Percutaneous Vertebroplasty w/MR-Guided Laser Ablation

描述（由申请人提供）：大约30-70%的癌症患者最终会经历肿瘤转移到脊柱。这类肿瘤通常会给病人带来极度的痛苦和虚弱。转移性脊柱病变的治疗策略本质上是姑息性的，目标是减少肿瘤肿块，减轻疼痛，保持神经功能和脊柱稳定。经皮椎体成形术，将液体水泥注射到受影响的椎体中，已成为治疗脊柱转移瘤的常用方法。目前，椎体成形术通常通过放疗或化疗来配合肿瘤的减少。这种双重治疗方法增加了管理成本，并可能使患者持续疼痛，直到两种治疗方案完成。

DESCRIPTION (provided by applicant): Approximately 30-70% of all cancer patients will eventually experience tumor metastasis to the spine. Such tumors are often excruciatingly painful and debilitating to the patient. Treatment strategies for metastatic spinal lesions are palliative in nature and are targeted toward reduction of tumor mass, alleviation of pain, preservation of neurological function, and stabilization of the spinal column. Percutaneous vertebroplasty, whereby liquid cement is injected into the body of the affected vertebra has become a popular method for managing spinal metastases. Currently, vertebroplasty is performed in conjunction with tumor reduction most often through radiation or chemotherapy. This dual treatment approach increases the cost of management and may leave patients with continuing pain until both treatment regimens have been completed. Recently, intravertebral ablation of spinal tumors using both laser and RF heating has been suggested. Coupling targeted thermal ablation of tumors with percutaneous vertebroplasty may result in a single treatment technique, which is effective at accomplishing all the goals of current therapies at once. BioTex has previously developed a magnetic resonance image guided laser therapy system, which allows visualization of laser heating in tissue structures. This system may be ideal for guidance of safe laser ablation of spinal tumors in conjunction with vertebroplasty. In this proposal, we investigate the technical feasibility of MR-guided laser ablation therapy adjuvant to percutaneous vertebropasty in a canine model. Appropriate laser treatment catheters and imaging sequences will be developed, and procedures will be carried out by interventional radiologists at the M.D. Anderson Cancer Center in Houston, Texas. Canine studies will allow for a critical evaluation of the safety and effectiveness of MR-guided laser ablation/vertebroplasty. If successful, this technique could lead to an improved treatment option for certain intravertebral spinal lesions.