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

项目摘要： 经皮肝肿瘤消融术使用超声（US）、计算机断层扫描（CT） 和CT透视引导。每种图像引导模态都有优点和缺点。用户提供 上级组织对比度和实时引导;然而，次优或无声窗，运动 （呼吸，散装），和差的施用器的醒目性妥协精确的肿瘤靶向和扩大技能 差距限制了广泛采用。CT提供的更大视野（FOV）对于评估邻近度至关重要 非目标解剖结构;然而，组织对比度差、沿着X-Y-Z轴的进入受限、运动和非目标解剖结构 实时引导限制了准确的肿瘤靶向。磁共振成像（MRI）提供了优越的上级软 但是对于实时引导来说，相对较长的采集时间带来了挑战 并且在扫描器孔内的访问受限。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、大量呼吸和患者运动，这会影响目标定位。此外，它们不涉及 与我们相关的挑战。建议建立一个学术工业伙伴关系， 解决方案包括两个主要要素。第一个是具有新型MRI兼容性的组合平台 用于优化同步US和虚拟MR图像的免提US和快速3D可变形图像配准 引导，引导，引导。第二个要素将是发展先进的磁共振成像方法，用于真实的- 通过MR温度测量结合近实时消融评估进行时间治疗监测 区域边缘使用先进的扩散和灌注MRI。该解决方案将提高主要疗效， 减少肝脏肿瘤消融后的局部复发。然而，该提案将侧重于微波消融 该解决方案适用于各种热疗法。

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.