Ultrasound-Guided HIFU for Tumor Treatment

描述(由申请人提供)： 热疗在癌症治疗中有重要的应用，即根治性或姑息性肿瘤消融术。高强度聚焦超声(HIFU)是一种极具吸引力的应用方式，因为它具有非侵入性(即经皮肤)的应用潜力。有几个因素限制了HIFU治疗的有效性，即：(1)基于对物理和生物学的坚定理解制定有效的治疗方案，(2)实时监测治疗进展以提供指导和控制，(3)准确和有效地提供适当的热剂量，以及(4)登记靶点和补偿组织运动。该项目的长期目标是开发一种综合热疗研究系统，该系统使用经皮HIFU作为热源，并将作为未来治疗平台的原型。具体目标是解决上述确定的需求，开发一种研究治疗系统，并在体内对该系统进行初步测试。目标1是开发HIFU暴露测量和热剂量学的定量方法，并验证和改进它们以用于治疗计划。目标2是改进我们处理射频超声(US)反向散射数据的算法，以实现对使用HIFU或其他热疗产生的治疗进展的实时监测和控制。目标3是开发新的HIFU方案，使用连续移动的焦点区域来产生所需的体积组织温度分布和病变几何形状，从而实现准确和有效的治疗。虽然空化通常与HIFU有关，并且可以机械地消融组织，但我们将尝试设计出将其作用降至最低的方案。目标4是改进用于治疗前多模式图像配准(例如，MR和3-D US)和使用治疗时间2-D US图像的运动补偿的算法，并将这些算法与HIFU治疗计划、US温度传感和简单的机器人系统相集成，以构建研究US引导的治疗系统。目标5是在体内病变放置的急性研究中测试该系统，并反复改进系统组件。采用了多学科团队方法，涉及声学、生物学、医学、应用数学、工程学和软件开发，并将建立在HIFU技术的大型集体经验的基础上。体外和体内实验、数值建模、图像处理方法和其他工程方面将有助于实现总体目标，元素之间的密切沟通使快速反馈和改进成为可能。

DESCRIPTION (provided by applicant): Thermal therapies have important applications in cancer treatment; viz., curative or palliative tumor ablation. High intensity focused ultrasound (HIFU) is an attractive modality for such applications because of its potential to be applied non-invasively (i.e., transcutaneously). Several factors limit the effectiveness of HIFU therapy; viz., the abilities to:(1) develop effective treatment protocols based on a firm understanding of the physics and biology, (2) monitor treatment progression in real time to provide guidance and control, (3) deliver the appropriate thermal dose accurately and efficiently, and (4) register the target and compensate for tissue motion. The project's long term objective is to develop an integrated thermal therapy research system that uses transcutaneous HIFU as the heat source and which would serve as a prototype for future therapy platforms. Specific aims address the needs identified above, development of a research therapy system, and preliminary testing of the system in vivo. Aim 1 is to develop quantitative approaches to HIFU exposimetry and thermal dosimetry, and to validate and refine them for treatment planning. Aim 2 is to refine our algorithms for processing radio frequency ultrasound (US) backscatter data to enable real time monitoring and control of treatment progression produced using HIFU or other thermal therapies. Aim 3 is to develop new HIFU protocols using continuously moving focal zones to produce desired volumetric tissue temperature profiles and lesion geometries, and thus enable accurate and efficient treatment. Although cavitation is often associated with HIFU and can ablate tissues mechanically, we will attempt to devise protocols that minimize its role. Aim 4 is to refine algorithms for pre-treatment multimode image registration (e.g., MR and 3-D US) and for motion compensation using time-of-treatment 2-D US images, and to integrate these algorithms with the HIFU therapy plan, US temperature sensing, and a simple robotic system to build a research US-guided therapy system. Aim 5 is to test the system in acute studies of lesion placement in vivo, and to iteratively refine the system components. A multidisciplinary team approach is taken, involving acoustics, biology, medicine, applied mathematics, engineering, and software development, and will build on a large collective experience with HIFU technology. In vitro and in vivo experimentation, numerical modeling, image processing methods and other engineering aspects will contribute to the overall goal, with close communication between elements to enable rapid feedback and refinements.