们没有好的,安全的治疗方法。我们的研究小组使用高强度聚焦超声(HIFU),它使用非常强大的超声波,可以阻塞胎盘中的血管,而无需在子宫中打一个洞。由于HIFU不需要进行侵入性手术,我们可以用它来治疗18周以下妊娠的严重TTTS。到目前为止,我们已经在怀孕的绵羊身上测试了这种治疗方法,这与人类怀孕有相似之处。在伦敦的夏洛特女王和切尔西医院,我们将与来自伦敦癌症研究所的HIFU专家、国际胎儿医学专家、妊娠支持团体和有TTTS经验的患者志愿者一起设计一项临床研究。作为精心设计的研究的一部分,我们将在18周前为大约13名被诊断患有TTTS的妇女和婴儿提供HIFU治疗。在这项非常早期的研究中,我们主要关注这项技术对母亲和婴儿是否安全,以及我们是否可以阻止血液流过连接胎盘两半的异常血管。如果高强度聚焦超声是安全有效的,那么当这些怀孕达到18周时,它将防止对风险更大的激光治疗的需要,并且很可能会导致进一步的更大规模的临床试验。我们将建立一个特殊的超声引导的HIFU系统,结合了婴儿和胎盘血管的最佳超声成像和专门设计的HIFU系统,以指导治疗。在胎盘的右边我们还将设计一个专门的计算机程序来控制整个系统。在不伤害母亲或婴儿的情况下修复异常的胎盘血管是困难的。我们在绵羊身上做的实验已经向我们展示了一些可能发生的问题。没有地方可以买到能拍出足够好的照片或能对异常血管进行精确治疗的HIFU系统。因此,我们需要建立一个在本研究中使用。我们建造的HIFU系统也可能在未来用于治疗怀孕或癌症治疗中可能发生的其他问题,因为它可能会阻塞滋养肿瘤的血管。
项目成果
期刊论文数量(3)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
EP21.26: Antenatal prediction of increased Twin-twin transfusion syndrome (TTTS) risk at 14 weeks using different colour Doppler filters
EP21.26:使用不同颜色多普勒滤波器对 14 周时双胎输血综合征 (TTTS) 风险增加的产前预测
- DOI:10.1002/uog.21579
- 发表时间:2019
- 期刊:
- 影响因子:7.1
- 作者:Girardelli S
- 通讯作者:Girardelli S
OP12.02: Mapping of the placental angioarchitecture in monochorionic twin pregnancies using different colour Doppler filters
OP12.02:使用不同颜色多普勒滤波器绘制单绒毛膜双胎妊娠的胎盘血管结构
- DOI:10.1002/uog.20764
- 发表时间:2019
- 期刊:
- 影响因子:7.1
- 作者:Girardelli S
- 通讯作者:Girardelli S
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Christoph Lees其他文献
The cardiac-fetal-placental unit: fetal umbilical vein flow rate is linked to the maternal cardiac profile in fetal growth restriction
心脏-胎儿-胎盘单位:胎儿生长受限中胎儿脐静脉流速与母体心脏特征相关联
- DOI:
10.1016/j.ajog.2022.08.004 - 发表时间:
2023-02-01 - 期刊:
- 影响因子:8.400
- 作者:
Herbert Valensise;Daniele Farsetti;Francesca Pometti;Barbara Vasapollo;Gian Paolo Novelli;Christoph Lees - 通讯作者:
Christoph Lees
Assessing cardiovascular benefits of beetroot juice and exercise in women planning to conceive: reply to correspondence.
评估甜菜根汁和运动对计划怀孕的女性的心血管益处:回复信件。
- DOI:
- 发表时间:
2024 - 期刊:
- 影响因子:4.9
- 作者:
M. M. Osman;Edward Mullins;Christoph Lees - 通讯作者:
Christoph Lees
The role of umbilical vein blood flow assessment in the prediction of fetal growth velocity and adverse outcome: a prospective observational cohort study
脐静脉血流评估在预测胎儿生长速度和不良结局中的作用:一项前瞻性观察队列研究
- DOI:
10.1016/j.ajog.2025.01.001 - 发表时间:
2025-07-01 - 期刊:
- 影响因子:8.400
- 作者:
Daniele Farsetti;Moira Barbieri;Elena Magni;Giulia Zamagni;Lorenzo Monasta;Gianpaolo Maso;Barbara Vasapollo;Francesca Pometti;Enrico Maria Ferrazzi;Christoph Lees;Herbert Valensise;Tamara Stampalija - 通讯作者:
Tamara Stampalija
Intrapartum ultrasound for assessment of cervical dilatation
- DOI:
10.1016/j.ajogmf.2021.100448 - 发表时间:
2021-11-01 - 期刊:
- 影响因子:
- 作者:
Wassim A. Hassan;Sasha Taylor;Christoph Lees - 通讯作者:
Christoph Lees
Vasa previa in singleton pregnancies: diagnosis and clinical management based on an international expert consensus
单胎妊娠中的前置血管:基于国际专家共识的诊断与临床管理
- DOI:
10.1016/j.ajog.2024.03.013 - 发表时间:
2024-12-01 - 期刊:
- 影响因子:8.400
- 作者:
Yinka Oyelese;Ali Javinani;Brittany Gudanowski;Eyal Krispin;Andrei Rebarber;Ranjit Akolekar;Val Catanzarite;Rohan D’Souza;Richard Bronsteen;Anthony Odibo;Matthias A. Scheier;Junichi Hasegawa;Eric Jauniaux;Christoph Lees;Deepa Srinivasan;Elizabeth Daly-Jones;Gregory Duncombe;Yaakov Melcer;Ron Maymon;Robert Silver;Alireza A. Shamshirsaz - 通讯作者:
