Vascular Modulation for Enhancement of Image-Guided RF Ablation

用于增强图像引导射频消融的血管调制

• 批准号: 7781804
• 负责人: Agata A Exner
• 金额: $ 20.49万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-02-01 至 2012-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7781804
• 关键词: Ablation; Address; Adjuvant Chemotherapy; Aftercare; Animals; Architecture; Blood Vessels; Blood flow; Clinical; Clinical Research; Cryoultramicrotomy; Data; Development; Dose; Effectiveness; Electrodes; Evaluation; Future; Histocompatibility Testing; Histology; Hour; Human; Image; Image Analysis; Image Enhancement; Imagery; Imaging Techniques; Inflammation; Inflammatory; Inflammatory Response; Lead; Lesion; Longitudinal Studies; Magnetic Resonance Imaging; Measurement; Methods; Modeling; Modification; Muscle; Necrosis; Neoplasm Metastasis; Neoplasms; Operative Surgical Procedures; Outcome; Pathologic; Patient Care; Patients; Perfusion; Pharmaceutical Preparations; Physiological; Preparation; Probability; Procedures; Radiofrequency Interstitial Ablation; Rattus; Reaction; Recurrence; Regimen; Research; Schedule; Scheme; Site; Smooth Muscle Myocytes; Staging; Techniques; Technology; Temperature; Testing; Time; Tissue Banks; Tissues; Translating; Translations; Tumor Tissue; Validation; Vasoconstrictor Agents; Vasodilator Agents; clinical practice; density; dosage; drug candidate; electric impedance; follow-up; image registration; improved; innovation; instrumentation; neoplastic; novel; novel strategies; oncology; prevent; public health relevance; radiofrequency; response; standard of care; tumor; vasoactive agent

DESCRIPTION (provided by applicant): Vascular modulation for enhancement of image-guided RF ablation since its clinical debut, image-guided radiofrequency (RF) ablation of tumors has been significantly refined, making the technique applicable to patients with primary and metastatic tumors of increasing sizes and complexities. Although considerable innovations have improved ablation technology, numerous issues have prevented this approach from surpassing other invasive means of tumor treatment. Effective follow-up and re-treatment of tumors have also been problematic because of difficulty in detecting and differentiating recurrences from inflammatory reaction. Our proposed technique uses mild vasoactive agents to improve both local image-guided ablation and post ablation imaging assessment. The inherent differences between normal and tumor vascularity can be intensified by administration of these vasoactive drugs. The resulting blood flow differences between normal and neoplastic tissue may provide differentiation between the two entities that is apparent on contrast-enhanced CT and/or CT perfusion images and may lead to improved ablation outcomes and follow-up procedures. We hypothesize that our selected vasoactive agents can modulate tumor blood flow to maximize the efficacy of tumor ablation. Furthermore, these vasoactive drugs can induce perfusion changes, which consistently predict the tumor-free margin following the ablation procedure. If successful, this combination of technologies has the potential to be translated quickly into clinical practice and improve the outcome of image-guided interventional oncology applications. The project will be carried out in three aims. Aim 1 will be utilized to test the effect of pharmacological manipulation on the outcome of RF ablation and to optimize the treatment techniques. Aim 2 will explore the application of vasoactive agents in distinguishing inflammation from tumor regrowth following an ablation procedure. Finally, Aim 3 will validate the results with a radiologic-pathologic correlation. PUBLIC HEALTH RELEVANCE: Our study evaluates a new approach for the improvement of image-guided radiofrequency (RF) ablation treatment of tumors and for optimized follow-up after the ablation treatment. This approach uses mild, clinically used vasodilators to divert blood flow from the tumors, permitting a more exact and more effective ablation treatment. In addition, a mild vasoconstrictor is then used to differentiate local tumor recurrence from normal inflammation in the ablated region in long-term imaging follow up. Both techniques address clear needs in the field of tumor RF ablation and will result in less invasive, more effective patient care. The use of available, safe vasoactive agents will allow rapid translation to clinical studies upon successful completion of the proposed research.

描述（由申请人提供）： 自临床首次亮相以来，肿瘤的图像引导射频（RF）消融术已得到显著改进，使该技术适用于大小和复杂性不断增加的原发性和转移性肿瘤患者。虽然相当多的创新已经改进了消融技术，但许多问题阻碍了这种方法超越其他侵入性肿瘤治疗手段。有效的后续行动和再治疗肿瘤也有问题，因为难以检测和区分复发性炎症反应。我们提出的技术使用温和的血管活性剂，以改善局部图像引导消融和消融后成像评估。这些血管活性药物的使用可以加强正常血管和肿瘤血管之间的固有差异。正常组织和肿瘤组织之间产生的血流差异可以提供两种实体之间的差异，这在对比增强CT和/或CT灌注图像上是明显的，并且可以改善消融结果和随访程序。我们假设我们选择的血管活性药物可以调节肿瘤血流，以最大限度地提高肿瘤消融的疗效。此外，这些血管活性药物可以诱导灌注变化，这一致地预测消融术后的无肿瘤边缘。如果成功的话，这种技术的组合有可能迅速转化为临床实践，并改善图像引导介入肿瘤学应用的结果。该项目将在三个目标中实施。目的1将用于测试药物操作对射频消融结果的影响，并优化治疗技术。目的2将探讨血管活性药物在区分消融术后炎症和肿瘤再生长中的应用。最后，目标3将通过放射学-病理学相关性验证结果。 公共卫生相关性： 我们的研究评估了一种新的方法，用于改善肿瘤的图像引导射频（RF）消融治疗和消融治疗后的优化随访。这种方法使用温和的，临床上使用的血管扩张剂转移肿瘤的血流，允许更准确和更有效的消融治疗。此外，在长期成像随访中，使用轻度血管收缩剂来区分局部肿瘤复发与消融区域的正常炎症。这两种技术都满足了肿瘤射频消融领域的明确需求，并将带来侵入性更小、更有效的患者护理。成功完成拟定研究后，使用可用、安全的血管活性药物可快速转化为临床研究。