Simultaneous MRI/US for real-time liver ablation guidance and confirmation

同步 MRI/US 用于实时肝脏消融指导和确认

• 批准号: 10677721
• 负责人: James H Holmes
• 金额: $ 76.67万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677721
• 关键词: 3-Dimensional; 3D ultrasound; Ablation; Acoustics; Adoption; Advanced Development; Algorithms; Anatomy; Animal Model; Animals; Breathing; Cattle; Cirrhosis; Clinical; Collaborations; Compensation; Diffusion; Diffusion Magnetic Resonance Imaging; Elements; Equipment; Etiology; Family suidae; Feedback; Fluoroscopy; Freedom; Goals; Hand; Human; Image; Institution; Intervention; Interventional Ultrasonography; Intestines; Iowa; Lesion; Liver; Location; Lung; Magnetic Resonance Imaging; Methods; Modality; Modeling; Monitor; Motion; Navigation System; Needles; Operative Surgical Procedures; Organ; Pathology; Patient-Focused Outcomes; Patients; Performance; Perfusion; Positioning Attribute; Procedures; Recurrence; Research; Roentgen Rays; Safety; Scientist; Site; Sum; System; Techniques; Technology; Temperature; Thermometry; Time; Tissue Model; Tissues; Translating; Ultrasonography; United States National Institutes of Health; Universities; Validation; Wisconsin; Work; X-Ray Computed Tomography; clinical practice; comparative; contrast enhanced; curative treatments; deep learning; experimental study; flexibility; image guided; image guided intervention; image guided radiation therapy; image registration; improved; in vivo imaging system; industry partner; innovation; liver ablation; liver tumor ablation; microwave ablation; microwave electromagnetic radiation; minimally invasive; multidisciplinary; novel; operation; pre-clinical; real-time images; respiratory; skills; soft tissue; success; technology validation; temporal measurement; treatment response; tumor; ultrasound; user-friendly; virtual

Project Summary: Percutaneous liver tumor ablation procedures are performed with ultrasound (US), computed tomography (CT) and CT-fluoroscopy guidance. Each image guidance modality has strengths and weakness. US provides superior tissue contrast and real-time guidance; however, suboptimal or absent acoustic windows, motion (respiratory, bulk), and poor applicator conspicuity compromise precise tumor targeting and a widening skill gap limit widespread adoption. The larger field-of-view (FOV) provided by CT is critical for evaluating proximity of non-target anatomy; however, poor tissue contrast, limited access along the X-Y-Z axis, motion, and non- real-time guidance limit accurate tumor targeting. Magnetic resonance imaging (MRI) provides superior soft tissue contrast but presents challenges with the comparatively long acquisition times for real-time guidance and limited access within the scanner bore. Image fusion technologies attempt to harness the strengths of each modality. Unfortunately, current image fusion technologies are unable to sufficiently account for liver deformation, bulk respiratory and patient motion which compromise targeting. Further, they do not address challenges associated with US. An Academic Industrial Partnership is proposed to develop and validate a solution comprised of two primary elements. The first is a combined platform with a novel MRI compatible hands-free US and fast 3D deformable image registration for optimized simultaneous US and virtual MR image guidance in the ablation setting. The second element will be development of advanced MRI methods for real- time treatment monitoring through MR Thermometry in combination with near-real-time assessment of ablation zone margins using advanced diffusion and perfusion MRI. This solution will improve primary efficacy and reduce local recurrence after ablation of liver tumors. This proposal will focus on microwave ablation however the solution is applicable for a wide variety of thermal therapies.

项目总结： 经皮肝肿瘤消融术使用超声(US)、计算机断层扫描(CT) CT透视引导。每种图像制导方式都有优缺点。美国提供 卓越的组织对比度和实时指导；然而，不理想或缺少声学窗口、运动 (呼吸、散装)和糟糕的涂抹器显着性影响了精确的肿瘤靶向和扩大的技能 差距限制了广泛采用。CT提供的较大视野(FOV)对于评估邻近性至关重要 非靶点解剖；然而，组织对比度差，沿X-Y-Z轴的访问受限，运动和非 实时指导限制了肿瘤的准确靶向。磁共振成像(MRI)提供卓越的软件 组织对比度，但对于实时指导来说，相对较长的采集时间带来了挑战 并且在扫描仪内孔内的访问受限。图像融合技术试图利用 每一种模式。不幸的是，目前的图像融合技术不能充分考虑肝脏 变形、大量呼吸和病人运动，影响目标定位。此外，它们不涉及 与美国相关的挑战。提出了学术产业合作伙伴关系，以开发和验证 解决方案由两个主要元素组成。第一个是具有新的磁共振兼容的组合平台 免提US和快速3D可变形图像配准，可同时优化US和虚拟MR图像 消融环境中的指导。第二个要素将是开发先进的磁共振成像方法，用于实时- 结合近实时消融评估的MR测温时间治疗监测 区域边缘使用先进的扩散和灌注磁共振成像。这一解决方案将提高初级疗效和 减少肝肿瘤消融术后局部复发。然而，该提案将重点放在微波消融上。 该解决方案适用于多种热疗。