Liquid Cooling Cycle for Ablation Using Integrated Thermal and Imaging Feedback

描述（由申请人提供）： 介入肿瘤学和肿瘤消融术是一个快速发展的癌症治疗领域，甚至可能是具有成本效益的门诊提供的图像引导治疗的局部肿瘤的潜在治愈或姑息治疗。冷冻治疗相对于热消融的一个明显优势是通过CT、US和MRI对冰缘进行了出色的可视化。然而，0 Co可见边缘不能反映细胞毒性组织温度（例如，<-20Co），以完全覆盖肿瘤体积。目前和新兴的冷冻技术不能测量组织对冷冻的反应，这是由于冷冻剂在加热期间的极其复杂的反应。此外，每个冷冻探针周围的可变散热器阻止了冰治疗区内的准确温度预测，使得当前的冷冻治疗操作者依赖，特别是在主要脉管系统附近。我们将展示一种新的冷冻技术的性能，使用单相液体冷却循环，可以提供综合的热反馈，从冷冻探针结合CT可视化。消融反应的组织反馈将允许确定可能改变冰形成和消融的任何相邻血管热量。液体冷却循环将有助于精确测量该邻近加热响应，从而表征局部组织状况，其将用于通过计算机断层扫描（CT）结合可见冰边缘快速预测周围温度分布。因此，冷冻治疗可以在手术过程中更快速和客观地得到纠正，以获得更好的结果，并且B所有从事介入肿瘤学的医生都使用更统一的技术。公共卫生相关性：该提案的目标是通过将新冷冻技术的热反馈与手术的计算机断层扫描（CT）可视化相结合，提高癌症消融结果的易用性和可重复性。新的冷冻技术允许在消融过程中立即反馈靶组织的热反应，这对心脏和肿瘤应用都有很大的希望。计划和提供精确的治疗方案以彻底破坏癌性肿瘤，同时保留相邻的关键结构的更大复杂性是该提案的主要焦点。平行的商业活动也将探索新完成的单探头原型的许可选择，因为它可能会立即应用于心律失常和更简单的商业途径。目前的提案定义了癌症冷冻治疗潜在重大进展的背景研究。

DESCRIPTION (provided by applicant): Interventional oncology and tumor ablation is a rapidly growing field of cancer therapy that may even be cost-effective for outpatient delivery of image-guided treatments of local tumors for potential cure or paliative management. A distinct benefit of cryotherapy over heat-based ablations is the excellent visualization of ice margins by CT, US and MRI. However, the 0Co visible margin is not reflective of cytotoxic tissue temperatures (e.g., <-20Co) that are needed to thoroughly cover a tumor volume. Current and emerging cryotechnologies can not measure tissue responses to freezing due to exceedingly complex responses of the cryogens during heating. In addition, variable heat-sinks around each cryoprobe prohibit accurate temperature prediction within the ice treatment zone, making current cryotherapy operator dependent, especially near major vasculature. We will demonstrate the performance of a new cryotechnology, using a single-phase liquid cooling cycle that can provide integrated thermal feedback from the cryoprobes in combination with CT-visualization. Tissue feedback of ablation response will allow determination of any adjacent vascular heat that may alter ice formation and ablation. A liquid cooling cycle will facilitate accurate measurements of this adjacent heating response, thereby characterizing local tissue conditions which will be used to quickly predict surrounding temperature distributions in conjunction with visible ice margins by computed tomography (CT). Cryotherapy can thereby be more rapidly and objectively corrected during the procedure for better outcomes and more uniform techniques use b all physicians practicing interventional oncology. PUBLIC HEALTH RELEVANCE: The goals of the proposal are to improve the ease-of use and reproducibility of cancer ablation outcomes by integrating thermal feedback from a new cryotechnology with computed tomography (CT) visualization of the procedure. New cryotechnology that allows immediate feedback of thermal responses by the target tissue during ablation holds great promise for both cardiac and oncologic applications. The greater complexity of planning and delivering accurate treatment profiles for thorough destruction of cancerous tumors while preserving adjacent crucial structures is the primary focus of this proposal. Parallel business activities will also explore licensing options for the newly completed single probe prototype highlighted in the Preliminary Results section since it may have immediate applications for cardiac arrhythmias and a simpler commercial path. The current proposal defines background research for potential major advances in cryotherapy treatments for cancer.