Imaging Feedback to Guide Ultrasonic Tissue Fractionation for Cancer Therapy

成像反馈指导超声组织分割用于癌症治疗

• 批准号: 8274879
• 负责人: Charles Alan Cain
• 金额: $ 46.41万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-04 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8274879
• 关键词: Ablation; Abscess; Acoustics; Affect; Aftercare; Anatomy; Animals; Arrhythmia; Benign Prostatic Hypertrophy; Cardiac ablation; Cell Death; Cell Survival; Cells; Chronic; Clinical; Development; Effectiveness; Electron Microscopy; Extinction (Psychology); Feedback; Fractionation; Image; Imaging Techniques; Individual; Kidney; Laboratories; Liquid substance; Liver; Local Therapy; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of brain; Malignant neoplasm of liver; Malignant neoplasm of lung; Malignant neoplasm of prostate; Mechanics; Metastatic Neoplasm to the Liver; Methods; Metric; Molecular; Organelles; Outcome; Physiologic pulse; Process; Prostate; Renal carcinoma; Research; Resolution; Scanning; Scheme; Structure; Techniques; Technology; Therapeutic procedure; Time; Tissues; Ultrasonics; Ultrasonography; Uterine Fibroids; base; breast fibroadenoma; cancer therapy; capsule; clinical application; malignant breast neoplasm; organ capsule; particle; soft tissue; sound; therapy outcome; thrombolysis

DESCRIPTION (provided by applicant): Histotripsy is the controlled use of ultrasound cavitation to mechanically fractionate tissue volumes noninvasively under image guidance. With an appropriate understanding of the dynamics of bubble cloud initiation and extinction, a precise volume of tissue can be fractionated with very narrow boundaries between normal and affected tissue. Since the fractionation occurs at the tissue, cellular, and molecular levels, the results are easily seen by both ultrasound and MR imaging. Moreover, the degree of fractionation is correlated with survival of cells in the treated volume. As fractionation (or liquefaction) progresses, the amount of backscattered sound decreases as well a cell survival. Eventually, when the tissue is highly fractionated, no recognizable cellular organelles can be observed, even with electron microscopy, and the homogenized tissue looks like a fluid with few remaining ultrasound scattering particles. Since the effects of histotripsy are apparent in standard images both during and after treatment, the opportunity to develop image based feedback schemes correlating image parameters with eventual clinical outcomes is obvious. Unlike many other ablation techniques, the imaging based feedback approaches proposed herein can now be developed on a rational basis since the tissue effects can be easily seen and characterized by histological analysis and chronic animal studies where some clinical "outcome" can be determined. Thus, we will develop methods to predict clinical outcome from image parameters available both during and after treatment. This will provide an answer to the critical question for most noninvasive ablative technologies, i.e., when should the treatment be stopped and what will be the spatial extent of the desired treatment? Development of these image guidance techniques could result in a significant transformation in the effectiveness of ablative therapies in a wide range of clinical applications, e.g., prostate cancer, benign prostatic hyperplasia (BPH), breast cancer, fibroadenomas of the breast, liver cancer and metastases, kidney cancer, uterine fibroids, thrombolysis, cardiac ablations for arrhythmia control, lung and brain cancer (under certain conditions), treatment of infected wounds and abscesses, etc.

描述（由申请人提供）：组织摧毁术是在图像引导下受控使用超声空化以无创方式机械破碎组织体积。通过对气泡云产生和消失的动力学的适当理解，可以用正常组织和受影响组织之间的非常窄的边界分离精确体积的组织。由于分级发生在组织，细胞和分子水平，结果很容易通过超声和MR成像看到。此外，分级分离的程度与处理体积中细胞的存活相关。随着分离（或液化）的进行，反向散射的声音的量以及细胞存活减少。最终，当组织被高度分离时，即使用电子显微镜也无法观察到可识别的细胞器，并且均质化的组织看起来像是几乎没有剩余超声散射颗粒的流体。由于在治疗期间和治疗后的标准图像中组织破坏的效果是明显的，因此开发将图像参数与最终临床结果相关联的基于图像的反馈方案的机会是显而易见的。与许多其他消融技术不同，本文提出的基于成像的反馈方法现在可以在合理的基础上开发，因为组织效应可以通过组织学分析和慢性动物研究容易地看到和表征，其中可以确定一些临床“结果”。因此，我们将开发方法来预测治疗期间和治疗后可用的图像参数的临床结果。这将为大多数非侵入性消融技术的关键问题提供答案，即，何时应停止治疗，以及所需治疗的空间范围是多少？这些图像引导技术的发展可以导致消融治疗在广泛的临床应用中的有效性的显著转变，例如，前列腺癌、良性前列腺增生（BPH）、乳腺癌、乳腺纤维腺瘤、肝癌和转移、肾癌、子宫肌瘤、血栓溶解、用于心律失常控制的心脏消融、肺癌和脑癌（在某些条件下）、感染伤口和脓肿的治疗等。

项目成果

Dual-beam histotripsy: a low-frequency pump enabling a high-frequency probe for precise lesion formation.

• DOI: 10.1109/tuffc.2014.6722617
• 发表时间: 2014-02
• 期刊: IEEE transactions on ultrasonics, ferroelectrics, and frequency control
• 作者: Lin KW;Duryea AP;Kim Y;Hall TL;Xu Z;Cain CA
• 通讯作者: Cain CA

Imaging feedback of histotripsy treatments using ultrasound shear wave elastography.

使用超声剪切波弹性成像进行组织解剖治疗的成像反馈。

• DOI: 10.1109/tuffc.2012.2307
• 发表时间: 2012
• 期刊: IEEE transactions on ultrasonics, ferroelectrics, and frequency control
• 作者: Wang,Tzu-Yin;Hall,TimothyL;Xu,Zhen;Fowlkes,JBrian;Cain,CharlesA
• 通讯作者: Cain,CharlesA

Targeted Lesion Generation Through the Skull Without Aberration Correction Using Histotripsy.

使用组织解剖学通过头骨生成有针对性的病变，无需像差校正。

• DOI: 10.1109/tuffc.2016.2531504
• 发表时间: 2016
• 期刊: IEEE transactions on ultrasonics, ferroelectrics, and frequency control
• 作者: Sukovich,Jonathan;Xu,Zhen;Kim,Yohan;Cao,Hui;Nguyen,Thai-Son;Pandey,Aditya;Hall,Timothy;Cain,Charles
• 通讯作者: Cain,Charles

In vivo histotripsy brain treatment.

• DOI: 10.3171/2018.4.jns172652
• 发表时间: 2019-10
• 期刊: Journal of neurosurgery
• 影响因子: 4.1
• 作者: Jonathan R. Sukovich;C. Cain;A. Pandey;N. Chaudhary;S. Camelo-Piragua;S. Allen;T. Hall;J. Snell;Zhiyuan Xu;J. Cannata;D. Teofilovic;J. Bertolina;N. Kassell;Zhen Xu

In vitro comminution of model renal calculi using histotripsy.

• DOI: 10.1109/tuffc.2011.1898
• 发表时间: 2011-05
• 期刊: IEEE transactions on ultrasonics, ferroelectrics, and frequency control
• 作者: Duryea AP;Maxwell AD;Roberts WW;Xu Z;Hall TL;Cain CA
• 通讯作者: Cain CA