Precise MRI-Directed Sonic Ablation of Prostate Cancer

描述（由申请人提供）：该研究的总体目标将是建立在我们在MRI指导下快速、精确地创建前列腺组织消融综合系统的基础上，该系统包括用于消融前列腺组织的先进设计，并最终用于前列腺癌。插入器可以通过会阴（间质插入器）直接插入前列腺，也可以通过尿道（经尿道）插入。将设计和测试几种经尿道涂布器的新设计，以最大限度地提高治疗的速度和精度。一个系统来执行自动旋转和线性机械控制的涂抹器在体内治疗将被构建。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塞的程序，将进一步发展。我们成功的MR温度成像（MRTI）系统将通过无参考方法、3点Dixon、每个TR的多个读数和相控阵成像来进一步增强，从而创建一个最佳的实时烧蚀监测系统。研究计划设想了一系列分层次的实验，首先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前列腺消融的广泛体内研究。在这些实验中，将测试和比较不同的涂抹器和方案在执行快速、可控消融方面的性能。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和前列腺周围组织的组织学分析技术的改进将使MRTI数据与治疗后的MR图像准确相关，并将评估慢性前列腺消融模型（7天或更长时间）。本工作完成后，我们计划完整定义一套适用于前列腺组织和前列腺癌临床消融的综合系统。

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.