Transcostal High Intensity Focused Ultrasound for the Treatment of Cancer

高强度聚焦超声(HIFU)用于癌症的非侵入性治疗的有效性已经在一系列不同的癌症中得到了明确的证明，包括肝癌、前列腺癌和乳腺癌。作为一种非侵入性的局部治疗，HIFU在侵袭性和有害副作用的风险方面比其他技术如化疗和手术具有相当大的优势。然而，尽管它有许多优点，但目前仍有许多重大挑战阻碍了其在临床上的广泛应用，特别是：需要通过肋骨传递能量，以及相关的皮肤烧伤和肋骨表面损伤的风险，器官运动对治疗精度的影响，对体内空化过程的缺乏了解，最后，缺乏有效的实时图像指导和治疗监测技术。本文件所述研究方案的总体目标是为这些问题制定切实可行的解决办法。这一提议的成功完成将产生一种安全有效的HIFU治疗肝、肾和胰腺肿瘤的原型临床设备，该设备已经过临床前测试，并符合患者使用的必要安全标准。

The efficacy of high intensity focused ultrasound (HIFU) for the non-invasive treatment of cancer has been clearly demonstrated for a range of different cancers including those of the liver, prostate and breast. As a non-invasive focal therapy, HIFU offers considerable advantages over other techniques such as chemotherapy and surgery, in terms of invasiveness and risk of harmful side-effects. Despite its advantages, however, there are a number of significant challenges currently hindering its widespread clinical application, specifically: the need to transmit energy through the rib cage and the associated risk of skin burns and damage to the rib surface, the effects of organ motion on treatment accuracy, a poor understanding of cavitation processes in vivo and, finally, the lack of effective techniques for real-time image guidance and treatment monitoring. The overall objective of the research programme described in this document is to develop practical solutions for these issues. Successful completion of this proposal will result in a prototype clinical device for the safe and effective HIFU treatment of tumours of the liver, kidney and pancreas that has undergone preclinical testing and conforms to the necessary safety standards for patient use.