ShEEP Request for Intravascular Ultrasound System

摘要 我们正在为一组退伍军人管理局的调查员申请“血管内超声系统(IVUS)”。 长期以来，静脉内超声一直被用于心脏病学和其他生理学研究的高级分支。 分辨率腔内成像。它是一种独特的方法，用于评估范围广泛的 全身管腔结构的异常通过产生断层扫描 腔内腔的整个长度的部分。IVUS成像已经能够获得 即使是最复杂的经皮超声、CT或 核磁共振检查。这种方法的独特性导致了各种临床应用。这些 基于微型超声换能器的导管在评价 尿路和胃肠道。目前，大多数心脏影像研究技术 大多使用经胸超声成像检查心脏。我们将概述 我们对该设备有重大需求的三个不同的研究领域：1) 心内科；2)泌尿科；3)胃肠病科。拟议的静脉内超声使用预计将提供更多 通过使用一系列断层切片对心脏进行成像来提取详细信息 (从心脏内部，即从心尖到心底，使用心电门控回调)和重建 心脏手术中心肌重构的三维几何学研究 失败和在治疗过程中。使用该软件可以重建单个长轴图像 内置的IVUS系统或更多部分可以使用定制软件创建 由我们团队开发。此外，我们建议将该系统用于其他重要的非 血管腔内检查，包括尿路和肛管。因为超声波检查 导管直径小于3 mm(3.2至9F)(取决于成像频率： 9至45兆赫)，它们可以很容易地进入尿路(人体和动物模型) 不需要扩张。除了厚度，这项技术还能使治疗性 准确地在括约肌区域进行注射，并测量注射的确切深度 材料。经尿路超声检查也被用来评估腔内注射的部署。 前列腺和括约肌内尿路支架。腔内超声已被用于 对膀胱肿瘤进行影像检查。小肿瘤被清楚地识别出来，它们的程度 可以对入侵进行评估。目前，还没有好的成像方法来评估肿瘤。 膀胱内的深度。一些泌尿科医生使用磁共振成像(MRI)来诊断 泌尿生殖系统疾病的分期，包括膀胱癌。泌尿科医生已经习惯了 使用超声波，并继续使用这种成像方式进行前列腺活检。因此，使用 经尿路超声对膀胱癌的诊断比其他检查更合理 情态。拟议的设备将有助于确定膀胱的分期 肿瘤。此外，静脉内超声可以帮助评估需要切除的组织的面积和深度，以便 实现完全切除。这一信息对判断膀胱癌的预后很重要。 癌症，以及适当的治疗干预措施。胃肠病学的应用 由Bhargava博士开发的产品已经使用了十多年(参见生物素描中的参考文献) 但由于旧机器的过时，对新平台的需求已经变得 势在必行。总而言之，我们预计这台设备将是我们 研究设施，将由多名调查人员联合使用。

Abstract We are requesting “Intravascular Ultrasound System (IVUS)” for a group of VA investigators. IVUS has long been used in cardiology and other branches of physiological research for high- resolution intraluminal imaging. It is a unique approach for the evaluation of a wide range of abnormalities within the luminal structures throughout the body by generating tomographic section of the entire length of the luminal cavity. IVUS imaging has been able to obtain information not available with even the most sophisticated percutaneous sonography, CT, or MRI. The uniqueness of this approach has led to a variety of clinical applications. These miniature ultrasound transducer based catheters have played a role in the evaluation of the urinary and gastrointestinal tracts. Currently, a majority of cardiac imaging research techniques have mostly examined the heart using trans-thoracic imaging with ultrasound. We will outline three distinct areas of research where we have significant need for this equipment: 1) cardiology; 2) urology and 3) gastroenterology. Proposed IVUS use is expected to provide more detailed information to be extracted by imaging the heart using a series of tomographic section (from within the heart i.e., from apex to base using a ECG gated pullback) and reconstructing the three dimensional geometry to examine the remodeling of the myocardium during heart failure and during treatment. A single long axis image can be reconstructed using the software built in the IVUS system or many more sections can be created using custom software developed by our group. In addition, we propose to use this system for other important non- vascular intra-luminal investigations including in urethra and anal canal. Because sonographic catheters are smaller than 3mm (3.2 to 9F) in diameter (depending on the imaging frequency: range 9 to 45 MHz), they can be easily passed into the urethra (human and animal model) without the need for dilatation. In addition to thickness, this technique enables the therapeutic injections precisely at the region of the sphincter and to measure the exact depth of the injected material. Transurethral sonography has also been used to assess the deployment of intra- prostatic and intra-sphincter urethral stents. Intra-luminal sonography has been used for imaging urinary bladder neoplasms. Small tumors are clearly identified, and their degree of invasion can be evaluated. Currently, there are no good imaging modalities to assess tumor depth within the urinary bladder. Some urologists use magnetic resonance imaging (MRI) for staging of genitourinary diseases, including bladder cancer. Urologists have been accustomed to ultrasound and continue to use this imaging modality for prostate biopsies. Therefore, the use of transurethral ultrasonography for bladder cancer is more reasonable than any other imaging modality. Proposed equipment will be instrumental in determining the staging of the bladder tumor. In addition, IVUS can help assess the areas and depth of tissue to resect in order to achieve complete resection. This information is important in determining prognosis from bladder cancer, and for appropriate therapeutic interventions. Gastroenterological applications that were developed by Dr. Bhargava have been used for over a decade (see references in bio-sketch) but due to the obsolescence of the older machine a need for the new platform has become imperative. In summary, we anticipate that this equipment will be a significant addition to our research facility and will be jointly used by multiple investigators.