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Monitoring and control of human liver cancer ablation using real-time, 3D echo decorrelation imaging

使用实时 3D 回波去相关成像监测和控制人类肝癌消融

基本信息

批准号：
10006862
负责人：
T Douglas Mast
金额：
$ 35万
依托单位：
UNIVERSITY OF CINCINNATI
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-08-10 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10006862
关键词：
3-Dimensional Ablation Accounting Adverse effects Algorithms Blinded Cancer Patient Cattle Cell Death Cirrhosis Clinic Clinical Clinical Trials Computers Data Disseminated Malignant Neoplasm Electrodes Environment Excision Family suidae Feedback Foundations Future Gender Gold Heating Histology Human Image Investigation Lead Liver Liver diseases Liver neoplasms Liver parenchyma Localized Malignant Neoplasm Magnetic Resonance Imaging Malignant Neoplasms Malignant neoplasm of liver Maps Metastatic Neoplasm to the Liver Methods Modality Monitor Morbidity - disease rate Motion Neoplasm Metastasis Operative Surgical Procedures Oryctolagus cuniculus Pathologic Patient Schedules Patients Performance Prediction of Response to Therapy Primary Neoplasm Primary carcinoma of the liver cells Procedures Public Health ROC Curve Radiofrequency Interstitial Ablation Recurrence Research Resected Risk Safety Specific qualifier value Specimen Testing Thermal Ablation Therapy Three-Dimensional Imaging Time Tissues Transducers Translating Translations Transplantation Ultrasonography Unresectable Validation X-Ray Computed Tomography cancer recurrence cancer therapy clinical practice common treatment contrast enhanced direct application follow-up imaging modality improved improved outcome in vivo innovation liver tumor ablation microwave ablation millisecond minimally invasive mortality novel novel strategies performance tests prevent radio frequency real time monitoring side effect standard of care success surgery outcome tumor tumor ablation

项目摘要

Project Summary/Abstract Liver cancer, including hepatocellular carcinoma (HCC) as well as metastatic tumors, is a major public health problem. For patients with unresectable liver cancer, thermal ablation, including radiofrequency ablation (RFA) and microwave ablation (MWA), is the current clinical standard of care; however, thermal ablation methods are limited by non-uniform and inconsistent treatment, leading to adverse side effects, local cancer recurrence, and decreased survival, severely limiting their clinical utility. Echo decorrelation imaging is a novel ultrasound approach that mitigates these problems by mapping ultrasound echo changes caused by tissue heating during thermal ablation. Research to date on echo decorrelation imaging has shown that this method reliably predicts ablation-induced cell death in vivo for rabbit and porcine liver tissue as well as VX2 liver cancer. Although echo decorrelation imaging is an extremely promising approach to thermal ablation monitoring and control, its translation to clinical practice will require validation of real-time, 3D ablation monitoring and control for human liver cancer ablation, including different tumor types (HCC and metastatic), as well as normal and abnormal human liver parenchyma (e.g., cirrhotic liver). Our central hypothesis for this study is that real-time monitoring and control by 3D echo decorrelation imaging will improve reliability of human liver tumor ablation. To test this hypothesis, we will implement 3D, real-time echo decorrelation imaging using a clinical ultrasound scanner and matrix array transducers, then validate the application of 3D echo decorrelation imaging to RFA and MWA. Methods for controlled ablation will be implemented for RFA using standard clinical electrodes and a clinical radiofrequency generator, with echo decorrelation serving as a treatment end point. To test the performance of clinical echo decorrelation imaging in human primary and metastatic cancer as well as diseased liver tissue, 3D echo decorrelation images will be formed from echo data recorded during open surgical RFA and percutaneous MWA procedures, then compared with follow-up contrast MRI and CT to assess prediction of ablated volume margins as well as local recurrence. Control of thermal ablation by 3D echo decorrelation imaging will first be studied in resected specimens of human metastatic liver cancer with normal liver tissue margins and specimens of cirrhotic human liver tissue, as well as in vivo swine liver. The study will then culminate in a treat-and-resect trial of echo decorrelation-controlled radiofrequency ablation in liver tumor patients, demonstrating the direct application of echo decorrelation imaging to improving clinical tumor ablation. This research will thus show feasibility for both effective prediction and real-time control of liver cancer ablation in human liver cancer and concomitant diseased liver tissue.

项目总结/文摘