MRI-guided Ultrasonic Ablation of Pancreatic Cancer

MRI引导下胰腺癌超声消融

• 批准号: 7789545
• 负责人: FRANK GRAHAM SOMMER
• 金额: $ 21.26万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-03-19 至 2012-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7789545
• 关键词: 3-Dimensional; Ablation; Acoustics; Acute; Adverse effects; Automobile Driving; Caliber; Cancer Etiology; Cancer Patient; Cessation of life; Characteristics; Chronic; Computer Simulation; Development; Devices; Diffusion weighted imaging; Disease; Electronics; Elements; Endoscopes; Family suidae; Goals; Heating; Histologic; Histopathology; Human; Image; Imaging Techniques; In Vitro; Intestines; Left; Length; Magnetic Resonance; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of pancreas; Maps; Mechanics; Methods; Modeling; Monitor; Normal tissue morphology; Output; Pancreas; Patients; Procedures; Research Design; Resected; Shapes; Simulate; Structure; System; Techniques; Temperature; Testing; Tissues; Transducers; Ultrasonics; Ultrasonography; Water; Weight; design; effective therapy; in vitro testing; in vivo; interstitial; minimally invasive; palliation; pancreas imaging; pancreatic neoplasm; prototype; public health relevance; tool; tumor

DESCRIPTION (provided by applicant): The goals of this study are the design, fabrication and initial in vitro and in vivo testing of a system for ablation (destruction) of pancreatic cancers, using high- intensity ultrasound to ablate via thermal heating effect, which will be monitored using MRTI (magnetic resonance thermal imaging). Heating of pancreatic cancers will ultimately be performed by insertion of MR-compatible ultrasonic delivery devices (called "applicators") into pancreatic cancers using endoscopic ultrasound (EUS) guidance. Following insertion of applicators into pancreatic cancers, patients will have the EUS endoscope removed, leaving MR-compatible applicators in place within the pancreatic tumor. These applicators will consist of several independently controlled high-output transducers capable of heating targeted regions of pancreatic cancer in a 3D conformal manner. The ultimate goal will be to treat all regions of pancreatic cancer to an ablative temperature in excess of 50 degrees centigrade, using MRTI to assure complete treatment, while sparing adjacent structures such as bowel. In this proposal, initial design and the in vitro testing of appropriately designed applicators will be performed in the first year, followed by continued development and testing in a swine model in the second year. Both acute (immediate) and chronic (longer-term) histologic changes caused by the ablative procedure in swine pancreata will be assessed by histologic analysis of resected pancreatic tissue after the ablative procedure. By correlating histologic changes with pancreatic treatment temperature profiles, as documented by MRTI, it will be possible to assess the desired thermal requirements for effective pancreatic tissue ablation using these techniques. In addition to MRTI for thermal monitoring of pancreatic ablation, a number of advanced MR imaging techniques (T2-weighted, contrast-enhanced, MTC (magnetization transfer contrast) and DWI (diffusion-weighted imaging) will be used to image the pancreas after the ablation procedure, in order to determine how effective these techniques are for discerning actual histologic changes following ablation. It is expected that these studies will result in a highly effective new technique for local ablation of pancreatic cancer with minimal side effects, providing an entirely new tool for cure or useful palliation of this disease. PUBLIC HEALTH RELEVANCE: Cancer of the pancreas is a common and highly malignant form of cancer that is the fourth leading cause of cancer death in the USA, but there are really no very good treatment methods. We propose the development of an image-guided minimally invasive technique to completely destroy pancreatic cancers while preserving normal tissues. If successful, the technique could be of great importance in providing meaningful treatment for a devastating disease for which there is no current effective treatment.

描述（由申请人提供）：这项研究的目标是设计，制造和初始体外和体内测试胰腺癌的消融系统（破坏），使用高强度超声通过热加热效果消融，该效应将使用mrti（磁性谐振热成像）进行监测。胰腺癌的加热最终将通过使用内窥镜超声（EUS）指南插入MR兼容MR兼容的超声输送设备（称为“施用者”）进行胰腺癌。将施用者插入胰腺癌后，患者将去除EUS内窥镜，使MR兼容的施用者在胰腺肿瘤内留下。这些施用者将由几个独立控制的高输出传感器组成，能够以3D形式的方式加热胰腺癌的靶向区域。最终目标是将所有胰腺癌的所有区域用于消融温度超过50摄氏度的温度，使用MRTI确保完整的治疗，同时保留诸如肠道等相邻结构。在此建议中，将在第一年进行初始设计和适当设计的涂抹器的体外测试，然后在第二年进行猪模型的持续开发和测试。急性（直接）和慢性（长期）组织学变化均由猪胰腺中的消融性程序引起的，将通过在消融过程后对切除的胰组织的组织学分析来评估。通过将组织学变化与MRTI记录的胰腺处理温度谱相关联，可以使用这些技术评估有效的胰腺组织消融的所需热需求。除MIRTI以进行胰腺消融的热监测外，许多先进的MR成像技术（T2加权，对比度增强，MTC，MTC（磁化转移对比）和DWI（磁化转移对比度）和DWI（扩散加权成像）将用于对这些技术进行iSIFICTIC的态度，以确定有效的方法。这些研究将为胰腺癌的局部消融提供一种高效的新技术，其副作用最少，这是一种全新的治疗或有用的抚养工具：胰腺癌是一种常见的癌症和高度恶性的癌症，这是美国癌症死亡的第四个主要治疗方法。在保留正常组织的同时，完全破坏了胰腺癌。