An Intraoperative Guidance Platform for Radio Frequency Ablation

项目摘要： 这项拟议研究计划的目标是开发一个平台， 射频消融（RFA）。RFA是一种热介导的消融技术，其中， 将一个电极经皮（或通过腹腔镜检查或开放手术方法）插入肿瘤中。无线电 施加射频（RF）能量，使体积为2cm至5cm的组织变性和变性， 直径.一些RFA电极的形状为直针;另一些则部署尖齿伞来消融 更大的体积。RFA具有吸引力，因为它可以永久使用，从而实现微创。RFA是一种广泛的 被公认的癌症治疗疗法，应用于不同器官的原发性和继发性肿瘤， 包括肝、肺、肾、乳腺和肌肉骨骼干预。RFA通常是首选治疗 为不能手术的患者提供选择。 RFA的典型方法是经皮。因此，医生无法直接看到 电极和组织。术中使用CT和超声来跟踪电极的位置，但 CT和超声（US）都具有有限的能力来可视化RFA下的组织坏死。很难 从而评估哪些组织已经被处理而哪些没有。目前，医生依靠“心理地图” 他们以前消融过的组织的位置，并估计下一步要去哪里。坏死体积也是 根据电极制造商提供的印刷品中的病变几何形状图表进行“心理估计”。这些图表 显示了均匀组织的预期消融几何形状，但未考虑解剖结构或存在 这可以改变和减少消融体积，因为它们将热量输送出去。 该计划的总体目标是开发一个术前计划和术中计划的平台。 RFA引导，基于RFA的电/热效应模拟和术中实时 坏死模式的预测。RFA模拟与CT术中图像的图像融合将 构成一个引导系统，能够显示哪些组织已经被治疗，哪些没有， 医生正确重新定位电极并实现一致的重叠。这将改善 RFA尤其适用于肿瘤大于2cm的患者，已证明完全坏死 在没有指导的情况下是很难实现的。

Project Summary: The objective of this proposed research program is to develop a platform for planning and guidance during Radio Frequency Ablation (RFA). RFA is a thermally mediated ablation technique, where an applicator carrying one electrode is inserted into tumors percutaneously (or via laparoscopy, or open surgical approaches). Radio Frequency (RF) energy is applied, denaturating and coagulating tissues in a volume of 2cm to 5cm of diameter. Some RFA electrodes are shaped as straight needles; others deploy an umbrella of tines to ablate a larger volume. RFA is attractive as it can be used percutaneously resulting minimally invasive. RFA is a widely accepted cancer treatment therapy, and is applied to primary and secondary tumors in different organs, including liver, lung, kidney, breast, and in musculoskeletal interventions. RFA is often the preferred treatment option for inoperable patients. The typical approach for RFA is percutaneous. Physicians therefore have no direct view of the location of electrodes and of tissues. CT and Ultrasound are used intraoperatively to track the location of electrodes, but both CT and Ultrasound (US) have limited ability to visualize the necrotization of tissues under RFA. It is hard therefore to assess which tissues have been treated and which not. Currently physicians rely on “mental maps” of where they have previously ablated tissues and estimate where to go next. The necrotization volume is also “mentally estimated” from lesion geometry charts provided in print by electrode manufacturers. These charts show the expected ablation geometry for a uniform tissue and do not account for the anatomy or the presence of blood vessels, which can modify and reduce the ablation volume as they transport heat away. The overarching goal of this program is to develop a platform for pre-operative planning and intraoperative RFA guidance, based on simulation of the electrical / thermal effects of RFA and real-time intraoperative prediction of necrotization patterns. Image fusion of RFA simulations onto CT intraoperative images would constitute a guidance system able to show which tissues have been treated and which not, allowing the physicians to properly repositions electrodes and achieve consistent overlap. This would improve outcomes of RFA particularly for patients with tumors greater than 2cm, for which total necrotization has been shown to be particularly hard to achieve without guidance.