An integrated theranostic system for breast cancer

乳腺癌是女性最常被诊断的癌症(皮肤癌除外)，以及 是美国女性癌症死亡的第二大原因。目前，一名女性 七分之七的人会在她的一生中患上乳腺癌。大多数患者需要手术治疗。 案子。然而，随着肿瘤在越来越早的阶段被发现，治疗肿瘤的新方法 更少的侵入性和更多的局部治疗是有必要的。与其前提形成鲜明对比的是， 比较高强度聚焦超声(HIFU)在临床上的应用 由于不可靠(基于B型)或极其昂贵和缓慢(基于MRI)造成的贫血 可用的监控技术。因此，迫切需要一种简单的、成本- 高效技术，可可靠、高效地监控HIFU治疗，从而确保 它的临床翻译。为了满足这两种需求并保持HIFU的低成本，同时 保留了它的所有优点，我们开发了基于辐射力的技术 可与HIFU无缝配合使用的谐波运动成像(HMI) 肿瘤靶向和消融的产生和监测，即聚焦的HMI 超声(HMIgFUS)。在拟议的研究中，我们将把HMIgFUS整合到临床 该系统将促进HMIFU的翻译，用于乳腺肿瘤的局部热疗。 潜在的假设是，使用并行波束形成的HMIGFUS将能够 在应用速度是关键的临床环境中，最佳地监测HIFU消融。这个 组建的团队包括超声波、乳房成像、乳房手术、小鼠肿瘤 模型建立及组织病理学分析。我们的团队已经证明了运动估计 在极高的帧速率(高达5000 fps)下使用并行波束成形是可行的 确保最高质量的运动估计，包括2)高精度位移，3) 相干合成可提高SNR，4)2D能力以及5)实时 实施。事实证明，这种可靠的监视技术在呈现 为广大乳腺癌患者提供完全非侵入性治疗 首次将其推向快速可靠的门诊程序，用于局部治疗 良性或小型、非转移性乳腺癌，从而将死亡率和风险降至最低。

Breast cancer is the most frequently diagnosed cancer (excluding skin cancer) in women, and is the second leading cause of cancer death among women in the U.S. Currently, one woman in seven will develop breast cancer in her lifetime. Surgical intervention is warranted in most cases. However, as tumors are being detected at increasingly earlier stages, new methods for less invasive and more focal treatments are warranted. In sharp contrast with its premise, the translation of high-intensity focused ultrasound (HIFU) to the clinic has been comparatively anemic due to the unreliable (B-mode-based) or extremely costly and slow (MRI-based) monitoring techniques available. There has thus been an urgent need for a simple, cost- efficient technology that can reliably and efficiently monitor HIFU treatment and thereby ensure its clinical translation. In order to address both needs and maintain the low cost of HIFU while preserving all its advantages, we have developed the radiation-force-based technique of Harmonic Motion Imaging (HMI) that can be used seamlessly with HIFU for simultaneous tumor targeting and generation and monitoring of ablation, namely HMI for Focused Ultrasound (HMIgFUS). In the proposed study, we will integrate the HMIgFUS into a clinical system that will facilitate translation of HMIFU for the focal, thermal treatment of breast tumors. The underlying hypothesis is that HMIgFUS using parallel beamforming will be capable of optimally monitoring HIFU ablation in a clinical setting where speed of application is key. The team assembled encompasses ultrasound, breast imaging, breast surgery, mouse tumor models and histopathological analysis. Our group has demonstrated that motion estimation using parallel beamforming is feasible 1) at extremely high framerates (up to 5000 fps) ensuring highest quality of motion estimation including 2) high precision displacements, 3) coherent compounding for SNR increase, 4) 2D capability as well as 5) real-time implementation. Such a reliable monitoring technique could prove pivotal in rendering an entirely noninvasive treatment accessible to a wide population of breast cancer patients for the first time by propelling it into fast and reliable outpatient procedure for the focal treatment of benign or small, non-metastatic breast cancer, thus minimizing mortality and risk.