Precise MRI-Directed Sonic Ablation of Prostate Cancer

描述(由申请人提供)：这项研究的总体目标将是在我们的进展的基础上，在MRI指导下，以快速、精确的方式创建一种集成的系统，用于消融前列腺组织，包括消融前列腺组织，最终消除前列腺癌。涂抹器可以通过会(间质涂抹器)直接插入前列腺，也可以通过尿路(经尿路)直接插入前列腺。将设计和测试几种用于经尿道敷贴器的新设计，旨在最大限度地提高治疗速度和精度。将建立一个系统，在活体治疗期间对涂抹器进行自动旋转和线性机械控制。将进一步开发预防直肠损伤的系统，包括使用循环水的直肠内冷却系统，以及在前列腺和直肠之间提供声学阻断的程序。我们成功的磁共振温度成像系统(MRTI)的进一步增强将使用无参考方法、3点Dixon、每TR多个读数和相控阵成像来创建用于消融监测的最佳实时系统。该研究计划设想了一系列家族性实验，对上述所有组件技术进行初步开发和测试，然后在犬模型中进行广泛的体内前列腺消融研究。在这些实验中，将测试和比较不同的涂敷器和方案在执行快速、受控消融方面的性能。MRTI技术也将在这些试验中进行测试，并使用相关的热电偶监测来评估准确性。治疗后切除的前列腺体和前列腺周围组织的组织学分析技术的改进将使MRTI数据和治疗后的磁共振成像准确相关，并将评估前列腺切除的慢性模型(7天或更长时间)。在这项工作完成后，我们计划完全定义一个适用于前列腺癌组织和前列腺癌的临床消融的集成系统。

DESCRIPTION (provided by applicant): The overall goal of the research will be to build on our progress in creating an integrated system for ablation of prostatic tissue incorporated advanced designs for the ablation prostate tissue, and ultimately prostatic carcinoma, in a rapid, precise fashion under MRI guidance. Applicators will either be directly inserted into the prostate gland through the perineum (interstitial applicators) of through the urethra (transurethral). Several new designs for transurethral applicators, designed to maximize speed and precision of treatment will be designed and tested. A system to perform automated rotational and linear mechanical control of applicators during in vivo treatments will be constructed. Systems for preventing rectal injury, including a endorectal cooling system using circulating water, and procedures for providing acoustic blocking between the prostate and rectum will be further developed. Further enhancements to our successful system for MR temperature imaging (MRTI) will be achieved using a referenceless approach, 3 point Dixon, multiple readouts per TR, and phased array imaging to create an optimal real-time system for monitoring of ablation. The research plan envisages a heirarchical series of experiments, with initial development and testing of all the component technologies described above, to be followed by extensive in vivo studies of prostate ablation in a canine model. In these experiments, different applicators and protocols will be tested and compared for performance in performing rapid, controlled ablation. MRTI techniques will be tested in these trials as well, with correlative thermocouple monitoring to assess accuracy. Improved histologic analysis techniques for resected prostate glands and periprostatic tissues following treatments will allow accurate correlation of MRTI data and post-treatment MR images, and a chronic model of prostatic ablation (7 or more days) will be assessed. At the completion of this work, we plan to have completely defined an integrated system suitable for clinical ablation of prostatic tissue and prostate cancer.