Thermochemical Ablation in Image-Guided Interventions: Initial Assessment

图像引导干预中的热化学消融：初步评估

• 批准号: 7447690
• 负责人: ERIK N CRESSMAN
• 金额: $ 16.25万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2010-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7447690
• 关键词: Ablation; Acids; Acute; Address; Animals; Appearance; Biological Markers; Blood gas; Breast; Cell Death; Coagulation Process; Colorectal Cancer; Data; Data Set; Defect; Electrolytes; Excision; Family suidae; Goals; Heating; Histologic; Human; Image; Injection of therapeutic agent; Invasive; Laboratories; Lesion; Liver; Malignant Neoplasms; Malignant neoplasm of lung; Malignant neoplasm of prostate; Measurement; Measures; Methods; Microscopic; Modality; Monitor; Necrosis; Normal tissue morphology; Osmolalities; Outcome; Pathologic; Pathology; Patients; Perfusion; Physiology; Primary carcinoma of the liver cells; Radiofrequency Interstitial Ablation; Rate; Reaction; Recording of previous events; Recurrence; Reproducibility; Research; Risk; Sampling; Serum; Shapes; Solid; Solutions; Specimen; Staining method; Stains; Sus scrofa; Techniques; Temperature; Testing; Tissues; Toxic effect; Water; X-Ray Computed Tomography; base; cost; human disease; image guided intervention; improved; in vivo; metastatic colorectal; size; tumor

DESCRIPTION (provided by applicant): The long-term research goal of this laboratory is to develop and implement new, low-cost, minimally invasive, image-guided interventions for human diseases, in particular to improve outcomes in solid malignancies amenable to this approach such as breast or prostate cancer, metastatic colorectal cancer, lung cancer, and hepatocellular carcinoma (HCC), which is the focus of this application. Current methods such as radiofrequency ablation are inadequate with regard to treatable lesion size, tumor recurrence, survival benefit, procedural risk, and cost. The objective in this application is to establish in vivo feasibility of a new ablation method recently discovered called thermochemical ablation. This technique, when narrowly defined, overcomes these shortcomings by exploiting the considerable heat energy released as water is formed in acid-base reactions. The central hypothesis of this application is that thermochemical ablation can create an evenly distributed zone of coagulation in liver tissue without systemic toxicity. To establish feasibility and test this hypothesis two aims are outlined below: Aim 1: Quantify the size, shape, reproducibility, and temperature history of acute thermochemical coagulation zones measured by multiple correlated modalities based upon the known key variables of volume and concentration, with injection rates of acid and base constant. The eventual goal is treatment in humans where excision and pathologic correlation of tissues in most patients is not feasible. To address this, perfusion defects seen on CT scans of treated, explanted pig livers will be measured and correlated with three volume data sets: gross pathology, viability staining, and microscopic pathology. This will provide initial data for a robust imaging biomarker of the zone of coagulation created using the method. Aim 2: Characterize acute effects of thermochemical ablation at both tissue and systemic levels. Tissue effects will be visualized in selected sections from treated specimens using histologic methods to image necrosis and cell death. The microscopic appearance of the ablations will be characterized and the transition zone to normal tissue will be evaluated. Systemic effects are possible due to the use of concentrated solutions of acid and base that could potentially alter the whole animal physiology. Therefore serum osmolality, arterial blood gas measurements (pO2, pCO2, pH), and electrolytes will be monitored, with serial sampling after injection to detect changes.

描述(由申请人提供)：该实验室的长期研究目标是开发和实施新的、低成本、微创的人类疾病干预措施，特别是改善适用于这种方法的实体恶性肿瘤的结果，如乳腺癌或前列腺癌、转移性结直肠癌、肺癌和肝细胞癌(HCC)，这是本申请的重点。目前的方法，如射频消融，在可治疗的病变大小、肿瘤复发、生存益处、手术风险和成本方面都是不够的。这项应用的目的是在体内建立一种新的消融方法的可行性，称为热化学消融。这项技术，当被狭义地定义时，通过利用在酸碱反应中形成水时释放的大量热能来克服这些缺点。这一应用的中心假设是，热化学消融可以在肝组织中创建一个均匀分布的凝固区，而不会产生全身毒性。为了建立可行性和检验这一假设，概述了以下两个目标：目标1：根据已知的关键变量体积和浓度，以酸和碱的注入速率为常数，量化急性热化学凝固区的大小、形状、重复性和温度历史。最终的目标是在人类中进行治疗，因为大多数患者的组织切除和病理相关性是不可行的。为了解决这一问题，将测量在治疗后移植的猪肝脏的CT扫描上看到的灌注缺陷，并将其与三个体积数据集相关联：大体病理、活性染色和微观病理。这将为使用该方法创建的凝固区的稳健成像生物标记物提供初始数据。目的2：从组织和系统水平描述热化学消融的急性效应。组织效应将在处理标本的选定切片上可视化，使用组织学方法来显示坏死和细胞死亡的图像。将对消融的显微外观进行表征，并对向正常组织的过渡区进行评估。由于酸和碱的浓缩液的使用可能会改变整个动物的生理，所以全身效应是可能的。因此，将监测血清渗透压、动脉血气测量(pO2、pCO2、pH)和电解质，并在注射后连续采样以检测变化。