An integrated theranostic system for breast cancer

乳腺癌是女性最常被诊断出的癌症（不包括皮肤癌）， 是美国女性癌症死亡的第二大原因。 七分之一的人会在有生之年患上乳腺癌。手术干预是必要的， 例然而，随着肿瘤在越来越早的阶段被检测到， 需要更少的侵入性和更集中的治疗。与其前提形成鲜明对比的是， 高强度聚焦超声（HIFU）在临床上的应用 由于不可靠（基于B模式）或极其昂贵和缓慢（基于MRI）导致贫血 现有的监测技术。因此，迫切需要一个简单的，成本- 高效的技术，可以可靠有效地监测HIFU治疗，从而确保 临床翻译为了满足这两种需求并保持HIFU的低成本， 在保留其所有优点的基础上，我们开发了基于辐射力的技术， 谐波运动成像（HMI），可与HIFU无缝配合使用， 肿瘤靶向以及消融的生成和监测，即用于聚焦的HMI 超声（HMIgFUS）。在拟议的研究中，我们将把HMIgFUS整合到临床上， 该系统将促进用于乳腺肿瘤的局灶性热治疗的HIFU的平移。 基本假设是使用并行波束成形的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。的 组建的团队包括超声、乳腺成像、乳腺手术、小鼠肿瘤 模型和组织病理学分析。我们的团队已经证明了运动估计 使用并行波束成形是可行的1）在极高的帧速率（高达5000 fps） 确保最高质量的运动估计，包括2）高精度位移，3） 相干复合以增加SNR，4）2D能力以及5）实时 实施.这种可靠的监测技术可以证明是关键的， 乳腺癌患者的广泛人群可以获得完全无创治疗， 首次将其推进到快速可靠的门诊程序中，用于重点治疗 良性或小的非转移性乳腺癌，从而最大限度地降低死亡率和风险。

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.