Precise MRI-Directed Sonic Ablation of Prostate Cancer

描述（由申请人提供）：本研究的总体目标将是在我们创建用于前列腺组织消融的集成系统的进展的基础上，结合用于消融前列腺组织的先进设计，并最终在MRI引导下以快速、精确的方式消融前列腺癌。施源器将通过会阴（间质施源器）或通过尿道（经尿道）直接插入前列腺。将设计和测试经尿道施源器的几种新设计，旨在最大限度地提高治疗速度和精度。将构建一个系统，用于在体内治疗期间对施用器进行自动旋转和线性机械控制。将进一步开发用于防止直肠损伤的系统，包括使用循环水的直肠内冷却系统，以及用于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（MRTI）系统将进一步增强，使用无参考方法、3点狄克逊、每个TR的多个读数和相控阵列成像，以创建用于监测消融的最佳实时系统。该研究计划设想了一系列分层实验，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前列腺消融体内研究。在这些实验中，将测试和比较不同的施源器和方案在执行快速、受控消融方面的性能。在这些试验中也将测试磁共振成像技术，并进行相关热电偶监测以评估准确性。治疗后切除的前列腺和前列腺周围组织的改进组织学分析技术将允许MRTI数据和治疗后MR图像的准确相关性，并将评估前列腺消融的慢性模型（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组织和前列腺癌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.