INTERACTIVE IMAGE GUIDED THERMAL THERAPY FOR LOCALIZED P

各种形式的微创热疗目前正在开发中，用于治疗局限性前列腺癌。它们包括近距离放射治疗、热疗、激光治疗、聚焦超声、聚焦微波和冷冻外科。这些局部治疗可以提供比目前的治疗标准显著的优势，如根治性前列腺切除术和外照射治疗。然而，安全和有效地使用局部热疗方法将需要在手术过程中实时监测组织温度和不可逆转的热损伤。之前，作为国家癌症研究所支持的第一阶段SBIR的一部分，我们开发了一种交互式、图像制导的激光计算机系统，能够使用磁共振测温仪实时、非侵入性地监测组织温度并预测不可逆热损伤。基于计算的温度，该系统提供反馈控制以产生所需大小的激光光凝损伤。在这项提案中，我们计划将该系统应用于激光治疗局限性前列腺癌的监测和反馈控制。我们将在体外和体内对该系统进行测试和优化。在第一阶段，该系统将围绕使用一个低成本的二极管激光光源来开发，该光源耦合到经尿道放置的扩散尖端光纤。在第二阶段，我们计划扩展系统的能力，以兼容使用多种来源和光纤的新的间质激光方法，以及聚焦超声和微波疗法。建议的商业应用：在本研究期间开发的交互式、图像引导、计算机控制的热疗系统将使前列腺和其他深层组织的微创热疗能够以安全有效的方式进行。目前美国约有5000台临床核磁共振扫描仪，开放式核磁共振扫描仪越来越受欢迎，因此支持核磁共振的热疗的潜在市场是巨大的。除了激光治疗局限性前列腺癌外，该系统还可用于任何需要对组织温度进行非侵入性监测和控制的应用，包括微波、超声波和射频。

Various forms of minimally-invasive thermal therapy are currently under development for treatment of localized prostate cancer. They include brachytherapy, hyperthermia, laser therapy, focused ultrasound, focused microwave, and cryosurgery. These local treatments could offer significant advantages over current standards of treatment such as radical prostatectomy, and external beam radiation therapy. However, safe and effective use of local thermal methods will require real-time monitoring of tissue temperatures and irreversible thermal damage during the procedure. Previously as part of a Phase I SBIR supported by the National Cancer Institute, we developed an interactive, image-guided laser-computer system capable of real-time, non-invasive monitoring of tissue temperatures and prediction of irreversible thermal damage using MR thermometry. Based on the calculated temperature, the system provides feedback control for producing laser photocoagulation lesions of a desired size. In this proposal we plan to adapt the system for use in monitoring and feedback control of laser therapy for the treatment of localized prostate cancer. We will perform testing and optimization of the system on in vitro and in vivo canine prostates. In Phase I the system will be developed around use of a low-cost diode laser source coupled to a diffusing tip optical fiber placed transurethrally. In the second phase, we plan to expand the system capabilities to be compatible with newer interstitial laser approaches using multiple sources and fibers as well as focused ultrasound and microwave therapies. PROPOSED COMMERCIAL APPLICATIONS: The interactive, image-guided, computer-controlled thermal therapy system developed during this research will allow minimally invasive thermal therapy in prostate and other deep tissues to be performed in a safe and effective manner. There are some 5000 clinical MRI scanners in the US currently and open MR scanners are increasing in popularity, thus the potential market for MRI-ready thermal therapy is significant. In addition to laser therapy for localized prostate cancer, the system will be useful in any application where non-invasive monitoring and control of tissue temperature is required including microwave, ultrasound, and radiofrequency.