Development of a Novel Gas Embolotherapy Technique

描述(由申请人提供)： 将栓子输送到动脉血流以阻断血流或栓子治疗是一种潜在的治疗多种癌症的方法，如肝细胞癌和肾癌。肝细胞癌是最常见的一种肝癌，每年每10万名男性中有2-30人发生，每年导致全球约125万人死亡。伴发的肝硬变使传统方法治疗肝细胞癌变得困难。全身化疗对存活率没有明显影响。除了这些类型的癌症，许多其他类型的癌症可能会使用介入疗法进行治疗。以前的栓塞术尝试使用固体栓子，如血块、明胶海绵、微粒、气球和彩带。栓塞术的一个主要困难是限制栓子向肿瘤的输送，即在不进行极具侵入性的操作的情况下将健康组织的缺血降至最低。 在这里，我们建议一种声学激活的气体栓塞术。虽然气泡已经被用作超声造影剂，但它们以前还没有被用来阻断肿瘤的血流。此外，这种新的方法包括将液滴引入血管流动中，液滴小到可以穿过毛细血管。这些液滴可以用超声波追踪，并在肿瘤附近通过高强度超声波蒸发，从而允许气泡阻挡肿瘤内的流动，气泡比产生液滴的液滴大得多。这种微创技术将允许选择性地将气体栓子输送到肿瘤，非常适合重复剂量和长期使用。拟议的研究使用计算和实验(动物和工作台)研究来提供这项技术的概念证明。这项工作将研究血管被气体栓子堵塞的物理现象和由于液滴蒸发而导致的血管变形。这项拟议的研究是由在流体动力学、气体传输以及诊断和治疗性超声波方面拥有专业知识的工程师、物理学家和临床医生合作完成的。这项拟议的研究是开发这项潜在革命性技术的重要第一步。

DESCRIPTION (provided by applicant): The delivery of emboli to arterial blood flow with the goal of flow occlusion, or embolotherapy, is a potential means to treat a variety of cancers, such as heptatocellular carcinoma (HCC) and renal carcinoma. HCC, the most common form of liver cancer, occurs in 2-30 per 100,000 males each year, resulting in approximately 1,250,000 deaths worldwide annually. The accompanying liver cirrhosis makes the treatment of HCC by traditional methods difficult. Systemic chemotherapy has no appreciable impact on survival rates. In addition to these types of cancer, many other types could potentially be treated using embototherapy. Previous attempts at embolotherapy have used solid emboli, such as blood clot, gelatin sponge, particulates, balloons and streamers. A major difficulty in embolotherapy is restricting delivery of the emboli to the tumor, i.e. minimizing ischemia of healthy tissue, without extremely invasive procedures. Here, we propose an acoustically activated gas embolotherapy. While gas bubbles have been used as ultrasonic contrast agents, they have not previously been used to occlude flow to tumors. Moreover, this novel approach involves introducing liquid droplets, which are small enough to pass through capillaries, into the vascular flow. The droplets could be tracked using ultrasound and vaporized via high intensity ultrasound near the tumor allowing gas bubbles, which are considerably larger than the liquid drops from which they originated, to occlude flow in the tumor. This minimally invasive technique would allow selective delivery of gas emboli to the tumor, and is well suited to repeated doses and long term use. The proposed research uses computational and experimental (animal and bench top) studies to provide proof of concept of this technique. This work will investigate the physical phenomena of vessel occlusion by gas emboli and vessel deformation due to the vaporization of liquid droplets. The proposed research is a collaboration of engineers, physicists, and clinicians with expertise in expertise in fluid dynamics, gas transport, and diagnostic and therapeutic ultrasound. The proposed research is an essential first step in developing this potentially revolutionary technique.