Advanced Treatment Endpoint Assessment in MR-guided Focused Ultrasound

MR 引导聚焦超声的高级治疗终点评估

• 批准号: 10115726
• 负责人: Henrik Carl Axel Odeen
• 金额: $ 7.63万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10115726
• 关键词: 3-Dimensional; Abdomen; Ablation; Acoustics; Address; Adipose tissue; Adoption; Aftercare; Area; Breast; Caring; Cellular Structures; Coagulative necrosis; Contrast Media; Dose; Environment; Evaluation; Fatty acid glycerol esters; Fiber Optics; Focused Ultrasound; Focused Ultrasound Therapy; Frequencies; Future; Goals; Heating; Image; Imaging Techniques; Lead; Lesion; Liquid substance; Long-Term Effects; Magnetic Resonance Imaging; Maps; Measurement; Measures; Medical; Methods; Modulus; Molecular Structure; Monitor; Motion; Noise; Normal tissue morphology; Oryctolagus cuniculus; Patients; Phase; Physics; Physiologic pulse; Precision therapeutics; Procedures; Property; Protons; Radiation; Recovery; Relaxation; Research; Safety; Signal Transduction; Sonication; Speed; System; Temperature; Testing; Thermometry; Time; Tissue Viability; Tissues; Treatment outcome; Ultrasonography; Universities; Utah; Work; aqueous; base; contrast enhanced; design; elastography; experience; first-in-human; image guided; imaging modality; improved; in vivo; interest; mechanical properties; necrotic tissue; novel; soft tissue; success; temporal measurement

ABSTRACT Tissue ablation during thermal therapies, such as focused ultrasound (FUS), result in tissue necrosis and irreversible changes in cell- and macromolecular-structure. The success of thermal therapies is defined in terms of adequately treating the desired target while sparing surrounding normal tissues. This demands methods for accurately determining tissue viability in real time so that treatments be efficacious, efficient and safe. Imaging methods that can detect irreversible tissue changes correlated to long-term effects are crucial for endpoint assessment and the general success and wide adoption of thermal therapies. The MR temperature imaging methods currently used are not always accurate, and the addition of other independent measurements of tissue viability are needed . In this application, we propose to develop and test a novel MRI pulse sequence to simultaneously measure four MR-derived parameters sensitive to tissue damage. Our sequence will first measure maps of the proton resonance frequency shift, from which temperature change and cumulative thermal dose can be calculated. Simultaneously, it measures the T1- relaxation time, which indicates temperature change in fat and evidence of fluid change at the point of ablation, as well as shear wave velocity, a direct measure of tissue stiffness, which often changes with ablation. T1 relaxation is measured using a novel mono flip angle approach we recently developed. The PRF shift and shear wave velocity are encoded in the MR phase images, and can be separated using novel methods we have developed. Because of the simultaneous acquisition, these properties are automatically co-registered providing substantially more information about the evolving FUS-induced tissue changes than what is currently available. The addition of T1-mapping and shear modulus measurements will enable evaluations in adipose tissues, where the PRF method does not work, allowing for more complete evaluations in areas such as the breast and abdomen. The proposed project will immediately benefit our current complementary work in performing first-in-human breast MR-guided FUS treatments with our novel hardware that enables high signal-to-noise ratio image acquisition. This work is an important step towards our long-term goal of developing comprehensive real time measurements that can accurately monitor and predict tissue viability during and following MRgFUS.

摘要 在热治疗（诸如聚焦超声（FUS））期间的组织消融导致组织损伤。 坏死和细胞和大分子结构的不可逆变化。热能的成功 治疗的定义是充分治疗所需的目标，同时保护周围环境， 正常组织这就需要真实的时间内准确测定组织活力的方法， 治疗是有效的，高效的和安全的。可以检测不可逆的成像方法 与长期效应相关的组织变化对于终点评估和一般评估至关重要。 热疗法的成功和广泛采用。目前的MR温度成像方法 使用的测量值并不总是准确的，并且增加了其他独立的组织测量值， 可行性是必须的。在这个应用中，我们建议开发和测试一种新的MRI脉冲 序列，以同时测量对组织损伤敏感的四个MR衍生参数。我们 序列将首先测量质子共振频率偏移的地图， 变化和累积热剂量。同时，它测量T1- 松弛时间，其指示脂肪中的温度变化和在所述温度下的流体变化的证据。 消融点，以及剪切波速度，组织硬度的直接测量，通常 随着消融而变化。T1弛豫测量使用一种新的单翻转角的方法， 最近开发的。在MR相位图像中编码PRF偏移和剪切波速度， 并且可以使用我们开发的新方法进行分离。由于同时 收购，这些属性自动共同注册，提供更多的 与目前可用的信息相比，关于FUS诱导的组织变化的进展信息。的 增加T1映射和剪切模量测量将能够评价脂肪 组织，其中PRF方法不起作用，允许在区域中进行更完整的评估 比如乳房和腹部。该项目将立即使我们目前的 在执行首次在人类乳腺MR引导FUS治疗与我们的互补工作 实现高信噪比图像采集的新型硬件。这项工作是一个重要的 朝着我们开发全面的真实的时间测量的长期目标迈出了一步，这些测量可以 在MRgFUS期间和之后准确监测和预测组织活力。