Optimizing microwave ablation techniques for targeted cancer therapy

描述（由申请人提供）： 该项目的长期目标是改进微波肿瘤消融的设备和技术，并通过优化系统设计和几种组织类型的能量输送将其应用扩展到新的患者群体。微波消融在许多方面上级目前可用的技术：微波提供快速的体积加热，导致更精确和完整的治疗;微波加热对组织性质的依赖性较小，使其更适合于新兴目标（例如，肺和骨）;并且使用多个天线改善了治疗控制、精确度和功效。不幸的是，目前的系统未能兑现这些承诺，本可以从改进的疗法中受益的患者受到了影响。 该提案基于这样的想法，即更多地了解微波组织加热将促进优化系统和技术的开发，这将提高患者的受益并扩大微波消融在癌症护理中的作用。随着微波消融系统开始进入市场，将需要优化的治疗方案，以提高患者的利益，并扩大微波消融在临床癌症护理中的作用。为此，我们建议：1）创建改进的组织数值模型，以更准确地预测器械性能。假设：精确的组织模型可改善数值模拟，简化设计和治疗优化。2)针对特定组织治疗优化天线设计和功率输送假设：可以针对特定组织或治疗目标优化天线设计和频率。应用高功率脉冲将更快地凝固组织微血管，以提高疗效。结合使用这些优化技术，消融速度将比当前系统快50%，消融面积将比当前系统大25%。3)开发多天线应用技术，以优化治疗速度和特异性。假设：多天线技术提高了疗效和精度，允许更有针对性的治疗，而不会增加侵入性。消融可以比当前系统快50%，大40%。4)通过使用集成治疗监测促进实时自适应功率控制假设：治疗监测可以在没有成像的情况下完成，仅使用组织间施用器。 如果成功，该项目将推进微波组织加热的知识，并创造创新和独特的方法来利用微波提供的所有优势进行功率输送。这些目标将通过增加可以用微波治疗的肿瘤的大小，将微波消融的范围进一步扩大到肝脏以外的区域，并增加受益于微创治疗的患者数量，从而大大改变临床实践。 公共卫生相关性： 该提案将联合收割机与最好的工程学和医学相结合，以更好地理解消融是如何产生的，开发用于改进系统设计的工具，并创建一个需要最小侵入性的癌症治疗平台，以提供最大的患者受益。

DESCRIPTION (provided by applicant): The long-term objective of this project is to improve devices and techniques for microwave tumor ablation and extend its application into new patient populations by optimizing system design and energy delivery in several tissue types. Microwave ablation is superior to currently available technologies in many respects: microwaves provide rapid volumetric heating, leading to more precise and complete treatments; microwave heating is less dependent on tissue properties, making it more suitable for emerging targets (e.g., lung and bone); and using multiple antennas improves treatment control, precision and efficacy. Unfortunately, current systems have failed to deliver on these promises and patients who could benefit from improved therapies have suffered. This proposal is based on the idea that understanding more about microwave tissue heating will facilitate development of optimized systems and techniques that will enhance patient benefit and expand the role of microwave ablation in cancer care. As microwave ablation systems begin to enter the marketplace, optimized treatment protocols will be required to enhance patient benefit and expand the role of microwave ablation in clinical cancer care. To this end, we propose to: 1) Create improved numerical models of tissue to more accurately predict device performance. Hypothesis: Accurate tissue models improve numerical simulations, easing design and treatment optimization. 2) Optimize antenna designs and power delivery for tissue-specific treatments Hypotheses: Antenna design and frequencies can be optimized for specific tissues or treatment targets. Applying high-power pulses will more rapidly coagulate tissue microvasculature to improve efficacy. When combined, these optimizations will create ablations 50% faster and 25% larger than current systems. 3) Develop multiple-antenna application techniques to optimize treatment speed and specificity. Hypotheses: Multiple-antenna techniques improve efficacy and precision, allowing more tailored treatments without increasing invasiveness. Ablations can be created by 50% faster and 40% larger than current systems. 4) Facilitate real-time adaptive power control by using integrated treatment monitoring Hypothesis: Treatment monitoring can be accomplished without imaging, using only the interstitial applicator. If successful, this project will advance knowledge of microwave tissue heating, and create innovative and unique approaches to power delivery that utilize all of the advantages that microwaves offer. These aims will substantially change clinical practice by increasing the size of tumors that can be treated with microwaves, further broadening the scope of microwave ablation to areas outside the liver and increasing the number of patients benefiting from minimally invasive treatments. PUBLIC HEALTH RELEVANCE: This proposal will combine the best of engineering and medicine to better understand how ablations are created, develop tools for improved system design, and create a cancer treatment platform that requires minimal invasiveness to provide maximal patient benefit.