MR GUIDED FOCUSED ULTRASOUND SURGERY FOR PROSTATE CANCER

MR 引导聚焦超声手术治疗前列腺癌

• 批准号: 7960874
• 负责人: CLARE M TEMPANY
• 金额: $ 5.48万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7960874
• 关键词: Ablation; Adverse effects; Anatomic structures; Blood Vessels; Breast; Clinical Treatment; Clinical Trials; Collaborations; Computer Retrieval of Information on Scientific Projects Database; Data; Data Set; Detection; Development; Devices; Disease; Dose; Focused Ultrasound Therapy; Funding; Funding Opportunities; Gland; Goals; Grant; Healthcare Systems; Human; Image; Imagery; Institution; Integrated Delivery Systems; Intervention; Lesion; Magnetic Resonance Imaging; Malignant neoplasm of prostate; Measurement; Medicine; Methods; Modeling; Necrosis; Operative Surgical Procedures; Phase; Prostate; Public Health; Radical Prostatectomy; Research; Research Personnel; Resources; Safety; Source; Structure; System; Temperature; Testing; Thermal Ablation Therapy; Time; Tissues; United States National Institutes of Health; Urethra; Uterine Fibroids; Validation; Work; adenoma; base; cancer imaging; design; direct application; image guided intervention; image guided therapy; image processing; intraoperative imaging; prevent; targeted delivery; tumor

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Project Summary Grant Number: R01-CA109246 Project Start: 11-MAY-2005 Project End: 31-MAR-2010 The fundamental principles of image-guided interventions are tumor detection, navigation, delivery and control of the intervention. The powerful union of focused ultrasound (FUS) and magnetic resonance imaging (MRI) or MR-guided FUS allows for accurate detection of the disease, measurement of tissue temperature changes and confirmation of thermally induced tissue changes. Such an integrated delivery system can provide a non-invasive treatment method for many tumors. We have designed, developed and tested integrated systems for use of FUS, which are currently in clinical trials for treatment of breast fibro-adenomas and uterine leiomyomas, led by this same team of investigators. Prostate cancer represents one of the most significant challenges in medicine and public health, facing the US healthcare system today. It presents an ideal model for this non-invasive thermal ablation method or FUS surgery. It is a discrete tumor, which is accessible, and of an appropriate size for targeted delivery of a focal treatment. MR is uniquely suited to imaging the prostate as it allows excellent visualization of the gland, its substructure and all surrounding tissues. MRI guidance can provide targeting, controlled delivery of the thermal energy and help prevent damage to the surrounding critical anatomic structures. In the proposed research, our goal is to develop an interactive comprehensive MR image-guided FUS system for treatment of localized prostate cancer. Our specific aims are 1) To test transrectal device for MR guided thermal therapy in the prostate. 2) To use MRI to define the target prostate lesions, on the basis of multi-parametric MR image data sets. These images will be analyzed, by registration and segmentation, for target definition and navigation, and then integrated into an on-line thermal dose planning system. 3) To perform phase I human trials to test the feasibility, safety and efficacy of MRgFUS for prostate cancer. These will be done prior to radical prostatectomy, with resulting pathological validation of thermal necrosis. The challenge is to increase the information content of intraoperative image data by using multimodal features, while at the same time preserving the interactivity and the near-real time features of intraoperative imaging. When this can be achieved, the precise delivery of FUS to maximize tumor ablation, and minimize side effects will be possible. Thus, at the conclusion of this project we will be poised to begin larger phase II/III clinical trials, with an industrial partner leading to commercial development of a device for further trials. Benefit to NCIGT Both the Prostate and FUS cores contribute and benefit from this collaboration by means of new scientific opportunities and funding. The Specific Aims require the development of an integrated multi-modal image display system to allow accurate targeting of focal prostate lesions for MR guided FUS. Rapid and spatially accurate thermal imaging will be required, not only at the focal point but at the critical normal, adjacent structures, such as the urethra and neuro-vascular bundles. Benefit to the Project The R01 benefits directly from the expertise within the FUS and Prostate cores. Much of the work now being done in the open-bore setting (Prostate Core) will be adapted and modified for use in the closed bore, high field strength system as outlined in the R01 Specific Aims. Imaging and image-processing advances, such as registration and segmentation, developed within the U41 will also have direct application to this R01.

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 项目摘要 授权编号：R 01-CA 109246 项目开始日期：2005年5月11日 项目结束日期：2010年3月31日 图像引导介入的基本原理是肿瘤检测、导航、递送和介入控制。聚焦超声（FUS）和磁共振成像（MRI）或MR引导的FUS的强大结合允许准确检测疾病，测量组织温度变化并确认热诱导的组织变化。这种整合的递送系统可以为许多肿瘤提供非侵入性治疗方法。我们设计、开发和测试了用于FUS的集成系统，目前正在进行治疗乳腺纤维腺瘤和子宫平滑肌瘤的临床试验，由同一个研究团队领导。前列腺癌是当今美国医疗保健系统面临的医学和公共卫生领域最重大的挑战之一。它为这种非侵入性热消融方法或FUS手术提供了理想的模型。它是一种离散的肿瘤，可接近，并且具有适当的大小，用于靶向递送局灶性治疗。磁共振成像是唯一适合成像前列腺，因为它允许良好的可视化腺体，其子结构和所有周围组织。MRI引导可以提供热能的靶向、受控输送，并有助于防止对周围关键解剖结构的损伤。在拟议的研究中，我们的目标是开发一个交互式的全面的MR图像引导FUS系统，用于治疗局限性前列腺癌。我们的具体目标是：1）测试用于前列腺MR引导热治疗的经直肠器械。2)在多参数MR图像数据集的基础上，使用MRI来确定目标前列腺病变。这些图像将被分析，通过配准和分割，目标定义和导航，然后集成到一个在线的热剂量计划系统。3)进行I期人体试验，以测试MRgFUS治疗前列腺癌的可行性、安全性和有效性。这些将在根治性椎间盘切除术之前完成，从而对热坏死进行病理学验证。挑战在于通过使用多模态特征来增加术中图像数据的信息内容，同时保留术中成像的交互性和近实时特征。当这一点能够实现时，精确输送FUS以最大限度地消融肿瘤并最大限度地减少副作用将是可能的。因此，在该项目结束时，我们将准备开始更大的II/III期临床试验，与工业合作伙伴一起进行进一步试验的设备的商业开发。 对NCIGT的好处 前列腺和FUS核心都通过新的科学机会和资金来促进和受益于这种合作。具体目标要求开发集成多模态图像显示系统，以便MR引导FUS准确定位局灶性前列腺病变。快速和空间准确的热成像将被要求，不仅在焦点，但在关键的正常，相邻的结构，如尿道和神经血管束。 项目效益 R 01直接受益于FUS和前列腺核心的专业知识。如R 01特定目标所述，目前在开孔设置（前列腺芯）中进行的大部分工作将进行调整和修改，以用于闭孔、高场强系统。在U41中开发的成像和图像处理技术，如配准和分割，也将直接应用于R 01。