MR Guided Focused Ultrasound Surgery

在本研究的当前资助期间，我们成功地实施了基于MRI的 用于监测聚焦超声治疗的温度测量。我们使用了基于核磁共振成像的温度测量法， 确定在短时间超声处理过程中组织损伤的阈值热剂量， 证明了其在治疗乳腺纤维腺瘤、乳腺癌和乳腺癌的临床环境中的有用性， 子宫肌瘤我们还开发了治疗计划的方法并展示了波前的影响 通过覆盖组织的变形。基于这些结果，我们建议通过测试 以下假设：腔内超声相控阵可用于有效凝固前列腺 当使用MRI温度监测时，为了验证这一假设，我们将首先探讨 通过开发一种线性阵列， 用于早期前列腺癌微创超声手术并进行临床前的系统 在动物模型中进行测试。其次，我们将探索使用MRI导出的温度信息的方法 以控制治疗，从而可以完成整个目标体积的凝固。最后， 我们将开发全尺寸的二维经直肠阵列，以充分利用相控阵的潜力 超声技术用于治疗前列腺疾病。在这项研究结束时，我们将 开发了必要的方法，用于临床可行性测试的精确和监测热 前列腺癌的凝固方法，可以减少治疗时间和阳痿率。这 该手术可能取代目前的开放手术， 的基础上，是少得多的侵略性。所提出的治疗方法的医疗保健益处是显著的， 包括更快恢复、降低成本以及降低感染和出血风险

During the current funded period of this research, we have successfully implemented MRI-based thermometry for the monitoring of focused ultrasound treatments. We have used MRI-based thermometry to determine the threshold thermal dose for tissue damage during short sonications, and we have demonstrated its usefulness in a clinical setting in treatments of breast fibroadenomas, breast cancer, and uterine fibroids. We have also developed methods for treatment planning and shown the impact of wavefront distortion by overlying tissues. Based on these results, we propose to further this research by testing the following hypothesis: Intracavitary ultrasound phased arrays can be used to effectively coagulate prostate tumors when MRI temperature monitoring is used. To test this hypothesis we will first, explore the feasibility of using intracavitary focused ultrasound phased arrays with MRI monitoring by developing a linear array system for minimally invasive ultrasound surgery of early stage prostate cancer and performing pre-clinical tests of it in an animal model. Second, we will explore methods to use MRI derived temperature information to control the treatment so that the coagulation of the complete target volume can be accomplished. Finally, we will develop full-scale two-dimensional transrectal arrays that will exploit the full potential of phased array ultrasound technology for the treatment of prostate disease. At the close of this research we will have developed the necessary methods for clinical feasibility testing of a precise and monitored thermal coagulation method for prostate cancer that can reduce both the treatment time and the impotency rate. This procedure may replace current open surgery with a method that could potentially be performed on outpatient basis and is much less invasive. The healthcare benefits of the proposed treatments are significant and include faster recovery, reduced cost, and a lowered risk of infection and bleeding