Alireza A. Shamshirsaz
Christoph Lees的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Christoph Lees', 18)}}的其他基金
A global registry of women affected by COVID-19 in pregnancy, understanding natural history to guide treatment and prevention
全球登记册记录了怀孕期间受 COVID-19 影响的妇女,了解自然史以指导治疗和预防
- 批准号:
MC_PC_19066 - 财政年份:2020
- 资助金额:
$ 204.88万 - 项目类别:
Intramural
相似国自然基金
Non-CG DNA甲基化平衡大豆产量和SMV抗性的分子机制
- 批准号:32301796
- 批准年份:2023
- 资助金额:30 万元
- 项目类别:青年科学基金项目
long non-coding RNA(lncRNA)-activatedby TGF-β(lncRNA-ATB)通过成纤维细胞影响糖尿病创面愈合的机制研究
- 批准号:LQ23H150003
- 批准年份:2023
- 资助金额:0.0 万元
- 项目类别:省市级项目
染色体不稳定性调控肺癌non-shedding状态及其生物学意义探索研究
- 批准号:82303936
- 批准年份:2023
- 资助金额:30 万元
- 项目类别:青年科学基金项目
变分法在双临界Hénon方程和障碍系统中的应用
- 批准号:12301258
- 批准年份:2023
- 资助金额:30.00 万元
- 项目类别:青年科学基金项目
BTK抑制剂下调IL-17分泌增强CD20mb对Non-GCB型弥漫大B细胞淋巴瘤敏感性
- 批准号:n/a
- 批准年份:2022
- 资助金额:10.0 万元
- 项目类别:省市级项目
Non-TAL效应子NUDX4通过Nudix水解酶活性调控水稻白叶枯病菌致病性的分子机制
- 批准号:
- 批准年份:2022
- 资助金额:30 万元
- 项目类别:青年科学基金项目
一种新non-Gal抗原CYP3A29的鉴定及其在猪-猕猴异种肾移植体液排斥反应中的作用
- 批准号:
- 批准年份:2022
- 资助金额:33 万元
- 项目类别:地区科学基金项目
非经典BAF(non-canonical BAF,ncBAF)复合物在小鼠胚胎干细胞中功能及其分子机理的研究
- 批准号:32170797
- 批准年份:2021
- 资助金额:58 万元
- 项目类别:面上项目
Non-Oberbeck-Boussinesq效应下两相自然对流问题的建模及高效算法研究
- 批准号:
- 批准年份:2021
- 资助金额:30 万元
- 项目类别:青年科学基金项目
植物胚乳发育过程中non-CG甲基化调控的分子机制探究
- 批准号:LQ21C060001
- 批准年份:2020
- 资助金额:0.0 万元
- 项目类别:省市级项目
相似海外基金
Non invasive methods to accelerate the development of injectable therapeutic depots
非侵入性方法加速注射治疗储库的开发
- 批准号:
EP/Z532976/1 - 财政年份:2024
- 资助金额:
$ 204.88万 - 项目类别:
Research Grant
I-Corps: Non-Invasive Software Tool for Risk Assessment of Intracranial Aneurysms (IA)
I-Corps:用于颅内动脉瘤 (IA) 风险评估的非侵入性软件工具
- 批准号:
2402381 - 财政年份:2024
- 资助金额:
$ 204.88万 - 项目类别:
Standard Grant
Creating a non-invasive window into the mind
创建一个非侵入性的心灵窗口
- 批准号:
DP240102254 - 财政年份:2024
- 资助金额:
$ 204.88万 - 项目类别:
Discovery Projects
SUPer-REsolution non-invasive Muscle measurements with miniaturised magnetIc SEnsors (SUPREMISE)
使用微型磁性传感器 (SUPREMISE) 进行超分辨率非侵入性肌肉测量
- 批准号:
EP/X031950/1 - 财政年份:2024
- 资助金额:
$ 204.88万 - 项目类别:
Fellowship
Bionic sensors for non-invasive health monitoring
用于无创健康监测的仿生传感器
- 批准号:
MR/Y003802/1 - 财政年份:2024
- 资助金额:
$ 204.88万 - 项目类别:
Fellowship
Non-Invasive Testing device for Anaemia (NITA)
非侵入性贫血检测设备 (NITA)
- 批准号:
MR/Y503356/1 - 财政年份:2024
- 资助金额:
$ 204.88万 - 项目类别:
Research Grant
In-vivo studies for a quantum optical non-invasive glucose sensor
量子光学非侵入式葡萄糖传感器的体内研究
- 批准号:
10105375 - 财政年份:2024
- 资助金额:
$ 204.88万 - 项目类别:
Launchpad
STTR Phase I: Non-invasive focused ultrasound treatment to modulate the immune system for acute and chronic kidney rejection
STTR 第一期:非侵入性聚焦超声治疗调节免疫系统以治疗急性和慢性肾排斥
- 批准号:
2312694 - 财政年份:2024
- 资助金额:
$ 204.88万 - 项目类别:
Standard Grant
CAREER: Development of Radio Frequency Non-Invasive Nanosecond Pulse Therapeutic Devices
职业:射频非侵入性纳秒脉冲治疗装置的开发
- 批准号:
2341047 - 财政年份:2024
- 资助金额:
$ 204.88万 - 项目类别:
Continuing Grant
DETECT: A Non-Invasive and Automated Real-Time Disease Detection Tool for Cattle
DETECT:一种针对牛的非侵入性自动化实时疾病检测工具
- 批准号:
10072590 - 财政年份:2023
- 资助金额:
$ 204.88万 - 项目类别:
Collaborative R&D