Transcranial Magnetic Resonance guided Histotripsy (tcMRgHt)

经颅磁共振引导组织解剖 (tcMRgHt)

• 批准号: 10183248
• 负责人: Zhen Xu
• 金额: $ 62.83万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10183248
• 关键词: Ablation; Acoustics; Aftercare; Algorithms; Anatomy; Blood; Brain; Brain Neoplasms; Brain region; Cadaver; Caliber; Cattle; Cells; Cerebrum; Clinical; Clinical Treatment; Cognitive deficits; Craniotomy; Data; Diagnosis; Disease; Edema; Essential Tremor; Excision; FDA approved; Family suidae; Focused Ultrasound; Fractionation; Future; Goals; Heating; Human; Image; Injury; Length; Location; Magnetic Resonance; Magnetic Resonance Imaging; Metastatic malignant neoplasm to brain; Methods; Modeling; Monitor; Morbidity - disease rate; Necrosis; Neoplasm Metastasis; Neuraxis; Operative Surgical Procedures; Patients; Performance; Pharmaceutical Preparations; Physiologic pulse; Positioning Attribute; Primary Brain Neoplasms; Primary Neoplasm; Radiation Dose Unit; Radiation necrosis; Radiation therapy; Rodent; Safety; Secondary to; Sonication; Speed; Structure; Surface; Survival Rate; System; Techniques; Technology; Temperature; Thermometry; Time; Tissues; Trauma; Ultrasonography; base; brain tissue; brain volume; clinical translation; cranium; design and construction; effective therapy; image guided; improved; in vivo; invention; millimeter; preclinical study; prevent; radiation risk; skull base; tool; tumor

Transcranial Magnetic Resonance guided Histotripsy (tcMRgHt) Project Summary The goal of this proposal is to develop the first integrated tcMRgHt system for treatment of brain tumors. Approximately 256,000 new patients are diagnosed with primary brain tumor annually worldwide, and many more patients are diagnosed with brain metastases. The current clinical treatment for brain tumors is a highly invasive surgery. The five-year survival rate is only 33% with many surviving patients suffering from cognitive deficits. Transcranial magnetic resonance guided focused ultrasound (tcMRgFUS) has been investigated as a noninvasive ablation method in the brain. However, due to the overheating of the skull, tcMRgFUS cannot treat a target volume >1 cm diameter in the brain or locations within 2 cm from the skull surface, rendering inoperable up to ~90% of the cortex regions where brain tumors often reside. We hypothesize that transcranial MR guided histotripsy (tcMRgHt) can overcome the treatment location and volume limitations of tcMRgFUS and provide a non-invasive ablation technique to improve the treatment of brain tumors. Using microsecond-length, high-amplitude ultrasound pulses applied from outside the skull, cavitation can be precisely generated to disrupt cells within the targeted brain region. The heating to the skull and surrounding tissue can be avoided by using a very low duty cycle (<0.1%). Our preliminary data show that histotripsy applied through excised human skulls was used to ablate a wide range of locations and brain volumes inside the skull, while keeping the temperature increase in the skull under 4°C. Although the feasibility of transcranial histotripsy and MRI guidance has been shown separately, developing and building an integrated tcMRgHt system is a substantial technical challenge. We propose the following three specific aims. 1) Design and construct an integrated tcMRgHt system. 2) Develop and optimize specialized RF pulse sequences for MRI guidance of tcMRgHt. 3) Validate the performance of the tcMRgHt system in ex vivo brain phantom and human cadaver. An integrated tcMRgHt system that can noninvasively treat a wide range of locations and volumes in the brain and validated in human cadavers would be a critical milestone to advance this promising technology for future clinical translation for treatment of brain tumors.

经颅磁共振引导组织检查(TcMRgHt) 项目摘要 这项提议的目标是开发第一个用于治疗的综合tcMRgHt系统 脑瘤的症状。约25.6万名新患者被诊断为原发性脑瘤 每年，全世界都有更多的患者被诊断为脑转移瘤。海流 脑肿瘤的临床治疗是一种高度侵入性的手术。五年存活率仅为 33%，许多存活的患者患有认知障碍。经颅磁 摘要共振引导聚焦超声(TcMRgFUS)是一种无创的超声检查方法。 脑内消融的方法。然而，由于头骨过热，tcMRgFUS无法 治疗脑内直径1厘米的目标体积或距颅骨表面2厘米以内的位置， 导致高达~90%的脑肿瘤经常驻留的皮质区域无法手术。我们 假设经颅MR引导的组织学检查(TcMRgHt)可以克服 TcMRgFUS的治疗位置和容量限制并提供一种无创的 消融技术，提高脑肿瘤的治疗水平。使用微秒长度， 从颅骨外施加高幅度的超声脉冲，可以精确地进行空化 产生来破坏目标脑区内的细胞。对头骨的加热和 可以通过使用非常低的占空比(&lt；0.1%)来避免周围的组织。我们的初步数据 结果表明，通过切除的人类头骨进行的组织摩擦检查被用于消融广泛的 头骨内的位置和脑体积，同时保持头骨内的温度升高 在4°C下，虽然经颅组织碎石术和MRI引导的可行性已经被证明 另外，开发和构建集成的tcmrgHt系统是一项重要的技术 挑战。我们提出了以下三个具体目标。1)设计和建设一体化的 TcMRgHt系统。2)开发和优化用于磁共振引导的专用RF脉冲序列 TcMRgHt.3)验证tcMRgHt系统在体外脑模型和 人类的身体。一个集成的tcMRgHt系统，可以非侵入性地治疗广泛的 大脑中的位置和体积并在人体身体上得到验证将是一个关键 里程碑式地推进这项前景看好的技术，用于未来的临床翻译治疗 脑瘤。